Multiple occurrence of carcinoma in the upper aerodigestive tract associated with esophageal cancer: Reference to smoking, drinking and family history

TLDR

Patients with high‑risk factors such as heavy smoking, drinking, or a family history of upper aerodigestive tract cancer require careful and frequent screening for second lesions. The study examined smoking, drinking, and family history in 143 esophageal cancer patients, using odds ratios to assess the risk of second upper aerodigestive tract cancers. Current and heavy smoking, current and heavy drinking, and a family history of upper aerodigestive tract cancer were each associated with markedly increased odds of second cancers, indicating these factors strongly predict multiple occurrences.

Abstract

Smoking and drinking habits as well as family history were examined in 143 men with esophageal cancer, including 30 who had associated second cancers of the upper aerodigestive tract (UADT) and 113 who did not. The risk of second cancers of UADT associated with the main lesions of the esophagus was evaluated, using odds ratios (ORs). As a result, the ORs of second cancers for current smoking and drinking were 5.3 and 7.6 respectively. The ORs significantly increased to 12.7 and 14.7 in heavy smokers and in heavy drinkers respectively. Furthermore, the risk of second cancer also significantly increased (8-fold) in patients who had close relatives with UADT cancer, compared to those without family history of any cancer. However, there were no differences in smoking or drinking habits regardless of family history. Our data thus suggest that a family history of UADT cancer as well as heavy smoking and drinking are clearly associated with multiple occurrence of UADT cancer. Therefore, careful and frequent examination for appearance of any second lesions are required for patients in these high-risk groups.