European Journal of Epidemiology

, Volume 27, Issue 7, pp 499–517 | Cite as

Risk of upper aerodigestive tract cancer and type of alcoholic beverage: a European multicenter case–control study

  • Manuela MarronEmail author
  • Paolo Boffetta
  • Henrik Møller
  • Wolfgang Ahrens
  • Hermann Pohlabeln
  • Simone Benhamou
  • Christine Bouchardy
  • Pagona Lagiou
  • Areti Lagiou
  • Alena Slámová
  • Miriam Schejbalová
  • Franco Merletti
  • Lorenzo Richiardi
  • Kristina Kjaerheim
  • Antonio Agudo
  • Xavier Castellsague
  • Tatiana Victorovna Macfarlane
  • Gary John Macfarlane
  • Renato Talamini
  • Luigi Barzan
  • Cristina Canova
  • Lorenzo Simonato
  • Anne-Marie Biggs
  • Peter Thomson
  • David Ian Conway
  • Patricia Ann McKinney
  • Ariana Znaor
  • Claire Marie Healy
  • Bernard Eugene McCartan
  • Paul Brennan
  • Mia Hashibe


The general relationship between cancers of the upper aerodigestive tract (UADT) and alcohol drinking is established. Nevertheless, it is uncertain whether different types of alcoholic beverages (wine, beer and liquor) carry different UADT cancer risks. Our study included 2,001 UADT cancer cases and 2,125 controls from 14 centres in 10 European countries. All cases were histologically or cytologically confirmed squamous cell carcinomas. Controls were frequency matched by sex, age and centre. Logistic regression models were used to estimate odds ratios (OR) and 95 % confidence intervals (95 %CI) adjusted for age, sex, centre, education level, vegetable and fruit intake, tobacco smoking and alcohol drinking, where appropriate. Risk of beverage-specific alcohol consumption were calculated among ‘pure drinker’ who consumed one beverage type exclusively, among ‘predominant drinkers’ who consumed one beverage type to more than 66 % and among ‘mixed drinkers’ who consumed more than one beverage type to similar proportions. Compared to never drinkers and adjusted for cumulative alcohol consumption, the OR and 95 %CI for wine, beer and liquor drinking, respectively, were 1.24 (0.86, 1.78), 1.54 (1.05, 2.27) and 0.94 (0.53, 1.64) among ‘pure drinkers’ (p value for heterogeneity across beverage types = 0.306), 1.05 (0.76,1.47), 1.25 (0.87,1.79) and 1.43 (0.95, 2.16) among ‘predominant drinkers’ (p value = 0.456), and 1.09 (0.79, 1.50), 1.20 (0.88, 1.63) and 1.12 (0.82, 1.53) among ‘mixed drinkers’ (p value = 0.889). Risk of UADT cancer increased with increasing consumption of all three alcohol beverage types. Our findings underscore the strong and comparable carcinogenic effect of ethanol in wine, beer and liquor on organs of the UADT.


Epidemiology Cancer Alcohol Wine Beer Liquor Head and neck cancer Upper aerodigestive tract cancer 



We gratefully acknowledge the study interviewers, data manager and our clinical colleagues in hospitals and primary care, who supported this study and especially, we thank the study participants and their families for their participation. We acknowledge the help of Prof. Martin Tickle in study conduct in the Manchester center and Professor Phil Sloan and Professor Nalin Thakker who in addition coordinated sample collection and processing for all the UK centers. GJM and TVM partly worked on this study while at the University of Manchester. In Glasgow, we acknowledge the clinical support of Dr Gerry Robertson and Mr John Devine and their colleagues. We are deeply thankful to Drs R. Mele and L. Forner for providing hospital controls and S. Sulfaro for pathology support from General Hospital of Pordenone (Italy). In Dublin, we acknowledge the clinical support of Prof. J. Reynolds, Prof. C. Timon and their colleagues. The Aviano center thanks Mrs O. Volpato for study coordination, Ms G.Bessega, L. Zaina, for their help in data collection and Drs S. Sulfaro and D. Politi for providing hospital case patients. We thank Kate Soldan who put in a lot of work in developing the infrastructure of this project at IARC. This work was supported by funding received from: European Community (5th Framework Programme) grant no. QLK1-CT-2001-00182; University of Athens Medical School and Bureau of Epidemiologic Research Academy of Athens for the Athens center; Padova University (Contract No CPDA057222) for the Padova center; Compagnia San Paolo, Associazione Italiana per la Ricerca sul Cancro, for the Turin center. MM was sponsored by a special training award at the IARC.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10654_2012_9699_MOESM1_ESM.pdf (218 kb)
Supplementary material 1 (PDF 218 kb)


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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Manuela Marron
    • 1
    Email author
  • Paolo Boffetta
    • 2
    • 3
  • Henrik Møller
    • 4
  • Wolfgang Ahrens
    • 5
  • Hermann Pohlabeln
    • 5
  • Simone Benhamou
    • 6
    • 7
  • Christine Bouchardy
    • 8
  • Pagona Lagiou
    • 9
  • Areti Lagiou
    • 10
  • Alena Slámová
    • 11
  • Miriam Schejbalová
    • 11
  • Franco Merletti
    • 12
  • Lorenzo Richiardi
    • 12
  • Kristina Kjaerheim
    • 13
  • Antonio Agudo
    • 14
  • Xavier Castellsague
    • 14
  • Tatiana Victorovna Macfarlane
    • 15
  • Gary John Macfarlane
    • 15
  • Renato Talamini
    • 16
  • Luigi Barzan
    • 17
  • Cristina Canova
    • 18
  • Lorenzo Simonato
    • 19
  • Anne-Marie Biggs
    • 20
  • Peter Thomson
    • 21
  • David Ian Conway
    • 22
  • Patricia Ann McKinney
    • 23
    • 24
  • Ariana Znaor
    • 25
  • Claire Marie Healy
    • 26
  • Bernard Eugene McCartan
    • 27
  • Paul Brennan
    • 28
  • Mia Hashibe
    • 29
  1. 1.Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)University Medical Center of the Johannes Gutenberg UniversityMainzGermany
  2. 2.The Tisch Cancer Institute and Institute for Translational EpidemiologyMount Sinai School of MedicineNew YorkUSA
  3. 3.International Prevention Research InstituteLyonFrance
  4. 4.Thames Cancer Registry, School of MedicineKing’s College LondonLondonUK
  5. 5.Bremen Institute for Preventive Research and Social Medicine (BIPS)University of BremenBremenGermany
  6. 6.INSERM, U946Fondation Jean Dausset-CEPHParisFrance
  7. 7.CNRS FRE2939Gustave-Roussy InstitutVillejuifFrance
  8. 8.Geneva Cancer RegistryGenevaSwitzerland
  9. 9.Department of Hygiene, Epidemiology and Medical StatisticsUniversity of Athens Medical SchoolAthensGreece
  10. 10.Faculty of Health ProfessionsAthens Technological Educational InstituteAthensGreece
  11. 11.1st Faculty of Medicine, Institute of Hygiene and EpidemiologyCharles University in PraguePragueCzech Republic
  12. 12.Unit of Cancer EpidemiologyCeRMS and University of TurinTurinItaly
  13. 13.Cancer Registry of NorwayOsloNorway
  14. 14.Institut Català d’Oncologia, IDIBELL, CIBER-ESPL’Hospitalet de LlobregatBarcelonaSpain
  15. 15.School of Medicine and DentistryUniversity of AberdeenAberdeenUK
  16. 16.Unit of Epidemiology and Biostatistics, National Cancer InstituteIRCCSAvianoItaly
  17. 17.General Hospital of PordenonePordenoneItaly
  18. 18.Respiratory Epidemiology and Public HealthImperial CollegeLondonUK
  19. 19.Department of Environmental Medicine and Public HealthUniversity of PadovaPaduaItaly
  20. 20.Warwick Medical SchoolUniversity of WarwickCoventryUK
  21. 21.School of Dental SciencesNewcastle UniversityNewcastleUK
  22. 22.Dental School, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
  23. 23.Centre for Epidemiology and BiostatisticsUniversity of LeedsLeedsUK
  24. 24.ISDNHS NSSEdinburghUK
  25. 25.Croatian National Cancer RegistryCroatian National Institute of Public HealthZagrebCroatia
  26. 26.Dublin Dental University HospitalTrinity College DublinDublinIreland
  27. 27.School of Medicine and Health SciencesRoyal College of Surgeons in IrelandDublinIreland
  28. 28.International Agency for Research on Cancer (IARC, WHO)LyonFrance
  29. 29.Division of Public Health, Department of Family and Preventive MedicineUniversity of Utah, School of MedicineSalt Lake CityUSA

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