Association of Cancer Sites With Tobacco and Alcohol Consumption and Socioeconomic Status of Patients: Interview Study From the Third National Cancer Survey

Summary.-The average annual age-adjusted incidence rates of cancer for 15 sites were determined for 10 ethnic-sex groups in Hawaii. Consumption rates for cigarettes, beer, wine and hard liquor were also determined for the same 10 groups based on personal interview of a sample of 9920 individuals. Covariance analysis was used to adjust each exposure variable for the other three, and the cancer incidence rates were then linearly regressed on these covariance-adjusted consumption rates. Statistically significant regression coefficients were found for cancer of the tongue/ mouth, pharynx, larynx, pancreas, lung, kidney and bladder regressed on cigarette consumption. Eight cancer sites, including tongue/mouth, pharynx, larynx, oesophagus, stomach, pancreas, lung and kidney, had significant positive regression coefficients for beer consumption which could not be explained by outlying values on the scattergram. Significant associations were also suggested between wine consumption and pharyngeal cancer and between hard-liquor consumption and pharyngeal, laryngeal and possibly brain cancer. No association was found between beer consumption and colorectal cancer. Multiple regression analysis with sex, cigarettes and alcoholic beverage as independent variables consistently found sex to be least important in determining cancer risk. This study supports the hypothesis that beer consumption may play a role in cancer risk for several sites. It is suggested that future studies of alcoholic beverages and cancer should examine not only types of alcoholic beverages, but individual brands of each type in an attempt to identify cancer risk due to carcinogens in only certain brands.

“…The association of wine consumption with this site is not surprising in view of previous reports (Martinez, 1969;Williams & Horm, 1977).…”

Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 59%

See 1 more Smart Citation

Associations between cancer incidence and alcohol/cigarette consumption among five ethnic groups in Hawaii

Hinds¹,

Kolonel²,

Lee³

et al. 1980

“…Further data and analysis by the Registrar General extended these findings (OPCS, 1978). An increased risk of melanoma with college education and with high income was found for males in the U.S. Third National Cancer Survey, but not for females (Williams & Horm, 1977).…”

mentioning

confidence: 81%

Malignant melanoma: social status and outdoor work

Lee¹,

Strickland²

1980

126

Summary. The incidence of, and mortality from, malignant melanoma of skin in whites are strongly influenced by socio-economic conditions. Professional and administrative workers have the highest rates of all. Clerks and salesmen have higher rates than skilled manual workers, who have higher rates than unskilled workers.Women, when classified by the occupation of their husbands, show a similar relationship to social status.The biases of incidence data from systems of cancer registration, and mortality data from death certificates are different, and the consistency of the data from different periods and from different populations suggests that the relationship is real.The bulk of the data is from Britain, but there is sufficient from the U.S. to indicate that the effect is not restricted to one country.No consistent increase in risk was found in outdoor workers compared with indoor workers of similar socio-economic status.

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mentioning

confidence: 99%

Alcohol, tobacco and breast cancer: should alcohol be condemned and tobacco acquitted?

Silva

2002

The first published report of an association between alcohol consumption and breast cancer risk was by Williams and Horm (1977). This investigation was hypothesis-generating, however, in that it examined multiple potential risk factors for several cancers and, apart from age, ethnic group and smoking habits, no account was taken of other potential confounding variables. A possible association between breast cancer and tobacco smoking was first proposed by Macmahon et al (1982). They hypothesised that cigarette smoking would reduce the risk of breast cancer, mainly on the basis of their observation that smoking was associated with a reduction in urinary oestrogen levels during the luteal phase of the menstrual cycle. However, Hiatt and Fireman (1986) proposed a contrary hypothesis. They postulated that tobacco smoke would have a direct carcinogenic effect as mutagens from cigarette smoke had been found in the breast fluid of non-lactating women.Since these initial reports, a substantial number of epidemiological investigations have assessed these hypotheses. The overall evidence from the epidemiological data published so far seems to indicate that alcohol intake may be associated with a slight increase in the risk of breast cancer. By contrast, the evidence for smoking has been rather inconsistent, with some studies showing a slight increase in risk and others reporting no association or, even, a protective effect. Most of these studies have been based on relatively small numbers of breast cancer cases, however, thus yielding rather imprecise estimates of the true effects of these exposures. In addition many of them were unable to take account of the fact that alcohol and tobacco consumption are correlated, as smokers are more likely to drink alcohol than non-smokers.Clarification of the independent effects, if any, of these exposures on the risk of breast cancer is of epidemiological relevance for various reasons. First, for populations where the prevalence of alcohol and/or tobacco consumption is high, even if the relative risk associated with these exposures is small, the effect of these exposures could still account for a substantial number of breast cancer cases. Second, unlike most of the known risk factors for breast cancer, alcohol and tobacco consumption are potentially modifiable behaviours and hence offer some scope for prevention. Third, clarification of the aetiological role of these exposures might shed light on the biology of breast cancer.In this issue, the Collaborative Group on Hormonal Factors in Breast Cancer (2002) has published a reanalysis of individual data from over 80% of the worldwide epidemiological information on alcohol, tobacco and breast cancer risk in women. This reanalysis of data from 53 different studies, which included 58 515 women with breast cancer and 95 067 without, showed that the relative risk of breast cancer increased by 7.1% for each additional 10 g day 71 intake of alcohol, i.e. for each extra unit (alcoholic drink) consumed on a daily basis. Relative to women who re...