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A large-scale statistical analysis of mouth and throat cancer incidence over a long period of time has looked at possible correlations between exposure to industrial chemicals, dust and alcoholic beverages in a wide variety of individuals in different occupations across Finland. The perhaps surprising conclusion drawn is that alcohol consumption rather than industrial chemicals or dusts is the critical factor associated with this form of cancer. There have been numerous studies undertaken to attempt to correlate, occupation, social class, and other factors with incidence of oral cancer. However, the results from different studies have tended to be conflicting. "Some studies have reported excess risks of cancers of the tongue, oral cavity and pharynx for electrical workers, waiters, cooks, butchers, printers, artists, pulp industry or wood workers, tailors and sewers, beverage manufacturers, packers, loaders, dockers and warehouse workers, seamen, plumbers and pipe fitters, journalists, motor vehicle drivers, dentists, hairdressers, shoemakers, launderers and dry-cleaners, bricklayers, painters and wall paper hangers, building hands, lawyers, public relations officers and sales professionals," the researchers say. However, an earlier, large study in Finland, which the team cites, suggested there was no variation in the risk by social class of cancer of the tongue. Cancer of the oral cavity in women was higher with increased social status and cancer of the pharynx was elevated in women of lowest social class. In men, risk for these types of cancer was highest among the lowest and highest social classes. In a paper to be published in the August 2008 issue of the International Journal of Cancer, Laura Tarvainen of the Department of Oral and Maxillofacial Surgery at the University of Helsinki, Pentti Kyyrönen and Eero Pukkala of the Finnish Cancer Registry, Institute of Statistical and Epidemiological Cancer Research, Timo Kauppinen of the Finnish Institute of Occupational Health, reveal details of their study into oral and throat cancer incidence. The team looked at a cohort of Finnish men and women born between 1906 and 1945 who were followed-up for almost 50 million person-years during the period 1971 to 1995. They recorded incident cases of cancer of the mouth and pharynx of which there were almost 3000 in the Finnish Cancer Registry. They then correlated this incidence with the occupations of the patients as recorded in the 1970 Census and converted almost 400 different occupations to likely chemical exposures to 43 chemical agents based on a job-exposure matrix (FINJEM). They then calculated cumulative exposure based on prevalence, level and duration of exposure. Poisson regression analysis was applied. Lawyers, authors, journalists, performing artists, musicians, electronics and telefitters, painters (building), building hands, dockers, unskilled labourers and hotel porters among males and private secretaries, dressmakers, shoemakers and cobblers, waitresses, pursers and stewardesses among females all showed high than standardized incidence ratios (SIRs) of oral cancer. Their multivariate analyses then revealed high relative risk for exposure to aliphatic and alicyclic hydrocarbons, pesticides and alcohol. Perhaps confounding their results is the fact that, while incidences are standardized, several occupations are much more poorly represented in the data than others. For instance, a mere ten journalists and four performing artists, compared with 254 farming, forestry and fishing workers and more than 500 individuals in industrial and construction work. Nevertheless, the overall conclusion drawn by the team is not necessarily related to occupation, nor occupational exposure, as it is. They suggest that exposure to solvents and possibly to pesticides, engine exhaust, textile dust and leather dust may increase the risk of cancer of mouth and pharynx. However, those occupations with high SIRs were mostly the ones with a high consumption of alcohol, which points the finger at a strong link between drinking and oral and throat cancer. Related links:
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Alcohol, a poison chalice?