Smoking and alcohol in the etiology of oral cancer: gender-specific risk profiles in the south of Greece

Oral and pharyngeal cancer (OC) mortality is very low in Greece, especially among men, compared to other European countries. We conducted a case-contr ol study of OC in Athens, and obtained information on tobacco, alcohol use and other potential risk factors and confounding variables for 110 incident cases and 115 hospital-based controls. We used multivariate logistic regre ssion to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Tob acco smoking (packyears, P-trend = 0.01) and alcohol use (drinks/week, P-tr end = 0.07) were independent risk factors, with a multiplicative effect for combined exposures (OR, 8.3; 95% CI, 2.4 - 29.1. for > 28 alcohol drinks/w eek and > 50 packyears of cigarette smoking). The type of alcoholic beverag e also seemed important: drinking ouzo and tsipouro (liquors of high ethano l concentration) was associated with greater increased OC risk than drinkin g comparable amounts of wine, beer or dark spirits. While alcohol drinking is more common for male cases Versus controls, few men reported regularly c onsuming large quantities of ethanol associated with highest risk of OC in other studies. This may partially explain the low rates of male OC mortalit y in Greece. Among the 38% of our cases who were women, however, neither sm oking nor alcohol drinking frequencies were significantly elevated compared to controls, and so the etiology of OC risk in females requires further in vestigation, (C) Published by Elsevier Science Ltd.