engleski

The Role of Alcohol in the Etiology of Oral Cancer

Alcohol is responsible for the onset of cancer in the areas of the oral cavity that function as a salivary reservoir (floor of the mouth, retromolar area, tongue and mandibular gingiva). This prospective epidemiologic investigation deals with alcohol and smoking tobacco use in 851 patients with oral cavity cancer (91% males, male to female ratio 10:1). Cancer of the reservoir was present in 96% of patients, 97% males and 86% females. Floor of the mouth and retromolar cancer is more frequent in male patients while cancer of the tongue and mandibular gingiva is more frequent in female patients. Alcohol is significantly correlated with cancer of the oral reservoir in tobacco smoking male patients, especially the floor of the mouth, retromolar region and tongue. In tobacco smoking female patients, alcohol is equally responsible for the onset of cancer of the mandibular gingiva and the retromolar region but is not responsible for the onset of cancer of the tongue. The sinergistic effect of alcohol and tobacco in male patients has a greater correlation with the onset of oral cavity cancer than the effect of a single risk factor. Female patients are more sensitive than male patients to the effect of a single risk factor, being more sensitive to alcohol than tobacco, but are significantly less sensitive to the sinergistic effect of alcohol and tobacco smoking in the onset of cancer of the oral cavity reservoir. Female patients must stop both smoking and alcohol consumption in order to prevent oral cavity cancer, while male patients must stop either smoking or alcohol consumption. In the second part of the investigation, 30 volonteers participated in evaluating salivary alcohol concentrations in the floor of the mouth, upper anterior vestible and palate at 1, 10, 20, 30 and 60 minute intervals following consumption of 150 ml of whiskey. Salivary alcohol levels were evaluated using Q.E.D. Saliva Alcohol Test (Enzymatics, Inc.). The highest concentration of alcohol was found in the floor of the mouth, i.e. the mouth reservoir. The localization of the higher concentrations of direct alcohol and alcohol excreted in saliva are in correlation with typical localizations of oral cavity cancer, therefor alcohol may be considered cancerogenic. The carcinogenic effect of alcohol on the oral cavity mucosa is a result of prolonged effect of alcohol excreted in saliva and not through the contact of high concentrations of alcohol following alcoholic beverage consumption. The duration of direct effect of alcohol following a single consumption is approximately 20 minutes, while the effect of saliva excreted alcohol in the floor of the mouth lasts approximately 7, 7 hours. It is with a great degree of certainty that we may conclude that an alcoholic will continue to consume alcohol during the 7, 7 hour resorption period, thus having a continuous effect of a certain amount of alcohol on the mucosa of the oral cavity, especially the mouth reservoir.

alcohol; saliva; oral cancer

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