Smoking, Alcohol and Oral Cancer in South East Scotland: a 10-year Experience

Objective: To examine the relationship of oral carcinoma to tobacco and alcohol consumption in patients referred over a 10-year period.

Design: Analysis of records obtained for the age of presentation, the tobacco and alcohol intake, the site and type of carcinoma.

Setting: All patients with carcinoma of the mouth and associated structures referred to the Joint Onocology/Maxillofacial Clinic at Edinburgh Royal Infirmary by General Medical and Dental Practitioners together with hospitals and hospital departments within South East Scotland.

Subjects: A total of 454 patients, with a mean age of presentation for males of 63.8 years, for females 68.0 years.

Results: 58% of those with carcinoma had a smoking history, with 24% drinking more than 20 units of alcohol per week. 60% of patients with oral tumours smoked. The tongue and floor of mouth were the most common sites, and over 95% of tumours here were squamous cell carcinoma. A high proportion of patients with floor of mouth tumours had a smoking history (79%) with a higher than average alcohol consumption (41% drank over 20 units).

Conclusion: It is suggested that these two carcinogens, smoking and alcohol, could be site specific in the oral cavity, and have an additive role. In public health terms the Scottish people need to reduce the intake of both in order to adequately reduce their risk of having oral carcinomas.