Laryngeal cancer

By and large, the incidence of laryngeal cancer is tending to increase over time in much of the world, often in parallel with changes in tobacco and/or alcohol consumption. There are encouraging examples of declining trends that can be attributed to decreasing use of either tobacco or alcohol. These observations are in line with what is known about the multiplicative effects of both exposures. Since it is now well known that the epidemiology of cancer of the epilarynx differs from that of the endolarynx, it is highly desirable that in the future, this should be better reflected in the way laryngeal tumours are classified. There is good reason to believe that a change in alcohol consumption would have an effect on neoplasms of the epilarynx, whereas a change in tobacco consumption would affect incidence of neoplasms of the lower larynx. To examine this hypothesis, combined analyses of both lung and laryngeal cancer trends may have to be carried out together and compared, as in a recent Italian study (Capocaccia et al, in press). Research along these lines should provide a better understanding of how time trends in laryngeal cancer incidence can be related to changes in either tobacco and/or alcohol consumption. We know enough to believe that continuous efforts to reduce the consumption of either factor would result in a decrease in laryngeal cancer and that the biggest effect could be expected from a simultaneous reduction in alcohol and tobacco consumption (Tuyns, 1991).