Epidemiological opportunities in alcohol-related cancer.

Alcohol combined with tobacco smoking is an established risk factor for cancers of the oropharynx, esophagus, and larynx. It should be possible to clarify further the role of alcohol itself, the modifying effects of tobacco, dose-response relationships, and nutritional cofactors. Studies are also needed to delineate the steps by which alcohol consumption leads to liver cancer and to resolve the suggestion that certain beverages may predispose to other cancers including those of the pancreas and rectum. Epidemiological investigations should be combined with experimental work to identify hazardous fractions in alcoholic beverages and to delineate the mechanisms by which alcohol promotes carcinogenesis. Epidemiologists and biometricians may also contribute toward the development of programs aimed at primary prevention and early detection of cancers related to alcohol and tobacco. Incorporation of research questions into data collection systems deserves serious questions into data collection systems deserves serious consideration as a means of obtaining additional valuable information for etiological studies.