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Smoking and drinking in relation to oral cancer and oral epithelial dysplasia

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Abstract

Objective

Risks associated with smoking and drinking are not necessarily constant over the multistage pathway to oral cancer. We investigated whether smoking and drinking patterns differ for persons with oral cancer (OC) relative to those with oral epithelial dysplasia (OED), a precancerous condition.

Methods

Incident cases of OC and OED were interviewed using a questionnaire containing questions on smoking and drinking. Odds ratios (ORs) compared the odds of smoking and drinking among persons with OC relative to OED.

Results

No adjusted ORs for smoking achieved statistical significance; however, most were <1.0. The odds of OC relative to OED increased with drinking level; the adjusted OR for 19+ drinks/week was 3.03 (1.56–5.87). Age drinking began and years of drinking were not notably different for OC and OED cases; a higher proportion of OC cases reported discontinuing alcohol for 9+ years before diagnosis.

Conclusions

The relationship between smoking and OED was at least as strong as that for smoking and OC, suggesting that smoking may have its greatest impact on oral carcinogenesis prior to malignant transformation. Drinking was more strongly associated with OC than OED, particularly at elevated consumption levels; the role of alcohol does not appear limited to a late-stage effect.

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References

  1. Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108

    Article  PubMed  Google Scholar 

  2. Mayne ST, Morse DE, Winn DM (2006) Cancers of the oral cavity and pharynx. In: Schottenfeld D, Fraumeni JF Jr (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 674–696

    Google Scholar 

  3. Melrose RJ (2001) Premalignant oral mucosal diseases. J Calif Dent Assoc 29:593–600

    PubMed  CAS  Google Scholar 

  4. Pindborg JJ, Reichart PA, Smith CJ, van der Waal I (1997) in collaboration with Sobin LH (eds) Histological typing of cancer and precancer of the oral mucosa. Springer, New York

  5. Silverman S Jr, Gorsky M, Lozada F (1984) Oral leukoplakia and malignant transformation. A follow-up study of 257 patients. Cancer 53:563–568

    Article  PubMed  Google Scholar 

  6. Castellsague X, Quintana MJ, Martinez MC et al (2004) The role of type of tobacco and type of alcoholic beverage in oral carcinogenesis. Int J Cancer 108:741–749

    Article  PubMed  CAS  Google Scholar 

  7. Franceschi S, Talamini R, Barra S et al (1990) Smoking and drinking in relation to cancers of the oral cavity, pharynx, larynx, and esophagus in northern Italy. Cancer Res 50:6502–6507

    PubMed  CAS  Google Scholar 

  8. Blot WJ, McLaughlin JK, Winn DM et al (1988) Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res 48:3282–3287

    PubMed  CAS  Google Scholar 

  9. Morse DE, Katz RV, Pendrys DG et al (1996) Smoking and drinking in relation to oral epithelial dysplasia. Cancer Epidemiol Biomarkers Prev 5:769–777

    PubMed  CAS  Google Scholar 

  10. Banoczy J, Gintner Z, Dombi C (2001) Tobacco use and oral leukoplakia. J Dent Educ 65:322–327

    PubMed  CAS  Google Scholar 

  11. Hashibe M, Sankaranarayanan R, Thomas G et al (2000) Alcohol drinking, body mass index and the risk of oral leukoplakia in an Indian population. Int J Cancer 88:129–134

    Article  PubMed  CAS  Google Scholar 

  12. Evstifeeva TV, Zaridze DG (1992) Nass use, cigarette smoking, alcohol consumption and risk of oral and oesophageal precancer. Eur J Cancer B Oral Oncol 28B:29–35

    Article  PubMed  CAS  Google Scholar 

  13. Lee CH, Ko YC, Huang HL et al (2003) The precancer risk of betel quid chewing, tobacco use and alcohol consumption in oral leukoplakia and oral submucous fibrosis in southern Taiwan. Br J Cancer 88:366–372

    Article  PubMed  CAS  Google Scholar 

  14. Loftus ER, Baric JM, Kapur KK, Chauncey HH (1981) Cigarette smoking and oral leukoplakia in healthy males. Spec Care Dentist 1:206–210

    PubMed  CAS  Google Scholar 

  15. Dietrich T, Reichart PA, Scheifele C (2004) Clinical risk factors of oral leukoplakia in a representative sample of the US population. Oral Oncol 40:158–163

    Article  PubMed  Google Scholar 

  16. Schepman KP, van der Meij EH, Smeele LE, van der Waal I (1998) Malignant transformation of oral leukoplakia: a follow-up study of a hospital-based population of 166 patients with oral leukoplakia from The Netherlands. Oral Oncol 34:270–275

    PubMed  CAS  Google Scholar 

  17. Roed-Petersen B (1971) Cancer development in oral leukoplakia. Follow-up of 331 patients. J Dent Res 50:711

    Google Scholar 

  18. Einhorn J, Wersall J (1967) Incidence or oral carcinoma in patients with leukoplakia of the oral mucosa. Cancer 20:2189–2193

    Article  PubMed  CAS  Google Scholar 

  19. Macigo FG, Mwaniki DL, Guthua SW (1995) The association between oral leukoplakia and use of tobacco, alcohol and khat based on relative risks assessment in Kenya. Eur J Oral Sci 103:268–273

    PubMed  CAS  Google Scholar 

  20. Gupta PC (1984) Epidemiologic study of the association between alcohol habits and oral leukoplakia. Community Dent Oral Epidemiol 12:47–50

    Article  PubMed  CAS  Google Scholar 

  21. Shiu MN, Chen TH (2004) Impact of betel quid, tobacco and alcohol on three-stage disease natural history of oral leukoplakia and cancer: implication for prevention of oral cancer. Eur J Cancer Prev 13:39–45

    Article  PubMed  Google Scholar 

  22. Fritz A, Percy C, Jack A et al (2000) International classification of diseases for oncology, 3rd edn. WHO, Geneva, pp 45–46

    Google Scholar 

  23. Graham S, Dayal H, Rohrer T et al (1977) Dentition, diet, tobacco, and alcohol in the epidemiology of oral cancer. J Natl Cancer Inst 59:1611–1618

    PubMed  CAS  Google Scholar 

  24. Hosmer DW, Lemeshow S (2000) Applied logistic regression, 2nd edn. John Wiley & Sons, Inc., New York

    Google Scholar 

  25. Lumerman H, Freedman P, Kerpel S (1995) Oral epithelial dysplasia and the development of invasive squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 79:321–329

    Article  PubMed  CAS  Google Scholar 

  26. Chen YK, Hsue SS, Lin LM (2004) p73 Expression for human buccal epithelial dysplasia and squamous cell carcinoma: does it correlate with nodal status of carcinoma and is there a relationship with malignant change of epithelial dysplasia? Head Neck 26:945–952

    Article  PubMed  Google Scholar 

  27. Soni S, Kaur J, Kumar A et al (2005) Alterations of rb pathway components are frequent events in patients with oral epithelial dysplasia and predict clinical outcome in patients with squamous cell carcinoma. Oncology 68:314–325

    Article  PubMed  CAS  Google Scholar 

  28. Lo Muzio L, Pannone G, Leonardi R et al (2003) Survivin, a potential early predictor of tumor progression in the oral mucosa. J Dent Res 82:923–928

    PubMed  CAS  Google Scholar 

  29. Mao L, Lee JS, Fan YH et al (1996) Frequent microsatellite alterations at chromosomes 9p21 and 3p14 in oral premalignant lesions and their value in cancer risk assessment. Nat Med 2:682–685

    Article  PubMed  CAS  Google Scholar 

  30. Rosin MP, Cheng X, Poh C et al (2000) Use of allelic loss to predict malignant risk for low-grade oral epithelial dysplasia. Clin Cancer Res 6:357–362

    PubMed  CAS  Google Scholar 

  31. Hayes RB, Bravo-Otero E, Kleinman DV et al (1999) Tobacco and alcohol use and oral cancer in Puerto Rico. Cancer Causes Control 10:27–33

    Article  PubMed  CAS  Google Scholar 

  32. Maserejian NN, Joshipura KJ, Rosner BA, Giovannucci E, Zavras AI (2006) Prospective study of alcohol consumption and risk of oral premalignant lesions in men. Cancer Epidemiol Biomarkers Prev 15:774–781

    Article  PubMed  CAS  Google Scholar 

  33. Banoczy J, Sugar L (1972) Longitudinal studies in oral leukoplakias. J Oral Pathol 1:265–272

    Article  PubMed  CAS  Google Scholar 

  34. Kabat GC, Chang CJ, Wynder EL (1994) The role of tobacco, alcohol use, and body mass index in oral and pharyngeal cancer. Int J Epidemiol 23:1137–1144

    Article  PubMed  CAS  Google Scholar 

  35. Mashberg A, Garfinkel L, Harris S (1981) Alcohol as a primary risk factor in oral squamous carcinoma. CA Cancer J Clin 31:146–155

    Article  PubMed  CAS  Google Scholar 

  36. Wight AJ, Ogden GR (1998) Possible mechanisms by which alcohol may influence the development of oral cancer—a review. Oral Oncol 34:441–447

    Article  PubMed  CAS  Google Scholar 

  37. Howie NM, Trigkas TK, Cruchley AT, Wertz PW, Squier CA, Williams DM (2001) Short-term exposure to alcohol increases the permeability of human oral mucosa. Oral Dis 7:349–354

    Article  PubMed  CAS  Google Scholar 

  38. Blot WJ (1992) Alcohol and cancer. Cancer Res 52:2119s–2123s

    PubMed  CAS  Google Scholar 

  39. Blot WJ (1999) Invited commentary: more evidence of increased risks of cancer among alcohol drinkers. Am J Epidemiol 150:1138–1140

    PubMed  CAS  Google Scholar 

  40. Altieri A, Bosetti C, Gallus S et al (2004) Wine, beer and spirits and risk of oral and pharyngeal cancer: a case–control study from Italy and Switzerland. Oral Oncol 40:904–909

    Article  PubMed  Google Scholar 

  41. Dal Maso L, La Vecchia C, Polesel J et al (2002) Alcohol drinking outside meals and cancers of the upper aero-digestive tract. Int J Cancer 102:435–437

    Article  PubMed  CAS  Google Scholar 

  42. Schlecht NF, Franco EL, Pintos J et al (1999) Interaction between tobacco and alcohol consumption and the risk of cancers of the upper aero-digestive tract in Brazil. Am J Epidemiol 150:1129–1137

    PubMed  CAS  Google Scholar 

  43. McCann SE, Sempos C, Freudenheim JL et al (2003) Alcoholic beverage preference and characteristics of drinkers and nondrinkers in western New York (United States). Nutr Metab Cardiovasc Dis 13:2–11

    Article  PubMed  CAS  Google Scholar 

  44. Barefoot JC, Gronbaek M, Feaganes JR, McPherson RS, Williams RB, Siegler IC (2002) Alcoholic beverage preference, diet, and health habits in the UNC Alumni Heart Study. Am J Clin Nutr 76:466–472

    PubMed  CAS  Google Scholar 

  45. Merletti F, Boffetta P, Ciccone G, Mashberg A, Terracini B (1989) Role of tobacco and alcoholic beverages in the etiology of cancer of the oral cavity/oropharynx in Torino, Italy. Cancer Res 49:4919–4924

    PubMed  CAS  Google Scholar 

  46. Franceschi S, Levi F, Dal Maso L et al (2000) Cessation of alcohol drinking and risk of cancer of the oral cavity and pharynx. Int J Cancer 85:787–790

    Article  PubMed  CAS  Google Scholar 

  47. Day NE, Brown CC (1980) Multistage models and primary prevention of cancer. J Natl Cancer Inst 64:977–989

    PubMed  CAS  Google Scholar 

  48. Holmes JD, Dierks EJ, Homer LD, Potter BE (2003) Is detection of oral and oropharyngeal squamous cancer by a dental health care provider associated with a lower stage at diagnosis? J Oral Maxillofac Surg 61:285–291

    Article  PubMed  Google Scholar 

  49. Cowan CG, Gregg TA, Napier SS, McKenna SM, Kee F (2001) Potentially malignant oral lesions in northern Ireland: a 20-year population-based perspective of malignant transformation. Oral Dis 7:18–24

    PubMed  CAS  Google Scholar 

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Acknowledgments

The authors thank the healthcare practitioners and study subjects who participated in the investigation. The study was supported by the New York University Oral Cancer Research for Adolescent and Adult Health Promotion Center, which is funded by the National Institutes of Health/National Institute of Dental and Craniofacial Research grant U54 DE14257 and NIH/NIDCR grant P50 DE10592.

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Authors and Affiliations

  1. Department of Epidemiology & Health Promotion, New York University College of Dentistry, 345 East 24th Street, Mail Code: 9416, New York, NY, 10010, USA

    Douglas E. Morse & Walter J. Psoter

  2. Department of Diagnostic Sciences, University of Medicine and Dentistry of New Jersey, Newark, NJ, 07103, USA

    Deborah Cleveland

  3. Department of Oral and Maxillofacial Surgery and Diagnostic Services, University of Florida College of Dentistry, Gainesville, FL, 32610, USA

    Donald Cohen

  4. Department of Veterans Affairs, New Jersey Health Care System, Department of General Surgery, East Orange, NJ, 07079, USA

    Mireseyed Mohit-Tabatabai

  5. Formerly University of Connecticut School of Dental Medicine, Farmington, CT, 06030, USA

    Diane L. Kosis

  6. Department of Oral Diagnosis, University of Connecticut School of Dental Medicine, Farmington, CT, 06030, USA

    Ellen Eisenberg

Authors
  1. Douglas E. Morse
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  2. Walter J. Psoter
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  3. Deborah Cleveland
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  4. Donald Cohen
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  5. Mireseyed Mohit-Tabatabai
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  6. Diane L. Kosis
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  7. Ellen Eisenberg
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Corresponding author

Correspondence to Douglas E. Morse.

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Morse, D.E., Psoter, W.J., Cleveland, D. et al. Smoking and drinking in relation to oral cancer and oral epithelial dysplasia. Cancer Causes Control 18, 919–929 (2007). https://doi.org/10.1007/s10552-007-9026-4

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  • DOI: https://doi.org/10.1007/s10552-007-9026-4

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