TOBACCO SMOKING, ALCOHOL-DRINKING AND DIETARY FACTORS AS DETERMINANTSOF NEW PRIMARIES AMONG MALE LARYNGEAL-CANCER PATIENTS - A CASE-COHORTSTUDY

Aims and background: The paper examines the determinants associated wi th second primary occurrence in laryngeal cancer cases. Methods: A ser ies of 220 incident male laryngeal cancer cases was interviewed 10 yea rs ago within the framework of a population-based, case-control study. The occurrence of other primaries among these patients was assessed l eans of the Lombardy Cancer Registry, which covers their area of resid ence. The relationship between tobacco, alcohol, dietary factors and t he risk of occurrence of new primaries was analyzed by means of a nest ed case-control study. Cases were defined as those subjects who develo ped a new primary, end controls as those without. Results: New primari es occurred among 36 subjects during an 8-year follow-up; 147 control cancer patients were matched for age and length of follow-up. A twofol d risk increase was associated with the highest tobacco consumption, w as registered at time of first primary; a weaker relationship, i.e. ri sk of 1.2 for alcohol the highest fertile, was seen for alcohol drinki ng. The occurrence of new primaries was also influenced by dietary hab its. In particular, those who had a high intake of monosaturated fatty acids had a one-third lower risk of developing a new primary. Conclus ions: Our results support the hypothesis that a healthy diet is protec tive among those who experience a laryngeal neoplasm and suggests that diet could be a potential preventive agent against the occurrence of new primaries among these patients.