Annals of Oncology 14:209-213, 2003
© 2003 European Society for Medical Oncology
Original Paper |
Cigarette tar yield and risk of upper digestive tract cancers: case–control studies from Italy and Switzerland
1 Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy; 2 International Agency for Research on Cancer, Lyon Cedex, France; 3 Registre Vaudois des Tumeurs, Institut Universitaire de Médecine Sociale et Préventive, Lausanne, Switzerland; 4 Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano, Pordenone; 5 Servizio di Epidemiologia e Oncogenesi, Istituto "Regina Elena" per lo Studio e la Cura dei Tumori, Rome; 6 Servizio di Epidemiologia dei Tumori, Registro Tumori del Veneto, Padua; 7 Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Milan, Italy
Received 25 June 2002; revised 19 September 2002; accepted 22 October 2002
Background:
Tobacco smoking is one of the main risk factors for oral, pharyngeal and oesophageal cancers in developed countries. Information on the role of the tar yield of cigarettes in upper digestive tract carcinogenesis is sparse and needs to be updated because the tar yield of cigarettes has steadily decreased over the last few decades.
Patients and methods:
We analysed two case–control studies, from Italy and Switzerland, conducted between 1992 and 1999, involving 749 cases of oral and pharyngeal cancer and 1770 controls, and 395 cases of squamous-cell oesophageal carcinoma and 1066 matched controls. Odds ratios (ORs) were estimated by unconditional multiple logistic regression models, including terms for age, sex, study centre, education and alcohol consumption.
Results:
Based on the brand of cigarettes smoked for the longest time, the multivariate ORs for current smokers compared with never smokers were 6.1 for <20 mg and 9.8 for 
20 mg tar for oral and pharyngeal neoplasms, and 4.8 and 5.4 for oesophageal cancer, respectively. For the cigarette brand smoked in the previous six months, the ORs for 10 mg compared with <10 mg were 1.9 for cancer of the oral cavity and pharynx and 1.8 for oesophageal cancer, after allowance for number of cigarettes and duration of smoking.
Conclusions:
The present study confirms the direct relationship between the tar yield of cigarettes and upper digestive tract neoplasms, and provides innovative information on lower tar cigarettes, which imply reduced risks compared with higher tar ones. However, significant excess risks were observed even in the lower tar category, thus giving unequivocal indications for stopping smoking as a priority for prevention of upper digestive tract neoplasms.
Key words: case–control studies, oesophageal cancer, oral cancer, risk factor, tar yield, tobacco smoking
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