Are racial differences in squamous cell esophageal cancer explained by alcohol and tobacco use?

Linda Morris Brown, Robert N. Hoover, Raymond S. Greenberg, Janet B. Schoenberg, Ann G. Schwartz, G. Marie Swanson, Jonathan M. Liff, Debra T. Silverman, Richard B. Hayes, Linda M. Pottern

    Research output: Contribution to journalArticle

    81 Citations (Scopus)

    Abstract

    Background: In the United States, incidence rates of squamous cell esophageal cancer are more than five times higher among black men than among white men. Reasons that might explain this large racial disparity are being sought. Purpose: We evaluated whether differential use of alcohol and tobacco can fully account for the excess of squamous cell esophageal cancer among U.S. blacks. Methods: We conducted a population-based, case-control study with in-person interviews with 373 squamous cell esophageal cancer case patients (124 white males and 249 black males) and 1364 control subjects (750 white males and 614 black males) from three U.S. geographic areas. Histologically confirmed cases of squamous cell esophageal cancer newly diagnosed from August 1, 1986, through April 30, 1989, among white and black men aged 30-79 years were included. Results: Alcohol use of more than one drink per day and/or current cigarette use of at least one pack per day accounted for 92.7% (95% confidence interval [CI] = 86.8%-98.5%) of the squamous cell esophageal cancers in blacks, versus 86.3% (95% CI = 75.5%-97.1%) in whites, and for 94% of the difference between the black and white annual incidence rates. The interaction between race and the continuous drinking/smoking variable in a logistic regression analysis was statistically significant (two-sided, P =.02). Exposure rates among controls at all levels of combined alcohol and tobacco use examined were slightly higher among blacks and accounted for a small portion of the racial differences in incidence rates. Conclusion: Although the vast majority of esophageal cancers in both blacks and whites in our data can be explained by use of alcohol and tobacco, it is not clear why heavy consumption of alcohol and/or tobacco is responsible for 14.9 per 100 000 per year more cases of squamous cell esophageal cancer among blacks than among whites. The differences in the odds ratios appear to account for more of the racial differences in incidence rates than do the prevalences of exposure to alcohol and tobacco alone. The reasons for this apparent racial difference in carcinogenic risk from the same level of alcohol and tobacco use are unknown, but they may include qualitative differences in alcohol consumption, differences in other environmental exposures that interact with alcohol and/or tobacco to modify risks, or differences in susceptibility to these factors. [J Natl Cancer Inst 86: 1340-1345, 1994].

    Original languageEnglish (US)
    Pages (from-to)1340-1345
    Number of pages6
    JournalJournal of the National Cancer Institute
    Volume86
    Issue number17
    DOIs
    StatePublished - Sep 7 1994

    Fingerprint

    Squamous Cell Neoplasms
    Tobacco
    Tobacco Use
    Alcohol
    Esophageal Neoplasms
    Cancer
    Alcohols
    Cell
    Incidence
    Alcohol Drinking
    Confidence Intervals
    Confidence interval
    Environmental Exposure
    Epithelial Cells
    Racial differences
    Tobacco Products
    Drinking
    Case-control Study
    Rate Control
    Smoking

    ASJC Scopus subject areas

    • Oncology
    • Cancer Research

    Cite this

    Brown, L. M., Hoover, R. N., Greenberg, R. S., Schoenberg, J. B., Schwartz, A. G., Swanson, G. M., ... Pottern, L. M. (1994). Are racial differences in squamous cell esophageal cancer explained by alcohol and tobacco use? Journal of the National Cancer Institute, 86(17), 1340-1345. https://doi.org/10.1093/jnci/86.17.1340

    Are racial differences in squamous cell esophageal cancer explained by alcohol and tobacco use? / Brown, Linda Morris; Hoover, Robert N.; Greenberg, Raymond S.; Schoenberg, Janet B.; Schwartz, Ann G.; Swanson, G. Marie; Liff, Jonathan M.; Silverman, Debra T.; Hayes, Richard B.; Pottern, Linda M.

    In: Journal of the National Cancer Institute, Vol. 86, No. 17, 07.09.1994, p. 1340-1345.

    Research output: Contribution to journalArticle

    Brown, LM, Hoover, RN, Greenberg, RS, Schoenberg, JB, Schwartz, AG, Swanson, GM, Liff, JM, Silverman, DT, Hayes, RB & Pottern, LM 1994, 'Are racial differences in squamous cell esophageal cancer explained by alcohol and tobacco use?', Journal of the National Cancer Institute, vol. 86, no. 17, pp. 1340-1345. https://doi.org/10.1093/jnci/86.17.1340
    Brown, Linda Morris ; Hoover, Robert N. ; Greenberg, Raymond S. ; Schoenberg, Janet B. ; Schwartz, Ann G. ; Swanson, G. Marie ; Liff, Jonathan M. ; Silverman, Debra T. ; Hayes, Richard B. ; Pottern, Linda M. / Are racial differences in squamous cell esophageal cancer explained by alcohol and tobacco use?. In: Journal of the National Cancer Institute. 1994 ; Vol. 86, No. 17. pp. 1340-1345.
    @article{a35a298141ec458fbe9265d7ba6443a1,
    title = "Are racial differences in squamous cell esophageal cancer explained by alcohol and tobacco use?",
    abstract = "Background: In the United States, incidence rates of squamous cell esophageal cancer are more than five times higher among black men than among white men. Reasons that might explain this large racial disparity are being sought. Purpose: We evaluated whether differential use of alcohol and tobacco can fully account for the excess of squamous cell esophageal cancer among U.S. blacks. Methods: We conducted a population-based, case-control study with in-person interviews with 373 squamous cell esophageal cancer case patients (124 white males and 249 black males) and 1364 control subjects (750 white males and 614 black males) from three U.S. geographic areas. Histologically confirmed cases of squamous cell esophageal cancer newly diagnosed from August 1, 1986, through April 30, 1989, among white and black men aged 30-79 years were included. Results: Alcohol use of more than one drink per day and/or current cigarette use of at least one pack per day accounted for 92.7{\%} (95{\%} confidence interval [CI] = 86.8{\%}-98.5{\%}) of the squamous cell esophageal cancers in blacks, versus 86.3{\%} (95{\%} CI = 75.5{\%}-97.1{\%}) in whites, and for 94{\%} of the difference between the black and white annual incidence rates. The interaction between race and the continuous drinking/smoking variable in a logistic regression analysis was statistically significant (two-sided, P =.02). Exposure rates among controls at all levels of combined alcohol and tobacco use examined were slightly higher among blacks and accounted for a small portion of the racial differences in incidence rates. Conclusion: Although the vast majority of esophageal cancers in both blacks and whites in our data can be explained by use of alcohol and tobacco, it is not clear why heavy consumption of alcohol and/or tobacco is responsible for 14.9 per 100 000 per year more cases of squamous cell esophageal cancer among blacks than among whites. The differences in the odds ratios appear to account for more of the racial differences in incidence rates than do the prevalences of exposure to alcohol and tobacco alone. The reasons for this apparent racial difference in carcinogenic risk from the same level of alcohol and tobacco use are unknown, but they may include qualitative differences in alcohol consumption, differences in other environmental exposures that interact with alcohol and/or tobacco to modify risks, or differences in susceptibility to these factors. [J Natl Cancer Inst 86: 1340-1345, 1994].",
    author = "Brown, {Linda Morris} and Hoover, {Robert N.} and Greenberg, {Raymond S.} and Schoenberg, {Janet B.} and Schwartz, {Ann G.} and Swanson, {G. Marie} and Liff, {Jonathan M.} and Silverman, {Debra T.} and Hayes, {Richard B.} and Pottern, {Linda M.}",
    year = "1994",
    month = "9",
    day = "7",
    doi = "10.1093/jnci/86.17.1340",
    language = "English (US)",
    volume = "86",
    pages = "1340--1345",
    journal = "Journal of the National Cancer Institute",
    issn = "0027-8874",
    publisher = "Oxford University Press",
    number = "17",

    }

    TY - JOUR

    T1 - Are racial differences in squamous cell esophageal cancer explained by alcohol and tobacco use?

    AU - Brown, Linda Morris

    AU - Hoover, Robert N.

    AU - Greenberg, Raymond S.

    AU - Schoenberg, Janet B.

    AU - Schwartz, Ann G.

    AU - Swanson, G. Marie

    AU - Liff, Jonathan M.

    AU - Silverman, Debra T.

    AU - Hayes, Richard B.

    AU - Pottern, Linda M.

    PY - 1994/9/7

    Y1 - 1994/9/7

    N2 - Background: In the United States, incidence rates of squamous cell esophageal cancer are more than five times higher among black men than among white men. Reasons that might explain this large racial disparity are being sought. Purpose: We evaluated whether differential use of alcohol and tobacco can fully account for the excess of squamous cell esophageal cancer among U.S. blacks. Methods: We conducted a population-based, case-control study with in-person interviews with 373 squamous cell esophageal cancer case patients (124 white males and 249 black males) and 1364 control subjects (750 white males and 614 black males) from three U.S. geographic areas. Histologically confirmed cases of squamous cell esophageal cancer newly diagnosed from August 1, 1986, through April 30, 1989, among white and black men aged 30-79 years were included. Results: Alcohol use of more than one drink per day and/or current cigarette use of at least one pack per day accounted for 92.7% (95% confidence interval [CI] = 86.8%-98.5%) of the squamous cell esophageal cancers in blacks, versus 86.3% (95% CI = 75.5%-97.1%) in whites, and for 94% of the difference between the black and white annual incidence rates. The interaction between race and the continuous drinking/smoking variable in a logistic regression analysis was statistically significant (two-sided, P =.02). Exposure rates among controls at all levels of combined alcohol and tobacco use examined were slightly higher among blacks and accounted for a small portion of the racial differences in incidence rates. Conclusion: Although the vast majority of esophageal cancers in both blacks and whites in our data can be explained by use of alcohol and tobacco, it is not clear why heavy consumption of alcohol and/or tobacco is responsible for 14.9 per 100 000 per year more cases of squamous cell esophageal cancer among blacks than among whites. The differences in the odds ratios appear to account for more of the racial differences in incidence rates than do the prevalences of exposure to alcohol and tobacco alone. The reasons for this apparent racial difference in carcinogenic risk from the same level of alcohol and tobacco use are unknown, but they may include qualitative differences in alcohol consumption, differences in other environmental exposures that interact with alcohol and/or tobacco to modify risks, or differences in susceptibility to these factors. [J Natl Cancer Inst 86: 1340-1345, 1994].

    AB - Background: In the United States, incidence rates of squamous cell esophageal cancer are more than five times higher among black men than among white men. Reasons that might explain this large racial disparity are being sought. Purpose: We evaluated whether differential use of alcohol and tobacco can fully account for the excess of squamous cell esophageal cancer among U.S. blacks. Methods: We conducted a population-based, case-control study with in-person interviews with 373 squamous cell esophageal cancer case patients (124 white males and 249 black males) and 1364 control subjects (750 white males and 614 black males) from three U.S. geographic areas. Histologically confirmed cases of squamous cell esophageal cancer newly diagnosed from August 1, 1986, through April 30, 1989, among white and black men aged 30-79 years were included. Results: Alcohol use of more than one drink per day and/or current cigarette use of at least one pack per day accounted for 92.7% (95% confidence interval [CI] = 86.8%-98.5%) of the squamous cell esophageal cancers in blacks, versus 86.3% (95% CI = 75.5%-97.1%) in whites, and for 94% of the difference between the black and white annual incidence rates. The interaction between race and the continuous drinking/smoking variable in a logistic regression analysis was statistically significant (two-sided, P =.02). Exposure rates among controls at all levels of combined alcohol and tobacco use examined were slightly higher among blacks and accounted for a small portion of the racial differences in incidence rates. Conclusion: Although the vast majority of esophageal cancers in both blacks and whites in our data can be explained by use of alcohol and tobacco, it is not clear why heavy consumption of alcohol and/or tobacco is responsible for 14.9 per 100 000 per year more cases of squamous cell esophageal cancer among blacks than among whites. The differences in the odds ratios appear to account for more of the racial differences in incidence rates than do the prevalences of exposure to alcohol and tobacco alone. The reasons for this apparent racial difference in carcinogenic risk from the same level of alcohol and tobacco use are unknown, but they may include qualitative differences in alcohol consumption, differences in other environmental exposures that interact with alcohol and/or tobacco to modify risks, or differences in susceptibility to these factors. [J Natl Cancer Inst 86: 1340-1345, 1994].

    UR - http://www.scopus.com/inward/record.url?scp=0028106842&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=0028106842&partnerID=8YFLogxK

    U2 - 10.1093/jnci/86.17.1340

    DO - 10.1093/jnci/86.17.1340

    M3 - Article

    C2 - 8064893

    AN - SCOPUS:0028106842

    VL - 86

    SP - 1340

    EP - 1345

    JO - Journal of the National Cancer Institute

    JF - Journal of the National Cancer Institute

    SN - 0027-8874

    IS - 17

    ER -