Influence of tobacco and alcohol on the stage of laryngeal cancer at diagnosis

Objective: This study sought to examine the influence of cigarette smoking and alcohol consumption on the stage of laryngeal cancer at diagnosis. Stud y Design: A retrospective review of 499 laryngeal cancer patients diagnosed between 1978 and 1997 was conducted Methods: Parameters that included smok ing history, history of alcohol consumption, and the tumor stage and locati on at diagnosis were analyzed using the proportional odds model, correlatio n coefficient, and Student t test, Results: Three hundred sixteen patients met the inclusion criteria, and 180 (56%) had advanced-stage disease at the time of presentation. The statistical model demonstrated a small but signi ficant relationship between tobacco and alcohol on the stage of laryngeal c ancer at diagnosis. Patients diagnosed with an advanced-stage tumor (stage III or IV) smoked a significantly greater amount and were more likely to be heavy drinkers than those diagnosed with a localized laryngeal cancer. Con clusions: Our results demonstrate that for every incremental increase in pa ck years of smoking there is a small but measurable increase in the odds th at a patient's laryngeal cancer will be stage III or TV at diagnosis. Likew ise, being a "heavy" drinker as opposed to a "social" drinker raises the Li kelihood of an advanced tumor. Given the preventable nature of these risk f actors, the moderation of alcohol consumption and cessation of smoking is p rudent advice that should be conveyed to all patients.