Cancer Causes & Control

, Volume 10, Issue 3, pp 201–207 | Cite as

Cigarette smoking, alcohol consumption and risk of nasopharyngeal carcinoma in Taiwan

  • Yu-Juen Cheng
  • Allan Hildesheim
  • Mow-Ming Hsu
  • I-How Chen
  • Louise A. Brinton
  • Paul H. Levine
  • Chien-Jen ChenEmail author
  • Czau-Siung Yang


Objectives: Nasopharyngeal carcinoma (NPC) is rare in most countries but occurs with relatively high frequency among southern Chinese populations throughout the world. A case-control study of NPC was conducted in Taiwan to investigate the importance of active and passive cigarette exposure and alcohol consumption as risk factors for this disease.

Methods: 375 histologically confirmed incident NPC cases (99% response rate) were prospectively identified from two hospitals in Taipei between July 1991 and December 1994 and administered a detailed questionnaire. 327 healthy community controls individually matched to cases on sex, age and residence were selected (88% response rate).

Results: After multivariate adjustment, the odds ratio (OR) and 95% confidence interval (CI) was 1.7 (1.1–2.9 with p = 0.03 for increasing dose-response) for those who smoked for 25 years compared with non-smokers. Passive smoking during childhood or adult life was not associated with an increased risk of disease. Alcohol consumption was not associated with NPC risk. The OR for subjects with 15 grams of ethanol per day compared to non-drinkers was 1.1 (95% CI = 0.7–1.7).

Conclusions: Our results suggest that long term cigarette smoking is associated with NPC but that low level exposure to cigarette smoke via passive exposure and alcohol consumption are not associated with disease risk.

alcohol consumption cigarette smoking nasopharyngeal carcinoma 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Muir C, Waterhouse J, Mack T, Powell J, Whelan S (1987) Cancer Incidence in Five Continents, Vol. 5. Lyon, France: International Agency for Research on Cancer, IARC Sci. Pub. no. 88.Google Scholar
  2. 2.
    National Cancer Control Office, Nanjing Institute of Geography (1979) Atlas of Cancer Mortality in The People's Republic of China. Shanghai: China Map Press.Google Scholar
  3. 3.
    Yu MC, Ho JHC, Ross RK, Henderson BE (1981) Nasopharyngeal carcinoma in Chinese: salted fish or inhaled smoke? Prev Med 10: 15-24.Google Scholar
  4. 4.
    Department of Health, Executive Yuan, ROC (1997) Cancer Registry Annual Report, Republic of China, 1994. Taipei: Department of Health, Executive Yuan.Google Scholar
  5. 5.
    Hecht SS, Hoffmann D (1988) Tobacco-specific nitrosamines, an important group of carcinogens in tobacco and tobacco smoke. Carcinogenesis 9: 875-884.Google Scholar
  6. 6.
    Preston-Martin S, Henderson BE, Pike MC (1982) Descriptive epidemiology of cancer of the upper respiratory tract in Los Angeles. Cancer 49: 2201-2207.Google Scholar
  7. 7.
    Lin TM, Chen KP, Lin CC, et al. (1973) Retrospective study on nasopharyngeal carcinoma. J Natl Cancer Inst 51: 1403-1408.Google Scholar
  8. 8.
    Lanier A, Bender T, Talbot M, et al. (1980) Nasopharyngeal carcinoma in Alaskan Eskimos, Indians, and Aleuts. Cancer 46: 2100-2106.Google Scholar
  9. 9.
    Mabuchi K, Bross DS, Kessler II (1985) Cigarette smoking and nasopharyngeal carcinoma. Cancer 55: 2874-2876.Google Scholar
  10. 10.
    Yu MC, Mo CC, Chong WX, Yeh FS, Henderson BE (1988) Preserved foods and nasopharyngeal carcinoma: a case-control study in Guangxi, China. Cancer Res 48: 1954-1959.Google Scholar
  11. 11.
    Yu MC, Garabrant DH, Huang TB, Henderson BE (1990) Occupational and other non-dietary risk factors for nasopharyngeal carcinoma in Guangzhou, China. Int J Cancer 45: 1033-1039.Google Scholar
  12. 12.
    Chen CJ, Liang KY, Chang YS, et al. (1990) Muliple risk factors of nasopharyngeal carcinoma: Epstein-Barr virus, malarial infection, cigarette smoking and familial tendency. Anticancer Res 10: 547-554.Google Scholar
  13. 13.
    Nam JM, McLaughlin JK, Blot WJ (1992) Cigarette smoking, alcohol and nasopharyngeal carcinoma: a case-control study among US Whites. J Natl Cancer Inst 84: 619-622.Google Scholar
  14. 14.
    Chow WH, Mclaughlin JK, Hrubec Z, Nam JM, Blot WJ (1993) Tobacco use and nasopharyngeal carcinoma in a cohort of US veterans. Int J Cancer 55: 538-540.Google Scholar
  15. 15.
    West S, Hildesheim A, Dosemeci M (1993) Non-viral risk factors for nasopharyngeal carcinoma in the Philippines: results from a case-control study. Int J Cancer 55: 722-727.Google Scholar
  16. 16.
    Henderson BE, Louie E, Jing JS, Buell P, Gardner MB (1976) Risk factors associated with nasopharyngeal carcinoma. New Engl J Med 295: 1101-1106.Google Scholar
  17. 17.
    Armstrong RW, Kannan Kutty M, Armstrong MJ (1978) Self-specific environments associated with nasopharyngeal carcinoma in Selangor, Malaysia. Soc Sci Med 12D: 149-156.Google Scholar
  18. 18.
    Armstrong RW, Armstrong MJ, Yu MC, Henderson BE (1983) Salted fish and inhalants as risk factors for nasopharyngeal carcinoma in Malaysian Chinese. Cancer Res 43: 2967-2970.Google Scholar
  19. 19.
    Yu MC, Ho JHC, Henderson BE, Armstrong RW (1985) Epidemiology of nasopharyngeal carcinoma in Malaysia and Hong Kong. Natl Cancer Inst Monogr 69: 203-207.Google Scholar
  20. 20.
    Yu MC, Ho JHC, Lai SH, Henderson BE (1986) Cantonese-style salted fish as a cause of nasopharyngeal carcinoma: report of a case-control study in Hong Kong. Cancer Res 46: 956-961.Google Scholar
  21. 21.
    Ng TP (1986) A case-referent study of cancer of the nasal cavity and sinuses in Hong Kong. Int J Epidemiol 15: 171-175.Google Scholar
  22. 22.
    Ning JP, Yu MC, Wang QS, Henderson BE (1990) Consumption of salted fish and other risk factors for nasopharyngeal carcinoma (NPC) in Tianjin, a low-risk region for NPC in the People's Republic of China. J Natl Cancer Inst 82: 291-296.Google Scholar
  23. 23.
    Sriamporn S, Vatanasapt V, Pisani P, Yongchaiyudha S, Rungpitarangsri V (1992) Environmental risk factors for nasopharyngeal carcinoma: a case-control study in northeastern Thailand. Cancer Epidemiol Biomarkers Prev 1: 345-348.Google Scholar
  24. 24.
    Lee HP, Gourley L, Duffy SW, Esteve J, Lee J, Day NE (1994) Preserved foods and nasopharyngeal carcinoma: a case-control study among Singapore Chinese. Int J Cancer 59: 585-590.Google Scholar
  25. 25.
    Chen CJ, Wang YF, Shieh T, Chen JY, Liu MY (1988) Multifactorial etiology of nasopharyngeal carcinoma. Epstein-Barr virus, familial tendency and environmental cofactors. In: Wolf GT, Carey TE, eds. Head and Neck Oncology Research. Amsterdam: Kugler, p. 469-476.Google Scholar
  26. 26.
    Geser A, Charay N, Day NE, Ho HC, De-the G (1978) Environmental Factors in the Etiology of Nasopharyngeal Carcinoma: Report on a Case-control Study in Hong Kong. Lyon, France: International Agency for Research on Cancer. IARC Sci. Pub. No. 20: 213-229.Google Scholar
  27. 27.
    Greenland S (1989) Modeling and variable selection in epidemiologic analysis. Am J Public Health 79: 340-349.Google Scholar

Copyright information

© Kluwer Academic Publishers 1999

Authors and Affiliations

  • Yu-Juen Cheng
    • 1
  • Allan Hildesheim
    • 2
  • Mow-Ming Hsu
    • 3
  • I-How Chen
    • 4
  • Louise A. Brinton
    • 2
  • Paul H. Levine
    • 2
  • Chien-Jen Chen
    • 1
    Email author
  • Czau-Siung Yang
    • 5
  1. 1.Graduate Institute of Epidemiology, College of Public HealthNational Taiwan UniversityTaipeiTaiwan (Fax
  2. 2.Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaUSA
  3. 3.Department of OtolaryngologyNational Taiwan University HospitalTaipeiTaiwan
  4. 4.Department of OtolaryngologyMacKay Memorial HospitalTaipeiTaiwan
  5. 5.Graduate Institute of Microbiology, College of MedicineNational Taiwan UniversityTaipeiTaiwan

Personalised recommendations