Smoking as an etiologic factor in the development of Warthin's tumor of the parotid gland

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In order to further examine a preliminary association between smoking and the subsequent development of Warthin's tumor, a case-control study was undertaken between the years 1980 and 1989. Consecutive patients with Warthin's tumor served as cases, and consecutive patients with pleomorphic adenomas served as controls. A positive history of smoking was defined as a patient with greater than a 10-pack year history.

There were 28 cases and 69 controls (ratio: 1:2.5). The number of male to female patients with Warthin's tumor and pleomorphic adenoma was 22 to 6 (3.7:1) and 22 to 47 (1:2.1), respectively. The mean age at presentation with Warthin's tumor or pleomorphic adenoma was 60.7 years and 40.7 years, respectively. In those patients for whom a definite smoking history was known (93 patients), an odds ratio of 8.1 (p<0.001) was calculated. In order to exclude sex as a possible confounder, the odds ratio in males only was 6.4 (p=0.007). In order to exclude age as a possible confounder, the odds ratio in all patients over 45 years (48 patients) was 11.2 (p<0.001).

In summary, smokers have eight times the risk of developing a Warthin's tumor than nonsmokers. This case-control study suggests that smoking may be one of the etiologic factors associated with this benign salivary gland tumor.

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Presented at the Third International Conference on Head and Neck Cancer, San Francisco, California, July 26–30, 1992.

1

From the Department of Surgery, University of Toronto, St. Michael's Hospital, Toronto, Ontario, Canada.

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