Skip to main content
Log in

Tobacco, alcohol, and diet in the etiology of laryngeal cancer: a population-based case-control study

  • Research Papers
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Cancer of the larynx constitutes an increasingly important problem in Polish males during the last 25 years. A population-based case-control study of laryngeal cancer among people under 65 years of age was conducted in Lower Silesia, a province in Southwest Poland, from 1986 to 1987, with 249 newly-diagnosed cancer cases and 965 controls. The estimated relative risk (RR) for smoking and alcohol are both very high: for smoking more than 30 cigarettes, RR=59.7 (95 percent confidence interval [CI]: 13.0–274); for drinking vodka regularly for more than 30 years, RR=10.4 (95 percent CI: 4.0–27.2). Exposures to alcohol and tobacco show a clear multiplicative effect in all categories of exposure. The risk was shown to be reduced by quitting smoking (RR=0.3, 95 percent CI: 0.14–0.64, after 10 years) or by having a history of intermittent smoking. Poor nutrition was also identified as a strong independent risk factor. However, data quality regarding this factor is not as high as for tobacco and alcohol. Smoking alone accounts in this study for an estimated 95.2 percent of all the cases of laryngeal cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Muir C, Waterhouse J, Mack T, Powell J, Whelan S, eds. Cancer Incidence in Five Continents, Vol. V. Lyon: International Agency for Research on Cancer, 1987; IARC Sci. Pub. No. 88.

    Google Scholar 

  2. Levi F, Maisonneuve P, Filberti R, et al. Cancer Incidence and Mortality in Europe. Sozial- und Präventivmedizin 1989; 34: (Suppl. 2), 24–5.

    Google Scholar 

  3. Zatonski W, Tyczynski J. Cancer in Poland. Epidemiological situation. In: Zatonski W, Boyle P, Tyczynski J, eds. Cancer Prevention: Vital Statistics to Intervention. Warszawa: PA Interpress, 1990.

    Google Scholar 

  4. Zatonski W, Becker N. Atlas of the Cancer Mortality in Poland. 1975–1979. Heidelberg: Springer-Verlag, 1988.

    Google Scholar 

  5. Zatonski W, Didkowska J, Gadomska H. Cancer of the larynx in Warsaw and selected rural areas. Neoplasma 1982; 30: 379–84.

    Google Scholar 

  6. Wynder EL, Bross IJ, Day. E. Study of environmental factors in cancer of the larynx. Cancer 1956; 9: 86–110.

    Google Scholar 

  7. Wynder EL, Covey LS, Mabuci K, et al. Environmental factors in cancer of the larynx. A second look. Cancer 1976; 38: 1591–601.

    Google Scholar 

  8. Staszewski J. Smoking and cancer in Poland. Br J Cancer 1960; 14: 419–35.

    Google Scholar 

  9. Burch JD, Howe GR, Miller AB, et al. Tobacco, alcohol, asbestos and nickel in the etiology of cancer of the larynx: a case-control study. JNCI 1981; 67: 1219–24.

    Google Scholar 

  10. Elwood JM, Pearson JCG, Skippen DH, et al. Alcohol, smoking, social and occupational factors in the aetiology of cancer of the oral cavity, pharynx and larynx. Int J Cancer 1984; 34: 603–12.

    Google Scholar 

  11. Olsen J, Sabreo S, Fasting U. Interaction of alcohol and tobacco as risk factors in cancer of the laryngeal region. J Epidemiol Community Health 1985; 39: 165–8.

    Google Scholar 

  12. De Stefani E, Correa P, Oreggia F, et al. Risk factors for laryngeal cancer. Cancer 1987; 60: 3087–91.

    Google Scholar 

  13. Tuyns AJ, Estève J, Raymond L, et al. Cancer of the larynx/hypopharynx, tobacco and alcohol: IARC International case-control study in Turin and Varese (Italy), Zaragoza and Navarra (Spain), Geneva (Switzerland) and Galvados (France). Int J Cancer 1988; 41: 483–91.

    Google Scholar 

  14. Graham S, Mettlin C, Marshall J, et al. Dietary factors in the epidemiology of cancer of the larynx. Am J Epidemiol 1981; 113: 675–80.

    Google Scholar 

  15. Brown L, Mason T, Pickle L, et al. Occupational risk factors for laryngeal cancer on the Texas Gulf Coast. Cancer Res 1988; 48: 1960–4.

    Google Scholar 

  16. Chan C, Gee J. Asbestos exposure and latyngeal cancer: An analysis of the epidemiologic evidence. J Occup Med 1988; 30: 23–7.

    Google Scholar 

  17. Flanders W, Rothman K. Occupational risk for laryngeal cancer. Am J Public Health 1982; 72: 369–72.

    Google Scholar 

  18. Breslow NE, Day NE. Statistical Methods in Cancer Research Vol. I (The Analysis of Case-Control Studies). Lyon: International Agency for Research on Cancer, 1980; IARC Sci. Pub. No. 32.

    Google Scholar 

  19. Bruzzi P, Green SB, Byar DP, et al. Estimating the attributable risk for multiple risk factors using case-control data. Am J Epidemiol 1985; 122: 904–14.

    Google Scholar 

  20. Jasinski J. Surveys on Alcohol Consumption in Poland in 1980. Warszawa: Spoleczny Komitet Przeciwalkoholowy, 1984.

    Google Scholar 

  21. Zatonski W, Becher H, Lissowka J. Intermediate nonsmoking period and reduction of laryngeal cancer risk. JNCI 1990; 82: 1427–8.

    Google Scholar 

  22. Jedrychowski W, Wahrendorf J, Popiela T, et al. A case-control study of dietary factors and stomach cancer risk in Poland. Int J Cancer 1986; 37: 837–42.

    Google Scholar 

  23. Gus (1950–1988). Roczniki Statystyczne GLOWNEGO URZEDU STATYSTYCZNEGO (Statistical yearbooks). Warszawa: Central Statistical Ofice, 1950–88.

    Google Scholar 

  24. Doll R, Peto R. The causes of cancer: Quantitative estimates of avoidable risks of cancer in the United States today. JNCI 1981; 66: 1191–308.

    Google Scholar 

  25. Doll R, Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J 1976; ii: 1525–36.

    Google Scholar 

  26. Ahrens W, Jöckel KH, Patzak W, et al. A case-control study on risk factors of laryngeal cancer (in German). Verb dtsch Gesellsch Arbmed 1989; 227–32.

  27. Przewozniak K, Leppanen A, and Zatonski W. Substancj e szkodliwe w dymie polskich i finskich papierosow. Analiza porownawcza (Harmful substances in the smoke of Polish and Finnish cigarettes, 1983: Comparative analysis). Pol Tyg Lek 1987; 29: 886–9.

    Google Scholar 

  28. Hoffmann D, Brunnemann KD, Adams JD, et al. Formation and analysis of N-nitrosamines in tobacco products and their endogenous formation in consumers. In: O'Neil IK, von Borstel RC, Miller CT, Long J, Bartsch H, eds. N-nitroso Compounds: Occurrence, Biological Effects and Relevance to Human Cancer. Lyon: International Agency for Research on Cancer, 1984; IARC Sci. Pub. No. 57: 743–62.

    Google Scholar 

  29. Malaveille C, Vineis P, Estève J, et al. Levels of mutagens in the urine of smokers of black and blond tobacco correlate with their risk of bladder cancer. Carcinogenesis (London) 1989; 10: 577–89.

    Google Scholar 

  30. Estève J, Tuyns AJ, Raymond L, et al. Tobacco and the risk of cancer. Importance of kinds of tobacco. In: O'Neil IK, von Borstel RC, Miller CT, Long J, Bartsch H, eds. N-nitroso Compounds: Occurrence, Biological Effects and Relevance to Human Cancer. Lyon: International Agency for Research on Cancer, 1984; IARC Sci. Pub. No. 57: 867–76.

    Google Scholar 

  31. Vineis P, Estève J, Terracini B. Bladder cancer and smoking in males: types of cigarettes, age at start, effect of stopping and interaction with occupation. Int J Cancer 1984; 34: 165–70.

    Google Scholar 

  32. Benhamou S, Benhamou E, Tirmache M, et al. Lung cancer and use of cigarettes: a French case-control study. JNCI 1985; 74: 1169–75.

    Google Scholar 

  33. Tuyns AJ. Incidence trends of laryngeal cancer in relation to national alcohol and tobacco consumption. In: Magnus K, ed. Trends in Cancer Incidence. Washington: Hemisphere, 1982: 199–214.

    Google Scholar 

  34. Herity B, Moriarty M, Daly L, et al. The role of tobacco and alcohol in the aetiology of lung and larynx cancer. Br J Cancer 1982; 46: 961–3.

    Google Scholar 

  35. Hillers V, Massey L. Interrelationships of moderate and high alochol consumption with diet and health status. Am J Clin Nutr 1985; 41: 356–62.

    Google Scholar 

  36. Ziegler R. Alcohol-nutrient interactions in cancer etiology. Cancer 1986; 58: 1942–8.

    Google Scholar 

  37. Ziegler W, Morris L, Blot W, et al. Esophageal cancer among black men in Washington, D.C. II. Role of nutrition. JNCI 1981; 67: 1199–206.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This work was conducted within the framework of the PR-6 Cancer Control in Poland-National Cancer Program and was supported by the Humboldt Foundation.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zatonski, W., Becher, H., Lissowska, J. et al. Tobacco, alcohol, and diet in the etiology of laryngeal cancer: a population-based case-control study. Cancer Causes Control 2, 3–10 (1991). https://doi.org/10.1007/BF00052355

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00052355

Key words

Navigation