Positive association between alcohol drinking and upper aerodigestive tract cancers


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.


Li Y, Mao Y, Zhang Y, Cai S, Chen G, Ding Y, Guo J, Chen K, Jin M. Alcohol drinking and upper aerodigestive tract cancer mortality: A systematic review and meta-analysis. Oral Oncol. 2014 Jan 6. pii: S1368-8375(13)00803-8. doi: 10.1016/j.oraloncology.2013.12.015. [Epub ahead of print] PubMed PMID: 24405883.

de Menezes RF, Bergmann A, Thuler LC. Alcohol consumption and risk of cancer:  a systematic literature review. Asian Pac J Cancer Prev. 2013;14(9):4965-72. PubMed PMID: 24175760.

Turati F, Garavello W, Tramacere I, Pelucchi C, Galeone C, Bagnardi V, Corrao  G, Islami F, Fedirko V, Boffetta P, La Vecchia C, Negri E. A meta-analysis of alcohol drinking and oral and pharyngeal cancers: results from subgroup analyses. Alcohol Alcohol. 2013 Jan-Feb;48(1):107-18. doi: 10.1093/alcalc/ags100. Epub 2012 Sep 4. PubMed PMID: 22949102.

Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V, Scotti L, Jenab M, Turati F, Pasquali E, Pelucchi C, Bellocco R, Negri E, Corrao G, Rehm J, Boffetta P, La Vecchia C. Light alcohol drinking and cancer: a meta-analysis. Ann Oncol. 2013 Feb;24(2):301-8. doi: 10.1093/annonc/mds337. Epub 2012 Aug 21. Review. PubMed PMID: 22910838.

Li Y, Yang H, Cao J. Association between alcohol consumption and cancers in the Chinese population–a systematic review and meta-analysis. PLoS One. 2011 Apr 15;6(4):e18776. doi: 10.1371/journal.pone.0018776. Review. PubMed PMID: 21526212; PubMed Central PMCID: PMC3078147.

Islami F, Tramacere I, Rota M, Bagnardi V, Fedirko V, Scotti L, Garavello W, Jenab M, Corrao G, Straif K, Negri E, Boffetta P, La Vecchia C. Alcohol drinking  and laryngeal cancer: overall and dose-risk relation–a systematic review and meta-analysis. Oral Oncol. 2010 Nov;46(11):802-10. doi: 10.1016/j.oraloncology.2010.07.015. Epub 2010 Sep 15. Review. PubMed PMID: 20833578.

Turati F, Garavello W, Tramacere I, Bagnardi V, Rota M, Scotti L, Islami F, Corrao G, Boffetta P, La Vecchia C, Negri E. A meta-analysis of alcohol drinking  and oral and pharyngeal cancers. Part 2: results by subsites. Oral Oncol. 2010 Oct;46(10):720-6. doi: 10.1016/j.oraloncology.2010.07.010. Epub 2010 Aug 21. Review. PubMed PMID: 20728401.

Lubin JH, Purdue M, Kelsey K, Zhang ZF, Winn D, Wei Q, Talamini R, Szeszenia-Dabrowska N, Sturgis EM, Smith E, Shangina O, Schwartz SM, Rudnai P, Neto JE, Muscat J, Morgenstern H, Menezes A, Matos E, Mates IN, Lissowska J, Levi F, Lazarus P, La Vecchia C, Koifman S, Herrero R, Franceschi S, Wünsch-Filho V, Fernandez L, Fabianova E, Daudt AW, Maso LD, Curado MP, Chen C, Castellsague X, Brennan P, Boffetta P, Hashibe M, Hayes RB. Total exposure and exposure rate effects for alcohol and smoking and risk of head and neck cancer: a pooled analysis of case-control studies. Am J Epidemiol. 2009 Oct 15;170(8):937-47. doi: 10.1093/aje/kwp222. Epub 2009 Sep 10. PubMed PMID: 19745021; PubMed Central PMCID: PMC2800266.

Bagnardi V, Blangiardo M, La Vecchia C, Corrao G. Alcohol consumption and the risk of cancer: a meta-analysis. Alcohol Res Health. 2001;25(4):263-70. PubMed PMID: 11910703.

Bagnardi V, Blangiardo M, La Vecchia C, Corrao G. A meta-analysis of alcohol drinking and cancer risk. Br J Cancer. 2001 Nov 30;85(11):1700-5. PubMed PMID: 11742491; PubMed Central PMCID: PMC2363992.

Alcohol Concern

NHS Choices – Health Risks of drinking too much alcohol




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