Mouth cancers form part of a wider group of upper aerodigestive tract (UADT) cancers (oral cavity, pharynx, larynx, and oesphagus), which are strongly associated with smoking and alcohol. The aim of this review was to quantify the association between alcohol drinking and UADT cancer mortality
The Medline and ISI Web of Science databases were searched for case-control, case-cohort or cohort studies were the exposure of interest was alcohol drinking and the outcomes of interest was death from UADT cancer. Two reviewers carried out study selection and quality assessment independently. Alcohol intake was converted to grams (g) of ethanol per day as a uniform measurement and the categorical and dose–response meta- analyses were used to evaluate the association between alcohol drinking and UADT cancer mortality.
- 10 studies (2926 UADT deaths) were included (8 prospective cohort,1 nested case-control and 1 case-control study).
- 8 were conducted in Asia, 2 in North America
- Oesophogeal cancer was reported in 8 studies, Oral cancer in 2 studies, 2 pharyngeal, 1 laryngeal and one on all UADT cancer.
- Compared with non/occasional drinkers, the pooled relative risks (RRs) of UADT cancer mortality were
- 2.01 [95% confidence interval (CI) = 1.56–2.59] for any,
- 1.26 (95% CI = 0.94–1.67) for light (≤12.5 g/day)
- 1.79 (95% CI = 1.26–2.53) for moderate (12.6–49.9 g/day),
- 3.63 (95% CI = 2.63–5.00) for heavy ( ≥ 50 g/day) drinkers
- Dose–response analysis showed that the increment in daily alcohol consumption was associated with an increased risk of UADT cancer mortality continuously.
The authors concluded
This study provides evidence of a positive association between alcohol drinking and UADT cancer mortality, especially when alcohol consumption reaching moderate-to-heavy level. Thus, public health recommendation on UADT cancer prevention and control should consider limiting the intake of alcoholic beverages.
This review focuses on mortality in UADT cancer and shows a positive association between alcohol consumption and death from UADT cancers. This risk increases with increasing consumption. That alcohol consumption is a risk factor to UADT cancers has been known for many years and a selection of reviews of this area can be found in the links section. Many counties have public health recommendations for alcohol consumption and dentists can play an role in helping identify patients drinking above these levels and signpost them to appropriate services.
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