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Alcohol - the neglected risk factor in head and neck cancer

Lookup NU author(s): Emerita Professor Janet WilsonORCiD


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Alcohol remains second only to cigarette smoking as a risk factor for head and neck cancer worldwide. The increase in incidence in head and neck cancer in a number of countries appears linked at least in part to contemporaneous rises in alcohol consumption. The relative increase in risk in women may also relate to increasing alcohol consumption. Women may be particularly sensitive to alcohol-induced tumours in the oral/ oropharyngeal sites. The risk is dose related, but with a non-linear increase for heavy drinkers (>100 g i.e. 12 units/day). The type of alcoholic beverage consumed seems less important. Potential mechanisms include local toxic cellular proliferation; carcinogenic action of metabolites e.g. acetaldehyde or impurities; induction of enzymes which activate procarcinogens; reduction of the protective retinoic acid; genetic polymorphism may play a part in certain geographic locations. Alcohol is also linked to stage at presentation, risk of second primary and the occurrence of comorbidity. Public awareness of the risks of alcohol remains disappointingly low. Those in identifiable high-risk groups should perhaps be targeted specifically for counselling.

Publication metadata

Author(s): Viswanathan H, Wilson JA

Publication type: Review

Publication status: Published

Journal: Clinical Otolaryngology and Allied Sciences

Year: 2004

Volume: 29

Issue: 4

Pages: 295-300

Print publication date: 01/08/2004

ISSN (print): 0307-7772

ISSN (electronic): 1749-4486


DOI: 10.1111/j.1365-2273.2004.00830.x

PubMed id: 15270811