Περίληψη:
Tobacco and alcohol are major risk factors for upper aerodigestive tract
(UADT) cancer and significant variation is observed in UADT cancer rates
across Europe. We have estimated the proportion of UADT cancer burden
explained by tobacco and alcohol and how this varies with the incidence
rates across Europe, cancer sub-site, gender and age. This should help
estimate the minimum residual burden of other risk factors to UADT
cancer, including human papillomavirus. We analysed 1981 UADT cancer
cases and 1993 controls from the ARCAGE multi-centre study. We estimated
the population attributable risk (PAR) of tobacco alone, alcohol alone
and their joint effect. Tobacco and alcohol together explained 73% of
UADT cancer burden of which nearly 29% was explained by smoking alone,
less than 1% due to alcohol on its own and 44% by the joint effect of
tobacco and alcohol. Tobacco and alcohol together explained a larger
proportion of hypopharyngeal/laryngeal cancer (PAR = 85%) than
oropharyngeal (PAR = 74%), esophageal (PAR = 67%) and oral cancer (PAR
= 61%). Tobacco and alcohol together explain only about half of the
total UADT cancer burden among women. Geographically, tobacco and
alcohol explained a larger proportion of UADT cancer in central (PAR =
84%) than southern (PAR = 72%) and western Europe (PAR = 67%). While
the majority of the UADT cancers in Europe are due to tobacco or the
joint effect of tobacco and alcohol, our results support a significant
role for other risk factors in particular, for oral and oropharyngeal
cancers and also for UADT cancers in southern and western Europe. (C)
2011 Elsevier Ltd. All rights reserved.
Συγγραφείς:
Anantharaman, Devasena
Marron, Manuela
Lagiou, Pagona and
Samoli, Evangelia
Ahrens, Wolfgang
Pohlabeln, Hermann and
Slamova, Alena
Schejbalova, Miriam
Merletti, Franco and
Richiardi, Lorenzo
Kjaerheim, Kristina
Castellsague, Xavier and
Agudo, Antonio
Talamini, Renato
Barzan, Luigi
Macfarlane,
Tatiana V.
Tickle, Martin
Simonato, Lorenzo
Canova, Cristina
and Conway, David I.
McKinney, Patricia A.
Thomson, Peter and
Znaor, Ariana
Healy, Claire M.
McCartan, Bernard E.
Hashibe,
Mia
Brennan, Paul
Macfarlane, Gary J.
