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Petti S, Scully C Oral Oncology 2005; 41: 828–834

Alcohol greatly elevates the oral cancer risk in tobacco smokers, and is thought to be a separate carcinogen, but little is known about the relationship of different patterns of alcohol consumption to this risk. This study investigated 20 countries in respect of WHO reported patterns of alcohol use, and male age-standardised oral cancer mortality rates (ASMRs) provided by the International Agency for Research on Cancer.

Overall annual alcohol consumption per capita in litres (AAC) varied from 2 in Albania to 21 in Moldova. Male ASMRs for oral cancer varied from 088 per 100,000 in Israel (AAC: 21) to 687 in Croatia (122). When multiple regression analysis took into account the best smoking data available, and the type of alcoholic beverage consumed, smoking and spirit consumption were the only variables related significantly to ASMR. The authors discuss possible explanations, and suggest that the carcinogenic effect of concentrated ethanol might overcome the possible cancer-preventing effects of polyphenols, which are higher in beers and wines.