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A prospective study of tobacco and alcohol use as risk factors for pharyngeal carcinomas in Singapore Chinese
Article first published online: 21 FEB 2007
Copyright © 2007 American Cancer Society
Volume 109, Issue 6, pages 1183–1191, 15 March 2007
How to Cite
Friborg, J. T., Yuan, J.-M., Wang, R., Koh, W.-P., Lee, H.-P. and Yu, M. C. (2007), A prospective study of tobacco and alcohol use as risk factors for pharyngeal carcinomas in Singapore Chinese. Cancer, 109: 1183–1191. doi: 10.1002/cncr.22501
- Issue published online: 7 MAR 2007
- Article first published online: 21 FEB 2007
- Manuscript Accepted: 4 DEC 2006
- Manuscript Revised: 28 NOV 2006
- Manuscript Received: 12 OCT 2006
- National Cancer Institute. Grant Numbers: R01 CA55069, R35 CA53890, R01 CA80205
- The Danish Cancer Society
- The Danish Agency for Science
- The Hans and Emma Skoubys Foundation
- nasopharyngeal carcinoma;
- pharyngeal carcinoma;
Nasopharyngeal carcinoma (NPC) is a rare disease in most populations; however, in areas of Southeast Asia and North Africa and in the Arctic, undifferentiated NPC is the most frequent pharyngeal malignancy. Although smoking and alcohol have been established firmly as synergistic risk factors for other pharyngeal carcinomas, previous studies on the association between these risk factors and NPC have not been consistent. Therefore, the authors analyzed this relation in a cohort of Singapore Chinese, which is a population with a high incidence of NPC.
From 1993 to 1998, a population-based cohort of 61,320 Singapore Chinese ages 45 years to 74 years who were free of cancer completed a comprehensive interview on living conditions and dietary and lifestyle factors. By linkage to Singapore population-based registries, the cohort was followed through 2005, and cancer occurrence was determined. The relative risk of NPC and other oropharyngeal carcinomas in the cohort was investigated by using a Cox proportional hazards model.
In total, 173 NPCs and 75 other oropharyngeal carcinomas were observed during 601,879 person-years of follow-up. Smoking for >40 years was associated with a doubled risk of NPC (relative risk, 2.0; 95% confidence interval, 1.2–3.3), whereas smoking intensity, age at smoking initiation, and alcohol consumption were not associated with NPC risk. In contrast, smoking duration, smoking intensity, age at smoking initiation, and alcohol consumption all were associated with an increased risk of other oropharyngeal carcinoma (P for trend, <.0001).
Smoking and alcohol influenced the risk of NPC and other oropharyngeal carcinomas differently in a high-incidence NPC population. Long-term smoking was a risk factor for NPC, but alcohol consumption was not. Cancer 2007. © 2007 American Cancer Society.