Re: Cancer of the Oral Cavity and Pharynx in Nonsmokers Who Drink Alcohol and in Nondrinkers Who Smoke Tobacco

Abstract
In their recent brief communication, Talamini et al. ( 1 ) reported on the risk of developing cancer of the oral cavity and pharynx in nonsmokers who drink alcohol and in nondrinkers of alcohol who smoke tobacco. Although the data were quite sparse (60 never-smoking and 32 never-drinking case subjects), the authors concluded that there was a statistically significant increased risk of cancer in these sites associated with heavy alcohol intake in nonsmokers and with heavy tobacco smoking in nondrinkers. In this letter, we present solid evidence that the same conclusion holds true for esophageal cancer. The results shown in Table 1 were gathered from a pooled analysis of five hospital-based case-control studies of squamous cell carcinoma of the esophagus conducted from 1986 through 1992 in the following four countries in South America: Brazil ( 2 ), Uruguay ( 3 ), Argentina ( 4 ), and Paraguay ( 5 ). These studies were coordinated by the International Agency for Research on Cancer (Lyon, France), and they were carried out with the same research protocol and data collection procedures, thus making the studies suitable for a pooled analysis. Overall, the pooled data included a total of 830 incident case subjects with esophageal cancer and 1779 control subjects. Control subjects were individually matched to the case subjects with respect to the admitting hospital, age (± 5 years), and sex.

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