Article

Cancer Causes & Control

, Volume 12, Issue 5, pp 419-429

Mouthwash in the etiology of oral cancer in Puerto Rico

  • Deborah M. WinnAffiliated withDivision of Cancer Control and Population Sciences
  • , Scott R. DiehlAffiliated withDivision of Intramural Research and Office of the Director, National Institute of Dental and Craniofacial Research
  • , Linda M. BrownAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute
  • , Lea C. HartyAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute
  • , Eleuterio Bravo-OteroAffiliated withUniversity of Puerto Rico
  • , Joseph F. FraumeniJr.Affiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute
  • , Dushanka V. KleinmanAffiliated withDivision of Intramural Research and Office of the Director, National Institute of Dental and Craniofacial Research
  • , Richard B. HayesAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute

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Abstract

Objectives: To determine if the risk of cancers of the mouth and pharynx is associated with mouthwash use in Puerto Rico, an area of relatively high risk.

Methods: Interviews were conducted with 342 cases of oral and pharyngeal cancer registered in Puerto Rico and diagnosed between 1992 and 1995 and with 521 population-based controls regarding mouthwash use and other factors. Mouthwash-related risks were estimated using unconditional logistic regression controlling for potential confounders.

Results: The adjusted odds ratio associated with using mouthwash with an alcohol content of 25% or greater was 1.0. Risks were not higher with greater frequency, years of use, or lifetime mouthwash exposure. Among tobacco and alcohol abstainers the odds ratio associated with mouthwash use was 2.8 (CI = 0.8–9.9), in contrast to 0.8 (CI = 0.4–1.7) and 0.9 (CI = 0.6–1.3) among those with light and heavy cigarette smoking/alcohol drinking behaviors, respectively.

Conclusions: There was no overall increased risk of oral cancer associated with mouthwash use. An elevated, but not statistically significant, risk was observed among the small number of subjects who neither smoked cigarettes nor drank alcohol, among whom an effect of alcohol-containing mouthwash would be most likely evident. Our findings indicate the need to clarify the mechanisms of oral carcinogenesis, including the possible role of alcohol-containing mouthwash.

alcohol drinking epidemiology human mouth neoplasms mouthwashes pharyngeal neoplasms smoking