Risk of cancers of the lung, head and neck in patients hospitalized for alcoholism in Sweden

Alcoholic patients are at increased risk of cancers of the head and neck bu t little information is available on the magnitude of the risk for specific sites and for different histological types. We followed 182 667 patients w ith a hospital discharge diagnosis of alcoholism during 1965-1994, for an a verage of 10.2 years. We compared their incidence of site- and histological type-specific cancers of the oral cavity, pharynx, larynx and lung with th at of the national population. The standardized incidence ratio (SIR) of ca ncer of the oral cavity and pharynx was 5.33 (95% confidence interval [CI] 5.04-5.64, based on 1207 cases). The SIRs of laryngeal and lung cancer were 4.21 (95% CI 3.78-4.68, 347 cases) and 2.40 (2.29-2.51, 1880 cases), respe ctively. The SIR was highest for cancers of the hypopharynx, floor of the m outh, mesopharynx and base of the tongue. The relative excess of lung cance r was similar for squamous cell carcinoma and adenocarcinoma. Low age at fi rst hospitalization was associated with higher SIRS for all sites under stu dy. 25 years after first hospitalization for alcoholism, the cumulative pro bability of developing a lung cancer was in the order of 5%, for oral and p haryngeal cancer it was 2.5%, and for oesophageal or laryngeal cancer 1% ea ch. Our study shows that the risk of head and neck cancer among heavy drink ers is highest for sites in direct contact with alcohol. The high risk of h ead and neck neoplasms may justify specific medical attention. (C) 2001 Can cer Research Campaign.