Kliniken & Institute … Institute Heidelberger Institut… Groups & Projects Working Groups Epidemiology and… Research Cancer epidemiology … Laryngeal cancer

Occupational and other risk factors for laryngeal cancer

Project team: Heribert Ramroth, Heiko Becher 

External collaborators:  Andreas Dietz, INHANCE, DKFZ Heidelberg

Funding: Eigenmittel

Funding period: 2000 - ongoing

The Rhein-Neckar-Larynx Study is a population-based case-control study 1:3 frequency matched by age and sex on laryngeal cancer in South-West Germany with 257 cases, histologically confirmed and diagnosed between 1.5.1998 and 31.12.2000 and 769 population controls. Information about occupational exposures, lifestyle factors and socio demographic background were obtained with face-to-face interviews using a detailed standardized questionnaire.

As expected, highest risks on laryngeal cancer were found for smoking and alcohol consumption (Ramroth et al. 2004). For occupational exposures we found higher risks for polycyclic aromatic hydrocarbons (Becher et al 2005), cement dust (Dietz et al. 2004) and wood dust (Ramroth et al. submitted), but no association for asbestos.

We did not find a risk modifying effect of genetic polymorphisms in enzymes involved in ethanol and tobacco carcinogen metabolism (Risch et al. 2002), but our results suggest that a reduced capacity of somatic cells to synthesize poly(ADP-ribose) (Rajaee-Behbahani et al. 2002) might be associated with an increased risk for laryngeal cancer. Further analyses related to alcohol, and active and passive smoking have additionally been performed.


Ramroth H, Ahrens W, Dietz A, Becher H.: Occupational asbestos exposure as a risk factor for laryngeal carcinoma in a population based case control study from German. Am J Ind Med (2011 May 2. doi: 10.1002/ajim.20963. [Epub ahead of print]

Ramroth H, Dietz A, Becher H: Intensity and inhalation of smoking in the aetiology of laryngeal cancer. Int J Environmental Research and Public Health 2011; 8, 976-984; doi:10.3390/ijerph8040976

Abbasi R, Ramroth H, Becher H, Dietz A, Schmezer P, Popanda O: Laryngeal cancer risk associated with smoking and alcohol consumption is modified by genetic polymorphisms in ERCC5, ERCC6, and RAD23B but not by polymorphisms in five other nucleotide excision repair genes. Int J Cancer 2009; 125:1431-1439. 

Ramroth H, Dietz A, Becher H.: Occupational wood dust exposure and the risk of laryngeal cancer. A population based case-control study in Germany.  Am J Ind Med 2008; 51:648-55.

Ramroth H, Dietz A, Becher H.: Environmental tobacco smoke and laryngeal cancer: results from a population-based case-control study. Eur Archives Oto-Rhino-Laryngology 2008; 265:1367-71.

Ramroth H, Dietz A, Becher H: Rauchen und Alkohol sind Hauptrisikofaktoren für Kehlkopfkrebs. Ergebnisse einer deutschen Fall-Kontroll-Studie im europäischen Vergleich. Deutsches Ärzteblatt 2006;103:A 1078-1083.

Becher H, Ramroth H, Ahrens W, Risch A, Schmezer P, Dietz A: Occupation, exposure to polycyclic aromatic hydrocarbons and laryngeal cancer risk. Int J Cancer 2005;116:451-457.

Ramroth H, Dietz A, Becher H: Interaction effects and population attributable risks for smoking and alcohol on laryngeal cancer and its subsites: a case-control study from Germany. Meth Inform Med 2004;43:499-504.

Dietz A, Ramroth H, Urban T, Ahrens W, Becher H: Exposure to cement dust, related occupational groups and laryngeal cancer risk: Results of a population based case-control study. International Journal of Cancer 2004;108:907-911.

Risch A, Ramroth H, Raedts V, Rajaee-Behbahani N, Schmezer P, Bartsch H, Becher H, Dietz A. Laryngeal cancer risk in Caucasians is associated with alcohol and tobacco consumption but not modified by genetic polymorphisms in class I alcohol dehydrogenases ADH1B and ADH1C, and glutathione-S-transferases GSTM1 and GSTT1. Pharmacogenetics. 2003;13(4):225-30.

Rajaee-Behbahani N, Schmezer P, Ramroth H, Burkle A, Bartsch H, Dietz A, Becher H. Reduced poly(ADP-ribosyl)ation in lymphocytes of laryngeal cancer patients: results of a case-control study. Int J Cancer. 2002;98(5):780-4.

Ramroth H, Altenburg HP, Becher H. Auswahl von Populationskontrollen für epidemiologische Fall-Kontroll-Studien unter Verwendung regionaler Stichproben. Informatik, Biometrie und Epidemiologie in Medizin und Biologie 2001; 32:60-70