title: Associations of tobacco use and alcohol drinking with laryngeal and hypopharyngeal cancer risks among men in Karunagappally, Kerala, India -Karunagappally cohort study.
abstract: BACKGROUND
  From among a cohort of 65,553 men aged 30-84 in Karunagappally Taluk, Kerala, India, 52 hypopharyngeal cancer cases and 85 laryngeal cancer cases were identified by the Karunagappally Cancer Registry during the period between 1990 and 2009.
  
  
  METHODS
  We conduct Poisson regression analysis of grouped data, taking into account age and education.
  
  
  RESULTS
  This study showed that the incidence rates of cancers of the hypopharynx and the larynx were strongly related to the number of bidis smoked a day (P<0.001 for both hypopharyngeal and laryngeal cancers) and duration of bidi smoking (P=0.009; P<0.001). Laryngeal cancer risk was significantly increased by bidi smoking (P<0.001), cigarette smoking (P=0.013) and regular alcohol use (P=0.005).
  
  
  CONCLUSIONS
  The present study, the first cohort study to examine the association of hypopharyngeal and laryngeal cancer incidence rates with bidi smoking in South Asia, clearly showed dose-response relationships between those cancer risks and bidi smoking; larger amounts of bidi smoked a day and longer durations of bidi smoking increased the incidence rates of those cancers. Tobacco chewing was found not related to the risk of hypopharynx or larynx cancer.
authors.affiliation: Regional Cancer Center, Trivandrum, Kerala, India ; Natural Background Radiation Cancer Registry, Karunagappally, Kerala, India.
authors.forename: Padmavathy Amma
authors.initials: PA
authors.lastname: Jayalekshmi
authors.forename: Athira
authors.initials: A
authors.lastname: Nandakumar
authors.forename: Suminori
authors.initials: S
authors.lastname: Akiba
authors.forename: Paleth
authors.initials: P
authors.lastname: Gangadharan
authors.forename: Chihaya
authors.initials: C
authors.lastname: Koriyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000453:epidemiology / Q000209:etiology; D007194:India / Q000453:epidemiology; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D064424:Tobacco Use / Q000453:epidemiology