ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Alcohol Consumption Increases the Incidence of Oral and Pharyngeal Cancer
Clinical Question Does consumption of alcoholic beverages increase the incidence of oral and pharyngeal cancer compared to non-drinkers?
Clinical Bottom Line Alcohol consumption increases the incidence of developing oral and pharyngeal cancer compared to non‐drinkers. The studies showed that even light drinking (=1 drink/day), displayed an increase in incidence. Evidence for this conclusion was found in multiple meta-analysis studies. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 11910703Bagnardi/200126 Studies, Total of 7,954 CasesMeta-Analysis
Key resultsAlcohol use and oral cancer incidence of drinking 2, 4, and 8 drinks/day was studied. For 2 drinks/day -­ RR=(1.73) and 95% CI=(1.67­‐1.78); 4 drinks/day ‐ RR=(2.77) and 95% CI=(2.67-­2.95); and 8 drinks/day -­ RR=(5.75) and 95% CI=(5.22-­6.34).
#2) 20728401Turati/201045 Studies, Total of 17,085 CasesMeta-Analysis
Key resultsThe association between light alcohol use (=1 drink/day) and oral cancer was RR=(1.17) and 95% CI=(1.01-­1.35), and pharyngeal cancer was RR=(1.23) and 95% CI= (0.87-­1.73). For heavy alcohol use (≥4 drinks/day), the RR for oral cancer was RR=4.64, 95% CI=(3.78-­5.70) and for pharyngeal cancer was RR=(6.62), 95% CI=(4.72-­9.29).
#3) 22910838Bagnardi/201223 Studies, Total of 2783 CasesMeta-Analysis
Key resultsThe association between light alcohol use (=1 drink/day) and oral cavity and pharyngeal cancer displayed RR (1.17), 95% CI (1.06-1.29) and p-­value (0.0024).
Evidence Search (Oral and Pharyngeal cancer) AND Alcohol AND Pharynx AND Meta-Analysis
Comments on
The Evidence
The information that was provided by these meta-analysis studies shows the highest level of evidence to help support the conclusion. The types of studies that were used in the meta-analyses included cohort and case-control studies.
Applicability Individuals who consume alcohol and healthcare providers can use this information to better understand the risks associated with alcohol consumption.
Specialty/Discipline (Public Health) (Oral Medicine/Pathology/Radiology) (General Dentistry)
Keywords Alcohol Consumption, Cancer, Oral Health, Oral and Pharyngeal
ID# 2509
Date of submission: 07/05/2013spacer
E-mail waite@ohsu.edu
Author John Waite
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ronald Sakaguchi, DDS, MS, PhD, MBA & Eli Schwarz, DDS, MPH, PhD
Faculty mentor/Co-author e-mail schwarz@ohsu.edu; sakaguch@ohsu.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Martina Parrone and Andrew Verrett (San Antonio, TX) on 08/08/2013
In 2012 a meta-analysis performed by Petti S PMID 22015229 , and updated in 2013 (PMID 23435775 ), concluded that alcohol in the absence of smoking and chewing betel quid was NOT a risk factor for oral cancer. Petti’s conclusion was also supported by a 2013 case-controlled study by Ferreira Antunes JL (PMID 23874521 ) that specifically evaluated the increase in risk of oral cancer associated with drinking independent of smoking. The authors of this latter study felt that “observational studies should be revised adequately accounting for the smoking-drinking interaction.” Evaluating risk factors for diseases with multifactorial etiology (like oral cancer) is difficult, particularly when a relationship also exists between risks factors (such as smoking and drinking). Further evaluation of the relationship between oral cancer and alcohol (in the absence of other risk factors) may be beneficial for patients that do not smoke, but consume alcohol.
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