The proposed is a population-based case-control study designed to elucidate further the etiology of cancers of the larynx, esophagus and oral cavity. Specifically, this study is designed: 1) to identify the mechanisms by which alcohol enhances the risk of these cancers; 2) to determine whether host susceptibility to alcohol is related to risk; 3) to determine whether dietary deficiencies of such nutrients as vitamins A and C, zinc, iron and others enhance the risk of these neoplasms; 4) to clarify the role of dental health and care in the genesis of these cancers; 5) to identify occupational exposures that increase the risk of these neoplasms; and 6) to compare epidemiologic features of these neoplasms according to specific subsites therein. Cases, identified through the population-based SEER tumor registry in Northwestern Washington State, will consist of all persons diagnosed with one of the three cancers under study in King, Pierce and Snohomish counties between 9/1/82 and 2/28/86. Controls will be randomly selected from the same three county populations to equal the number of cases of oral cancer identified and to be of the same age and sex composition as the overall case group. Thus, a single control group, protocol and set of study instruments will be used to study all three groups of cancer cases. Each subject will be interviewed in their home to ascertain detailed information on prior use of tobacco and alcohol, dietary intake, dental health, and several other relevant factors of etiologic interest. In addition, dental information will be abstracted from each subject's dental records in a standardized format. It is anticipated that the results of this investigation will not only further the understanding of factors that lead to the development of the cancers under study and provide additional etiologic leads to be pursued, but will also provide comprehensive information regarding alcohol use and abuse and diet and nutrition in a general population sample of individuals.
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