Is alcohol responsible for more intra-oral cancer?

The role of the major risk factors, tobacco smoking and alcohol consumption, on trends in intra-oral cancer mortality in England and Wales between 1911 and 1990 was investigated, using lung cancer and liver cirrhosis as surrogate markers for smoking and drinking. Standardised mortality data on lung cancer and liver cirrhosis from the Office of Population Censuses and Surveys, aggregated into 5-year time periods for ages 35-64 and 65+ years, were regressed on corresponding data for intra-oral cancer. The strongest associations were in males aged 35-64 with a high negative correlation between lung and intra-oral cancer (rho=-0.98, 95% CI -0.99 to -0.96, P<0. 01) and, conversely, a positive correlation between liver cirrhosis and intra-oral cancer (rho=0.71, 95% CI 0.34 to 0.89, P<0.01). The findings suggest that rising alcohol consumption since the 1950s is more closely related to increasing intra-oral cancer incidence and mortality than smoking, most notably among younger males since the early 1970s.