Alcohol drinking and esophageal squamous cell carcinoma with focus on light‐drinkers and never‐smokers: A systematic review and meta‐analysis

Abstract

Quantification of the association between alcohol drinking and risk of esophageal squamous cell carcinoma (ESCC) is an open issue, particularly among light alcohol drinkers, never-smokers, and Asian populations, in which some high-risk polymorphisms in alcohol metabolizing genes are more prevalent. To address these issues, we conducted a systematic review and meta-analysis using 40 case-control and 13 cohort studies that reported on the risk associated with alcohol drinking for at least three levels of consumption. In studies adjusted for age, sex, and tobacco smoking, the relative risk (RR) and 95% confidence interval (CI) for the association between light alcohol drinking ( 12.5 g/d) and risk of ESCC was 1.38 (1.14-1.67). The association was slightly stronger in Asian countries than in other populations. The adjusted RRs (95% CIs) were 2.62 (2.07-3.31) for moderate drinking (>12.5-<50 g/d) and 5.54 (3.92-7.28) for high alcohol intake (!50 g/d); the RRs were slightly higher in non-Asian populations. In prospective studies, the RR (95% CI) was 1.35 (0.92-1.98) for light, 2.15 (1.55-2.98) for moderate, and 3.35 (2.06-5.46) for high alcohol intakes; light drinking showed an association with ESCC in Asia (five studies) but not in other regions (three studies). Among never-smokers (nine studies), the RR (95% CI) was 0.74 (0.47-1.16) for light, 1.54 (1.09-2.17) for moderate, and 3.09 (1.75-5.46) for high intakes. This meta-analysis further corroborates the association of moderate and high alcohol intake with risk of ESCC and provides risk estimates based on multiple prospective studies. Light alcohol intake appears to be associated to ESCC mainly in studies in Asia, which suggests a possible role of genetic susceptibility factors.

Dietary and Demographical Risk Factors for Oesophageal Squamous Cell Carcinoma in the Eastern Anatolian Region of Turkey Where Upper Gastrointestinal Cancers are Endemic

“…Alcohol and smoking synergistically promote oesophageal cancer development, and the risk ESCC is directly proportional to the number of cigarettes smoked and the amount of alcohol consumed daily (Tran et al, 2005;Vioque et al, 2008;Islami et al, 2011;Mao et al, 2011). In the present study, we found that smoking correlated with ESCC, whereas alcohol intake did not.…”

The Economic Burden of Cancers Attributable to Tobacco Smoking, Excess Weight, Alcohol Use, and Physical Inactivity in Canada

“…For the rr values associated with alcohol use, we utilized the meta-analyses by Bagnari et al 24,25 [cancers of the lip, oral cavity, and pharynx (International Statistical Classification of Diseases and Related Health Problems, 10th revision, codes C00-14); the nasal cavity, middle ear, accessory sinuses, and larynx (C30-32); the stomach (C16); the liver (C22); the female breast (C50); the ovary (C56); and the prostate (C61)], the meta-analysis by Islami et al 26 [cancers of the esophagus (C15)], the meta-analysis by Fedirko et al 27 [cancers of the colorectum (C18-20)], and the meta-analysis by Tramacere et al 28 [cancers of the pancreas (C25)]. 29 .…”

Corrigendum to “European Code against Cancer 4th Edition: Alcohol drinking and cancer‿ [Cancer Epidemiology 39S1 (2015) S67–S74]

“…Significant dose-response relationships are found with different metrics of exposure to alcohol, such as level, frequency [25] and duration [26] of consumption and for moderate intake in women [4,27,28]. Among non-smokers, reported RRs for oesophageal squamous cell carcinoma and laryngeal cancer range from 0.74 (95% CI: 0.47-1.16) for light intakes, to 3.09 (95% CI: 1.75-5.46) for high intakes [27][28][29]. Risks for oropharyngeal cancer are as high as 5.40 (95% CI: 4.49-6.50) [30].…”