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Risk of upper aerodigestive tract cancer and type of alcoholic beverage: a European multicenter case–control study

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Abstract

The general relationship between cancers of the upper aerodigestive tract (UADT) and alcohol drinking is established. Nevertheless, it is uncertain whether different types of alcoholic beverages (wine, beer and liquor) carry different UADT cancer risks. Our study included 2,001 UADT cancer cases and 2,125 controls from 14 centres in 10 European countries. All cases were histologically or cytologically confirmed squamous cell carcinomas. Controls were frequency matched by sex, age and centre. Logistic regression models were used to estimate odds ratios (OR) and 95 % confidence intervals (95 %CI) adjusted for age, sex, centre, education level, vegetable and fruit intake, tobacco smoking and alcohol drinking, where appropriate. Risk of beverage-specific alcohol consumption were calculated among ‘pure drinker’ who consumed one beverage type exclusively, among ‘predominant drinkers’ who consumed one beverage type to more than 66 % and among ‘mixed drinkers’ who consumed more than one beverage type to similar proportions. Compared to never drinkers and adjusted for cumulative alcohol consumption, the OR and 95 %CI for wine, beer and liquor drinking, respectively, were 1.24 (0.86, 1.78), 1.54 (1.05, 2.27) and 0.94 (0.53, 1.64) among ‘pure drinkers’ (p value for heterogeneity across beverage types = 0.306), 1.05 (0.76,1.47), 1.25 (0.87,1.79) and 1.43 (0.95, 2.16) among ‘predominant drinkers’ (p value = 0.456), and 1.09 (0.79, 1.50), 1.20 (0.88, 1.63) and 1.12 (0.82, 1.53) among ‘mixed drinkers’ (p value = 0.889). Risk of UADT cancer increased with increasing consumption of all three alcohol beverage types. Our findings underscore the strong and comparable carcinogenic effect of ethanol in wine, beer and liquor on organs of the UADT.

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Acknowledgments

We gratefully acknowledge the study interviewers, data manager and our clinical colleagues in hospitals and primary care, who supported this study and especially, we thank the study participants and their families for their participation. We acknowledge the help of Prof. Martin Tickle in study conduct in the Manchester center and Professor Phil Sloan and Professor Nalin Thakker who in addition coordinated sample collection and processing for all the UK centers. GJM and TVM partly worked on this study while at the University of Manchester. In Glasgow, we acknowledge the clinical support of Dr Gerry Robertson and Mr John Devine and their colleagues. We are deeply thankful to Drs R. Mele and L. Forner for providing hospital controls and S. Sulfaro for pathology support from General Hospital of Pordenone (Italy). In Dublin, we acknowledge the clinical support of Prof. J. Reynolds, Prof. C. Timon and their colleagues. The Aviano center thanks Mrs O. Volpato for study coordination, Ms G.Bessega, L. Zaina, for their help in data collection and Drs S. Sulfaro and D. Politi for providing hospital case patients. We thank Kate Soldan who put in a lot of work in developing the infrastructure of this project at IARC. This work was supported by funding received from: European Community (5th Framework Programme) grant no. QLK1-CT-2001-00182; University of Athens Medical School and Bureau of Epidemiologic Research Academy of Athens for the Athens center; Padova University (Contract No CPDA057222) for the Padova center; Compagnia San Paolo, Associazione Italiana per la Ricerca sul Cancro, for the Turin center. MM was sponsored by a special training award at the IARC.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University, Mainz, Germany

    Manuela Marron

  2. The Tisch Cancer Institute and Institute for Translational Epidemiology, Mount Sinai School of Medicine, New York, NY, USA

    Paolo Boffetta

  3. International Prevention Research Institute, Lyon, France

    Paolo Boffetta

  4. Thames Cancer Registry, School of Medicine, King’s College London, London, UK

    Henrik Møller

  5. Bremen Institute for Preventive Research and Social Medicine (BIPS), University of Bremen, Bremen, Germany

    Wolfgang Ahrens & Hermann Pohlabeln

  6. INSERM, U946, Fondation Jean Dausset-CEPH, Paris, France

    Simone Benhamou

  7. CNRS FRE2939, Gustave-Roussy Institut, Villejuif, France

    Simone Benhamou

  8. Geneva Cancer Registry, Geneva, Switzerland

    Christine Bouchardy

  9. Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece

    Pagona Lagiou

  10. Faculty of Health Professions, Athens Technological Educational Institute, Athens, Greece

    Areti Lagiou

  11. 1st Faculty of Medicine, Institute of Hygiene and Epidemiology, Charles University in Prague, Prague, Czech Republic

    Alena Slámová & Miriam Schejbalová

  12. Unit of Cancer Epidemiology, CeRMS and University of Turin, Turin, Italy

    Franco Merletti & Lorenzo Richiardi

  13. Cancer Registry of Norway, Oslo, Norway

    Kristina Kjaerheim

  14. Institut Català d’Oncologia, IDIBELL, CIBER-ESP, L’Hospitalet de Llobregat, Barcelona, Spain

    Antonio Agudo & Xavier Castellsague

  15. School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK

    Tatiana Victorovna Macfarlane & Gary John Macfarlane

  16. Unit of Epidemiology and Biostatistics, National Cancer Institute, IRCCS, Aviano, Italy

    Renato Talamini

  17. General Hospital of Pordenone, Pordenone, Italy

    Luigi Barzan

  18. Respiratory Epidemiology and Public Health, Imperial College, London, UK

    Cristina Canova

  19. Department of Environmental Medicine and Public Health, University of Padova, Padua, Italy

    Lorenzo Simonato

  20. Warwick Medical School, University of Warwick, Coventry, UK

    Anne-Marie Biggs

  21. School of Dental Sciences, Newcastle University, Newcastle, UK

    Peter Thomson

  22. Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK

    David Ian Conway

  23. Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK

    Patricia Ann McKinney

  24. ISD, NHS NSS, Edinburgh, UK

    Patricia Ann McKinney

  25. Croatian National Cancer Registry, Croatian National Institute of Public Health, Zagreb, Croatia

    Ariana Znaor

  26. Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland

    Claire Marie Healy

  27. School of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland

    Bernard Eugene McCartan

  28. International Agency for Research on Cancer (IARC, WHO), Lyon, France

    Paul Brennan

  29. Division of Public Health, Department of Family and Preventive Medicine, University of Utah, School of Medicine, Salt Lake City, UT, USA

    Mia Hashibe

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  1. Manuela Marron
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Correspondence to Manuela Marron.

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Marron, M., Boffetta, P., Møller, H. et al. Risk of upper aerodigestive tract cancer and type of alcoholic beverage: a European multicenter case–control study. Eur J Epidemiol 27, 499–517 (2012). https://doi.org/10.1007/s10654-012-9699-1

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