The Synergistic Effects of Alcohol and Tobacco Consumption on the Risk of Esophageal Squamous Cell Carcinoma: A Meta-Analysis

Prabhu, Anoop; Kenneth, O.; Rubenstein, Joel H.

doi:10.1038/ajg.2014.71

Cited by 216 publications

(146 citation statements)

References 29 publications

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“…There is a known synergistic effect of alcohol and tobacco consumption on the risk of cancer of the oral cavity, pharynx and esophagus [22][23][24]. For example, the risk of oral cavity and pharynx cancers is about 5-10 times higher for heavy smokers than for nonsmokers, and about 5 times higher for heavy drinkers than for nondrinkers.…”

Section: Discussionmentioning

confidence: 99%

A local mechanism by which alcohol consumption causes cancer

López‐Lázaro

2016

Oral Oncology

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Epidemiological data indicate that 5.8% of cancer deaths world-wide are attributable to alcohol consumption. The risk of cancer is higher in tissues in closest contact on ingestion of alcohol, such as the oral cavity, pharynx and esophagus. The risk of these cancers is increased even in people who have only one alcoholic drink per day. However, since ethanol is not mutagenic and the carcinogenic metabolite of ethanol (acetaldehyde) is mostly produced in the liver, it is not clear why alcohol use preferentially exerts a local carcinogenic effect. It is well known that ethanol causes cell death at the concentrations present in alcoholic beverages; however, this effect has been overlooked probably because dead cells cannot give rise to cancer. Here I discuss that the cytotoxic effect of ethanol on the cells lining the oral cavity, pharynx and esophagus activates the division of the stem cells located in deeper layers of the mucosa to replace the dead cells. Every time stem cells divide, they become exposed to unavoidable errors associated with cell division (e.g., mutations arising during DNA replication and chromosomal alterations occurring during mitosis) and also become highly vulnerable to the genotoxic activity of endogenous and exogenous DNA-damaging agents (e.g., reactive oxygen species, acetaldehyde and tobacco carcinogens). Alcohol consumption probably increases the risk of developing cancer of the oral cavity, pharynx and esophagus by promoting the accumulation of cell divisions in the stem cells that maintain these tissues in homeostasis. Because the cytotoxic activity of ethanol is concentration-dependent, the risk of these cancers will not only increase with increasing amounts of ethanol, but also with increasing concentrations; an ounce of whisky is probably more carcinogenic when taken undiluted than when taken mixed with non-alcoholic beverages. The local cytotoxic effect of ethanol can also explain the known synergistic effect of alcohol and tobacco use on the risk of these cancers. Understanding the mechanisms of carcinogenicity of alcohol is important to reinforce the epidemiological evidence and to raise public awareness of the strong link between alcohol consumption and cancer.

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Section: Discussionmentioning

confidence: 99%

A local mechanism by which alcohol consumption causes cancer

López‐Lázaro

2016

Oral Oncology

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“…Aunque la validez de estas excepciones está en revisión, su ocurrencia es motivo de investigación (91) . Como se ha dicho antes el consumo de tabaco y de alcohol son por lejos los factores de riesgo más importantes y su combinación tiene un efecto sinérgico sobre el riesgo, en particular en el SC (97) .…”

Section: Anfamed -Issn: 2301-1254unclassified

Cáncer: magnitud del problema en el mundo y en Uruguay, aspectos epidemiológicos

Barrios¹,

Garau²

2017

An Facultad Med (Univ Repúb Urug)

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ResumenEl problema del cáncer es uno de los desafíos más relevantes de nuestra época. Como consecuencia de la transición demográfico-epidemiológica, el cáncer es actualmente una de las principales causas de muerte en el mundo y en Uruguay. Debido a que esta transición está aún en curso y con diferentes diná-micas alrededor del mundo, el problema del cáncer está cambiando en su escala y perfil. Se estima que el número de casos nuevos anuales pasará de alrededor de 14 millones en 2012 a más de 20 millones en 2030, y que casi dos tercios de esos casos ocurrirán en los países menos desarrollados. En tanto que estos últimos no cuentan con recursos similares a aquellos de los países desarrollados para enfrentar la enfermedad, esta situación plantea un desafío dramático para gobiernos y autoridades sanitarias.En Uruguay se diagnostican unos 13000 casos nuevos de cáncer (exceptuando al cáncer de piel distinto al melanoma), y más de 8000 pacientes mueren por esta enfermedad anualmente. Se examina, en particular, la situación epidemiológica de los cuatro tipos de cáncer más importantes: el cáncer de mama femenino, y los de próstata, pulmón y colo-recto, éstos dan cuenta de la mitad del total. Se analizan, además: el cáncer cervico-uterino y el cáncer de esófago. Las tasas estandarizadas por edad de mortalidad por cáncer (todos los sitios reunidos) muestran un descenso sostenido en las últimas décadas. No obstante, Uruguay exhibe en general tasas de incidencia comparables al conjunto de los países desarrollados, pero tasas de mortalidad más elevadas. Palabras claveCáncer, incidencia, mortalidad, epidemiología, Uruguay. AbstractThe burden of cancer is one of the most relevant challenges of our time. As a consequence of the demographic-epidemiologic transition, cancer is currently one of the leading causes of death, globally and in Uruguay. This transition is still in progress but with different dynamics around the world; therefore, the burden of cancer is changing its scale and profile. The projections indicate that the number of new cases will grow from 14 million in 2012 to more than 20 million in 2030, and that almost two thirds of them will take place in developing countries. Since less developed countries don`t have

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“…The main risk factors for OSCC are tobacco smoking (including swallowed toxins from cigarette smoke) and alcohol overconsumption, particularly when in combination. 12 Among dietary factors, fruit and vegetable intake is protective, 13 while intake of red meat 14 and very hot beverages are risk factors. 15 Genetic factors are also involved; a pooled analysis of three genome-wide association studies found new susceptibility loci for OSCC.…”

Section: Squamous Cell Carcinomamentioning

confidence: 99%

Oesophageal cancer

et al. 2017

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SummaryOesophageal cancer is a clinically challenging disease requiring a multidisciplinary approach.The extensive treatment may be associated with serious limitations in health-related quality of life and yet still a poor prognosis. Recent decades have witnessed a gradual improvement in prognosis in many countries. Endoscopic procedures have increasingly been used in the treatment of premalignant and early oesophageal tumours. Neoadjuvant therapy with chemotherapy or chemoradiotherapy has supplemented surgery as standard treatment of locally advanced oesophageal cancer. Surgery has become more standardised and centralised. There are several therapeutic alternatives for palliative treatment. This review aims to provide insights into the current clinical management, on-going controversies and future needs in oesophageal cancer.3

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The Synergistic Effects of Alcohol and Tobacco Consumption on the Risk of Esophageal Squamous Cell Carcinoma: A Meta-Analysis

Abstract: There is a positive synergistic effect of alcohol and tobacco use for ESCC. The observed combined effect of the two factors is almost double if there were no synergy. Efforts for controlling the burden of ESCC should focus on individuals who use both alcohol and tobacco.

Cited by 216 publications

References 29 publications

A local mechanism by which alcohol consumption causes cancer

A local mechanism by which alcohol consumption causes cancer

Cáncer: magnitud del problema en el mundo y en Uruguay, aspectos epidemiológicos

Oesophageal cancer

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