Selected factors in the risks of upper alimentary cancers.

This study investigates whether liver cirrhosis, alcoholic beverages, smoked tobaccos, age, occupations, and multiple primary cancers are significant risk factors for malignancies of the upper alimentary tract. It utilizes maximum likelihood estimates of logistic parameters in multivariate analyses of these factors to assess risks of upper alimentary cancers (UAC) among 529 cancer patients, 204 with liver cirrhosis and 325 without liver cirrhosis. All patients are black males, discharged from U.S. Veterans Administration Hospitals from 1969 to 1975 with newly diagnosed and histologically confirmed primary cancers. In comparison with cirrhotics without UAC, cirrhotics with UAC have similar frequencies of liver cirrhosis by type, severity, and histological confirmation but are notably younger and have liver cirrhosis before cancer at a significantly higher frequency and over a significantly longer period. When there is simultaneous adjustment for all six factors, only liver cirrhosis, age, and multiple primaries (mainly at floor of mouth, soft palate, and esophageal sites) are significantly associated with increased cancer risk at upper alimentary sites where such processes as glycogen storage in some squamous cells, as obtains in the liver, may contribute to further elucidation of the implication of liver cirrhosis as a major pathway in cancer risk at upper alimentary sites.