Relationship between type of tobacco used and localization of tumour in patients with gastric cancer.

The relationship between the type of tobacco used and the localization of the tumour was studied in 493 patients with gastric cancer. The relative frequency of tumour site was found to vary significantly with the type of tobacco. In men who used all kinds of tobacco, a pipe was the most common form of smoking. Women smoked only cheroots or cigarettes or both. Male smokers showed a significantly higher percentage of tumours at the cardia than did female smokers. Female smokers had a significantly higher percentage of tumours involving the entire stomach than male smokers. Male smokers with tumours at the cardia were significantly more often pipe smokers and cigarette smokers than cheroot smokers. Male smokers with tumours involving the entire stomach were significantly more often cheroot smokers than cigarette smokers. The localization of tumours in cigarette smokers differed in men and women, indicating that cigarette smoking per se possibly plays a subordinate causal role. On the other hand, the distribution pattern of the localization among cheroot smokers was practically the same in both sexes, which might indicate that this type of smoking plays an important role. The same probably applies to pipe smoking, especially when combined with snuff or chewing tobacco, but these types of tobacco had not been used by the women. It is mentioned that not only the nature of tobacco used, but also concurrent factors may influence the localization of the tumours.