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

Abstract

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.

Rebuttal to a critique of a study of cancer incidence and alcohol/cigarette consumption in Hawaii

“…When we assume a doubling of the mean population consumption of cigarettes from 5 to 10 pack-years, these same cancer sites are shown again to have the greatest percentage increase in incidence rates. Similarly, we concluded in our original paper (Hinds et al, 1980) that the cancer sites most strongly influenced by mean population beer consumption were oesophagus and larynx. These conclusions are likewise compatible with past epidemiological findings on alcohol and cancer.…”

“…First, the critique's authors stated that the conclusions in our paper (Hinds et al, 1980) depended on the arbitrary choice of a standard population for age adjustment. In fact, the choice of a population standard was not arbitrary.…”

“…SIR.-In a recent short communication by Hernandez-Llamas & Kimball (1 982) a detailed critique of our study of the association between cancer incidence and alcohol/cigarette consumption (Hinds et al, 1980) was presented. We believe many of the comments contained in the critique are inappropriate and the overall conclusions of its authors are unjustified.…”

“…As stated in our original paper (Hinds et al, 1980) we "assumed that current consumption rates for an ethnicsex population reflect the past consumption rates". We know of no data which can (Armstrong & Doll, 1975;Breslow & Enstrom, 1974;Kono & Ikeda, 1979) because it was necessary, given the nature of the data, and did not seem unreasonable.…”

“…Ninth, the critique's authors stated that Table V in our original paper (Hinds et al, 1980), was uninformative because an arbitrary baseline was chosen. HernandezLlamas & Kimball seem to have missed the point of that table.…”