Alcohol and cancer

Association of ADH1B and ALDH2 genotypes with the risk of lung adenocarcinoma

OBJECTIVE

The incidence of lung adenocarcinoma (LAD) is increasing worldwide. Single-nucleotide polymorphisms in aldehyde dehydrogenase 2 family member gene ( ALDH2 ) rs671 and alcohol dehydrogenase 1B ( ADH1B ) rs1229984 are common and functionally important genetic variants to metabolize endogenous and exogenous aldehyde chemicals, related to cancer.

METHODS

This is a case-control study. A total of 150 newly diagnosed LAD patients were from Kaohsiung Medical University Hospital, Taiwan, between 2019 and 2022. Two control groups, TWB-1 ( n  = 600) and TWB-2 ( n  = 29 683), were selected from Taiwan Biobank (TWB), and the case patients were frequency-matched with TWB-1 based on age category (30-60 or >60 years old), sex, and education levels. Logistic regression models were employed to analyze the association between two genetic variants and LAD risk.

RESULTS

A significant association was noted between ALDH2 and LAD risk. Those with ALDH2 rs671 *2/*2 in TWB-1 and TWB-2 controls had a 2.68-fold (95% CI = 1.43-4.99) and a 1.83-fold (95% CI = 1.07-3.11) increased risk of LAD, respectively, compared with those with ALDH2 rs671 *1/*1 or *1/*2 , after adjusting for covariates. This association was particularly pronounced in females. No overall significant association between ADH1B rs1229984 and LAD risk was observed.

CONCLUSION

The findings indicate a strong and robust risk association between ALDH2 rs671*2/*2 and LAD in the Taiwan population, particularly in Taiwanese female adults.

Global, regional and national burden and trends of larynx cancer among adults aged 55 and older from 1990 to 2021: results from the global burden of disease study 2021

BACKGROUND

Laryngeal cancer (LC), as a common head and neck tumor, significantly impacts the quality of life. Utilizing data from the 2021 Global Burden of Disease (GBD) study, we sought to delve deeply into the global LC burden experienced by individuals aged 55 and older from 1990 to 2021 at the global, regional, and national levels. This research encompassed three key indicators: incidence rate, mortality, and disability-adjusted life years (DALYs).

METHODS

Based on the GBD 2021 database, we selected data from 204 countries and regions covering the period from 1990 to 2021 for individuals aged 55 and above. We analyzed LC's performance in terms of incidence, mortality, and DALYs, calculating the age-standardized rates and the mean average annual percent change (AAPC) at global, regional, and national levels. In our analysis of global trends, we carefully considered multiple variables including age, sex, and the socio-demographic index (SDI). Furthermore, we assessed potential risk factors for LC-associated DALYs and made prospective predictions for the possible scenario by 2035.

RESULTS

Globally, the age-standardized DALY rate of LC among adults aged 55 years and older has undergone significant changes. Specifically, this rate dropped sharply from 245.89 cases per 100,000 people in 1990 to 153.76 cases per 100,000 people in 2021, with an AAPC showing a decreasing trend of -2.916. Simultaneously, the age-standardized incidence rate and mortality rate also exhibited a similar downward trend. From a regional perspective, South Asia ranked highest in relevant indicators in 2021, reporting a death toll of 29,258.96, confirmed cases of 34,234.23, and DALYs related to LC reaching 709,622.00. In contrast, the figures in Oceania were the lowest, with only 26.23 deaths, 29.53 incident cases, and 609.09 DALYs. When divided according to the quintiles of the SDI, in 2021, the medium-high SDI led in incidence rates, while the low SDI ranked last. However, in terms of mortality and DALY rates, medium-low SDI topped the list, with high SDI being the lowest. In terms of gender differences, in 2021, the age-standardized DALY rate of LC in males was approximately 7.13 times that of females, with the former reaching 282.12 cases per 100,000 people and the latter only 39.59 cases per 100,000 people. Among all age groups, a notable decrease was observed in the age-specific incidence rate and DALY for adults aged 60-64 years, with AAPC values of -0.123 (95% CI: -0.130 to -0.116) and - 3.553 (95% CI: -3.620 to -3.486), respectively. Similarly, the mortality rate for adults aged 65-69 years also showed a significant decline, with an AAPC of -0.123 (95% CI: -0.127 to -0.118). Additionally, tobacco has been revealed as the most important risk factor affecting the mortality and DALY of LC in adults aged 55 years and older. Looking ahead, it is predicted that by 2035, the incidence rate, mortality rate, and DALY rate of LC among people over 55 years old will continue to decline.

CONCLUSIONS

Despite the current data and future predictions indicating a decline in the global age-standardized incidence rate, the absolute number of estimates continues to increase. Therefore, we advocate that cancer prevention strategies should place greater emphasis on vigorously addressing modifiable risk factors, particularly for the male population, which requires special attention and scientific intervention.

Increased PD-1/PD-L1 Immune Checkpoint Expression Is Associated With Oral Squamous Cell Carcinoma in Never-Smokers and Never-Drinkers

BACKGROUND

This study aimed to explore the disparities in PD-1 and PD-L1 expression among oral squamous cell carcinomas (OSCCs) in individuals categorized as never-smokers/never-drinkers versus smokers/drinkers.

METHODS

Immunohistochemical staining for PD-1 and PD-L1, along with PDCD1LG2/cen9 dual color probe analysis, was conducted on 130 OSCC specimens from both smoker/drinker and never-smoker/never-drinker cohorts. Associations between smoking/drinking status, clinicopathologic data, immunohistochemical antibody expression, fluorescence in situ hybridization, and survival outcomes were assessed.

RESULTS

OSCC in never-smokers/never-drinkers exhibited significantly elevated PD-1 expression (p = 0.003), increased PD-L1-TPS expression (p = 0.044), and elevated PD-L1-CPS expression (p < 0.001). High PD-L1-ICS expression was more prevalent in never-smokers (p = 0.042). Moreover, never-smokers and never-drinkers demonstrated augmented PD-L1 gene copy numbers (p = 0.081 and p = 0.054, respectively). Increased PD-L1 gene copy number, particularly amplification, correlated with PD-L1-TPS (p = 0.039 and p < 0.001). Conversely, PD-L1 gene copy loss was associated with negative PD-L1-CPS (p = 0.023). Notably, positive PD-L1-CPS was significantly linked with improved overall survival (p = 0.023).

CONCLUSIONS

OSCC arising in never-smokers/never-drinkers exhibit heightened PD-1/PD-L1 signaling, suggesting potential efficacy of immune checkpoint therapy in this subgroup of tumors.

A chance for countries to support Ireland's world-leading cancer warning labels for alcohol containers

Ireland has regulated for all packaged alcohol products to include a health warning that states that 'there is a link between alcohol and fatal cancers'. This warning is being opposed in the World Trade Organization by 12 member states who are raising that the warning is an unnecessary barrier to trade. The World Health Organization is supporting Ireland. Countries should not oppose Ireland's warning which is defensible from legal and public health perspectives.

Consumption of Red Versus White Wine and Cancer Risk: A Meta-Analysis of Observational Studies

BACKGROUND/OBJECTIVES

While alcoholic beverage consumption increases cancer risk, red wine has been touted as a healthier option. To address this unexplored question, we conducted a meta-analysis to summarize evidence from observational studies.

METHODS

A literature search of PubMed and EMBASE through December 2023 identified studies examining wine and cancer risk. A random-effects meta-analysis was performed to estimate relative risks (RRs) and 95% confidence intervals (CIs) for an association between wine intake and overall cancer risk.

RESULTS

A total of 20 cohort and 22 case-control studies were included. Wine intake was not associated with overall cancer risk (n = 95,923) when comparing the highest vs. lowest levels of consumption, with no differences observed by wine type (red: summary RR = 0.98 [95% CI = 0.87, 1.10], white: 1.00 [0.91, 1.10]; Pdifference = 0.74). However, white wine intake was significantly associated with an increased risk of cancer among women (white: 1.26 [1.05, 1.52], red: 0.91 [95% CI: 0.72, 1.16], Pdifference = 0.03) and in analyses restricted to cohort studies (white: 1.12 [1.03, 1.22], red: 1.02 [95% CI: 0.96, 1.09], Pdifference = 0.02). For individual cancer sites, there was a significant difference in associations between red and white wine intake only in skin cancer risk [6 studies, white: 1.22 (1.14, 1.30), red: 1.02 (0.95, 1.09); Pdifference = 0.0003].

CONCLUSIONS

We found no differences in the association between red or white wine consumption and overall cancer risk, challenging the common belief that red wine is healthier than white wine. Our significant results related to white wine intake in subgroup analyses warrant further investigation.

Colorectal Cancer Incidence in Steatotic Liver Disease (MASLD, MetALD, and ALD)

BACKGROUND AND AIMS

Obesity and alcohol consumption are established risk factors for colorectal cancer (CRC). Recently, a multisociety consensus group has introduced a new classification for steatotic liver disease (SLD), which encompasses metabolic dysfunction-associated steatotic liver disease (MASLD), MASLD and increased alcohol intake (MetALD), and alcohol-associated liver disease (ALD). However, the risk of developing CRC in each of these SLD subgroups is unknown. This nationwide cohort study investigated the risk of CRC in MASLD, MetALD, and ALD patients. The primary endpoint was the occurrence of CRC in each SLD subgroup.

METHODS

We conducted a nationwide, population-based study that included 1,497,813 patients diagnosed with MASLD, MetALD, or ALD, alongside 4,885,536 individuals with no known liver disease as a comparison group. The primary outcome was the incidence of CRC and the risk of CRC was compared between MASLD, MetALD and ALD.

RESULTS

The 5- and 10-year cumulative CRC incidence rates were 0.22% and 0.48% for MASLD, 0.32% and 0.73% for MetALD, and 0.43% and 0.97% for ALD, and 0.15% and 0.31% for the comparison group, respectively. The cumulative incidence of CRC was highest for ALD and significantly greater than that for MetALD, MASLD, and the comparison group (both P < .001). Using the comparison group as the reference and adjusting for age, sex, smoking habit, number of colorectal examinations, diabetes mellitus, dyslipidemia, hypertension, and medication use, the adjusted hazard ratios for CRC were 1.73 (95% CI, 1.59-1.87) for ALD, 1.36 (95% CI, 1.28-1.45) for MetALD, and 1.28 (95% CI, 1.22-1.35) for MASLD.

CONCLUSIONS

The risk of CRC differs significantly among patients with SLD, with the highest incidence observed in those with ALD, followed by MetALD and MASLD.

Genotoxic effects in island populations of Cartagena de Indias, Colombia due to environmental exposure to mercury and cadmium

Background

Contamination of Cartagena Bay, Colombia with heavy metals such as mercury (Hg) and cadmium (Cd) presents a major environmental and public health concern, particularly for human communities residing on nearby islands and coastal areas. These populations face enhanced exposure risks owing to their traditional fishing practices and continuous interactions with polluted marine environments. This study aimed to evaluate the genotoxic effects of environmental exposure to Hg and Cd in populations from the island zone of the Cartagena district, Bolívar.

Methods

Ninety-four individuals from the four island communities (study group) and 30 individuals from the urban area of Cartagena (control group) participated in this study. The blood samples were collected to measure total mercury (T-Hg) and Cd concentrations, and a Buccal Micronucleus Cytome (BMCyt) assay was used to evaluate exposure effects.

Results

Cadmiun levels in the blood of the study group were within the normal range and comparable to those of the control group (p > 0.05). However, the study group exhibited significantly higher T-Hg levels (7.34 μg/L) compared to the control group (2.01 μg/L), surpassing the accepted limit. Moreover, the study group showed a higher incidence of DNA damage and cell death biomarkers (p < 0.05). Additionally, significant correlations were observed between total blood Hg levels and the frequencies of micronuclei, karyorrhexis, and karyolysis.

Conclusion

These results suggest that island populations of Cartagena are exposed to high levels of Hg and exhibit genotoxic damage, indicating a problem that must be addressed.

Advances in nanotechnology-based approaches for the treatment of head and neck squamous cell carcinoma

Head and neck squamous cell carcinoma (HNSCC), one of the most common types of cancers occurring in the head and neck region, is often associated with high mortality rates due to its invasiveness and morbidity. The mainstream treatment methods in clinical settings, including surgery, chemotherapy, and radiotherapy, may cause poor overall survival rate and prognosis, with issues such as drug resistance, damage to adjacent healthy tissues, and potential recurrences. Other treatment approaches such as immunotherapy, photodynamic therapy (PDT), and photothermal therapy (PPT) also suffer from inefficient tumor targeting and suboptimal therapeutic outcomes. Early detection is vital for HNSCC patients, but it is always limited by insensitivity and confusing clinical manifestations. Hence, it is highly desirable to develop optimized therapeutic and diagnostic strategies. With the boom in nanomaterials, nanotechnology-conducted HNSCC therapy has attracted widespread attention. Nanoparticles (NPs) are distinguished by their unique morphology and superior physicochemical property, and some can exhibit direct antitumor activity, while others serve as promising candidates for drug delivery. In addition, NPs offer the potential for structural modification for drug delivery and tumor targeting, enabling specific delivery to tumor cells through conjugation with biomarker ligands and improving cargo biocompatibility. This work reviews current therapies and diagnosis methods for HNSCC, highlights the characteristics of the major NPs, surveys their uses and advantages in the treatment of HNSCC, and discusses the obstacles and prospects in clinical applications, aiming to enlighten future research directions for nanotechnology-based therapy for HNSCC.

Impact of smoking and alcohol drinking on the prognosis of 721 nasopharyngeal carcinoma

OBJECTIVE

This study aimed to examine the correlation between smoking, alcohol drinking, and the prognosis of Nasopharyngeal Carcinoma (NPC).

METHODS

Clinical data from 721 NPC cases treated at our hospital between January 2005 and December 2010 were collected. Information on smoking and drinking, including duration, daily quantity, and cumulative amount, was recorded and graded according to WHO standards. Statistical analysis was performed to assess the influence of smoking and alcohol drinking on NPC patient prognosis. After controlling for confounding factors, survival analysis compared the 5-year Progression-Free Survival rate (PFS) and Overall Survival rate (OS) among patients with varying degrees of smoking and drinking. The association between smoking, drinking, cumulative amount, and NPC patient prognosis was evaluated. Multivariate Cox regression analysis was then employed, considering patient demographic characteristics and clinical features, to comprehensively analyze prognostic influencing factors in NPC patients. Additionally, the multivariate Cox regression analysis was utilized to comprehensively examine the influencing factors of prognosis, taking into account the patients' basic demographic characteristics and clinical features. The findings revealed significant differences in the aforementioned rates.

RESULTS

(1) Analysis of PFS and OS differences in NPC patients considered smoking status, smoking duration, daily smoking quantity, and cumulative smoking amount. No significant influence of smoking on NPC patient PFS and OS within 5-years was observed (p > 0.05). (2) Non-drinkers with NPC exhibited higher 5-year PFS and OS rates compared to drinkers (p = 0.047, p = 0.026). Furthermore, non-drinkers and those with a drinking duration of less than 120 months or between 120-240 months showed higher 5-year PFS and OS rates than individuals with a drinking duration exceeding 240 months (p < 0.05). Similarly, non-drinkers and individuals consuming less than 50 g/day had higher 5-year PFS and OS rates compared to those consuming 50-100 g/day or more than 100 g/day (p < 0.05). Additionally, the 5-year PFS and OS rates were higher in the non-drinking and light drinking groups compared to the moderate and heavy drinking groups (p < 0.05). (3) A partial synergistic effect between smoking and alcohol drinking was observed in NPC. (4) Alcohol drinking emerged as an independent prognostic factor for NPC.

CONCLUSION

Alcohol drinking is a significant factor influencing the prognosis of nasopharyngeal carcinoma, with the adverse effects further amplified when combined with smoking.

LEVEL OF EVIDENCE

Level 2.

Development and internal validation of risk stratification tool for lymph node metastasis in pT3-4 laryngeal squamous cell carcinoma patients

OBJECTIVE

To identify risk factors for Lymph Node Metastasis (LNM) in pT3-4 Laryngeal Squamous Cell Carcinoma (LSCC) patients with negative margins, and develop a nomogram to predict LNM risk.

METHODS

872 patients were divided into training (2010-2014) and validation (2015-2016) cohorts. Univariate and multivariate analyses identified LNM risk factors. A nomogram incorporating significant factors was developed in the training cohort.

RESULTS

Smoking history, maximal tumor diameter ≥3.0 cm, depth of tumor invasion >1.0 cm, and supraglottic tumor location were significantly associated with LNM on multivariate analysis. A predictive nomogram incorporating these factors showed good discrimination (C-index > 0.7) in both cohorts. Patients were stratified into low, moderate and high-risk subgroups based on total risk scores.

CONCLUSIONS

A LNM risk prediction model and risk grouping system was established, which may aid treatment selection for pT3-4 LSCC patients. The model and algorithm could help optimize neck management for this high-risk patient population.

LEVEL OF EVIDENCE: 2

Oral cancer incidence rate is associated with access to dental care: City and statewide analyses

INTRODUCTION

Access to dental care may affect diagnosis of oral squamous cell carcinoma (OSCC). We tested whether the incidence rate of OSCC is higher in regions with less dental care access in the city of Chicago and state of Illinois.

STUDY DESIGN

Ecological cohort.

SETTING

Population, outpatients, and inpatients.

METHODS

We extracted 5-year averages of the state-wide county-level and city-level OSCC incidence rates from 2015 to 2019 from the Illinois Department of Public Health. Dental care access information was also collected for each county for the same period, as well as the percentage of people that had ≥1 visit to a dentist in the previous year in Chicago. Multivariate Poisson regression was used to investigate the relationship between county-level access to dental care (and city-level dentist visits) and OSCC incidence rate, controlling for confounders, with additional flexible semiparametric models for confirmatory sensitivity analysis.

RESULTS

In Illinois, higher 5-year incidence rate of OSCC was significantly associated with low access to dental care by county (IRR = 0.96, 95% CI 0.91, 0.98). Southern/southwestern counties had higher incidence rates of OSCC (15.5%-28.4%) and the lowest rates of dental care access (47.5%-69.2%) compared to northern counties (10.3%-15% and 55.4%-80.6%, respectively). In Chicago, people with more dentist visits had a reduced chance of being diagnosed with OSCC (IRR = 0.97, 95% CI 0.91, 0.99), consistent with state-wide analyses.

CONCLUSION

OSCC incidence rate is closely associated with poor local dental healthcare access in a major state and urban city. Increasing dental access could improve cancer outcomes via improved oral health and earlier detection.

Curcumin attenuates smoking and drinking activated NF-κB/IL-6 inflammatory signaling axis in cervical cancer

BACKGROUND

High-risk strains of HPV are known to cause cervical cancer. Multiple clinical studies have emphasized that smoking and drinking are critical risk factors for cervical cancer and its high-grade precursors. In this study, we investigated if smoking and/or drinking augment the molecular mechanisms of cervical carcinogenesis and defined a potential therapeutic approach for their attenuation.

METHODS

The impact of benzo[a]pyrene (B[a]P) and/or ethanol (EtOH) exposure on cervical cancer cells was assessed by measuring changes in their cell migration and invasion characteristics. Expression of HPV16 E6/E7, NF-κB, cytokines, and inflammation mediators was determined using qRT-PCR, immunoblotting, ELISA, luciferase reporter assay, and confocal microscopy. Herein, we used curcumin (Cur), and PLGA nanoparticle formulation of curcumin (PLGA-Cur) and determined effectiveness of free Cur and PLGA-Cur formulation on smoking and drinking activated NF-κB/IL-6 mediated inflammatory signaling pathways using in vitro cervical cancer models.

RESULTS

Treatments with B[a]P and/or EtOH altered the expression of HPV16 E6/E7 oncogenes and EMT markers in cervical cancer cells; it also enhanced migration and invasion. In addition, B[a]P and/or EtOH exposure promoted inflammation pathways through TNF-α and NF-κB signaling, leading to IL-6 upregulation and activation of VEGF. The molecular effects caused by B[a]P and/or EtOH exposure were effectively attenuated by curcumin (Cur)/PLGA-Cur treatment.

CONCLUSIONS

These data suggest a molecular link between smoking, drinking, and HPV infectivity in cervical carcinogenesis. In addition, attenuation of these effects by treatment with Cur/PLGA-Cur treatment, implies the role of curcumin in cervical cancer prevention and treatment.

Global, regional, and national burden and trends of air pollution-related neoplasms from 1990 to 2019: An observational trend study from the Global Burden of Disease Study 2019

BACKGROUND

Air pollution-related neoplasms are a major global public health issue and are one of the leading causes of death worldwide. Air pollution is one of the important risk factors of air pollution-related neoplasms and is associated with a variety of air pollution-related neoplasms.The primary objective of this study was to estimate the epidemiological patterns of death rates and disability-adjusted life years (DALYs) associated with air pollution-related neoplasms on a global scale, covering the period from 1990 to 2019. Furthermore, we aimed to predict the trends in these epidemiological patterns up to 2050. By achieving these goals, our study seeks to provide a comprehensive understanding of the potential causes underlying the observed disparities in neoplasm-related health outcomes, ultimately contributing to the development of effective strategies for addressing this major public health issue.

METHODS

Based on data from the 2019 Global Burden of Disease (GBD) study, the indicators of the air pollution-related neoplasms disease burden was the numbers and age-standardized rates (ASR) of deaths and disability-adjusted life years (DALYs) from 1990 to 2019. First, we compared the burden of air pollution-related neoplasms and temporal trends by gender, age, socio-demographic index (SDI), region, and country. Furthermore, driving factors and improvement potential were evaluated using decomposition and frontier analysis. Finally, forecasting analyses of the changing trend in the burden of air pollution-related neoplasm up to 2050 was conducted based on time series forecasting models.

RESULTS

In 2019, air pollution-related neoplasms accounted for 387.45 million (95 % UI 288.04-490.06 million) deaths and 8951.97 million (95 % UI 6680.89-11342.60 million) DALYs globally. Deaths and DALYs demonstrated an upward trend from 1990 to 2019, while their ASR showed a downward trend. The disease burden and the decline degree of males were both significantly higher than that of females, and the high burden was mainly in the elderly groups. The middle SDI region possessed the highest burden with the most significant upward trend, while the high SDI region had the lowest burden with the most significant downward trend. Decomposition analyses represented that the increase in the overall deaths and DALYs of air pollution-related neoplasms was mainly driven by population growth. The predictive analyses expected that the deaths and DALYs of air pollution-related neoplasms will continue to rise, while their corresponding ASR will decrease by 2050.

CONCLUSION

The global burden of air pollution-related neoplasms remained high, and deaths and DALYs will be on upward trends up to 2050, with differences among genders, ages, SDI levels, GBD regions, and countries. It is essential to understand the air pollution-related neoplasm burden and contributing epidemiological factors for implementing effective and factor-tailored interventions to reduce the global burden.

Trigeminal neuralgia and risk of cancer: A population-based cohort study

BACKGROUND

Evidence of an association between trigeminal neuralgia (TN) and subsequent cancer risk remains sparse. The present study aimed to examine the association between TN and cancer risk in the Danish population.

METHODS

A nationwide population-based cohort study using hospital diagnoses collected routinely and prospectively from Danish population-based registries in 1994-2022.

RESULTS

We identified 7846 individuals with a first-time diagnosis of TN. Within one year of diagnosis, we observed 193 cancer cases (standardized incidence rate (SIR) = 2.45, 95% confidence interval (CI) = 2.11-2.82). Absolute risk (AR) for all cancers within one year of TN diagnosis was 2.5% (95% CI = 2.2-2.9). Cancers of the head, neck and nervous system were most strongly associated with TN (AR 0.9% (95% CI = 0.7-1.1); SIR = 13.5 (95% CI = 10.5-17.0)) and the risk was persistently elevated one year after TN diagnosis. We observed 827 cancer diagnoses beyond one year after TN diagnosis, where smoking related cancers were associated with elevated cancer risk (SIR 1.13 = (95% CI = 0.98-1.29)).

CONCLUSIONS

TN was associated with an elevated risk of cancers of the head, neck and nervous system including site-specific cancers in the area. Our results suggest the potential importance of smoking related tumors in TN, either as a symptom, cause or shared risk factor.

Wine, Polyphenols, and the Matrix Effect: Is Alcohol Always the Same?

While the number of publications on wine and health is steadily increasing, ranging from a molecular level to epidemiological studies, often with contradictory results, little attention has been given to a holistic approach to research, starting from the molecular level to arrive at pharmacological and medical conclusions. In this review, some unusual concepts are considered, such as the phytocomplex, the vehicle, and the Matrix effect. The concept of the phytocomplex is discussed, specifically the biological activities of Tyrosol, Hydroxytyrosol, and Resveratrol; indeed, the interactions among different molecules in herbal matrices provide a specific response. This is often markedly different from the response evoked by single constituents in the modulation of microbial populations in the gut, in intestinal stability and bioaccessibility, and, obviously, in inducing biological responses. Among the many alcoholic beverages which contain these molecules, wine has the most peculiar Matrix effect, which can heavily influence the bioavailability of the phytocomplex obtained by the fermentation processes that produce this beverage. Wine's Matrix effect plays an instrumental role in improving the beneficial compounds' bioavailability and/or in inhibiting alcohol metabolites' carcinogenicity. Underestimation of the wine Matrix effect could lead to deceiving results, as in the case of dealcoholized wine or wine-compound-based nutritional supplements; alternatively, this can occur in the emphasis of a single component's toxic activity, in this case, alcohol, ignoring the specific molecular-level protective action of other compounds (polyphenols) that are present in the same matrix. The dark side of the Matrix effect is also discussed. This review confirms the research recommendations made by the WHO Scientific Group, which suggests it is important "to investigate the possible protective effects of ingredients other than alcohol in alcoholic beverages", considering that most recent studies seem not only relevant but also capable of directing future research towards innovative points of view that have so far been too neglected.

Developing an alcohol strategy for the Northwest Territories: Evaluating global research evidence against rural and remote realities

OBJECTIVES

This paper outlines the engagement process that was used to develop the Northwest Territories Alcohol Strategy, based on a recommendation by the developers of the Canadian Alcohol Policy Evaluation report, and how this informed the final actions in the strategy.

METHODS

A literature review, four targeted engagement activities, and iterative validation by advisory groups and community and Indigenous leadership were used to evaluate, modify, or reject the original recommendations and develop the final actions that were included in the NWT Alcohol Strategy.

RESULTS

There are fourteen original CAPE recommendations, four of which had already been implemented in the Northwest Territories before the development of the strategy. On completion of the process, four recommendations had already been implemented in the NWT. Two recommendations were included in the strategy without changes, two were adapted for use in the strategy, and six were not included. One stand-alone alcohol policy measure was created and included.

CONCLUSION

Alcohol strategies are dependent on a variety of contextual factors. Developers need to take into consideration the unique geography, political climate, and cultural context of the region for which they are being developed, in order to produce a strategy that is applicable, acceptable, and feasible at the community level.

Colorectal and gastric cancer and its association with dietary patterns in Colombia

Introduction

Cancer is a leading cause of death in the Americas. Colorectal cancer is the third most common cancer, while stomach cancer is the sixth most common cancer worldwide. Tobacco and alcohol consumption, unhealthy diet, physical inactivity and air pollution are risk factors for these cancers. This study aimed to identify the association between dietary patterns and gastric and colorectal cancer.

Methodology

A multi-cluster ecological study, using as secondary sources two national databases, the HIGIA (High-Cost Account) and the ENSIN 2015 (National Survey of Nutritional Status of Colombia 2015), was carried out. The population consisted of 2585 people over 50 years of age, distributed in six regions of Colombia: Atlántica, Central, Oriental, Pacífica, Amazonía-Orinoquía, and Bogotá. Multiple linear regression was performed using R2 to measure goodness of fit to estimate the effect between colorectal cancer incidence rate/gastric cancer incidence rate and exposure factors.

Results

A positive association was observed between colorectal cancer and non-compliance with the recommendation of vigorous physical activity (p = 0.00) and consumption of beverages/grilled food pattern (p = 0.001). Conversely, it decreased incidence by enjoying some specific health insurance and following a conservative dietary pattern (p = 0.05). Gastric cancer incidence was found to increase with age (p = 0.000), sex (p = 0.001), and consumption of the beverages/grilled food pattern (p = 0.006). However, being in the first wealth quartile decreased the incidence (p = 0.002).

Conclusion

There is evidence of an association between diet, physical activity and wealth quartile with colorectal and gastric cancer. This information should be considered for preventive interventions in the population.

Direct factor Xa inhibitors and the risk of cancer and cancer mortality: A Danish population-based cohort study

BACKGROUND

Preclinical animal studies have suggested that myeloid cell-synthesized coagulation factor X dampens antitumor immunity and that rivaroxaban, a direct factor Xa inhibitor, can be used to promote tumor immunity. This study was aimed at assessing whether patients with atrial fibrillation taking direct factor Xa inhibitors have lower risk of cancer and cancer-related mortality than patients taking the direct thrombin inhibitor dabigatran.

METHODS AND FINDINGS

This nationwide population-based cohort study in Denmark included adult patients with atrial fibrillation and without a history of cancer, who started taking a factor Xa inhibitor or dabigatran between 2011 and 2015. Data on medical history, outcomes, and drug use were acquired through Danish healthcare registries. The primary outcome was any cancer. Secondary outcomes were cancer-related mortality and all-cause mortality. Outcome events were assessed during 5 years of follow-up in an intention-to-treat analysis. The propensity score-based inverse probability of treatment weighting was used to compute cumulative incidence and subdistribution hazard ratios (SHRs) and corresponding 95% confidence intervals (CIs), with death as a competing event. Propensity scores were estimated using logistic regression and including in the model sex, age group at index date, comorbidities, and use of comedications. A total of 11,742 patients with atrial fibrillation starting a factor Xa inhibitor and 11,970 patients starting dabigatran were included. Mean age was 75.2 years (standard deviation [SD] 11.2) in the factor Xa cohort and 71.7 years (SD 11.1) in the dabigatran cohort. On the basis of the propensity score-weighted models, after 5 years of follow-up, no substantial difference in the cumulative incidence of cancer was observed between the factor Xa inhibitor (2,157/23,711; 9.11%, 95% CI [8.61%,9.63%]) and dabigatran (2,294/23,715; 9.68%, 95% CI [9.14%,10.25%]) groups (SHR 0.94, 95% CI [0.89,1.00], P value 0.0357). We observed no difference in cancer-related mortality (factor Xa inhibitors cohort 1,028/23,711; 4.33%, 95% CI [4.02%,4.68%]. Dabigatran cohort 1,001/23,715; 4.22%, 95% CI [3.83%,4.66%]; SHR 1.03, 95% CI [0.94,1.12]), but all-cause mortality was higher in the factor Xa inhibitor cohort (factor Xa inhibitors cohort 7,416/23,711; 31.31%, 95% CI [30.37%,32.29%]. Dabigatran cohort 6,531/23,715; 27.56%, 95% CI [26.69%,28.45%]; HR 1.17, 95% CI [1.13,1.21]). The main limitations of the study were the possibility of residual confounding and the short follow-up period.

CONCLUSIONS

In this population based cohort study, factor Xa inhibitor use was not associated with an overall lower incidence of cancer or cancer-related mortality when compared to dabigatran. We did observe an increase in all-cause mortality in the factor Xa inhibitor cohort.

Integrative Analysis Reveals STC2 as a Prognostic Biomarker of Laryngeal Squamous Cell Carcinoma

Stanniocalcin 2 (STC2) is involved in many tumour types, but it remains unclear what its biological function is in laryngeal squamous cell carcinoma (LSCC). Therefore, we investigated STC2's expression, potential function, and prognostic significance of in LSCC. The expression and prognosis of STC2 in LSCC were described using the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. In the TCGA database, the relationship between STC2 and immune infiltration, expression of immune cell chemokine and receptor genes, immune cell molecular marker genes, and epithelial‒mesenchymal transition (EMT) marker genes were analysed. The biological processes involved in STC2 and its expression-related genes were analysed comprehensively using bioinformatics. The single-gene ceRNA network of STC2 was constructed in the TCGA database. Finally, LSCC patients' tumour tissue STC2 expression was verified. STC2 silencing with the RNAi technique was used for the determination of cellular functions in a laryngeal cancer cell line. STC2 expression was higher in most tumours, including LSCC, than in normal tissues and was associated with poor prognosis. The relative proportions of naïve B, plasma, follicular helper T, and macrophage M0 cells in LSCC and normal samples differed significantly. STC2 expression correlated significantly positively with that of TGFB1 (biomarker of Tregs) and significantly negatively with that of D79A and CD19 (biomarkers of B cells). Furthermore, STC2 affected chemokine and receptor gene expression in immune cells. STC2 expression correlated with EMT marker gene expression in LSCC. STC2 was enriched in the PI3K/AKT signalling pathway, extracellular matrix (ECM) organisation, ECM-receptor interaction, and other tumour-related signalling pathways. STC2 was highly expressed in our clinical samples. N-cadherin and vimentin expression were decreased in the TU686 cell line after successful silencing of STC2, indicating that high STC2 expression may prompt LSCC cells to adopt a mesenchymal cell phenotype. STC2 silencing substantially reduced proliferation and migration in the TU686 cell line. STC2 may be a promising predictive biomarker for tumours, providing new approaches for LSCC diagnosis and treatment monitoring.

Dietary patterns suggest that dark chocolate intake may have an inhibitory effect on oral cancer: a Mendelian randomization study

Background

Previous studies reported that variations in dietary intake patterns substantially impact human health, specifically tumorigenesis. However, confounding factors in previous cohort studies have obscured the relationship between dietary differences and the risk of oral cancer (OC).

Materials and methods

We developed an outcome dataset from genome-wide association studies (GWAS) data on three OCs within the GAME-ON project, using GWAS-META merging. We extracted 21 dietary exposures, including 10 dietary patterns, 6 vitamins, and 5 micronutrients, from the UK Biobank database, using the inverse variance weighting method as the primary statistical method. Sensitivity analysis was conducted to detect heterogeneity and pleiotropy. Serum metabolite concentrations were adjusted using multivariate Mendelian randomization.

Results

Of the 10 analyzed dietary patterns, 8 showed no significant association with the risk of developing OC. Consumption of dark chocolate (inverse variance weighted [IVW]: Odds ratio (OR) = 0.786, 95% confidence interval [CI]: 0.622-0.993, p = 0.044) and sweet pepper exhibited an inverse relationship with OC risk (IVW: OR = 0.757, 95% CI: 0.574-0.997, p = 0.048). Reverse MR analysis revealed no reverse causality. Furthermore, no significant correlation was observed between the intake of 6 vitamins and 5 micronutrients and the risk of developing OC. After using multivariable MR to adjust for serum caffeine, linoleate, theophylline, and theobromine metabolism levels, consuming dark chocolate was unrelated to a decreased risk of OC. After adjusting each serum metabolite individually, the observed p-values deviated from the original values to varying degrees, indicating that the components of dark chocolate could have different effects. Among these components, theophylline demonstrated the most significant inhibitory effect.

Conclusion

This study demonstrated a causal relationship between the intake of dark chocolate and sweet peppers and a lower risk of OC. The components of dark chocolate could have different effects.

Effects of mobile Internet use on the health of middle-aged and older adults: evidences from China health and retirement longitudinal study

The rapid development of digital technology has radically changed people's lives. Simultaneously, as the population is rapidly aging, academic research is focusing on the use of Internet technology to improve middle-aged and older people's health, particularly owing to the popularity of mobile networks, which has further increased the population's accessibility to the Internet. However, related studies have not yet reached a consensus. Herein, empirical analysis of the influence of mobile Internet use on the subjective health and chronic disease status of individuals in their Middle Ages and above was conducted utilizing ordered logit, propensity score matching (PSM), and ordered probit models with data from the 2020 China Health and Retirement Longitudinal Study. The study aimed to provide a theoretical basis and reference for exploring technological advances to empower the development of a healthy Chinese population and to advance the process of healthy aging. The health of middle-aged and older adults mobile Internet users was greatly improved, according to our findings. Further, the use of mobile Internet by these persons resulted in improvements to both their self-assessed health and the state of their chronic diseases. As per the findings of the heterogeneity analysis, the impact of mobile Internet use was shown to be more pronounced on the well-being of middle-aged persons aged 45-60 years compared to those aged ≥ 60 years. Further, the endogeneity test revealed that the PSM model could better eliminate bias in sample selection. The results suggest that the estimates are more robust after eliminating endogeneity, and that failure to disentangle sample selectivity bias would overestimate not only the facilitating effect of mobile Internet use on the self-assessed health impacts of middle-aged and older adults, but also the ameliorating effect of mobile Internet use on the chronic diseases of middle-aged and older adults. The results of the mechanistic analysis suggest that social engagement is an important mediating mechanism between mobile Internet use and the health of middle-aged and older adults. This implies that mobile Internet use increases opportunities for social participation among middle-aged and older adults, thereby improving their health.

Alcohol: Epigenome alteration and inter/transgenerational effect

While DNA serves as the fundamental genetic blueprint for an organism, it is not a static entity. Gene expression, the process by which genetic information is utilized to create functional products like proteins, can be modulated by a diverse range of environmental factors. Epigenetic mechanisms, including DNA methylation, histone modification, and microRNAs, play a pivotal role in mediating the intricate interplay between the environment and gene expression. Intriguingly, alterations in the epigenome have the potential to be inherited across generations. Alcohol use disorder (AUD) poses significant health issues worldwide. Alcohol has the capability to induce changes in the epigenome, which can be inherited by offspring, thus impacting them even in the absence of direct alcohol exposure. This review delves into the impact of alcohol on the epigenome, examining how its effects vary based on factors such as the age of exposure (adolescence or adulthood), the duration of exposure (chronic or acute), and the specific sample collected (brain, blood, or sperm). The literature underscores that alcohol exposure can elicit diverse effects on the epigenome during different life stages. Furthermore, compelling evidence from human and animal studies demonstrates that alcohol induces alterations in epigenome content, affecting both the brain and blood. Notably, rodent studies suggest that these epigenetic changes can result in lasting phenotype alterations that extend across at least two generations. In conclusion, the comprehensive literature analysis supports the notion that alcohol exposure induces lasting epigenetic alterations, influencing the behavior and health of future generations. This knowledge emphasizes the significance of addressing the potential transgenerational effects of alcohol and highlights the importance of preventive measures to minimize the adverse impact on offspring.

Integrating GEO, network pharmacology, and in vitro assays to explore the pharmacological mechanism of Bruceae Fructus against laryngeal cancer

The goal of this study is to look into the pharmacological mechanism of Bruceae Fructus in conjunction with GEO, network pharmacology, and in vitro assays for the treatment of laryngeal cancer to provide theoretical support for its therapeutic use. The active components and matching targets of Bruceae Fructus were retrieved from the TCMSP database, while genes linked with laryngeal cancer were obtained from the GEO, GeneCards, DisGeNET, and DrugBank databases. Besides, the components and targets were supplemented by literatures in PubMed database. Cytoscape software was used to create the active ingredients-target network diagram. The String database was used to build the PPI network. Following that, the core targets were subjected to GO enrichment and KEGG pathway analysis using the DAVID database. Finally, AutoDock was used to perform molecular docking between the core components and the core targets. To investigate the biological effects of beta-sitosterol, the viability of laryngeal cancer cells was assessed after beta-sitosterol therapy using the MTS technique. Following that, how beta-sitosterol affected colony formation after 14 days of culture of treated cells was researched. Flow cytometry was utilized to detect apoptosis to examine the influence of beta-sitosterol on laryngeal cancer cell apoptosis, and then detected mRNA and protein expression levels of 10 key genes by RT-qPCR and Western Blot assay. There were 1258 laryngeal cancer-related genes and 15 Bruceae Fructus components, with beta-sitosterol and luteolin serving as key components. Bruceae Fructus' primary targets against laryngeal cancer were IL6, JUN, TNF, IL2, IL4, IFNG, RELA, TP53, CDKN1A, and AKT1. GO enrichment yielded 41 CC, 78 MF, and 383 BP. Platinum drug resistance, the PI3K-Akt signaling pathway, the p53 signaling pathway, apoptosis, the HIF-1 signaling pathway, and 147 additional pathways have been added to KEGG. The results of molecular docking revealed that the core components had a high affinity for the core target. The results of the cell experiment indicate that beta-sitosterol suppressed Hep-2 cell activity in a concentration-dependent manner. Besides, beta-sitosterol has powerful antiproliferative properties in Hep-2 cells. Flow cytometry results showed that beta-sitosterol promoted laryngeal cancer cell apoptosis in a concentration-dependent manner. The results of RT-qPCR and Western Blot assay showed that the mRNA and protein expression levels of TP53, JUN, TNF-α, CDKN1A, and IL-2 were significantly up-regulated after beta-sitosterol treatment, while the mRNA and protein expression levels of RELA, AKT1, IL-6, IFNG, and IL-4 were significantly down-regulated. This study integrating GEO, network pharmacology, and in vitro assays investigated the probable mechanism of Bruceae Fructus' anti-laryngeal cancer activity, which can give a theoretical foundation for additional future animal experiments.

DNA modifications: Biomarkers for the exposome?

The concept of the exposome is the encompassing of all the environmental exposures, both exogenous and endogenous, across the life course. Many, if not all, of these exposures can result in the generation of reactive species, and/or the modulation of cellular processes, that can lead to a breadth of modifications of DNA, the nature of which may be used to infer their origin. Because of their role in cell function, such modifications have been associated with various major human diseases, including cancer, and so their assessment is crucial. Historically, most methods have been able to only measure one or a few DNA modifications at a time, limiting the information available. With the development of DNA adductomics, which aims to determine the totality of DNA modifications, a far more comprehensive picture of the DNA adduct burden can be gained. Importantly, DNA adductomics can facilitate a "top-down" investigative approach whereby patterns of adducts may be used to trace and identify the originating exposure source. This, together with other 'omic approaches, represents a major tool for unraveling the complexities of the exposome and hence allow a better a understanding of the environmental origins of disease.

Psychosocial factors, health behaviors and risk of cancer incidence: Testing interaction and effect modification in an individual participant data meta-analysis

Depression, anxiety and other psychosocial factors are hypothesized to be involved in cancer development. We examined whether psychosocial factors interact with or modify the effects of health behaviors, such as smoking and alcohol use, in relation to cancer incidence. Two-stage individual participant data meta-analyses were performed based on 22 cohorts of the PSYchosocial factors and CAncer (PSY-CA) study. We examined nine psychosocial factors (depression diagnosis, depression symptoms, anxiety diagnosis, anxiety symptoms, perceived social support, loss events, general distress, neuroticism, relationship status), seven health behaviors/behavior-related factors (smoking, alcohol use, physical activity, body mass index, sedentary behavior, sleep quality, sleep duration) and seven cancer outcomes (overall cancer, smoking-related, alcohol-related, breast, lung, prostate, colorectal). Effects of the psychosocial factor, health behavior and their product term on cancer incidence were estimated using Cox regression. We pooled cohort-specific estimates using multivariate random-effects meta-analyses. Additive and multiplicative interaction/effect modification was examined. This study involved 437,827 participants, 36,961 incident cancer diagnoses, and 4,749,481 person years of follow-up. Out of 744 combinations of psychosocial factors, health behaviors, and cancer outcomes, we found no evidence of interaction. Effect modification was found for some combinations, but there were no clear patterns for any particular factors or outcomes involved. In this first large study to systematically examine potential interaction and effect modification, we found no evidence for psychosocial factors to interact with or modify health behaviors in relation to cancer incidence. The behavioral risk profile for cancer incidence is similar in people with and without psychosocial stress.

Role of Healthy Lifestyle and Diet Quality in the Development of Colorectal Cancer in the Adult Population in the Kurdistan Region: A Case-Control Study

Background The incidence of colorectal cancer (CRC) is increasing in developing countries. The factors contributing to the risk of CRC are not known in developing countries. Therefore, this study aimed to explore the role of a healthy lifestyle on CRC in the adult population in the Kurdistan Region of Iraq. Methodology In this case-control investigation, patients previously diagnosed with CRC were included as cases (n = 84) and the healthy adult population as healthy controls (n = 87). The patients were selected from the Gastroenterology Unit of Azadi Teaching Hospital and Emergency Teaching Hospital. The healthy controls were selected from the caregivers of patients who met the eligibility criteria. Results Individuals with a history of chronic disease (63.08% vs. 40.52%; p = 0.0043), a history of hypertension (71.74% vs. 40.80%; p = 0.0003), and a history of inflammatory bowel disease (IBD) (59.42% vs. 42.16%; p = 0.0267) had a significantly higher prevalence of CRC compared to healthy controls. CRC patients had significantly lower diet quality scores than healthy controls (36.27 vs. 37.83; p = 0.0002). The study showed that CRC patients had a significantly lower lifestyle index score compared to healthy controls (10.20 vs. 11.69; p = 0.0002). In addition, CRC patients had lower scores for diet (0.42 vs. 1.00; p < 0.0001), smoking (2.92 vs. 4.0; p < 0.0001), and physical activity (1.02 vs. 1.70; p < 0.0001) compared to healthy controls. However, CRC patients and healthy controls had similar alcohol index scores (5.0 vs. 530; p = 1.000) and body mass index (1.04 vs. 1.01; p = 0.8982). Conclusions This study showed that CRC was associated with having a history of bad diet quality and unhealthy lifestyles. In addition, a history of chronic diseases, hypertension, and IBD was associated with the risk of CRC.

A Discourse of Deviance: Blame, Shame, Stigma and the Social Construction of Head and Neck Cancer

Cancer of the head and neck is a confronting condition, as the disease and its treatments alter the appearance and function of body organs associated with physical appearance and identity. Many of the risk factors for head and neck cancers, including tobacco, alcohol, and human papilloma virus, can also have significant negative social and moral permutations. Language and action (discourse) plays an important role in constructing disease and illness and shape the way it is managed, both institutionally and socially. This research used a critical constructionist lens to investigate how the common discourses surrounding head and neck cancer are constructed within the healthcare context and how this influences patients and healthcare professionals' responses to the illness. Data were collected through semi-structured interviews, field noting, journaling and literature reviews. Analysis was guided by a three-dimensional approach to critical discourse analysis that investigated text, discursive practices, and social context. The overarching finding was that deviance dominates the common discourse and shapes head and neck cancer and responses to it. Deviance is channelled through metaphors, adjectives, descriptors, and collective nouns and is made overt through labelling, avoidance, blaming, shame, and categorization. Discourse is contextualized by a sociocultural understanding that when someone deviates from what is perceived as normal, they are devalued. Open dialogue and reflection on head and neck cancer discourse could enable better understanding of how people experience their condition and inform more supportive responses.

Association between alcohol dehydrogenase polymorphisms (rs1229984, rs1573496, rs1154460, and rs284787) and susceptibility to head and neck cancers: A systematic review and meta-analysis

OBJECTIVE

Head and neck cancer (HNC) is a prevalent and complex group of malignancies with increasing incidence globally. Alcohol dehydrogenases (ADHs) play a crucial role in alcohol metabolism, and their polymorphisms have been linked to HNC risk. This systematic review and meta-analysis aims to evaluate the association between ADH polymorphisms and susceptibility to HNCs, incorporating additional analyses and adding more studies to increase power and accuracy of the results.

DESIGN

Subgroup analysis, meta-regression analysis, and sensitivity analyses were conducted to explore potential differences within the data and assess the stability of pooled odds ratios (ORs). To mitigate the risk of false conclusions from meta-analyses, a trial sequential analysis was performed.

RESULTS

For ADH1B rs1229984, the pooled OR (95 % confidence interval (CI)) was 0.73 (0.65, 0.82), 0.42 (0.35, 0.50), 0.57 (0.44, 0.73), 0.56 (0.50, 0.62), and 0.80 (0.73, 0.88), as well as for ADH7 rs1573496, the pooled OR was 0.72 (0.62, 0.85), 0.36 (0.17, 0.74), 0.76 (0.64, 0.91), 0.80 (0.71, 0.91), and 0.38 (0.18, 0.78) with a p < 0.05 in all allelic, homozygous, heterozygous, recessive, and dominant models, respectively. However, no significant association was found between the ADH7 rs1154460 and rs284787 polymorphisms and the risk of HNC with pooled ORs of 1.11 (p = 0.19) and 1.09 (p = 0.24) for the recessive model, respectively. The ethnicities, tumor subsites, control sources, sample sizes, quality scores, and Hardy-Weinberg equilibrium statuses were confounding factors.

CONCLUSION

The ADH1B rs1229984 and ADH7 rs1573496 polymorphisms are significantly associated with a reduced risk of HNC.

Association between drinking status and risk of kidney stones among United States adults: NHANES 2007-2018

OBJECTIVE

This study aimed to investigate the relationship between drinking status and kidney stones occurrence among United States (US) adults who consume alcohol.

METHODS

We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES 2007-2018). Questionnaires yielded information on alcohol consumption and kidney health. Drinking status was categorized into four groups-former, mild, moderate, and heavy-based on alcohol consumption patterns. The aim was to explore the relationship between drinking status and the prevalence of kidney stones occurrence. For this analysis, we examined a group of individuals diagnosed with kidney stones. With survey weights applied, the total weight of the group was 185,690,415.

RESULTS

We used logistic regression to measure the relationship between drinking status and the likelihood of developing kidney stones. In a fully adjusted model, former drinkers were less likely to have previously experienced kidney stones (OR 0.762, 95% CI 0.595-0.977, P < 0.05). In subgroup analysis, heavy alcohol consumption was associated with a significantly reduced likelihood of kidney stones occurrence in various populations. The adjusted odds ratios (with 95% confidence intervals) of kidney stones risk for heavy alcohol consumption were 0.745 (0.566-0.981) for young individuals, 0.566 (0.342-0.939) for older individuals, 0.708 (0.510-0.981) for individuals of white race, 0.468 (0.269-0.817) for individuals with underweight/normal BMI, 0.192 (0.066-0.560) for widowed people, 0.538 (0.343-0.843) for smoking individuals, 0.749 (0.595-0.941) for individuals without a cancer history, and 0.724 (0.566-0.925) for individuals without a stroke history.

CONCLUSIONS

In US adults who consume alcohol, a negative linear relationship is apparent between drinking status and the prevalence of kidney stones, with heavy drinking showing a lower prevalence compared to former drinkers. However, the causal relationship between drinking status and kidney stones requires further investigation in future research endeavors.

Tacrolimus Drug Exposure Level and Smoking Are Modifiable Risk Factors for Early De Novo Malignancy After Liver Transplantation for Alcohol-Related Liver Disease

De novo malignancy (DNM) is the primary cause of mortality after liver transplantation (LT) for alcohol-related liver disease (ALD). However, data on risk factors for DNM development after LT are limited, specifically in patients with ALD. Therefore, we retrospectively analyzed all patients transplanted for ALD at our center before October 2016. Patients with a post-LT follow-up of <12 months, DNM within 12 months after LT, patients not on tacrolimus in the 1st year post-LT, and unknown smoking habits were excluded. Tacrolimus drug exposure level (TDEL) was calculated by area under the curve of trough levels in the 1st year post-LT. 174 patients received tacrolimus of which 19 (10.9%) patients developed a DNM between 12 and 60 months post-LT. Multivariate cox regression analysis identified TDEL [HR: 1.710 (1.211-2.414); p = 0.002], age [1.158 (1.076-1.246); p < 0.001], number of pack years pre-LT [HR: 1.021 (1.004-1.038); p = 0.014] and active smoking at LT [HR: 3.056 (1.072-8.715); p = 0.037] as independent risk factors for DNM. Tacrolimus dose minimization in the 1st year after LT and smoking cessation before LT might lower DNM risk in patients transplanted for ALD.

Alcohol consumption and the risk of all-cause and cause-specific mortality-a linear and nonlinear Mendelian randomization study

BACKGROUND

Many observational studies support light-to-moderate alcohol intake as potentially protective against premature death. We used a genetic approach to evaluate the linear and nonlinear relationships between alcohol consumption and mortality from different underlying causes.

METHODS

We used data from 278 093 white-British UK Biobank participants, aged 37-73 years at recruitment and with data on alcohol intake, genetic variants, and mortality. Habitual alcohol consumption was instrumented by 94 variants. Linear Mendelian randomization (MR) analyses were conducted using five complementary approaches, and nonlinear MR analyses by the doubly-ranked method.

RESULTS

There were 20 834 deaths during the follow-up (median 12.6 years). In conventional analysis, the association between alcohol consumption and mortality outcomes was 'J-shaped'. In contrast, MR analyses supported a positive linear association with premature mortality, with no evidence for curvature (Pnonlinearity ≥ 0.21 for all outcomes). The odds ratio [OR] for each standard unit increase in alcohol intake was 1.27 (95% confidence interval [CI] 1.16-1.39) for all-cause mortality, 1.30 (95% CI 1.10-1.53) for cardiovascular disease, 1.20 (95% CI 1.08-1.33) for cancer, and 2.06 (95% CI 1.36-3.12) for digestive disease mortality. These results were consistent across pleiotropy-robust methods. There was no clear evidence for an association between alcohol consumption and mortality from respiratory diseases or COVID-19 (1.32, 95% CI 0.96-1.83 and 1.46, 95% CI 0.99-2.16, respectively; Pnonlinearity ≥ 0.21).

CONCLUSION

Higher levels of genetically predicted alcohol consumption had a strong linear association with an increased risk of premature mortality with no evidence for any protective benefit at modest intake levels.

Risk factors of secondary cancer in laryngeal, oropharyngeal, or hypopharyngeal cancer after definitive therapy

BACKGROUND

Our previous research showed that a high rate of secondary carcinogenesis is observed during follow-up after transoral surgery in patients with early-stage laryngeal, oropharyngeal, and hypopharyngeal cancers. We speculate that the contributing factors are alcohol drinking, smoking, and aging; however, we could not provide clear evidence. In this study, we aimed to identify the risk factors for secondary carcinogenesis in patients with these cancers, particularly factors associated with drinking and/or smoking.

METHODS

The medical records of all-stage laryngeal, oropharyngeal, and hypopharyngeal cancer patients who had undergone definitive treatment were retrospectively analyzed. Assessments included visual and endoscopic observations of the primary site, enhanced cervical CT or US of the primary site and regional lymph nodes, PET-CT, and enhanced whole-body CT. Clinical characteristics were compared in patients with and without secondary carcinogenesis and in patients with hypopharyngeal cancer and patients with other cancers.

RESULTS

Hypopharyngeal cancer was an independent risk factor for secondary cancer. The 5-year incidence rate of secondary cancer was 25.5%, 28.6%, and 41.2% in laryngeal, oropharyngeal, and hypopharyngeal cancers, respectively. Radiotherapy was defined as an independent risk factor in hypopharyngeal cancer patients with secondary cancers. No direct correlation was found between secondary carcinogenesis and alcohol consumption, smoking, or aging.

CONCLUSIONS

Patients with hypopharyngeal cancer require close follow-up as they are at high risk of developing secondary cancer, possibly because out-of-field radiation exposure may induce systemic secondary carcinogenesis in hypopharyngeal cancer patients with genetic abnormality induced by alcohol consumption.

Lung Cancer and Lifestyle Factors: Umbrella Review

This review explores the effect of common everyday factors, such as alcohol, tea and coffee consumption, on the risk for lung cancer. We performed an umbrella review of current systematic reviews. The risk for lung cancer was increased with alcohol or coffee intake and decreased with tea intake. While evidence for alcohol is of low quality, the effect of coffee may be confounded by the smoking effect. The protective effect of tea intake is present, but the evidence is also of low quality.

Association between alcohol use and retinal dysfunctions in patients with alcohol use disorder: A window on GABA, glutamate, and dopamine modulations

BACKGROUND

Alcohol is the most widely consumed addictive substance around the world and have deleterious effect on the central nervous system. Alcohol consumption affect the balance of certain neurotransmitters like GABA, glutamate and dopamine. The retina provides an easy means of investigating dysfunctions of synaptic transmission in the brain. The purpose of this study is to assess the impact of alcohol consumption on retinal function using pattern electroretinogram (PERG) and flash electroretinogram (fERG).

METHODS

We recorded PERG and fERG under scotopic and photopic condition in 20 patients with alcohol use disorder and 20 controls. Implicit time and amplitude of numerous parameters were evaluated: a- and b-waves for fERG, OP3 and OP4 for dark-adapted 3.0 oscillatory potentials fERG, P50 and N95 for PERG.

RESULTS

Patients with alcohol use disorder showed a significant increase in N95 implicit time without a significant change in the amplitudes of oscillatory potentials.

CONCLUSION

The results of our study reflect the impact of alcohol use on ganglion cell function and could highlight alterations in glutamatergic neurotransmission inside the retina. We believe that ERG could be used as an early marker of alcohol consumption.

Do Pathophysiologic Mechanisms Linking Unhealthy Lifestyle to Cardiovascular Disease and Cancer Imply Shared Preventive Measures? - A Critical Narrative Review

Growing evidence has shown a bidirectional link between the cardiologic and oncologic fields. Several investigations support the role of unhealthy behaviors as pathogenic factors of both cardiovascular disease and cancer. We report epidemiological and research findings on the pathophysiological mechanisms linking unhealthy lifestyle to cardiovascular disease and cancer. For each unhealthy behavior, we also discuss the role of preventive measures able to affect both cardiovascular disease and cancer occurrence and progression.

Imaging Characteristics Predictive of Cervical Extranodal Tumor Extension in Patients With Head and Neck Squamous Cell Carcinoma

OBJECTIVES

The aims of the study were to determine the predictive imaging findings of extranodal extension (ENE) in metastatic cervical lymph nodes of head and neck squamous cell carcinoma and to investigate the interobserver agreement among radiologists with different experience levels.

MATERIALS AND METHODS

Patients with cervical lymph node dissection and who had metastatic lymph nodes and preoperative imaging were included. Three radiologists evaluated nodal necrosis, irregular contour, gross invasion, and perinodal fat stranding. They also noted their overall impression regarding the presence of the ENE. Sensitivity, specificity, odds ratios based on logistic regression, and interobserver agreement of ENE status were calculated.

RESULTS

Of 106 lymph nodes (that met inclusion criteria), 31 had radiologically determined ENE. On pathologic examination, 22 of 31 nodes were positive for ENE. The increasing number of metastatic lymph nodes was associated with the presence of the ENE ( P = 0.010). Irregular contour had the highest sensitivity (78.6%) and gross invasion had the highest specificity (96%) for the determination of the ENE. The radiologists' impression regarding the presence of the pathlogical ENE had 39.3% sensitivity and 82% specificity. Metastatic lymph nodes with a perinodal fat stranding and with the longest diameter of greater than 2 cm were found to be strong predictors of the ENE. The gross invasion demonstrated the highest κ value (0.731) among the evaluated imaging criteria.

CONCLUSIONS

In the assessment of ENE, the gross invasion had the highest specificity among imaging features and showed the highest interobserver agreement. Perinodal fat stranding and the longest diameter of greater than 2 cm in a metastatic lymph node were the best predictors of the ENE.

Disordered alcohol and substance use in Irish farmers: A cross-sectional survey

PURPOSE

Farming is a high-pressure occupation. Populations of farmers face significant health risks, including injury, mental illness, and in some cases, heavy alcohol use. However, there is little research on farmers' use of substances beyond alcohol. This study examines factors relating to Irish farmers' disordered alcohol and substance use.

METHODS

In accordance with STROBE guidelines for cross-sectional research and reporting, we examined disordered alcohol and substance use in 351 Irish farmers using the Alcohol Use Disorders Identification Tool (AUDIT) and Drug Use Disorders Identification Tool (DUDIT).

FINDINGS

While 28% of farmers did not drink, 40% of those who did drink exceeded the AUDIT threshold for disordered use. Similarly, while 95% of farmers did not use substances, 78% of farmers who did use substances exceeded the DUDIT threshold for disordered use. Age was the most important risk factor for disordered alcohol and substance use and correlated with other main risk factors: lower income, no children, part-time farmer, and full-time off-farm roles. Disordered drinking was highest in farmers engaged in full-time education.

CONCLUSIONS

This population of Irish farmers report broadly healthy alcohol and substance use behaviors. Irish farmers may serve as a model group whose strengths can be utilized in interventions within and beyond the Irish farming community. Our results confirm the importance of analyzing demographic factors in farmers' drinking and identify younger farmers as especially at-risk for harmful alcohol and substance use.

A State-of-the-Science Review of Alcoholic Beverages and Polycyclic Aromatic Hydrocarbons

BACKGROUND

The association between alcohol and certain cancers is well established, yet beyond ethanol and its metabolite acetaldehyde, little is known about the presence of other carcinogenic compounds in alcoholic beverages, including polycyclic aromatic hydrocarbons (PAHs), such as benzo[a]pyrene (a Group I carcinogen).

OBJECTIVES

We summarized the published literature on PAH levels in alcoholic beverages to identify potential gaps in knowledge to inform future research.

METHODS

Medline and Scopus were searched for primary research published from January 1966 to November 2023 that quantified PAH levels among various types of alcoholic beverages, including whisky, rum, brandy, gin, vodka, wine, and beer. Studies that were not primary literature were excluded; only studies that quantified PAH content in the specified alcoholic beverages were included.

RESULTS

Ten studies published from 1966 to 2019 met the criteria for review. Other than beverage type, no publication reported selection criteria for their samples of tested alcohol products. Studies used a variety of analytical methods to detect PAHs. Of the 10 studies, 7 were published after 2000, and 6 assessed < 20 products. Of the studies, 7 examined spirits; 3, beer; and 4, wines. Benzo[a]pyrene was most prevalent among spirit products, particularly whisky, with values generally exceeding acceptable levels for drinking water. Some beer and wine products also contained PAHs, albeit at lower levels and less frequently than spirit products.

DISCUSSION

PAHs are found in some alcohol products and appear to vary by beverage type. However, there is an incomplete understanding of their presence and levels among large, representative samples from the range of currently available alcohol products. Addressing this gap could improve understanding of alcohol-cancer relationships and may have important implications for public health and the regulation of alcohol products. In addition, novel methods, such as direct mass spectroscopy, may facilitate more thorough testing of samples to further investigate this relationship. https://doi.org/10.1289/EHP13506.

Drinking patterns, alcoholic beverage types, and esophageal cancer risk in Africa: a comprehensive systematic review and meta-analysis

Africa is the continent most affected by esophageal cancer in the world. Alcoholic beverages are controversially blamed, as esophageal cancer is a rare disease in several other countries ranked in the top 10 for consumption of alcoholic beverages. This study aims to conduct a comprehensive systematic review of published literature, statistically summarizing the strength of the association between drinking patterns and types, and the risk of esophageal cancer in Africa. A computerized search of reputable databases such as Medline/PubMed, EMBASE, Web of Science, and African Journals Online was performed to identify relevant studies published up to September 2023. The quality of the studies was evaluated using the Newcastle-Ottawa scale for case-control studies and the Agency for Healthcare Research and Quality tool for cross-sectional studies. A funnel plot and Egger test were utilized to assess potential publication bias. Meta-analyses were conducted using random-effects models with RevMan 5.3 and Stata software to estimate summary effects. The systematic review identified a total of 758,203 studies, primarily from Eastern and Southern Africa. The pooled samples across all studies comprised 29,026 individuals, including 11,237 individuals with cancer and 17,789 individuals without cancer. Meta-analysis revealed a significant association between alcohol consumption and the risk of esophageal cancer (odds ratio [OR] = 1.81; 95% confidence interval [CI], 1.50-2.19). Further analysis based on the frequency of alcoholic beverage consumption indicated a stronger association with daily (OR = 2.38; 95% CI, 1.81-3.13) and weekly (OR = 1.94; 95% CI, 1.32-2.84) drinkers in contrast to occasional drinkers (OR = 1.02; 95% CI, 0.81-1.29). Additionally, consumption of traditional alcoholic beverages was significantly associated with the risk of esophageal cancer in African populations (OR = 2.00; 95% CI, 1.42-2.82). However, no relationship has been established between the exclusive consumption of non-traditional drinks and the risk of esophageal cancer. In conclusion, the results of this study confirm the hypothesis that daily and weekly drinking patterns, significantly increase the risk of esophageal cancer in Africa, while occasional consumption does not show a significant association. Additionally, the consumption of traditional alcoholic beverages is notably linked to the risk of esophageal cancer in African populations.

Cyp3A4 *1G polymorphism is associated with alcohol drinking: A 5-year retrospective single centered population-based study in China

INTRODUCTION

We investigated the epidemiology of Cytochrome P450 (CYP) 3A4 genotype and the relationship between CYP3A4 genotype and alcohol drinking habits.

MATERIALS AND METHODS

A single-centered retrospective study was conducted on 630 patients who underwent CYP3A4*1G genetic testing. Their relevant information on epidemiology and etiology was collected. Laboratory testing, including CYP3A4*1G genotype, liver function tests, and serum lipid measurements were performed. Bi-variate logistic regressions were used to examine the relationship between variables. The relationship between alcohol drinking and CYP3A4*1G genotype was estimated. Demographic and clinical features were analyzed. Participants with drinking history were divided into non-heavy drinking and heavy drinking groups. Liver function and dyslipidemia of participants with drinking histories were compared between CYP3A4*1G mutation (GA+AA) and wild-type (GG) groups.

RESULTS

Participants with CYP3A4*1G mutation(GA+AA) had an increased adjusted odds ratio (AOR) of 2.56 (95% CI, 1.4-4.65; P = 0.00) for alcohol abuse when compared with participants without CYP3A4 mutation (GG). In the subgroup of participants with alcohol abuse, there are no significant differences in liver injury levels and serum lipid levels between CYP3A4*1G mutant and wild-type groups. Patients with CYP3A4*1G mutation had an increased AOR of cardiac-vascular diseases and malignant diseases compared with patients without CYP3A4*1G mutation. The epidemiology had no difference between GA and AA group.

CONCLUSION

The study indicated that there was association between alcohol drinking and CYP3A4*1G genetic mutation. In the subgroup of participants with alcohol abuse, there are no significant differences in liver injury and dyslipidemia between CYP3A4*1G mutant and wild-type groups. CYP3A4*1G mutation was also related to cardiac-vascular diseases and malignant diseases.

Cancer pain and alcohol self-medication

BACKGROUND

Cancer survivors are at increased risk of pain due to their either cancer and/or treatments. Substances like alcohol may be used to self-medicate cancer pain; however, these substances pose their own health risks that may be more pronounced for cancer survivors.

METHODS

We used cross-sectional data from the Behavioral Risk Factor Surveillance System (BRFSS) 2012-2019 to quantify the association between cancer pain and alcohol use. We used negative binomial regression, with interaction terms added to examine variations across age, sex, and race. We also examined whether alcohol use relates to cancer pain control status.

RESULTS

Cancer survivors with cancer pain were more likely to be younger, female, Black, and to have been diagnosed with breast cancer. Cancer pain was associated with lower alcohol consumption (incidence rate ratio (IRR): 0.88, confidence interval (CI): 0.77, 0.99). This association was primarily among people 65 and older, women, and white and Hispanic people. Cancer pain control status was not related to alcohol use.

CONCLUSIONS

Lower alcohol use among cancer survivors with pain has many possible explanations, including several alternative pain management strategies or a decrease in social engagement. Our findings of racial and gender disparities in cancer pain are consistent with the broader evidence on disparities in pain.

IMPLICATIONS FOR CANCER SURVIVORS

Cancer pain management for marginalized groups should be improved. Healthcare providers should screen cancer survivors for both pain and substance use, to prevent unhealthy self-medication behaviors.

Factors Influencing Postoperative Prognosis in Patients with Hypopharyngeal and Laryngeal Carcinoma

OBJECTIVES

Despite the increasingly modern surgical techniques in the oncology field, the factors that influence postoperative prognosis in patients with hypopharyngeal and laryngeal carcinoma (HLC) remain unclear. The study aimed to evaluate the factors influencing the prognosis of HLC patients with pathological diagnosis of squamous cell carcinoma, and the findings are intended to direct follow-up management strategies.

METHODS

A retrospective cohort study was performed. The study population included 407 postoperative patients with HLC from 2011 to 2015. Univariate and multivariate analyses were used to examine the prognostic factors identified.

RESULTS

Based on univariate analysis results, smoking and alcohol history, tumor differentiation, preoperative radiotherapy, primary tumor sites, flap reconstruction, lymph node invasion (LNI), and preoperative albumin levels (PAL) significantly affects the prognosis of HLC patients (P < .05). Meanwhile, multivariate analysis revealed that smoking pack-year (OR = 1.002, 95% CI = 1.001 ∼ 1.003), primary tumor sites (OR = 6.241, 95% CI = 1.715 ∼ 18.433), LNI (OR = 2.869, 95% CI = 1.095 ∼ 8.743), and PAL (OR = .020, 95% CI = .004 ∼ 0.104) were associated with complications. Tumor differentiation (OR = 0.650, 95% CI = .383 ∼ 0.855), primary tumor sites (OR = 12.392, 95% CI = 3.290 ∼ 26.679), LNI (OR = 16.323, 95% CI = 2.726 ∼ 47.729), preoperative radiotherapy (OR = 9.300, 95% CI = 3.182 ∼ 27.181), and PAL (OR = .321, 95% CI = .141 ∼ .732) were associated with overall survival rates.

CONCLUSION

Smoking and alcohol history, tumor differentiation, LNI, primary tumor sites, flap reconstruction, PAL, and preoperative radiotherapy are crucial factors that influence the postoperative prognosis of patients with HLC. In addition, a monogram of five factors was established to predict the survival rates of HLC patients.

Pharmacy Students' Knowledge, Attitudes, and Awareness Toward Marijuana Use

Introduction: The aim of this study was to assess the knowledge, attitudes, and awareness of pharmacy students toward marijuana use. Methods: Pharmacy students were asked to complete a survey that assess students' knowledge, attitudes, and awareness toward marijuana use. This study also compared students' awareness about the harmful effects of marijuana in comparing with alcohol and smoking tobacco. Participants were asked about the possibilities of marijuana-induced cancer and addiction. Results: Twenty-three percent of pharmacy students reported having used marijuana at some point in their lives. In comparison with tobacco and alcohol, most of the students agreed that tobacco (49%) and alcohol (42%) are more harmful than marijuana (P < .0001). More than sixty percent of students considered marijuana as an addictive substance (P < .02). A 45% of students opposed the possibility of marijuana-induced cancer. Thirty-six percent of the students agreed that marijuana should be legalized for both medical and recreational use with a similar percentage of the students (30 - 32%) believed that marijuana should be legalized for medical use only. Conclusion: With the prevalence of marijuana use and discrepancy among pharmacy students' responses regarding knowledge, attitudes, and awareness pharmacy schools need to adopt educational activities about the benefits and risks of marijuana.

Oral squamous cell carcinomas: state of the field and emerging directions

Oral squamous cell carcinoma (OSCC) develops on the mucosal epithelium of the oral cavity. It accounts for approximately 90% of oral malignancies and impairs appearance, pronunciation, swallowing, and flavor perception. In 2020, 377,713 OSCC cases were reported globally. According to the Global Cancer Observatory (GCO), the incidence of OSCC will rise by approximately 40% by 2040, accompanied by a growth in mortality. Persistent exposure to various risk factors, including tobacco, alcohol, betel quid (BQ), and human papillomavirus (HPV), will lead to the development of oral potentially malignant disorders (OPMDs), which are oral mucosal lesions with an increased risk of developing into OSCC. Complex and multifactorial, the oncogenesis process involves genetic alteration, epigenetic modification, and a dysregulated tumor microenvironment. Although various therapeutic interventions, such as chemotherapy, radiation, immunotherapy, and nanomedicine, have been proposed to prevent or treat OSCC and OPMDs, understanding the mechanism of malignancies will facilitate the identification of therapeutic and prognostic factors, thereby improving the efficacy of treatment for OSCC patients. This review summarizes the mechanisms involved in OSCC. Moreover, the current therapeutic interventions and prognostic methods for OSCC and OPMDs are discussed to facilitate comprehension and provide several prospective outlooks for the fields.

Unpacking assertions made by the alcohol industry and how they make them: An analysis of submissions into Australia's National Alcohol Strategy

INTRODUCTION

Alcohol is a leading cause of morbidity and mortality globally. One significant barrier to the implementation of evidence-based alcohol policy is alcohol industry opposition. Making submissions to national policy processes is one way in which the industry exert influence. The aim of this study was to analyse alcohol industry submissions into Australia's National Alcohol Strategy to determine key assertions made by the alcohol industry and the ways in which they use evidence and refute the effectiveness of public health policies to make their claims.

METHODS

Submissions made by alcohol industry actors (n = 12) were analysed using content analysis to determine key industry assertions. A pre-existing framework on alcohol industry use of evidence was then applied to analyse the evidentiary practices used to make these assertions.

RESULTS

Five common industry assertions were identified: 'Drinking alcohol in moderation has health benefits'; 'Alcohol isn't the cause of violence'; 'Targeted initiatives, not population level alcohol policies, are needed'; 'Strong alcohol advertising regulations are not necessary'; and 'Minimum unit price and pricing and taxation policies more broadly are not needed'. The industry systematically manipulated, misused and ignored evidence throughout their submissions.

DISCUSSION AND CONCLUSIONS

The alcohol industry is misusing evidence in their submissions to government consultations to make their assertions about alcohol policy. It is therefore essential that industry submissions are scrutinised and not accepted on face value. Additionally, it is suggested that the alcohol industry requires a distinct model of governance similarly to that which regulates the tobacco industry to prevent their attempts to undermine evidence-based public health policy.

Single-nucleotide polymorphism at alcohol dehydrogenase 1B: A susceptible gene marker in oro-/hypopharyngeal cancers from genome-wide association study

INTRODUCTION

In the era of precision preventive medicine, susceptible genetic markers for oro-/hypopharyngeal squamous cell carcinoma (OPSCC) have been investigated for genome-wide associations.

MATERIALS AND METHODS

A case-control study including 659 male head and neck squamous cell carcinoma (HNSCC) patients, including 331 oropharyngeal cancer, treated between March 1996 and December 2016 and 2400 normal controls was performed. A single-nucleotide polymorphism (SNP) array was used to determine genetic loci that increase susceptibility to OPSCC.

RESULTS

We analyzed the allele frequencies of 664,994 autosomal SNPs in 659 HNSCC cases; 7 SNPs scattered in loci of chromosomes 5, 7, 9, 11, and 19 were significant in genome-wide association analysis (Pc < 1.0669 × 10-7 ). In OPSCCs (n = 331), two clustered regions in chromosomes 4 and 6 were significantly different from the controls. We successfully identified a missense alteration of the SNP region in alcohol dehydrogenase 1B (ADH1B) (https://genome.ucsc.edu; hg38); the top correlated locus was rs1229984 (p = 1 × 10-11 ). Adjusted for environmental exposure, including smoking, alcohol, and areca quid, a region in chromosome 12, related to alcohol metabolism, was found to independently increase the susceptibility to OPSCC. The ADH1B rs1229984 AA genotype had better overall survival compared to the AG and GG genotypes (p = 0.042) in OPSCC. The GG genotype in rs1229984 was significantly associated with a younger age of onset than other genotypes (p = 0.001 and <0.001, respectively) in OPSCC patients who consumed alcohol.

CONCLUSION

ADH1B was an important genetic locus that significantly correlated with the development of OPSCCs and patient survival.

Effect of Diet and Oxidative Stress in the Pathogenesis of Lymphoproliferative Disorders

Lymphomas are a heterogeneous group of pathologies that result from clonal proliferation of lymphocytes. They are classified into Hodgkin lymphoma and non-Hodgkin lymphoma; the latter develops as a result of B, T, or NK cells undergoing malignant transformation. It is believed that diet can modulate cellular redox state and that oxidative stress is implicated in lymphomagenesis by acting on several biological mechanisms; in fact, oxidative stress can generate a state of chronic inflammation through the activation of various transcription factors, thereby increasing the production of proinflammatory cytokines and causing overstimulation of B lymphocytes in the production of antibodies and possible alterations in cellular DNA. The purpose of our work is to investigate the results of in vitro and in vivo studies on the possible interaction between lymphomas, oxidative stress, and diet. A variety of dietary regimens and substances introduced with the diet that may have antioxidant and antiproliferative effects were assessed. The possibility of using nutraceuticals as novel anticancer agents is discussed; although the use of natural substances in lymphoma therapy is an interesting field of study, further studies are needed to define the efficacy of different nutraceuticals before introducing them into clinical practice.

Alcohol consumption and cancer incidence in women: interaction with smoking, body mass index and menopausal hormone therapy

BACKGROUND

Alcohol consumption has been associated with increased risks of certain site-specific cancers and decreased risks of some other cancers. There is, however, little reliable evidence as to whether the alcohol-associated risks for specific cancers are modified by smoking, body mass index (BMI) and menopausal hormone therapy (MHT) use.

METHODS

In the prospective UK Million Women Study, 1,233,177 postmenopausal women without prior cancer, mean age 56 (SD 5) years, reported their alcohol consumption in median year 1998 (IQR 1998-1999), and were followed by record-linkage for incident cancer. 438,056 women who drank no alcohol or < 1 drink/week were excluded. Cox regression yielded adjusted relative risks (RRs) and 95% confidence intervals (CIs) for 21 cancers by alcohol amount; statistical significance of interactions with smoking, BMI and MHT use was assessed after allowing for multiple testing.

RESULTS

In 795,121 participants, mean consumption was 6.7 (SD 6.4) alcoholic drinks/week. During 17 (SD 5) years of follow-up, 140,203 incident cancers were recorded. There was strong evidence for a substantial association between alcohol intake and risk of upper aero-digestive cancers (oesophageal squamous cell carcinoma, oral cavity, pharynx and larynx; RR per 1 drink/day = 1.38 [95% CI 1.31-1.46]). There was also strong evidence for more moderate positive associations with breast, colorectal and pancreatic cancer (RRs per 1 drink/day = 1.12 [1.10-1.14], 1.10 [1.07-1.13], 1.08 [1.02-1.13] respectively), and moderate negative associations with thyroid cancer, non-Hodgkin's lymphoma, renal cell carcinoma and multiple myeloma (RRs per 1 drink/day = 0.79 [0.70-0.89], 0.91 [0.86-0.95], 0.88 [0.83-0.94], 0.90 [0.84-0.97] respectively). Significant interactions between alcohol and smoking were seen for upper aero-digestive cancers (RRs per 1 drink/day = 1.66 [1.54-1.79], 1.23 [1.11-1.36], 1.12 [1.01-1.25] in current, past, and never smokers respectively). BMI and MHT did not significantly modify any alcohol-associated risks.

CONCLUSIONS

These findings provide robust evidence that greater alcohol intake, even within relatively moderate ranges, increases the risk of cancers of the aerodigestive tract, breast, colorectal and pancreatic cancer, and probably decreases the risk of thyroid cancer, non-Hodgkin's lymphoma, renal cell carcinoma and multiple myeloma. Associations of alcohol intake with cancer risk were not modified by MHT use, adiposity or smoking, except in the case of upper aero-digestive cancers, where the alcohol-associated risk was largely confined to smokers.

Association between alcohol and urolithiasis: a mendelian randomization study

The causal relationship between alcohol and urolithiasis remains uncertain, despite previous observational studies reporting an association between the two. To determine the causality, we conducted a two-sample Mendelian randomization (MR) analysis. In this study, we aimed to investigate the causal relationship between alcohol and kidney stones using a two-sample MR approach. Two sets of genetic instruments were utilized in the analysis, both of which were derived from publicly available genetic summary data. The first set consisted of 73 single-nucleotide polymorphisms (SNPs) robustly linked to alcohol intake frequency (AIF) and the second set was comprised of 69 SNPs associated with alcohol consumption (AC). Our MR analysis was performed using several methods including the inverse-variance weighted (IVW) method, weighted median method, MR-Egger regression, MR Pleiotropy RESidual Sum and Outlier test. Our results from the MR analysis revealed a borderline significant association between AIF and the risk of urolithiasis. This was established through the use of the IVW method (OR (95% CI) = 1.29 (1.02, 1.65), p = 0.036) and the weighted median approach (OR (95% CI) = 1.44 (1.10, 1.89), p = 0.008). The MR-Egger model also yielded similar risk estimates (OR (95% CI) = 1.39 (0.66, 2.93), p = 0.386), although the relationship was not statistically significant. Sixty-eight SNPs were identified as having a substantial and independent link with AC. However, the IVW approach revealed no significant effect of AC on the risk of urolithiasis (OR (95% CI) = 0.74 (0.48, 1.14), p = 0.173). The MR analysis suggested a potential causal association between alcohol intake frequency and the risk of urolithiasis, but not alcohol consumption.