Tobacco and Public Health - TCSC Indonesia

Odds Ratio
2.5
2
1.5
1
0.5
0
0.30
2.1
1(ref)
0.44
1.1
0.71
0.11
Current 1–9 10�
0.04
in women (Wynder and Bross 1961; Tuyns et al. 1977; Negri et al. 1992; Castellsagué
et al. 1999b). Moreover, different smoking and alcohol consumptions have been shown
to account for the differences in rates between sexes or urban and rural areas (Tuyns
et al. 1977; Negri et al. 1992).
In some areas of China and central Asia where the higher incidence rates of the
world are observed, and rates in women are comparable to those in men, these two
factors appear to play only a limited role, and nutritional deficiencies or other yet not
well-identified factors may play an important role (Munoz and Day 1996). The effect
of tobacco, however, is not negligible in some areas of Asia and Africa. Tobacco
accounted for 50% of cases in men and 14% in women in urban Shanghai (Gao et al.
1994), 54% of cases in Bombay (Jayant et al. 1977), and 54% in men in Bulawayo,
Zimbabwe (Vizcaino et al. 1995).
Adenocarcinoma of the oesophagus
EVA NEGRI 391
Adenocarcinoma of the oesophagus is much less frequent, worldwide, than SCCO.
There are thus fewer and smaller studies available. Most studies have been conducted
in North America and Europe, and only few data from other areas of the world are
available. This neoplasm resembles under many aspects to the adenocarcinoma of the
gastric cardia, and cancers that occur at the oesophageal-gastric junction are difficult
to attribute to one site or the other. Thus, several studies have considered adenocarcinomas
of the oesophagus and gastric cardia together. There is, however, evidence that
these two cancers differ as concerns their geographic distribution and risk factors
(Lagergren et al. 1999; Corley and Buffler 2001; Eksteen et al. 2001). Thus, in this
review we consider only studies showing separate results for adenocarcinoma of the
oesophagus. Table 22.2 presents the results of selected studies of ACO according to
0.28
Years since smoking cessation
10�
1–9
Current
Years since
drinking
cessation
Fig. 22.2 Odds ratios of cancer of the oesophagus for various combinations of times since
cessation of alcohol and tobacco consumption. Data from Bosetti et al. (2000).