TOBACCO USE AND NASOPHARYNGEAL CARCINOMA IN A COHORT OF UNITED-STATESVETERANS

The risk of nasopharyngeal carcinoma (NPC), a relatively rare neoplasm in the United States, was examined in relation to tobacco use in a co hort of nearly 250,000 US veterans whose mortality experience was foll owed for 26 years. A total of 48 NPC deaths were identified during the follow-up period. Current smokers had a nearly 4-fold increase in ris k of NPC compared with non-users of any tobacco, with risk increasing to 6.4 among those smoking more than 2 packs daily. After adjustment f or age and number of cigarettes smoked, risks were inversely associate d with age at starting to smoke, with the highest risk observed among those who started smoking before age 15, although no clear trend assoc iated with duration of smoking was observed. Former cigarette smokers had a small excess risk of NPC, but no association was detected for ci gar/pipe users. This study adds strong evidence to the increasing lite rature linking cigarette smoking to NPC. (C) 1993 Wiley-Liss, Inc.