Risk of upper aerodigestive tract cancer and type of alcoholic beverage: a European multicenter case–control study

Manuela Marron, Paolo Boffetta, Henrik Møller, Wolfgang Ahrens, Hermann Pohlabeln, Simone Benhamou, Christine Bouchardy, Pagona Lagiou, Areti Lagiou, Alena Slámová, Miriam Schejbalová, Franco Merletti, Lorenzo Richiardi, Kristina Kjaerheim, Antonio Agudo, Xavier Castellsague, Tatiana MacFarlane, Gary Macfarlane, Renato Talamini, Luigi BarzanCristina Canova, Lorenzo Simonato, Anne-Marie Biggs, Peter Thomson, David Ian Conway, Patricia Ann McKinney, Ariana Znaor, Claire Marie Healy, Bernard Eugene McCartan, Paul Brennan, Mia Hashibe

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


The general relationship between cancers of the upper aerodigestive tract (UADT) and alcohol drinking is established. Nevertheless, it is uncertain whether different types of alcoholic beverages (wine, beer and liquor) carry different UADT cancer risks. Our study included 2,001 UADT cancer cases and 2,125 controls from 14 centres in 10 European countries. All cases were histologically or cytologically confirmed squamous cell carcinomas. Controls were frequency matched by sex, age and centre. Logistic regression models were used to estimate odds ratios (OR) and 95 % confidence intervals (95 %CI) adjusted for age, sex, centre, education level, vegetable and fruit intake, tobacco smoking and alcohol drinking, where appropriate. Risk of beverage-specific alcohol consumption were calculated among ‘pure drinker’ who consumed one beverage type exclusively, among ‘predominant drinkers’ who consumed one beverage type to more than 66 % and among ‘mixed drinkers’ who consumed more than one beverage type to similar proportions. Compared to never drinkers and adjusted for cumulative alcohol consumption, the OR and 95 %CI for wine, beer and liquor drinking, respectively, were 1.24 (0.86, 1.78), 1.54 (1.05, 2.27) and 0.94 (0.53, 1.64) among ‘pure drinkers’ (p value for heterogeneity across beverage types = 0.306), 1.05 (0.76,1.47), 1.25 (0.87,1.79) and 1.43 (0.95, 2.16) among ‘predominant drinkers’ (p value = 0.456), and 1.09 (0.79, 1.50), 1.20 (0.88, 1.63) and 1.12 (0.82, 1.53) among ‘mixed drinkers’ (p value = 0.889). Risk of UADT cancer increased with increasing consumption of all three alcohol beverage types. Our findings underscore the strong and comparable carcinogenic effect of ethanol in wine, beer and liquor on organs of the UADT.
Original languageEnglish
Pages (from-to)499-517
Number of pages19
JournalEuropean Journal of Epidemiology
Issue number7
Early online date13 Jun 2012
Publication statusPublished - Jul 2012


  • epidemiology
  • cancer
  • alcohol
  • wine
  • beer
  • liquor
  • head and neck cancer
  • upper aerodigestive tract cancer


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