{
  "abstract": "Introduction While a large proportion of buccal mucosa cancer (BMC) is attributed to tobacco use, the contribution of alcohol is little-known. In India, alcohols include internationally-recognised (IRL) and locally-brewed liquor (LBL) types, which might contribute differently to the risk of BMC. We conducted an observational study to evaluate the association of local and foreign alcoholic beverage use on the risk of developing BMC.Methods Data from 1803 BMC cases and 1903 visitor controls from a multicentric case-control study was analysed for 11 IRLs and 30 LBLs. Healthy visitor controls were randomly sampled from the source population of the study centres which enrolled the cases. Quantitative data on the amount, the number of times consumed per day or week, and the lifetime duration of consumption for each of the alcoholic beverages were collected using an interviewer administered standardised questionnaire, which was then used to estimate the grams per day consumption of alcohol. Odds ratios (OR) and 95% CI were estimated after adjustment for potential confounders, including tobacco use. The joint effect of tobacco and alcohol on BMC risk, the attributable fraction (AF) of cases and state-wise population attributable fraction (PAF) were estimated.Results An increased risk of 1.68 (95% CI=1.44–1.97), 1.72 (95% CI=1.46–2.04), and 1.87 (95% CI=1.46–2.39) was observed for ever-users of any alcohol, IRLs and LBLs, respectively for BMC. The findings show 9 grams/day of alcohol increased the risk of BMC by approximately 50%, and 62% of cases could be attributed to alcohol drinking and chewing tobacco, with an overall PAF of 11.3% for India.Conclusion This study shows that alcohol, even in low quantities, increases the risk for BMC. Prevention of consumption of tobacco and alcohol together could substantially reduce the incidence of BMC.",
  "authors": [
    {
      "affiliations": [
        "Division of Molecular Epidemiology and Population Genomics, Center for Cancer Epidemiology, Navi Mumbai, Maharashtra, India",
        "Homi Bhabha National Institute, Mumbai, Maharashtra, India"
      ],
      "name": "Grace Sarah George"
    },
    {
      "affiliations": [
        "Division of Molecular Epidemiology and Population Genomics, Center for Cancer Epidemiology, Navi Mumbai, Maharashtra, India",
        "Homi Bhabha National Institute, Mumbai, Maharashtra, India"
      ],
      "name": "Aniket Patil"
    },
    {
      "affiliations": [
        "Division of Molecular Epidemiology and Population Genomics, Center for Cancer Epidemiology, Navi Mumbai, Maharashtra, India",
        "Homi Bhabha National Institute, Mumbai, Maharashtra, India"
      ],
      "name": "Romi Moirangthem"
    },
    {
      "affiliations": [
        "Division of Molecular Epidemiology and Population Genomics, Center for Cancer Epidemiology, Navi Mumbai, Maharashtra, India",
        "Homi Bhabha National Institute, Mumbai, Maharashtra, India"
      ],
      "name": "Pravin Narayanrao Doibale"
    },
    {
      "affiliations": [
        "Division of Molecular Epidemiology and Population Genomics, Center for Cancer Epidemiology, Navi Mumbai, Maharashtra, India",
        "Homi Bhabha National Institute, Mumbai, Maharashtra, India"
      ],
      "name": "Ankita Manjrekar"
    },
    {
      "affiliations": [
        "Division of Molecular Epidemiology and Population Genomics, Center for Cancer Epidemiology, Navi Mumbai, Maharashtra, India",
        "Homi Bhabha National Institute, Mumbai, Maharashtra, India"
      ],
      "name": "Shruti Vishwas Golapkar"
    },
    {
      "affiliations": [
        "Nargis Dutt Memorial Cancer Hospital, Barshi, Maharashtra, India"
      ],
      "name": "Nandkumar Panse"
    },
    {
      "affiliations": [
        "Dr Bhubaneswar Borooah Cancer Institute, Guwahati, Assam, India"
      ],
      "name": "Manigreeva Krishnatreya"
    },
    {
      "affiliations": [
        "Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Varanasi, Uttar Pradesh, India"
      ],
      "name": "Aseem Mishra"
    },
    {
      "affiliations": [
        "Homi Bhabha National Institute, Mumbai, Maharashtra, India",
        "Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India"
      ],
      "name": "Arjun Singh"
    },
    {
      "affiliations": [
        "Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France"
      ],
      "name": "Harriet Rumgay"
    },
    {
      "affiliations": [
        "Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France"
      ],
      "name": "Bayan Hosseini"
    },
    {
      "affiliations": [
        "Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA"
      ],
      "name": "Anil Chaturvedi"
    },
    {
      "affiliations": [
        "Radiation Effects Research Foundation, Hiroshima, Japan"
      ],
      "name": "Preetha Rajaraman"
    },
    {
      "affiliations": [
        "Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France"
      ],
      "name": "Ann Olsson"
    },
    {
      "affiliations": [
        "Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France"
      ],
      "name": "Isabelle Soerjomataram"
    },
    {
      "affiliations": [
        "Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India",
        "Advanced Centre for Treatment Research and Education in Cancer, Navi Mumbai, Maharashtra, India"
      ],
      "name": "Pankaj Chaturvedi"
    },
    {
      "affiliations": [
        "Division of Molecular Epidemiology and Population Genomics, Center for Cancer Epidemiology, Navi Mumbai, Maharashtra, India",
        "Homi Bhabha National Institute, Mumbai, Maharashtra, India"
      ],
      "name": "Rajesh Dikshit"
    },
    {
      "affiliations": [
        "Division of Molecular Epidemiology and Population Genomics, Center for Cancer Epidemiology, Navi Mumbai, Maharashtra, India",
        "Homi Bhabha National Institute, Mumbai, Maharashtra, India"
      ],
      "name": "Sharayu Mhatre"
    }
  ],
  "title": "Association of alcohol and different types of alcoholic beverages on the risk of buccal mucosa cancer in Indian men: a multicentre case-control study",
  "uid": "117ea919-5f82-5590-b74c-9ca0242d75d7"
}