An Analysis of Cohort Mortality from Tongue Cancer in Japan, England and Wales and the United States

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Abstract
Smith, E M (Department of Preventive Medicine and Environmental Health, University of lowa, lowa City, IA 52242, USA). An analysis of cohort mortality from tongue cancer in Japan, England and Wales, and the United States. International Journal of Epidemiology 1982, 11: 329–335. Alcohol and tobacco consumption were compared to rates of tongue cancer mortality among birth cohorts in Japan, England and Wales, and the United States for the years 1846–1975. During 1931–75 Japan had low and the US had high, stable sex, and age-specific and adjusted mortality. Rates in England and Wales, highest among the three nations, dropped dramatically, showing a classic cohort effect, which coincided with a continual rise in tobacco and a sharp decline in alcohol use since 1900. The US had a similar upsurge in smoking, but comparatively little change in drinking habits. In all countries, the alcohol but not the tobacco patterns were consistent with cohort deaths for not only tongue cancer but also other alcohol-related diseases when a dose-response time lapse was taken into account. In contrast to other studies this research suggests that alcohol may be a carcinogen even in the absence of tobacco.

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