title: Alcoholism and risk for cancer of the cervix uteri, vagina, and vulva.
abstract: We conducted a population-based cohort study to analyze the risk of developing cancers of the female genitals among 36,856 patients with a hospital discharge diagnosis of alcoholism (ICD-7: 307, 322; ICD-8: 291, 303; ICD-9: 291, 303, 305A) in Sweden between 1965 and 1995. The follow-up was done by linkages of national registries. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were computed based on nationwide specific cancer rates. The first year of follow-up was excluded from all analyses to minimize the impact of selection bias. We found that alcoholic women had excess risks for in situ cervical cancer (SIR, 1.7; 95% CI, 1.6-1.9), for invasive cervical cancer (SIR, 2.9; 95% CI, 2.4-3.5), and for cancer of the vagina (SIR, 4.6; 95% CI, 2.2-8.5) but not for cancer of the vulva (SIR, 1.0; 95% CI, 0.4-2.0). The fact that alcoholics had an excess risk also for the in situ cancer suggests that the observed excess in invasive cervical cancer may not only be attributable to less use of Pap smear screening among them. The alcoholic women may be at higher risk for the progression from human papillomavirus infection to a malignant lesion for lifestyle-related reasons (promiscuity, smoking, use of contraceptive hormones, and dietary deficiencies). We conclude that alcoholic women are at high risk for in situ and invasive cervical cancer and for cancer of the vagina.
authors.affiliation: International Agency for Research on Cancer, Lyon, France. Weiderpass@iarc.fr
authors.forename: E
authors.initials: E
authors.lastname: Weiderpass
authors.forename: W
authors.initials: W
authors.lastname: Ye
authors.forename: R
authors.initials: R
authors.lastname: Tamimi
authors.forename: D
authors.initials: D
authors.lastname: Trichopolous
authors.forename: O
authors.initials: O
authors.lastname: Nyren
authors.forename: H
authors.initials: H
authors.lastname: Vainio
authors.forename: H O
authors.initials: HO
authors.lastname: Adami
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications*; D002278:Carcinoma in Situ / Q000150:complications / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D016017:Odds Ratio; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000472:pathogenicity; D030361:Papillomavirus Infections / Q000150:complications; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000150:complications; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000209:etiology*; D014625:Vaginal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D014626:Vaginal Smears; D014846:Vulvar Neoplasms / Q000453:epidemiology / Q000209:etiology*