Cancer Causes & Control

, Volume 22, Issue 7, pp 1037–1046 | Cite as

Alcohol and tobacco, and the risk of cancers of the upper aerodigestive tract in Latin America: a case–control study

  • K. Szymańska
  • R. J. Hung
  • V. Wünsch-Filho
  • J. Eluf-Neto
  • M. P. Curado
  • S. Koifman
  • E. Matos
  • A. Menezes
  • L. Fernandez
  • A. W. Daudt
  • P. Boffetta
  • P. BrennanEmail author
Original paper



Cancers of the upper aerodigestive tract (UADT; including oral cavity, pharynx, larynx and oesophagus) have high incidence rates all over the world, and they are especially frequent in some parts of Latin America. However, the data on the role of the major risk factors in these areas are still limited.


We have evaluated the role of alcohol and tobacco consumption, based on 2,252 upper aerodigestive squamous-cell carcinoma cases and 1,707 controls from seven centres in Brazil, Argentina, and Cuba.


We show that alcohol drinkers have a risk of UADT cancers that is up to five times higher than that of never-drinkers. A very strong effect of aperitifs and spirits as compared to other alcohol types was observed, with the ORs reaching 12.76 (CI 5.37–30.32) for oesophagus. Tobacco smokers were up to six times more likely to develop aerodigestive cancers than never-smokers, with the ORs reaching 11.14 (7.72–16.08) among current smokers for hypopharynx and larynx cancer. There was a trend for a decrease in risk after quitting alcohol drinking or tobacco smoking for all sites. The interactive effect of alcohol and tobacco was more than multiplicative. In this study, 65% of all UADT cases were attributable to a combined effect of alcohol and tobacco use.


In this largest study on UADT cancer in Latin America, we have shown for the first time that a prevailing majority of UADT cancer cases is due to a combined effect of alcohol and tobacco use and could be prevented by quitting the use of either of these two agents.


Upper aerodigestive tract South America Tobacco Alcohol Cancer 



Upper aerodigestive tract


Squamous-cell carcinoma


Odds ratio


Confidence interval



The study was funded by the European Commission INCO-DC programme (grant no IC18-CT97-0222), with additional funding from Fondo para la Investigacion Cientifica y Tecnologica (Argentina) and Fundação de Amparo à Pesquisa no Estado de São Paulo (grant no 01/01768-2). Katarzyna Szymańska undertook the work reported in this paper during the tenure of a Postdoctoral Fellowship awarded by the International Agency for Research on Cancer. The authors thank Valerie Gaborieau from IARC for technical help and Mathieu Boniol from IARC (now at IPRI, France) for valuable statistical advice.


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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • K. Szymańska
    • 1
  • R. J. Hung
    • 1
    • 9
  • V. Wünsch-Filho
    • 2
  • J. Eluf-Neto
    • 2
  • M. P. Curado
    • 1
    • 3
    • 11
  • S. Koifman
    • 4
  • E. Matos
    • 5
  • A. Menezes
    • 6
  • L. Fernandez
    • 7
  • A. W. Daudt
    • 8
  • P. Boffetta
    • 1
    • 10
    • 11
  • P. Brennan
    • 1
    Email author
  1. 1.International Agency for Research on Cancer (IARC)Lyon CedexFrance
  2. 2.Universidade de São PaoloSão PaoloBrazil
  3. 3.Goiania Cancer RegistryGoianiaBrazil
  4. 4.School of Public HealthRio de JaneiroBrazil
  5. 5.University of Buenos AiresBuenos AiresArgentina
  6. 6.Federal University of PelotasPelotasBrazil
  7. 7.Institute of Oncology and RadiobiologyLa HavanaCuba
  8. 8.Clinical Hospital of Porto AlegrePorto AlegreBrazil
  9. 9.Samuel Lunenfeld Research Institute of Mount Sinai HospitalTorontoCanada
  10. 10.The Tisch Cancer Institute, Mount Sinai School of MedicineNew YorkUSA
  11. 11.International Prevention Research InstituteLyonFrance

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