Regular Article

British Journal of Cancer (2001) 85, 46–54. doi:10.1054/bjoc.2000.1825 www.bjcancer.com
Published online 3 July 2001

Risk factors for cancer of the oral cavity and oro-pharynx in Cuba

L Fernandez Garrote1, R Herrero2,3, R M Ortiz Reyes1, S Vaccarella4, J Lence Anta1, L Ferbeye1, N Muñoz2 and S Franceschi2

  1. 1Instituto de Oncologia y Radiobiologia, Calle 29 y E Vedado, La Habana, 10400, Cuba
  2. 2International Agency for Research on Cancer, 150 Cours Albert Thomas, F-69372 Lyon cédex 08, France
  3. 3Costa Rica Cancer Institute, San José, Costa Rica
  4. 4Servizio di Epidemiologia e biostatistica, IRCSS Centro di Riferimento Oncologico di Aviano, Via Pedemontana occidentale 12, I-33081 Aviano (PN), Italy

Received 10 January 2001; Revised 12 January 2001; Accepted 21 February 2001.

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Abstract

In terms of worldwide levels, Cuba has an intermediate incidence of cancer of the oral cavity and oro-pharynx. We studied 200 cases of cancer of the oral cavity and pharynx, of whom 57 women (median age = 64) and 200 hospital controls, frequency matched with cases by age and sex, in relation to smoking and drinking history, intake of 25 foods or food groups, indicators of oral hygiene and sexual activity, and history of sexually transmitted diseases. Odds ratios (OR) and 95% confidence intervals (CI) were obtained from unconditional multiple logistic regressions and adjusted for age, sex, area of residence, education, and smoking and drinking habits. In the multivariate model, high educational level and white-collar occupation, but not white race, were associated with halving of oral cancer risk. Smoking greater than or equal to30 cigarettes per day showed an OR of 20.8 (95% CI: 8.9–48.3), similar to smoking greater than or equal to4 cigars daily (OR = 20.5). Drinking greater than or equal to 70 alcoholic drinks per week showed an OR of 5.7 (95% CI: 1.8–18.5). Hard liquors were by far the largest source of alcohol. Increased risk was associated with the highest tertile of intake for maize (OR = 1.9), meat (OR = 2.2) and ham and salami (OR = 2.0), whereas high fruit intake was associated with significantly decreased risk (OR = 0.4). Among indicators of dental care, number of missing teeth and poor general oral condition at oral inspection showed ORs of 2.7 and 2.6, respectively. Number of sexual partners, marriages or contacts with prostitutes, practice of oral sex and history of various sexually transmitted diseases, including genital warts, were not associated with oral cancer risk. 82% of oral cancer cases in Cuba were attributable to tobacco smoking, 19% to smoking cigars or pipe only. The fractions attributable to alcohol drinking (7%) and low fruit intake (11%) were more modest. Thus, decreases in cigarette and cigar smoking are at present the key to oral cancer prevention in Cuba. © 2001 Cancer Research Campaign http://www.bjcancer.com

Keywords:

oral cancer, alcohol, tobacco, sexual habits

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