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Role of Tobacco and Alcoholic Beverages in the Etiology of Cancer of the Oral Cavity/Oropharynx in Torino, Italy¹

Unit of Cancer Epidemiology, University of Torino, Torino, Italy [F. M., P. B., G. C., B. T.], and Veterans Administration Medical Center, East Orange, New Jersey, and Department of Surgery, University of Medicine and Dentistry, New Jersey Medical School [A. M.]

A population-based case-control study of cancer of oral cavity-oropharynx was conducted in the city of Torino, Italy, between 1982 and 1984. One hundred twenty-two cases (86 males and 36 females) and 606 controls (385 males and 221 females) were compared with respect to lifelong alcohol and tobacco consumption. A 4- to 6-fold increase in risk among subjects with medium or high tobacco consumption was observed, as well as a trend in increasing risk with duration and with earlier age at the start of smoking. Other findings included a sharp reduction in risk with cessation of smoking, no clear protective effect of usage of filter, no differences in risk according to color of tobacco, and a higher risk for cigar versus pipe/cigarette smokers.

An effect of alcoholic beverages was found in subjects with an average daily consumption of 120 or more grams of alcohol, with a higher risk in beer drinkers.

Among heavy consumers of alcohol and tobacco, risks of both oral and oropharyngeal cancer were very high. A positive association between oral cancer and low educational level, after adjustment for alcohol and tobacco, was found. Attributable risks for alcohol and tobacco in the population were 23% and 72% in men and 34% and 54% in women.

¹ This investigation was supported by the Consiglio Nazionale delle Ricerche, Rome (Progetto Finalizzato Oncologia, Contracts 85.02391.44 and 86.00595.44); Associazione Italiana per la Ricerca sul Cancro; and Ministry of Public Education. Computer facilities were made available by a grant from Consorzio per il Sistema Informativo, CSI-Piemonte, Torino. The International Agency for Research on Cancer, Lyons (France), contributed to the training of the interviewers. Participation in the study took place within the framework of the United States-Italy Cooperation for Cancer Research.

² To whom requests for reprints should be addressed, at Epidemiologia dei Tumori, Dipartimento di Scienze Biomediche e Oncologia Umana, Università di Torino, v a Santena 7, 10126 Torino, Italy.

Received 9/22/88. Revised 2/24/89. Accepted 5/ 3/89.

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