Cigarette smoking and alcohol ingestion as risk factors for laryngeal squamous cell carcinoma at Kenyatta National Hospital

Abstract

Background: Laryngeal squamous cell carcinoma is strongly linked to tobacco inhalation as a cause. It is estimated to account for more than 70% of laryngeal squamous cell carcinomas and up to 89% when combined with alcohol. Objective: To determine the prevalence of cigarette smoking and alcohol ingestion among patients with laryngeal squamous cell carcinoma and estimate the odds attributed to cigarette smoking and alcohol ingestion. Methods: Fifty cases and fifty controls were recruited of matching age, sex and region of residence. History of smoking and alcohol intake was taken and analyzed to estimate the relative strengths of these exposures. Results: 33 (66%) of the cases and 3 (6%) among controls smoked cigarettes. 74% had smoked for more than 30 years p <0.0001 OR 21.3 (95% CI: 2.6- 176.1). Cessation of smoking was associated with reduced risk (stopped <10yrs OR 19.5 (95% CI: 2.0-191). An ever smoker had increased risk compared to controls p< 0.001 OR 6 (95% CI 2.1- 18.023). Those who smoked only had glottic cancer p< 0.001 OR 19.75 (95% CI 2.0-188.55). Those who smoked and drank alcohol had supraglottic cancer p< 0.0001 OR 10.5 (95%CI 2.6-42). Being a current smoker and long duration of smoking were independent risk factors p= 0.002 OR 14.6 (95%CI 2.6- 80) and p <0.01 OR 7.3 (95%CI 1.6-33) respectively. PAR for cigarette smoking is 62%. Conclusion: Being a current smoker and long duration of smoking are important variables in assessment of cigarette smoking as a risk factor for laryngeal squamous cell carcinoma.