A meta-analysis of alcohol drinking and oral and pharyngeal cancers. Part 2: results by subsites.
Oral and pharyngeal cancers are strongly related to alcohol drinking. We combined findings from all case-control and cohort studies published up to September 2009 and presented analyses by subsites, using a meta-analytic approach. Summary measures were obtained using random-effects models, and taking into account the correlation between estimates from the same study. We also performed a dose-risk analysis, using a random-effects meta-regression model. Compared to non- or occasional drinkers, the overall relative risks (RR) for light drinkers were 1.17 (95% confidence interval, CI, 1.01-1.35) for oral (nine studies) and 1.23 (95% CI, 0.87-1.73) for pharyngeal (five studies) cancer, with no significant heterogeneity between the two sites (p=0.793). RRs for heavy drinkers were 4.64 (95% CI, 3.78-5.70) for oral (17 studies) and 6.62 (95% CI, 4.72-9.29) for pharyngeal (17 studies) cancer (p of heterogeneity between the two sites=0.075). The summary RRs for heavy drinkers were 4.11 (95% CI, 2.46-6.87) for tongue (five studies), 7.76 (95% CI, 4.77-12.62) for oropharyngeal (four studies), and 9.03 (95% CI, 4.46-18.27) for hypopharyngeal (four studies) cancer. In conclusion, the alcohol-related RRs are higher for pharyngeal than for oral cancer, particularly at higher doses, while the association with cancer of the tongue was similar to that for oral cancer.
Turati
Federica
F
Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy.
Garavello
Werner
W
Tramacere
Irene
I
Bagnardi
Vincenzo
V
Rota
Matteo
M
Scotti
Lorenza
L
Islami
Farhad
F
Corrao
Giovanni
G
Boffetta
Paolo
P
La Vecchia
Carlo
C
Negri
Eva
E
D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000209:etiology; D010610:Pharyngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D018570:Risk Assessment; D012307:Risk Factors