Active and Involuntary Tobacco Smoking and Upper Aerodigestive Tract Cancer Risks in a Multicenter Case-Control Study

Abstract

Introduction Several important issues for the established association between tobacco smoking and upper-aerodigestive tract (UADT) cancer risks include the associations with smoking by cancer subsite, by type of tobacco, and among never alcohol drinkers, and the associations with involuntary smoking among nonsmokers. Our aim was to examine these specific issues in a large scale case-control study in Europe. Methods Analysis was performed on 2,103 UADT squamous cell carcinoma cases and 2,221 controls in the Alcohol-Related Cancers and Genetic Susceptibility in Europe (ARCAGE) project, a multicenter case-control study in 10 European countries. Unconditional logistic regression was performed to obtain odds ratios (OR) and 95% confidence intervals (CI). Results Compared to never tobacco smoking, current smoking was associated with UADT cancer risks (OR=6.72, 95% CI 5.45–8.30 for overall; 5.83, 4.50–7.54 for oral cavity and oropharynx; 12.19, 8.29–17.92 for hypopharynx and larynx; 4.17, 2.45–7.10 for esophagus). Among never drinkers, dose-response relationships with tobacco smoking packyears were observed for hypopharyngeal and laryngeal cancers (ptrend = 0.01), but not for oral cavity and oropharyngeal cancers (ptrend = 0.282). Among never smokers, ever exposure to involuntary smoking was associated with an increased risk of UADT cancers (OR=1.60, 95% CI 1.04–2.46). Conclusion Our results corroborate that tobacco smoking may play a stronger role in the development of hypopharyngeal and laryngeal cancers than that of oral cavity and oropharyngeal cancers among never drinkers and that involuntary smoking is an important risk factor for UADT cancers. Public health interventions to reduce involuntary smoking exposure could help reduce UADT cancer incidence.

A Literature Analysis of the Risk Factors for Oral Cancer

“…Furthermore, heavy smoker were not only more likely to be diagnosed at a younger age but also at an advanced stage. Apart from active smoking, patients who were exposed to passive smoke were also found to have higher odds ratios (1.62 ~ 2.46) for contracting oral cavity and oropharynx cancers in a hospital-based case control study (Lee et al, 2009). The odds ratios or relative risks for contracting oral cancer among cigarette smoker, alcohol drinkers, or betel quid chewers are summarized in Table 2 Table 2.…”

Impacto do tabagismo na saúde bucal dos pacientes atendidos em um ambulatório de clínica médica

“…Além de ser prejudicial à saúde geral, o tabagismo também compromete a saúde bucal (4,5) . O hábito de fumar foi associado ao aumento de risco de câncer bucal, leucoplasia, gengivite ulcerativa necrosante aguda, candidíase bucal, insucesso de implantes dentais e doença periodontal, além de interferir no resultado de terapias periodontais cirúrgicas e não cirúrgicas (4)(5)(6)(7)(8)(9) . Fumar resulta em vasoconstrição periférica e, consequentemente, em prejuízo à cicatrização de feridas na boca (6) .…”

“…O hábito de fumar foi associado ao aumento de risco de câncer bucal, leucoplasia, gengivite ulcerativa necrosante aguda, candidíase bucal, insucesso de implantes dentais e doença periodontal, além de interferir no resultado de terapias periodontais cirúrgicas e não cirúrgicas (4)(5)(6)(7)(8)(9) . Fumar resulta em vasoconstrição periférica e, consequentemente, em prejuízo à cicatrização de feridas na boca (6) . Causa também descoloração nos dentes e nas restaurações dentais, prejudica os sentidos do olfato e paladar, e frequentemente provoca halitose (6)(7)(8)(9) .…”

“…Fumar resulta em vasoconstrição periférica e, consequentemente, em prejuízo à cicatrização de feridas na boca (6) . Causa também descoloração nos dentes e nas restaurações dentais, prejudica os sentidos do olfato e paladar, e frequentemente provoca halitose (6)(7)(8)(9) . O hábito de mascar tabaco geralmente causa enrugamento da mucosa bucal, recessão gengival e câncer na cavidade oral (6) .…”

Clinical Presentation and Pathological Study of Head and Neck Cancer in Malwa Region of Punjab

“…4 Incidence of oral cavity SCC and oropharyngeal SCC in patients under the age of 45 years increases for accounts for approximately 1% -6%. 5,6 Tobacco and alcohol are the two strongest aetiological factors for the development of HNSCC, both independently and synergistically. 7,8 They have long been implicated as the traditional risk factors for HNSCC in adults, regardless of age.…”