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Oral Cancer Statistics

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Oral Cancer Statistics

Postby KevLa » Wed Jan 18, 2017 7:58 am

Good day, my pipe-smoking friends!

Like me, you've probably read or heard that one of the chief health risks associated with pipe smoking is oral cancer. Now, I am not a wishful thinker, but neither do I accept information unquestioningly. Since taking up pipe smoking after becoming concerned about my future health, six years ago, and eventually making the full switch from cigarette smoking to pipe smoking about four-and-a-half years ago, I have continued to attempt to research the health ramifications. The following exercise might be of interest to you, but please bear in mind that I am no expert on health, and am not very good at maths or statistical analysis.

Unlike brain cancer, oral cancer is within the class of cancers known as 'head and neck cancers'.

According to Action on Smoking and Health (A.S.H.), a pipe smoker is nearly 4 times more likely to develop oral cancer than a non-smoker.

According to Google, the population in the U.K. in 2013 was approximately 64,100,000 people.

According to the Office of National Statistics, the median age of U.K. residents in 2014 was 40 years old. This means that approximately half of the population were over 40 years old.

According to Cancer Research UK, there were 11,449 new cases of head or neck cancer in the U.K. in 2014.

Also according to Cancer Research UK, there is a much higher incidence of head or neck cancer among those above the age of 40 than among those below.

Let us take that total number of cancer cases, which one would presume would include (mostly?) smokers of one form of tobacco or another, and instead deliberately treat it, for the sake of argument, as being all non-smokers. If we multiply it by 4, we have 45,796.

11,449 X 4 = 45,796.

If we take the 64.1 millions of residents, and divide that number in half, we are left with the number of residents who are over the age of 40 years: 32,050,000.

64,100,000 / 2 = 32,050,000.

How many times does that number of cancer cases fit into the population over 40 years old?

32,050,000 / 45,796 = 700 (rounded up).

Remember that we arrived at the 45,796 by treating all new cases of head or neck cancer as being non-smokers, and multiplying by 4. The actual number of non-smokers among those cases is unquestionably lower, and probably very significantly so. And those cases were of any kind of head or neck cancer, not just oral cancer.

Also please note the sources for the statistics we've used are either anti-smoking or neutral.

Can we conclude that the chances of a U.K. pipe smoker, in each year of life above the age of 40 years old, developing oral cancer is (probably much) less than 1 in roughly 700 ?

Please share your thoughts :)

PS. Lung cancer is a different kettle of fish altogether. I strongly recommend that you do not inhale tobacco smoke.
Kev-La :ugeek:__,~
"One being's junk is another's art." Motto of Pipes (Autobot warrior, from Transformers: Generation 1).
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Re: Oral Cancer Statistics

Postby PipeStoke » Wed Jan 18, 2017 9:42 am

Nice one, Kev. :)

I'd say, given the reservations you take, you're not entirely off – up to a point. ;)

I wouldn't multiply the 11,449 by four. This is the total number for 2014, correct? Multiplying 11,449 by four gives you a number not entirely valid for the calsulation.

If smokers are four times as likely to develop head or neck cancers as non-smokers, you would instead want to divide 11,449 by five and multiply by four so you get a ratio of 4:1 - the second number being a quarter of the first:

(11,449/5) x 4 = 9159

So, that means that about 9159 smokers will develop a head or neck cancer, while 2290 non-smokers will develop it.

That then means that rather than a 1/700 risk, it is reduced considerably to 1/3500 (rounded up).

32,050,000/9159 = 3500

However, and this is where the main problem lies: This is the risk per year. Remember that the 9159 cases are for the year of 2014.

So if you're a smoker and you're aged 60, you've spent 20 years above the age of 40 while smoking. That means you need to divide the 1/3500 by twenty.

3500/20 = 175

So that makes the risk, 1/175.

There's another way to go about this - and this is perhaps an interesting exercise in checking the numbers. 16.9% of the adult UK population smokes. According to Wikipedia, approximately 15,000,000 of the population is below the age of 19, making them in this regard not adults - I know there's a discrepancy with ages 18-19 here, but that's the structure of the numbers. At most, it'll be about by about a million which isn't too substantial in a population of 64,000,000.

So, that leaves 49,000,000 adults, of which 17% (16.9%) smoke.

(49,000,000/100)*17 = 8,300,000.

Of these 8,300,000, 9159 will develop head or neck cancer in any given year.

8,300,000/9159 = 1/900

Already now, we have a bit of a problem. This gives us a number that is substantially higher than above, which was 1/3500 per year. In this calculation, by age 60, you would be a 1/45 risk over the preceding 20 years, rather than 1/175.


Of course, I did the second calculation because it would highlight that the statistics struggle with these sorts of numbers. It really depends on what is counted as 'being a smoker' in one set of data vs. another. Does the 9159 number come from people who are smokers or do they include people who were smokers but have quit? Does 'party smoker' count as 'smoker' in one set of data vs. another? etc.

Having said that, I have no doubt that the health risk is there. To me however, the most important point, is neither to overstate, nor trivialise the risks.
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Re: Oral Cancer Statistics

Postby KevLa » Wed Jan 18, 2017 10:21 am

Extremely helpful and interesting, my friend. I knew that my "statistical analysis" is likely wrong, but couldn't work out in what way. I knew that if I could count on anyone here to help me out, it would be your good self.

I did think about the "divide by five, times by four" method that you mention, but realised that A.S.H. are claiming that pipe smokers are 4 times more likely to develop oral cancer than non-smokers. The statistic doesn't tell us anything about cigarette smokers, cigar smokers, snuff takers, tobacco chewers, snus users...
This was why I elected to simply treat the figure as being all non-smokers, knowing that it would give a result skewed vastly towards greater risk, and yet if the result was still low, it could still be used to show that its not nearly so bad as it sounds when the anti-smokers tell us "four times greater risk!" 4x does not give us x, but if x is taken to be more than x is even remotely likely to be, and yet the result of 4x is still low, then the truth is going to be even lower.

Also, please note that by "in each year of life above the age of 40 years old", I meant the equivalent of rolling the dice afresh on each and every birthday. This would take into account your point regarding increasing risk over time, would it not?


Anyway, how are things with you, mate? Did you and yours have a nice Christmas? :)
Kev-La :ugeek:__,~
"One being's junk is another's art." Motto of Pipes (Autobot warrior, from Transformers: Generation 1).
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Re: Oral Cancer Statistics

Postby PipeStoke » Thu Jan 19, 2017 3:08 pm

Thanks, mate. :)

I know what you mean, and I tend to err on the side of 'the answer I don't really want' whenever I do these sorts of calculations. I only ever do them for fun, of course as I have no professional reason to. :lol:

The way I see it with the 'per year risk,' I think the idea is that yes, you'll roll the die every year, but of course the more times you roll the die, the more likely you are that it'll come up with the number you don't want. So at age 60, you will have rolled the die 20 times. The analogy of rolling the die for each person on an individual level doesn't entirely make sense of course: If you didn't have cancer at age 59, you're not 20 times as likely to get cancer as you were when you were 40.

The die roll makes more sense if we imagine a thousand people sitting in a room rolling dice. One throw a year each. Collectively, over the twenty years between age 40 and 60, there will be X number of them rolling the undesired number at some point.

If we want to go further with the analogy, what we're looking at then, is that if the smoker has a six-sided die, the non-smoker has a 24-sided die. It doesn't entirely make sense anyway of course, because the risk of getting a 'six' at least once out of twenty throws of the die, is so high it's not representative of the actual risk, which is much lover. Smokers might have a 45-sided die and the non-smokers a 200-sided die.

We had a lovely Christmas and New Years, Kev. Most of the time just my wife, our cats and me. It was too hot, but just quiet and relaxing. :) I hope yours was, too?
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Re: Oral Cancer Statistics

Postby KevLa » Sat Jan 21, 2017 8:55 am

Cheers, chaps. I'll be posting further when I can get to a proper computer. I'm off work at the moment, and my 'phone won't let me type long posts :)
Kev-La :ugeek:__,~
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