title: Tobacco smoking, alcohol drinking and dietary factors as determinants of new primaries among male laryngeal cancer patients: a case-cohort study.
abstract: OBJECTIVE
  The paper examines the determinants associated with second primary occurrence in laryngeal cancer cases.
  
  
  METHODS
  A series of 220 incident male laryngeal cancer cases was interviewed 10 years ago within the framework of a population-based, case-control study. The occurrence of other primaries among these patients was assessed by means of the Lombardy Cancer Registry, which covers their area of residence. The relationship between tobacco, alcohol, dietary factors and the risk of occurrence of new primaries was analyzed by means of a nested case-control study. Cases were defined as those subjects who developed a new primary, and controls as those without.
  
  
  RESULTS
  New primaries occurred among 36 subjects during an 8-year follow-up; 147 control cancer patients were matched for age and length of follow-up. A twofold risk increase was associated with the highest tobacco consumption, as registered at time of first primary; a weaker relationship, i.e. risk of 1.2 for the highest tertile, was seen for alcohol drinking. The occurrence of new primaries was also influenced by dietary habits. In particular, those who had a high intake of monosaturated fatty acids had a one-third lower risk of developing a new primary.
  
  
  CONCLUSIONS
  Our results support the hypothesis that a healthy diet is protective among those who experience a laryngeal neoplasm and suggests that diet could be a potential preventive agent against the occurrence of new primaries among these patients.
authors.affiliation: Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano (PN), Italy.
authors.forename: A
authors.initials: A
authors.lastname: Russo
authors.forename: P
authors.initials: P
authors.lastname: Crosignani
authors.forename: F
authors.initials: F
authors.lastname: Berrino
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D016022:Case-Control Studies; D004032:Diet / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000209:etiology*; D016017:Odds Ratio; D012907:Smoking / Q000009:adverse effects*