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Alcohol intake and cancer of the upper digestive tract

BMJ 1999; 318 doi: (Published 08 May 1999) Cite this as: BMJ 1999;318:1289

Pattern of risk in Italy is different from that in Denmark

  1. Carlo La Vecchia, Associate professor of epidemiology,
  2. Silvia Franceschi, Consultant epidemiologist,
  3. Adriano Favero, Staff scientist,
  4. Renato Talamini, Registrar,
  5. Eva Negri, Head, unit of epidemiological methods
  1. Istituto di Statistica Medica e Biometria, Università di Milano, 20133 Milan, Italy
  2. Centro Regionale Oncologico, 33081 Aviano PN, Italy
  3. Istituto di Ricerche Farmacologiche, Mario Negri, 20157 Milan, Italy
  4. Department of Public Health and Epidemiology, University of Birmingham, Birmingham B15 2TT
  5. 4 Inverlea Court, Mickleton, Gloucestershire GL55 6TZ
  6. St Bartholomew's and the Royal London School of Medicine and Dentistry, London E1 2AD
  7. National Barrett's Oesophagus Registry, Wexham Park Hospital, Slough, Berkshire SL2 4HL
  8. Copenhagen Centre of Prospective Population Studies, Danish Epidemiology Science Centre at the Institute of Preventive Medicine, Copenhagen University Hospital, Kommunehospitalet, DK-1399 Copenhagen K, Denmark

    EDITOR—A Danish study of 156 subjects with upper digestive tract cancers showed that wine drinkers may be at a lower risk than drinkers with a similar intake of beer or spirits.1 Wine is the most common alcoholic beverage in Italy, accounting for over 80% of alcohol intake.2 We investigated the separate and combined effect of wine drinking in a large dataset.3

    Data were collected between 1984 and 1993 in Greater Milan and the province of Pordenone, Northern Italy, on 547 histologically confirmed incident cases of cancer of the oral cavity and pharynx (466 men, 81 women; age 22-74 (median 57)) and 412 cases of cancer of the oesophagus (345 men, 67 women; age 26-74 (median 60)). Controls were 2375 subjects (1797 men, 578 women; age 25-74 (median 56)) admitted to the same network of hospitals with acute non-neoplastic conditions unrelated to alcohol or tobacco consumption. Of these, 570 were admitted for trauma, 593 for non-traumatic orthopaedic conditions, 475 for acute surgical diseases, 428 for eye diseases, and 309 for miscellaneous other illnesses. Trained interviewers questioned cases and controls, using a structured questionnaire; questions on the days per week that each type of alcoholic beverage (wine, beer, and spirits) was consumed and the average number of drinks per day were included.

    View this table:

    Distribution of 547 cases of oral and pharyngeal cancer, 412 cases of oesophageal cancer, and 2375 controls, and corresponding multivariate odds ratios* and 95% confidence intervals, according to total number of drinks per week of wine only and wine, beer, or spirits, Italy, 1984-93

    The table gives the distribution of cases of oral and pharyngeal and oesophageal cancer and of the comparison group according to consumption of various alcoholic beverages. When non-drinkers and moderate drinkers (<3 drinks a day) were used as the comparison group, the odds …

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