Cigarette smoking and Warthin's tumor

The etiology of Warthin's tumor, a benign parotid gland tumor, is unknown. Recent evidence suggests a possible relation with cigarette smoking as well as increasing incidence. We reviewed the medical record of subjects with a major salivary gland tumor newly diagnosed in Jefferson County, Alabama, from 1968 to 1989, and identified 149 Warthin's tumors. The 533 cases with other major salivary gland tumors were used as controls. The analysis showed that 96% of Warthin's tumors occurred in whites. The relative incidence of Warthin's tumor among smokers versus nonsmokers was 7.6 for men (95 percent confidence interval 3.2-18.3; p < 0.001) and 17.4 for women (95 percent confidence interval 6.5-54.7; p < 0.001). Smokers of both sexes with Warthin's tumor smoked more heavily than did those with other salivary gland tumors (p < 0.001). From 1968 through 1988, Warthin's tumors steadily increased in number and as a proportion of salivary gland tumors (males, p = 0.003; females, p = 0.008). We also observed a significant increase in the incidence rate for Warthin's tumor (p = 0.041) but not for other salivary gland tumors. We conclude that Warthin's tumor is strongly associated with cigarette smoking and that the incidence rate is increasing. The disease is rare in blacks.