Objective: To describe smoking and alcohol consumption trends in patients with oral cavity cancer over the past 25 years.
Design: Retrospective cohort study.
Setting: Single-institution tertiary care cancer center.
Patients: Patients with oral cancer treated primarily with surgery from 1985 to 2009. Patients with previous head and neck cancer were excluded.
Main outcome measures: The medical records of 1617 patients were reviewed. Patient demographics and details on smoking and alcohol consumption were recorded. Patients were divided in 5 different cohorts according to the year of initial surgery.
Results: There were no differences in sex, age, or stage of disease among cohorts. Oral tongue was the most common subsite (49%). There was a progressive decrease in tobacco use; 80% in cohort 1 vs 60% in cohort 5 (P < .001). A decrease in the daily amount of tobacco used was also found; 55% of patients in cohort 1 smoked more than 1 pack per day compared with 30% in cohort 5 (P < .001). Alcohol consumption decreased from 80% in cohort 1 to 67% in cohort 5 (P < .007). The percentage of patients who consumed more than 3 drinks per day decreased from 23% in cohort 1 to 9% in cohort 5 (P < .001).
Conclusion: Over the past 25 years there has been a progressive decrease in the prevalence of tobacco and alcohol users in patients with oral cancer.