A case-control investigation of alcohol, tobacco, and diet in head and neck cancer

The importance of both smoking and drinking as risk factors in head and neck cancer was confirmed in a case-control investigation of 150 patients with cancer of the head and neck and 319 with other cancers diagnosed during the prior 2-yr period at five selected hospitals in New York City. Nonsmoking drinkers were at only slightly higher risk to head and neck cancer, whereas nondrinking smokers had 2 to 4 times the risk of abstainers of alcohol and tobacco. The risk for a heavy drinker who smoked was from 6 to 15 times greater than for the nondrinker and nonsmoker. Smoking and drinking appear to be less important risk factors in head and neck cancer that occurred in individuals age 65 and over. The average age of nonsmokers and nondrinkers with head and neck cancer was about 15 yr older than for nonabstaining head and neck cancer patients or for patients with nonsmoking-related cancer sites. A significantly greater proportion of head and neck cancer patients reported use of multiple alcoholic beverages than “other” cancer patients during the 5-yr period prior to diagnosis. Comparison of reported dietary intake between head and neck cancer and the control patients revealed little difference. Almost one-half of the total group of cancer patients were apparently unaware of their diagnosis or its implications.