Abstract
In terms of worldwide levels, Cuba has an intermediate incidence of cancer of the oral cavity and oro-pharynx. We studied 200 cases of cancer of the oral cavity and pharynx, of whom 57 women (median age = 64) and 200 hospital controls, frequency matched with cases by age and sex, in relation to smoking and drinking history, intake of 25 foods or food groups, indicators of oral hygiene and sexual activity, and history of sexually transmitted diseases. Odds ratios (OR) and 95% confidence intervals (CI) were obtained from unconditional multiple logistic regressions and adjusted for age, sex, area of residence, education, and smoking and drinking habits. In the multivariate model, high educational level and white-collar occupation, but not white race, were associated with halving of oral cancer risk. Smoking ≥30 cigarettes per day showed an OR of 20.8 (95% CI: 8.9–48.3), similar to smoking ≥4 cigars daily (OR = 20.5). Drinking ≥ 70 alcoholic drinks per week showed an OR of 5.7 (95% CI: 1.8–18.5). Hard liquors were by far the largest source of alcohol. Increased risk was associated with the highest tertile of intake for maize (OR = 1.9), meat (OR = 2.2) and ham and salami (OR = 2.0), whereas high fruit intake was associated with significantly decreased risk (OR = 0.4). Among indicators of dental care, number of missing teeth and poor general oral condition at oral inspection showed ORs of 2.7 and 2.6, respectively. Number of sexual partners, marriages or contacts with prostitutes, practice of oral sex and history of various sexually transmitted diseases, including genital warts, were not associated with oral cancer risk. 82% of oral cancer cases in Cuba were attributable to tobacco smoking, 19% to smoking cigars or pipe only. The fractions attributable to alcohol drinking (7%) and low fruit intake (11%) were more modest. Thus, decreases in cigarette and cigar smoking are at present the key to oral cancer prevention in Cuba. © 2001 Cancer Research Campaign http://www.bjcancer.com
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References
Blot WJ, McLaughlin JK, Winn DM, Austin DF, Greenberg RS and Preston-Martin S (1988) Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res 48: 3282–3287
Boffetta P (1993) Black (air-cured) and blond (flue-cured) tobacco and cancer risk. V: oral cavity cancer. Eur J Cancer 29A: 1331–1335
Bundgaard T, Wildt J, Frydenberg M, Elbrønd O and Nielsen JE (1995) Case-control study of squamous cell cancer of the oral cavity in Denmark. Cancer Causes Control 6: 57–67
Corrao MA, Guindon GE, Sharma N and Shokoohi DF (2000). Tobacco control country profiles,
Day GL, Blot WJ, Austin DF, Bernstein L, Greenberg RS and Preston-Martin S (1993) Racial differences in risk of oral and pharyngeal cancer: alcohol, tobacco, and other determinants. J Natl Cancer Inst 85: 465–473
De Stefani E, Deneo-Pellegrini H, Mendilaharsu M and Ronco A (1999) Diet and risk of cancer of the upper aerodigestive tract. I. Foods. Oral Oncol 35: 17–21
Estève J, Riboli E, Péquignot G, Terracini B, Merletti F and Crosignani P (1996) Diet and cancers of the larynx and hypopharynx: the IARC multi-center study in southwestern Europe. Cancer Causes Control 7: 240–252
Fernandez Garrote L, Sankaranarayanan R, Lence Anta JJ, Rodriguez Salva A and Parkin DM (1995) An evaluation of the oral cancer control program in Cuba. Epidemiol 6: 428–431
Franceschi S, Bidoli E, Baron AE and La Vecchia C (1990) Maize and risk of cancers of the oral cavity, pharynx, and esophagus in northeastern Italy. J Natl Cancer Inst 82: 1407–1411
Franceschi S, Muñoz N, Bosch FX, Snijders PJF and Walboomers JMM (1996) Human papillomavirus and cancers of the upper aerodigetive tract: a review of epidemiological and experimental evidence. Cancer Epidemiol Biom & Prev 5: 567–575
Franceschi S, Favero A, Conti E, Talamini R, Volpe R and Negri E (1999) Food groups, oils and butter, and cancer of the oral cavity and pharynx. Br J Cancer 80: 614–620
Franceschi S, Bidoli E, Herrero R and Muñoz N (2000) Comparison of the oral cavity and pharynx worldwide: etiological clues. Oral Oncol 36: 106–115
Franco EL, Kowalski LP, Oliveira BV, Curado MP, Pereira RN and Silva ME (1989) Risk factors for oral cancer in Brazil: a case-control study. Int J Cancer 43: 992–1000
Gillison ML, Koch WM, Capone RB, Spafford M, Westra WH and Wu L (2000) Evidence for a causal association between human papillomavirus and a subset of head and neck cancers. J Natl Cancer Inst 92: 709–720
Grønbæk M, Becker U, Johansen D, Tønnesen H, Jensen G and Sørensen TIA (1998) Population based cohort study of the association between alcohol intake and cancer of the upper digestive tract. Br Med J 317: 844–848
Hayes RB, Bravo-Otero E, Kleinman DV, Brown LM, Fraumeni JF Jr, Harty LC and Winn DM (1999) Tobacco and alcohol use and oral cancer in Puerto Rico. Cancer Causes & Control 10: 27–33
Herrero R, Muñoz N, Franceschi S, Castellsagué X, Meijer CJLM and Walboomers JMM (2000). International case-control study of HPV and cancer of the oral cavity and pharynx. Abstract No 166, Proceeding of the 18th International Papillomavirus Conference, Barcelona, 23–28 July 2000, p. 184
IARC (1986). Monographs on the Evaluation of the Carcinogenic Risks to Humans, Volume 38, Tobacco Smoking,
IARC (1988). Monographs on the Evaluation of the Carcinogenic Risks to Humans, Volume 44, Alcohol Drinking,
Jensen OM (1979) Cancer morbidity and causes of death among Danish brewery workers. Int J Cancer 23: 454–463
La Vecchia C, Bosetti C, Negri E, Levi F and Franceschi S (1998) Cigar smoking and cancers of the upper digestive tract [letter]. J Natl Cancer Inst 90: 1670
La Vecchia C, Franceschi S, Bosetti C, Levi F, Talamini R and Negri E (1999a) Time since stopping smoking and the risk of oral and pharyngeal cancers. J Natl Cancer Inst 91: 726–727
La Vecchia C, Franceschi S, Favero A, Talamini R and Negri E (1999b) Alcohol intake and cancer of the upper digestive tract. Pattern of risk in Italy is different from that in Denmark. Br Med J 318: 1289–1290
Levi F, Pasche C, La Vecchia C, Lucchini F, Franceschi S and Monnier P (1998) Food groups and risk of oral and pharyngeal cancer. Int J Cancer 77: 705–709
Li J-Y, Ershow AG, Chen Z-J, Wacholder S, Li G-Y and Guo W (1989) A case-control study of cancer of the esophagus and gastric cardia in Linxian. Int J Cancer 43: 755–761
Maden C, Beckmann AM, Thomas DB, McKnight B, Sherman KJ and Ashley RL (1992) Human papillomaviruses, herpes simplex viruses, and the risk of oral cancer in men. Am J Epidemiol 135: 1093–1102
Marshall JR, Graham S, Haughey BP, Shedd D, O'shea R and Brasure J (1992) Smoking, alcohol, dentition and diet in the epidemiology of oral cancer. Oral Oncol Eur J Cancer 28B: 9–15
McLaughlin JK, Gridley G, Block G, Winn DM, Preston-Martin S and Schoenberg JB (1988) Dietary factors in oral and pharyngeal cancer. J Natl Cancer Inst 80: 1237–1243
Mezzetti M, Ferraroni M, Decarli A, La Vecchia C and Benichou J (1996) Software for attributable risk and confidence interval estimation in case-control studies. Computers & Biomed Res 29: 63–75
Negri E, La Vecchia C, Franceschi S and Tavani A (1993) Attributable risk for oral cancer in Northern Italy. Cancer Epidemiol Biom & Prev 2: 189–193
Parkin DM, Muir CS, Whelan SL, Gao YT, Ferlay J and Powell J (1992). Cancer Incidence in Five Continents, Vol,
Schlecht NF, Franco EL, Pintos J and Kowalski LP (1999) Effect of smoking cessation and tobacco type on the risk of cancers of the upper aero-digestive tract in Brazil. Epidemiol 10: 412–418
Schwartz SM, Daling JR, Doody DR, Wipf GC, Carter JJ and Madeleine MM (1998) Oral cancer risk in relation to sexual history and evidence of human papillomavirus infection. J Natl Cancer Inst 90: 1626–1636
Shanks TG and Burns DM (1998) Disease consequences of cigar smoking.
Sydenham EW, Thiel PG, Marasas WPO, Shephard GS, Van Shalkwyk DJ and Kock KR (1990) Natural occurrence of some Fusarium mycotoxins in corn from low and high esophageal cancer prevalence areas of the Transkei, southern Africa. J Agricul Food Chem 38: 1900–1903
Talamini R, Vaccarella S, Barbone F, Tavani A, La Vecchia C, Herrero R, Muñoz N and Franceschi S (2000) Oral hygiene, dentition, sexual habits and risk of oral cancer. Br J Cancer 83: 1238–1242
Van Rensburg ES, Bradshaw D and Rose EF (1985) Esophageal cancer in Zulu men, South Africa: a case-control study. Br J Cancer 51: 399–405
Velly AM, Franco EL, Schlecht N, Pintos J, Kowalski LP, Oliveira BV and Curado MP (1998) Relationship between dental factors and risk of upper aerodigestive tract cancer. Oral Oncol 34: 284–191
WHO (World Health Organization) (1997). Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death (Based on the Recommendations of Ninth Revision Conference, 1975),
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Garrote, L., Herrero, R., Reyes, R. et al. Risk factors for cancer of the oral cavity and oro-pharynx in Cuba. Br J Cancer 85, 46–54 (2001). https://doi.org/10.1054/bjoc.2000.1825
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DOI: https://doi.org/10.1054/bjoc.2000.1825
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