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Interaction effects and population-attributable risks for smoking and alcohol on laryngeal cancer and its subsites. A case-control study from Germany.
Methods Inf Med. 2004; 43(5):499-504.MI

Abstract

OBJECTIVES

To assess the joint effect of smoking and alcohol consumption on laryngeal risk on tumor subsites.

METHODS

Population-based case-control study in South-West Germany with 257 histologically confirmed cases (236 males, 21 females), age 37 to 80 years, and 769 population controls (702 males, 67 females), 1:3 frequency matched by age and sex.

RESULTS

Half of the tumors (50.6%) were glottic or subglottic, 17.5% were supraglottic. Due to advanced stage, the subsite of 31.9% of the tumors could not be determined clearly. There is a strong increase in risk with increasing tobacco consumption with an odds ratio (OR) of 59.8 (95% confidence interval (CI) 21.3-167.3) for heavy smoking (>80 packyears (py)), all cases combined. In comparison to current smokers, cancer risk is reduced for ex-smoking (>2 years) OR=0.36, 95% CI 0.24-0.53. The risks were higher for supraglottic than for glottic and subglottic tumors. The effect of alcohol is not as strong. A significantly increased odds ratio of 2.0, 95% CI (1.0-3.9) results for 75-100 g ethanol/day only for glottic and subglottic tumors. The OR rises from 2.2, 95% CI (1.1-4.3) for 100-150 g ethanol/day to 4.3, 95% CI (1.4-13.2) for more than 150 g ethanol/day (all models adjusted for education). The joint effect of smoking and alcohol results appears sub-multiplicative but super-additive. Almost 90% of the tumors can be attributed to both factors.

CONCLUSION

Contrary to earlier investigations we observed a sub-multiplicative effect of smoking and alcohol. The risk for persons with both high alcohol and tobacco consumption is extremely high which indicates the importance of intervention.

Authors+Show Affiliations

Department of Tropical Hygiene and Public Health, University of Heidelberg, Heidelberg, Germany. hramroth@urz.uni-heidelberg.deNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15702209

Citation

Ramroth, H, et al. "Interaction Effects and Population-attributable Risks for Smoking and Alcohol On Laryngeal Cancer and Its Subsites. a Case-control Study From Germany." Methods of Information in Medicine, vol. 43, no. 5, 2004, pp. 499-504.
Ramroth H, Dietz A, Becher H. Interaction effects and population-attributable risks for smoking and alcohol on laryngeal cancer and its subsites. A case-control study from Germany. Methods Inf Med. 2004;43(5):499-504.
Ramroth, H., Dietz, A., & Becher, H. (2004). Interaction effects and population-attributable risks for smoking and alcohol on laryngeal cancer and its subsites. A case-control study from Germany. Methods of Information in Medicine, 43(5), 499-504.
Ramroth H, Dietz A, Becher H. Interaction Effects and Population-attributable Risks for Smoking and Alcohol On Laryngeal Cancer and Its Subsites. a Case-control Study From Germany. Methods Inf Med. 2004;43(5):499-504. PubMed PMID: 15702209.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interaction effects and population-attributable risks for smoking and alcohol on laryngeal cancer and its subsites. A case-control study from Germany. AU - Ramroth,H, AU - Dietz,A, AU - Becher,H, PY - 2005/2/11/pubmed PY - 2005/3/18/medline PY - 2005/2/11/entrez SP - 499 EP - 504 JF - Methods of information in medicine JO - Methods Inf Med VL - 43 IS - 5 N2 - OBJECTIVES: To assess the joint effect of smoking and alcohol consumption on laryngeal risk on tumor subsites. METHODS: Population-based case-control study in South-West Germany with 257 histologically confirmed cases (236 males, 21 females), age 37 to 80 years, and 769 population controls (702 males, 67 females), 1:3 frequency matched by age and sex. RESULTS: Half of the tumors (50.6%) were glottic or subglottic, 17.5% were supraglottic. Due to advanced stage, the subsite of 31.9% of the tumors could not be determined clearly. There is a strong increase in risk with increasing tobacco consumption with an odds ratio (OR) of 59.8 (95% confidence interval (CI) 21.3-167.3) for heavy smoking (>80 packyears (py)), all cases combined. In comparison to current smokers, cancer risk is reduced for ex-smoking (>2 years) OR=0.36, 95% CI 0.24-0.53. The risks were higher for supraglottic than for glottic and subglottic tumors. The effect of alcohol is not as strong. A significantly increased odds ratio of 2.0, 95% CI (1.0-3.9) results for 75-100 g ethanol/day only for glottic and subglottic tumors. The OR rises from 2.2, 95% CI (1.1-4.3) for 100-150 g ethanol/day to 4.3, 95% CI (1.4-13.2) for more than 150 g ethanol/day (all models adjusted for education). The joint effect of smoking and alcohol results appears sub-multiplicative but super-additive. Almost 90% of the tumors can be attributed to both factors. CONCLUSION: Contrary to earlier investigations we observed a sub-multiplicative effect of smoking and alcohol. The risk for persons with both high alcohol and tobacco consumption is extremely high which indicates the importance of intervention. SN - 0026-1270 UR - https://www.unboundmedicine.com/medline/citation/15702209/Interaction_effects_and_population_attributable_risks_for_smoking_and_alcohol_on_laryngeal_cancer_and_its_subsites__A_case_control_study_from_Germany_ L2 - http://www.diseaseinfosearch.org/result/4098 DB - PRIME DP - Unbound Medicine ER -