Prospective study of the association of alcohol with cancer of the upper aerodigestive tract and other sites

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Abstract
The association of alcohol consumption with cancers of the upper aerodigestive tract, hepato-biliary-pancreatic system, urogenital organs (except for prostate), and lymphohematopoietic tissue was evaluated in a prospective study of 6,701 American men of Japanese ancestry living in Hawaii. Compared with cancer-free subjects, subjects who subsequently developed cancers of the upper aerodigestive tract (oral-pharynx, esophagus, and larynx), liver, biliary tract, and lymphohematopoietic tissue consumed significantly larger amounts of total alcohol-mainly in the form of beer. Subjects who developed oral-pharyngeal and esophageal cancer also consumed larger amounts of wine and spirits. Because the upper aerodigestive tract cancers were associated positively with cigarette smoking, age-adjusted relative risks (RR) were calculated, based on joint exposure to cigarette smoking and heavy alcohol intake (≥30 ml/day) in this population. A markedly increased risk was observed among subjects who were both heavy alcohol drinkers and smokers (RR=17.3, 95 percent confidence interval [CI]=6.7–44.2), compared with subjects who did not smoke and did not drink heavily. The risk for these cancers also was increased among heavy alcohol drinkers who were nonsmokers (RR=8.6, CI=2.1–36.0).