Each year there are approximately 80,000 cases and 40,000 deaths of cancer of the upper aero-digestive tract (UADT) in the 15 European Union countries. This makes it the fourth most common cancer in the European Union. Proportionally, these cancers are most prominent among middle-aged adults and represent the primary form of cancer among men aged under 55. Strong time trends are also occurring, with increasing rates observed among young and middle-aged men.

The study on alcohol-related cancers and genetic susceptibility in Europe (ARCAGE) was established in 2002. It is a multicenter case-control study, including 15 centers in the European Union. Approximately 2,000 incidence cases of head and neck cancer and a comparable group of controls have been interviewed on lifestyle factors such as alcohol consumption, dietary habits, and tobacco consumption. Biological samples are available for most of the study subjects.

The 15 participating centres are Prague (Czech Republic), Bremen (Germany), Greece (Athens), Aviano, Padova and Turin (Italy), Dublin (Ireland), Oslo (Norway), Edinburgh, Manchester and Newcastle (UK), Paris (France), Tartu (Estonia), Zagreb (Croatia) and Barcelona (Spain). The International Agency for Cancer Research (Lyon, France), is responsible for the overall co-ordination of the study.

The specific objectives of the study are to:

1. Investigate whether specific patterns and types of known etiological factors are important including specific type of alcohol consumption (i.e. spirits, beer, wine) and patterns of drinking (heavy binge drinking vs regular moderate consumption).
   
   
2. Investigate other dietary patterns including the potential protective effect of fruit and fresh vegetables, and possible risks associated with salted fish, preserved meat and pickled vegetables.
   
   
3. Investigate the interaction between high alcohol consumption and other dietary or lifestyle factors, especially low consumption of fruits and vegetables, and tobacco consumption.
   
   
4. Investigate the role of genetic susceptibility to alcohol and tobacco metabolism and DNA damage in explaining international differences, as well individual risk for UADT cancers.
   
   
5. Provide a sufficient number of cases to enable subgroup analysis of specific groups including different age and sex categories. This includes risk factors which have a more prominent effect in men aged less than 55, as UADT cancers are proportionally high in this group and are increasing.
   
   
6. Combine information on lifestyle and dietary exposures, genetic susceptibility and biomarkers for DNA repair, assess the extent to which these variables can be used at the level of the individual to identify high risk groups for development of UADT cancers.