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. Author manuscript; available in PMC: 2011 Nov 1.
Published in final edited form as: Eur J Cancer Prev. 2010 Nov;19(6):431–465. doi: 10.1097/CEJ.0b013e32833d936d

Table 2.

Case-Control Studies on Alcohol and Oral Cavity and Pharyngeal Cancers

Ref
No.		 Reference, study
location and period		 Organ site
(ICD code)		 Characteristics of
cases		 Characteristics
of controls		 Exposure
assessment		 Exposure categories Relative risk 95% CI Adjustme
nt factors
in study
design or
analysis		 Comments
Oral Cavity Cancer Only
20 Zheng, et al. (1990)
Beijing, China (PRC), 1988–89		 Oral cavity (ICD9 141, 143–145) 404 (248 men, 156 women) cases diagnosed at seven participating hospitals in the Beijing area; histologically confirmed; 100% response rate 404 randomly selected non-cancer hospital-based controls, individually matched on age, sex, hospital; 100% response rate Interviewer-administered standardized questionnaire Total alcohol in spirit equivalent
Never
Ever
Ex-drinkers Current
   0–26 g/day
   26–49
   50–99
   >99


1
1.53
1.15
1.59
1.33
1.14
1.37
2.78



1.02–2.30
0.55–2.43
1.05–2.42
0.74–2.34
0.63–2.07
0.71–2.62
1.22–6.32		 Age, sex, education, smoking Looked at type of alcohol and joint effects with smoking
19 Zheng, et al. (1997)
Beijing, China (PRC), 1988–89		 Tongue 111 (65 men, 46 women) cases diagnosed at seven participating hospitals in the Beijing area; aged 20–80 yrs; histologically confirmed; 111 randomly selected non-cancer hospital-based controls, excluded patients of alcohol and tobacco-related conditions; individually matched on age, sex, hospital Interviewer-administered standardized questionnaire Total alcohol in spirit equivalent
Never
Ever
Ex-drinkers Current
   0–50 g/day
   50
   >50

Years of drinking
Never drinker
≤25 years
>25


1
1.17
0.94
1.20
1.20
0.69
1.63



1

1.24
1.26



0.59–2.38
0.28–3.22
0.58–2.50
0.45–3.18
0.21–2.26
0.60–4.44





0.54–2.83
0.56–2.83		 Education, smoking Part of Zheng (1990) study;

Looked at type of alcohol and joint effects with smoking
18 Rao, et al. (1998)
Bombay, India, 1980–84		 Tongue
(ICD 1410, 141–4)		 637 male cases from the hospital 635 hospital-based unmatched controls free from cancer, infectious disease, benign lesion Interviewer-administered questionnaire before clinical examination Total alcohol
Frequency
Non-user
Once/day

Twice

Years of drinking
Non-user
1–10 years

11–20

21–30

31+ 		Anterior/base tongue
1/1
1.5/1.5

3.7/1.1



1/1
1.2/1.5

2.0/1.6

3.3/2.0

1.3/0.5


0.9–2.5/1.1–2.3
1.7–10.8/0.4–3.1



0.6–2.6/0.9–2.5
0.9–4.4/0.9–2.9
1.4–8.9/1.0–4.6
0.3–4.8/0.2–1.4
14 Balaram, et al. (2002)
Southern, India, 1996–99		 Oral cavity 591 (309 men, median age 56 yrs; 282 women, median age 58) cases from 3 center in Bangalore, Madras, and Trivandrum; response rate 97% 582 (292 men, dedian age 55 yrs; 290 women, median age 52 yrs) hospital-based controls from the same hospitals as cases; frequency matched by center, age and sex; response rate 90% Interviewer (social worker)-administered questionnaire Total alcohol
Men only
Abstainers
Former (abstained 12+ months)
Current
<3 drinks/wk
3–13
≥ 14
p for trend

Years since quit drinking
Current
< 10
≥ 10
χ2 for trend

1
1.78



2.17
2.14
1.97




1
0.94
0.62
0.36


0.97–3.28



1.00–4.69
0.89–5.19
0.85–4.57
0.01




0.43–2.09
0.19–2.05
p=0.55		 Center, age, education, paan chewing, smoking Looked at alcohol cessation and joint effects with paan chewing
Pharyngeal Cancer Only
23 Tuyns, et al. (1988)
Italy, Spain, Switzerland, France
1980–83		 Hypopharynx (ICD 9 148.0–148.1, 148.3, 149.8) 281 male cases from Turin and Varese (Italy), Navarra and Zaragoza (Spain), Geneva (Switzerland), Calvados (France); histologically confirmed; response rate 75% (Spain and Italy) and 92% (Geneva) 3,057 male population controls stratified by age from census lists, electoral lists, or population registries; response rate 75% (64% in Geneva and 56% in Turin) Interviewer-administered questionnaire Total alcohol
0–20 g/day
21–40
41–80
81–120
121+
1
1.57
3.15
5.59
12.54

0.72–3.42
1.58–6.24
2.79–11.21
6.29–25.00		 Age, place, age/place interaction Looked at joint effects with smoking
22 Nam, et al. (1992)
USA, 1986		 Nasopharynx 204 (141 men, 63 women) whites from the National Mortality Followback Survey who died of NPC, age <65 yrs; 89% overall response rate for whole study population 408 (282 men, 126 women) randomly selected (2:1 controls:cases) whites from the same survey, matched on age and sex; died from causes unrelated to smoking or alcohol use Questionnaire from next of kin Total alcohol
0–3 drinks/week
4–23

≥24

p for trend 		Men/Women
1/1

1.1/1.2

1.9/7.3


0.6–1.8/0.4–3.1
1.1–3.2/2.1–32.5
0.007 / <0.001		 Gender, cigarette use Looked at joint effects with smoking
26 Maier, et al. (1994)
Heidelberg, Germany, 1990–91		 Oropharynx and hypopharynx 105 male cases from the Otorhinolaryngology-Head and Neck Surgery Dept. of the University of Heidelberg; histologically confirmed 420 outpatient males without known cancer from the same center as cases; matched (4:1 controls:cases) on age and residential area Interviewer-administered standardized questionnaire Total alcohol
<25 g/day
25–50
50–75
75–100
>100
X2 for trend
1
3.5
12.9
54.7
125.2
70.59

1.4–8.6
4.7–35.6
13.5–221.0
28.4–551.6
p=0.0001		 Tobacco smoking Beer is preferred alcoholic beverage in area
24 Cheng, et al. (1999)
Taipei, Taiwan,
1991–94		 Nasopharynx 375 (260 men, 115 women) from 2 teaching hospitals in Taipei; histologically confirmed; 99% response rate 327 (223 men, 104 women) population controls with no history of NPC using the National Household Registration System, individually matched on age, sex, residence; 88% response rate Interviewer-administered structured questionnaire Drinking status
Never
Former
Current

Total alcohol
0 g of ethanol/day
0– <15
≥15
p for trend

Years of drinking
Non-drinker
<15
≥15
p for trend

1
1.6
0.8


1

0.7
1.1




1
10.7
1.1


0.6–4.5
0.6–1.2




0.5–1.2
0.7–1.7
0.9




0.4–1.2
0.7–1.6
0.9		 Age, sex, race, education, family history of NPC, smoking
25 De Stefani, et al. (2004)
Montevideo, Uruguay, 1997–2003		 Hypophyranx 85 males cases identified in the four major hospitals in Montevideo; microscopically confirmed; 97.5% response rate 640 hospital-based male controls from the same hospitals as cases; excluded patients of alcohol and tobacco-related conditions with no recent changes in diet; frequency matched (2:1 controls:cases) on age and residence; 97% response rate Interviewer-administered questionnaire Total alcohol
Never
Former
Current
   1–60 ml
   ethanol/day
   61–120
   121–240
   241+
   p for trend

Years of drinking
Never
1–29 years
30–39
40–49
50+
p for trend

Years since quit drinking
Current
1–4 years
5–9
10+
Never
p for trend
1
5.8
6.0
2.3

7.6
5.6
12.8




1
5.1
3.9
8.2
7.9




1
1.4
1.3
0.4
0.2

1.7–19.3
2.0–18.0
0.7–8.1

2.3–24.4
1.7–18.6
4.0–41.2
<0.0001




1.5–17.4
1.2–12.9
2.5–26.5
2.3–27.8
0.0005




0.6–3.2
0.4–4.3
0.1–1.5
0.1–0.5
0.0007		 Age, residence, urban/rural status, education, BMI, smoking Looked at cessation of alcohol, type of alcohol, and joint effects with smoking
Oral Cavity and Pharyngeal Cancer
17 Franceschi, et al. (1990)
Milan & Pordenone, Italy, 1986–89		 Oral cavity
(ICD9 140, 141, 143–145)		 157 men identified from hospitals in Milan and Pordenone; below age 75 yrs; histologically confirmed; response rate 98% 1272 hospital-based non-cancer male patients from same hospitals as cases matched on age and area of residence; excluded patients of alcohol and tobacco-related conditions; response rate 97% Interviewer-administered questionnaire Total alcohol
≤ 19 drinks/wk
20–34
35–59
60+
χ2 for trend

Years of drinking
<30 years
30–39
40+
χ2 for trend
1

1.1
3.2
3.4
18.74



1
1.2
0.7
1.28


0.5–2.5
1.6–6.2
1.7–7.1
p<0.01




0.7–2.0
0.4–1.3
NS		 Age, area of residence, education, occupation, smoking habits Also looked at pharyngeal cancers; Looked at type of alcohol and joint effects with smoking
Pharynx, hypopharynx/
larynx junction included
(ICD9 146, 148, 161.1)		 134 men, below age 75 yrs; histologically confirmed; response rate 98% overall for cases 1272 hospital-based non-cancer male patients from same hospitals as cases matched on age and area of residence; excluded patients of alcohol and tobacco-related conditions; response rate 97% Interviewer-administered questionnaire Total alcohol
≤ 19 drinks/wk
20–34
35–59
60+
χ2 for trend

Years of drinking
<30 years
30–39
40+
χ2 for trend
1

0.9
1.5
3.6
21.66



1
1.1
0.9
0.16


0.4–2.0
0.8–3.1
1.8–7.2
p<0.01




0.6–2.1
0.4–1.8
NS		 Age, area of residence, education, occupation, smoking habits Also looked at oral cancers; Looked at type of alcohol and joint effects with smoking
15 Choi, et al. (1991)
Seoul, Korea, 1986–89		 Oral cavity (ICDO 140, 141, 143–145) 157 (113 men, 44 women) cases from the Korea Cancer Center Hospital (KCCH); cytological and/or histopathological confirmation 471 (339 men, 132 women) hospital-based non-cancer controls from KCCH matched (3:1 controls: cases) on age, sex, admission date; excluded patients of alcohol and tobacco-related conditions Interviewer-administered standardized questionnaire in hospital Total alcohol1
Non-drinker
<1 hop/day
1–2 hop/day
2–4 hop/day
>4 hop/day		 Men only

1
0.59
3.61
4.23
14.82


0.25–1.40
1.82–7.17
2.13–8.40
5.03–43.67		 Smoking Looked at pharynx also;

1 1 hop=90 ml of soju [generally 20% alcohol, 14 g of ethanol]

Soju is most frequent alcohol type
Pharynx (ICDO 146–149) 152 (133 men, 19 women) cases from the Korea Cancer Center Hospital (KCCH); cytological and/or histopathological confirmation 456 (399 men, 57 women) hospital-based non-cancer controls from KCCH matched (3:1 controls: cases) on age, sex, admission date; excluded patients of alcohol and tobacco-related conditions Interviewer-administered questionnaire Total alcohol1
Non-drinker
<1 hop/day
1–2 hop/day
2–4 hop/day
>4 hop/day 		Men only

1
1.22
2.16
4.07
11.23


0.60–2.50
1.13–4.15
2.11–7.85
4.23–29.83		 Smoking Looked at oral cavity also

1 1 hop=90 ml of soju [generally 20% alcohol, 14 g of ethanol]

Soju is most frequent alcohol type
21 Znaor, et al. (2003)
Chennai & Trivandrum, India, 1993–99		 Oral cavity
(ICD9 140, 141, 143–5)		 1563 male cases from the Cancer Institute (Chennai) and the Regional Cancer Center (Trivandrum); histologically confirmed 1,711 male patients with non-tobacco-related cancers from same centers as cases and 1927 healthy male hospital visitors from only Chennai Interviewer-administered questionnaire Total alcohol
Average amount of ethanol
Never drinker
0–<20 ml/day
20–50
>50

Years of drinking
Never drinker
<20 years
20–29
30–39
≥40



1

1.23
2.40
2.98



1

1.79
2.06
2.20
2.51





0.98–1.54
1.87–3.06
2.34–3.80





1.44–2.21
1.62–2.62
1.62–3.00
1.51–4.16		 Age, center, education, smoking Looked at pharynx also; Looked at type of alcohol and joint effects with smoking and chewing
Pharynx
(ICD9 146, 148, 149)		 636 male cases from the Cancer Institute (Chennai) and the Regional Cancer Center (Trivandrum); histologically confirmed 1,711 male patients with non-tobacco-related cancers from same centers as cases and 1927 healthy male hospital visitors from only Chennai Interviewer-administered questionnaire Total alcohol
Average amount of ethanol
Never drinker
0–<20 ml/day
20–50
>50

Years of drinking
Never drinker
<20 years
20–29
30–39
≥40




1
1.09
2.34
3.60



1

1.36
2.46
2.95
3.06





0.80–1.49
1.71–3.21
2.70–4.82





1.01–1.83
1.83–3.30
2.06–4.21
1.72–5.45		 Age, center, education, smoking Looked at oral cavity; Looked at type of alcohol and joint effects with smoking and chewing
16 De Stefani, et al. (2007)
Montevideo, Uruguay, 1988–2000		 Oral cavity (excluding lip) 335 males cases identified in the four major hospitals in Montevideo; microscopically confirmed; 97% response rate 1501 hospital-based non-cancer male controls; excluded patients of alcohol and tobacco-related conditions with no recent changes in diet; 97% response rate Interviewer-administered questionnaire in hospital Total alcohol
Never
Ever
Former
Current
   1–60 ml ethanol/day
   61–120
   121–240
   241+
   p for trend

Years of drinking
Never
1–29 years
30–39
40–49
50+
p for trend
1
3.3
3.0
3.4
1.2

4.3
4.9
7.0




1
2.5
3.9
3.4
3.3

2.2–4.8
1.9–4.7
2.3–5.2
0.8–2.0

2.7–6.8
3.1–7.9
4.2–11.5
<0.0001




1.5–4.2
2.5–6.2
2.1–5.4
2.0–5.5
<0.0001		 Age, residence, urban/rural status, hospital, year of diagnosis, education, family history of cancer, occupation, vegetable and fruit consumption, mate, smoking Looked at pharynx also; Looked at type of alcohol and joint effects with smoking
Pharynx (excluding nasopharynx) 441 males cases identified in the four major hospitals in Montevideo; microscopically confirmed; 97% response rate 1501 hospital-based non-cancer male controls; excluded patients of alcohol and tobacco-related conditions with no recent changes in diet; 97% response rate Interviewer-administered questionnaire Total alcohol
Never
Ever
Former
Current
   1–60 ml ethanol/day
   61–120
   121–240
   241+
   p for trend

Years of drinking
Never
1–29 years
30–39
40–49
50+
p for trend
1
4.3
3.9
4.5
1.4

4.4
7.9
11.7




1
3.3
4.8
4.6
4.7

2.9–6.4
2.5–6.1
3.0–6.8
0.9–2.2

2.8–7.0
5.0–12.3
7.2–18.9
<0.0001




2.0–5.3
3.0–7.5
2.9–7.1
2.9–7.6
<0.0001		 Age, residence, urban/rural status, hospital, year of diagnosis, education, family history of cancer, occupation, vegetable and fruit consumption, mate, smoking Looked at oral cavity also; Looked at type of alcohol and joint effects with smoking
57 Marron, et al. (2009)
International Consortium of Head and Neck Cancer.
Combined analysis of 13 studies from US, South and Central American, European countries		 Oral cavity
(ICD9 140, 141, 143–5)






Oro-pharynx/ Hypo-pharynx
(ICD9 146, 148)		 3,390 cases








3,875 cases		 12,593 controls








12,593 controls		 Interview or self-administrated questionnaire Years since quit drinking
Current
>1–4 years
5–9
10–19
20+
Never
p for trend

Years since quit drinking
Current
>1–4 years
5–9
10–19
20+
Never
p for trend

1
0.81
0.77
0.66
0.45
0.65




1
1.04
0.95
1.15
0.74
0.65


0.61–1.07
0.52–1.15
0.47–0.92
0.26–0.78
0.36–1.16
0.05




0.73–1.48
0.61–1.49
0.92–1.43
0.50–1.09
0.42–1.02
0.18		 Age, sex, race/ethnicity, education, study center, tobacco pack-years, alcohol drinking frequency Looked at alcohol cessation only.
Oral Cavity and Pharyngeal Cancer Combined
30 Blot, et al. (1988)
USA, 1984–85		 Oral cavity and pharynx (ICD9 141, 143–146, 148, 149), excluding salivary gland and nasopharynx 1,114 (762 men, 352 women) cases identified from the population-based registries covering metropolitan Atlanta (Georgia), Los Angeles and Santa Clara and San Mateo counties (California), New Jersey; aged 18–79; pathologically confirmed; 75% response rate 1,268 population controls from random-digit-dialing, aged 18–64, frequency matched on age, sex, race (black, white), 79% (under 65 yrs) and 76% (65+ yrs) response rate. Interviewer-administered structured questionnaire Total alcohol
<1 drink/wk
1–4

5–14

15–29

30+		 Men/Women
1/1
1.2/1.2

1.7/1.3

3.3/2.3

8.8/9.1		 Men/Women

0.7–2.0/0.7–1.9
1.0–2.7/0.8–2.1
2.0–5.4/1.2–4.5
5.4–14.3/3.9–21		 Age, race, study location, smoking, respondent status (self vs. proxy) Looked at type of alcohol, controlling for other types, and joint effects with smoking; Association and trend similar for all oral cavity and pharynx
40 Merletti, et al. (1989)
Torino, Italy, 1982–84		 Oral cavity and oropharynx
(ICD9 140.3–140.5, 141, 143–146)		 122 (86 men, 36 women); histologically confirmed; 85% response rate 606 (385 men, 221 women) population-based controls randomly selected from files of residents, stratified by age and sex; 55% response rate Interviewer-administered standardized questionnaire Men
Total alcohol
1–20 g/day
21–40
41–80
81–120
>120

Women
Total alcohol
1–20 g/day
21–40
>40

1
0.7
1.3
0.6
2.1



1
3.0
3.4


0.2–2.6
0.4–3.8
0.2–2.1
0.6–6.8




0.9–10.5
0.9–12.9		 Age, education, area of birth, smoking habits Looked at type of alcohol and joint effects with smoking
29 Barra, et al. (1990)
Milan & Pordenone Italy, 1986–90		 Oral cavity and pharynx 305 male cases from hospitals in Pordenone and Milan; median age=58 yrs, histologically confirmed; 2% refusal rate 1621 male hospital-based non-cancer controls, median age=57 yrs, matched by area of residence and age; excluded patients of alcohol and tobacco-related conditions; 3% refusal rate Interviewer-administered questionnaire in hospital Total alcohol
≤ 20 wine/wk
22–55 drinks/wk
56–83
≥84
1
0.8

1.8
4.1

0.3–2.3

0.8–4.4
2.0–8.2		 Age, area of residence, occupation, smoking and drinking habits Includes study population from Franceschi (1990); Looked at types of alcohol
28 Barra, et al. (1991)
Pordenone, Italy, 1985–90		 Oral cavity and pharynx 272 (236 men, 36 women) cases from hospitals in Pordenone, median age=60 yrs, histologically confirmed; 3% refusal rate 1,884 (1122 men, 762 women) non-cancer, hospital-based controls, median age=58 yrs, matched by area of residence and age; excluded patients of alcohol and tobacco-related conditions; 3% refusal rate Interviewer- administered questionnaire in hospital Total alcohol

≤ 20 drinks/wk
21–34
35–55
56–83
≥ 84
p for trend 		Non-cancer controls
1

2.2
2.4
6.6
11.4



1.2–4.0
1.2–4.7
3.5–12.5
6.0–21.4
<0.01		 Age, sex, education, occupation, tobacco Includes study population from Barra (1990) study;
Also compared results to cancer control group with similar results;
Looked at types of alcohol
45 Maier, et al. (1992)
Heidelberg & Giessen, Germany, 1987–88		 Oral cavity, pharynx, larynx 200 male cases from the departments of ENT of the Universities of Heidelberg and Giessen; histologically confirmed 800 outpatient males without known cancer matched on age and residential area (4:1 controls:cases) Interviewer-administered questionnaire Total alcohol
<25 g/day
25–50
50–75
75–100
>100
1
1.7
6.7
16.2
21.4

1.0–2.7
3.9–11.3
7.1–36.8
11.2–40.6		 Tobacco smoking Beer is preferred alcoholic beverage in area;
Looked at joint effects with smoking
38 Marshall, et al. (1992)
New York, USA, 1975–83		 Oral cavity and pharynx 290 (201 men, 89 women) cases identified from pathology records of 20 major hospitals in Erie, Niagara, Monroe (New York); aged 45 yrs or younger; pathologically confirmed; response rate of those contacted 60% 290 (201 men, 89 women) population controls individually matched on age, sex, neighborhood; response rate 41% Interviewer-administered standardized questionnaire Quantity-frequency-duration derived quintiles
1
2
3
4
5
p for trend




1
2.4
2.7
3.4
14.8





1.1–5.2
1.2–6.1
1.6–7.4
6.8–32.3
<0.0001		 Excluded black cases from analysis
39 Mashberg, et al. (1993)
New Jersey, USA, 1972–83		 Oral cavity and oropharynx 359 white and black male veterans with invasive cancer and in situ carcinoma identified in the Department of Veterans Affairs Medical Center; median age: 57 yrs; histologically confirmed 2,280 white or black male patients from the same center as cases of the same age range as cases (37–80 yrs); median age:58 yrs; excluding patients with cancer or dysplasia of the pharynx, larynx, lung, esophagus Interviewer-administered standardized questionnaire Total alcohol (in whiskey equiv./day)1
Minimal
2–5 WE/day
6–10
11–21
22+
Ex-drinker (abstained 2+ yrs)


1
2.6
6.4
7.9
7.1
1.9



1.4–4.7
3.7–11.0
4.6–13.4
4.1–12.2
0.6–5.7		 Age, race, tobacco smoking Looked at type of alcohol and joint effects with smoking

11 whiskey equivalent is 10.2 g of alcohol
35 Kabat, et al. (1994)
USA, 1977–90		 Oral cavity and pharynx (excluding nasopharynx) 1,560 (1,097 men, 463 women) cases enrolled in 28 hospitals in 8 US cities 2,948 (2,075 men, 873 women) hospital-based controls matched on age, sex, race, hospital, date of interview Interviewer-administered questionnaire Total alcohol
(whiskey equiv.)
Non-drinker
Occasional

1–3.9 oz/day

4–6.9

7+		 Men/Women


1/1
1.4/1.2

2.9/1.8

4.7/4.8

7.3/--		 Men/Women



0.9–2.0/0.9–1.6
2.0–4.2/1.3–2.6
3.2–7.1/2.9–7.8
5.1–10.7/---		 Age, education, smoking, race, time period, type of hospital Looked at type of alcohol and joint effects with smoking

1 oz WE=10.2 g of alcohol
42 Sanderson, et al. (1997)
Netherlands, 1980–90		 Oral cavity and oropharynx (excluding salivary glands and lip) 303 women aged ≥40 yrs from the University Hospital’s Head Cancer Center 1779 women controls from a national survey by National Central Bureau of Statistics matched on age Hospital records (cases) and national survey (controls) Total alcohol
Non-drinker
1–5 units1/day
>5
1
3.5

20.8

2.5–4.8

11.4–37.8		 Age, tobacco smoking Looked at joint effects with smoking

11 alcohol unit = 330 ml beer, 150 ml wine or 30 ml spirit
34 Hayes, et al. (1999)
Puerto Rico, 1992–95		 Oral cavity and pharynx (excluding lip, salivary glands, nasopharynx) (ICD9 141–143–146, 148, 149) 342 (286 men, 56 women) identified through pathology laboratories and Central Cancer Registry, aged 21–79 yrs; histologically confirmed; 70% response rate 521 (417 men, 104 women) population-based controls frequency matched by age and gender; 83% response rate Interviewer-administered questionnaire Total alcohol
Non-drinker
1–7 drinks/week
8–21

22–42

>42
p for trend

Years since last drank alcohol
Non-drinker
Recent use (<2 yr)
Quit 2–9 yr

Quit 10–19 yr

Quit 20+ yr		 Men/Women
1/1
0.8/0.8

1.4/0.9

3.3/9.1

7.7/--


Men/Women


1/1
2.4/1.2

3.6/1.0

2.7/1.1

1.3/0.9

0.3–2.1/0.3–2.1
0.6–3.4/0.0–17.0
1.4–8.0/0.9–94.2
3.3–17.9/---
<0.0001/0.02





1.0–5.4/0.4–3.4
1.5–9.0/0.2–5.4
1.0–7.0/0.2–6.4
0.5–3.6/0.2–4.8		 Age, tobacco use Looked at cessation of alcohol and joint effects with smoking
32 Franceschi, et al. (2000)
Italy & Switzerland, 1992–97		 Oral cavity and pharynx
(excluding lip, salivary glands, nasopharynx)		 754 (638 men, 116 women) cases from major teaching and general hospitals in Pordenone, Rome, Latina (Italy) and Vaud (Switzerland); aged 22–77, 95% response rate, histologically confirmed 1,775 (1,254 men, 521 women) hospital-based non-cancer controls from the same network of hospitals as cases; excluded tobacco and alcohol-related conditions; frequency matched (5:1 for women, 2:1 for men controls:cases) on age, sex, area of residence; response rate 95% Interviewer-administered questionnaire Total alcohol
Never
1–20 drinks/wk
21–62
63–90
≥ 91
X2 for trend

Years of drinking
≤ 27 years
28–35
36–44
≥ 45
X2 for trend

Years since quit drinking
Current
1–3 years
4–6
7–10
≥ 11
χ2 for trend
1
0.7

2.4
8.0
11.6
167.4



1
1.0
1.1
0.9
0.15




1
1.2
1.8
3.3
1.9
1.6

0.4–1.1

1.5–3.9
4.6–14.2
6.3–21.5
p<0.001




0.7–1.5
0.7–1.7
0.5–1.5
p=0.70





0.6–2.4
1.0–3.5
1.5–7.3
1.0–3.8
p=0.21		 Age, sex, study center, education, interviewer, tobacco smoking Study population from Franceschi (1999);
Looked at alcohol cessation
33 Garrote, et al. (2001)
Havana, Cuba, 1996–99		 Oral cavity and oropharynx 200 (143 men, 57 women) cases identified in the Instituto Nacional de Oncologia y Radiobiologia (INOR) of Havana; median age 64 yrs; 88% response rate 200 (136 men, 64 women) hospital-based controls admitted to INOR and 3 other major hospitals in Havana; excluded patients of alcohol and tobacco-related conditions; frequency matched on age and sex; median age 62 yrs; 79% response rate Interviewer (dentist)-administered questionnaire Total alcohol
Abstainers
Former (abstained 12+ months)
Current
   <7 drinks/week
   7–20
   21–69
   70+
   X2 for trend

Years of drinking
<33 years
33–44
≥45
χ2 for trend
1
1.04



1.09

1.60
2.20
5.73
8.75



1
1.98
1.81
0.56

0.52–2.06



0.46–2.57

0.70–3.67
0.89–5.45
1.77–18.52
p<0.01




0.93–4.22
0.85–3.87
p=0.46		 Age, sex, area of residence, education, smoking Looked at cessation of alcohol, type of alcohol, and joint effects with smoking
43 Schwartz, et al. (2001)
Washington, USA, 1985–95		 Oral cavity and oropharynx (excluding lip) 333 (237 men, 96 women) cases of in situ and invasive cancers ascertained through the population-based Cancer Surveillance System (participant of SEER), aged 18–65 from two original studies; response rate 54% and 63% 541 (387 men, 154 women) population-based controls frequency matched on age and sex; response rate 63% and 61% Interviewer-administered structured questionnaire Total alcohol
<1 drink/week
1–7
8–14
15–42
≥43
1

1.0
1.7
2.8
4.7


0.6–1.5
1.0–2.9
1.7–4.8
2.4–9.4		 Age, sex, race, smoking Looked at joint effects with smoking and ADH3
27 Altieri, et al. (2004)
Itlay and Switzerland, 1992–97		 Oral cavity and pharynx 749 (634 men, 115 women) cases from Pordenone, Rome, Latina (Italy) and Vaud (Switzerland) admitted to major teaching and general hospitals in area under surveillance; aged 22–77; histologically confirmed 1,772 (1,252 men, 520 women) hospital-controls from the same network of hospitals as cases; aged 20–78 yrs; excluded patients of alcohol and tobacco-related conditions Interview-administered structured questionnaire Total alcohol
1–2 drinks/day
3–4
5–7
8–11
≥12
X2 for trend
1

2.1
5.0
12.2
21.1
272.07


1.5–2.9
3.5–7.1
8.4–17.6
14.0–31.8
p<0.0001		 Age, sex, study center, education, smoking habit Looked at type of alcohol
31 Castellsague, et al. (2004)
Spain, 1996–99		 Oral cavity and oropharynx
(ICDO C1–C10)		 375 (304 men, 71 women) cases identified from hospitals in Granada (1), Sevilla (1), Barcelona (2); mean age 60 yrs; histologically confirmed; 76.5% response rate 375 (304 men, 71 women) non-cancer hospital-controls from same hospitals as cases, frequency matched on age and sex, mean age 60 yrs; excluded patients with alcohol and tobacco-related diagnoses; 91% response rate Interviewer-administered standardized questionnaire in hospital Total alcohol
Never drinker
Ever
Ex-drinker
Current
   1 drink/day
   2
   3–4
   5–6
   7–10
   ≥ 11
   p for trend

Years of drinking
Never drinker
1–20 years
21–30
31–40
41–50
≥ 51
p for trend

Years since quit drinking
Never drinker
Current
1–2
3–7
8–13
≥ 14
p for trend
1

2.86
2.12
3.46
2.00
3.74
6.22
10.58
10.29
13.66




1

1.37
2.49
3.18
4.00
5.13




1

3.5
3.9
1.7
2.3
1.5


1.59–5.15
1.13–3.99
1.88–6.35
1.06–3.77
1.62–8.63
2.82–13.71
4.57–24.46
4.57–23.17
6.02–31.96
<0.0001





0.65–2.91
1.22–5.09
1.61–6.29
1.99–8.02
2.45–10.72
<0.0001





1.9–6.5
1.7–9.1
0.8–3.9
1.0–5.3
0.7–3.3
0.003		 Age group, sex, education, tobacco smoking, center Looked at type of alcohol, joint effects with smoking, and alcohol cessation
37 Llewellyn, et al. (2004a)
England, UK, 1990–97		 Oral cavity and oropharynx (excluding salivary glands, nasopharynx, hypopharynx) (ICD10 C00-C06, C09, C10) 116 (65 men, 51 women) cases identified by the Thames Cancer Registry; aged ≤45 yrs; 59% response rate 207 (112 men, 95 women) non-cancer patient controls matched (2:1 controls:cases when feasible) on age, sex, area of residence Self-completed questionnaire Total alcohol
Within recommended levels1
Over recommended levels		 Men/Women
1/1


1.6/1.6		 Men/Women



0.8–3.1/0.6–4.2		 Social class, race, ever smoking, (matching variables: age, sex, area of residence) 1Recommended levels for men: ≤ 21 units/wk, for women: ≤14 units/wk
36 Llewellyn, et al. (2004b)
England, UK, 1999–2001		 Oral cavity and oropharynx (ICD10 C00-C06, C09, C10) 53 (28 men, 25 women) cases from 14 participating hospitals in the southeast of England; aged ≤45 yrs; 80% response rate 91 (45 men, 46 women) non-cancer patient controls matched (2:1 controls:cases when feasible) on age, sex, area of residence Interviewer-administered standardized questionnaire and self-completed questionnaire Total alcohol
Within recommended levels1
Over recommended levels		 Men/Women
1/1


8.1/3.8		 Men/Women



1.6–40.1/0.7–20.7		 Social class, race, ever smoking (matching variables: age, sex, area of residence) 1Recommended levels for men: ≤ 21 units/wk, for women: ≤14 units/wk
41 Rodriguez, et al. (2004)
Italy and Switzerland,
1984–93, 1992–97		 Oral cavity and pharynx 137 (113 men, 24 women) from Milan and Pordenone, Italy (1984–93) and Vaud, Switzerland (1992–1997), below age 46 yrs; histologically confirmed; 95% response rate 298 (226 men, 72 women) non-cancer hospital-based controls, matched 2:1 (control:case) for men and 3:1 for women on age, sex, study center, below age 46 yrs; excluded patients of alcohol and tobacco-related conditions; response rate 95% Interviewer-administered questionnaire Total alcohol
Non-drinkers
<3 drinks/day
3-<6
6-<10
≥ 10
X2 for trend
1
0.70
0.99
3.69
4.94
17.53

0.27–1.78
0.35–2.81
1.23–11.08
1.62–15.10
p<0.0001		 Age, sex, study center, education, marital status, BMI, tobacco, coffee consumption Study populations from Franceschi (1990) and Franceschi (2000)

Looked at joint effects with smoking
44 Shiu, et al. (2004)
Taipei, Taiwan, 1988–98		 Oral cavity and pharynx
(ICD 140–149, excludes 142 and 147)		 74 (71 men, 3 women) randomly selected from 1,688 cancers identified at a medical center; 74% response rate 187 patients with periodontal disease free of leukoplakia and oral cancer, randomly selected from 25,882 patients; 94% response rate

164 leukoplakia patients free of oral cancer, randomly selected from 435 identified at the same medical center; 82% response rate		 Interviewer-administered questionnaire Leukoplakia vs. normal
Total alcohol
No
Yes

Oral cancer vs. leukoplakia
Total alcohol
No
Yes


1
0.76





1
2.37



0.40–1.43






1.47–3.82		 Smoking, betel quid chewing