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Ekholm O, Bloomfield K, Thygesen LC. Alcohol habits and alcohol-related health conditions of self-defined lifetime abstainers and never binge drinkers. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024. [PMID: 39231784 DOI: 10.1111/acer.15433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/31/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Prior research has shown that using lifetime abstainers as the reference group to examine the association between alcohol use and health-related consequences has several disadvantages. The aim of the present study was to examine the consistency of self-reported lifetime abstention and never-binge drinking, respectively, using national, longitudinal data collected in 2019 and 2020. Additionally, the prevalence of alcohol-related morbidity among lifetime abstainers was examined by linking survey data to alcohol-related morbidity data in a national patient register. METHODS Data come from the Danish Health and Wellbeing Survey in 2019 and from a follow-up survey of the same individuals in 2020. A random sample of 14,000 individuals aged 15 years or older was drawn in mid-August 2019. Data were collected between September and December 2019. All those who were invited to the survey in 2019 and who were still alive and living in Denmark were invited to participate in a follow-up survey in 2020. Data in both waves were collected by self-administered questionnaires. Both questionnaires included the standard questions on alcohol consumption from the European Health Interview Survey model questionnaire. Information on alcohol-related morbidity was obtained from the Danish National Patient Register. RESULTS In all, 5000 individuals completed the questionnaire in both waves. Approximately half (44.4%) of the individuals who declared that they were lifetime abstainers in 2020 (n = 252) had reported in 2019 to have drunk at some point in their life. Moreover, 39.7% contradicted earlier reported binge drinking. Furthermore, 2.4% of the respondents who defined themselves as lifetime abstainers in 2020 had earlier been diagnosed with an alcohol-related health condition. CONCLUSION The present research reaffirms previous studies which have found self-reported lifetime abstainers to be unreliable as a consistent reference group. Additionally, the results indicated that a non-negligible proportion of lifetime abstainers had been diagnosed with an alcohol-related health condition.
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Affiliation(s)
- Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Kim Bloomfield
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Centre for Alcohol and Drug Research, University of Aarhus, Aarhus, Denmark
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Ortolá R, Sotos-Prieto M, García-Esquinas E, Galán I, Rodríguez-Artalejo F. Alcohol Consumption Patterns and Mortality Among Older Adults With Health-Related or Socioeconomic Risk Factors. JAMA Netw Open 2024; 7:e2424495. [PMID: 39133491 PMCID: PMC11320169 DOI: 10.1001/jamanetworkopen.2024.24495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/30/2024] [Indexed: 08/13/2024] Open
Abstract
Importance Alcohol consumption is a leading cause of morbidity and mortality that may be more important in older adults with socioeconomic or health-related risk factors. Objective To examine the association of alcohol consumption patterns with 12-year mortality and its modification by health-related or socioeconomic risk factors. Design, Setting, and Participants This prospective cohort study used data from the UK Biobank, a population-based cohort. Participants were current drinkers aged 60 years or older. Data were analyzed from September 2023 to May 2024. Exposure According to their mean alcohol intake in grams per day, participants' drinking patterns were classified as occasional: ≤2.86 g/d), low risk (men: >2.86-20.00 g/d; women: >2.86-10.00 g/d), moderate risk (men: >20.00-40.00 g/d; women: >10.00-20.00 g/d) and high risk (men: >40.00 g/d; women: >20.00 g/d). Main Outcomes and Measures Health-related risk factors were assessed with the frailty index, and socioeconomic risk factors were assessed with the Townsend deprivation index. All-cause and cause-specific mortality were obtained from death certificates held by the national registries. Analyses excluded deaths in the first 2 years of follow-up and adjusted for potential confounders, including drinking patterns and preferences. Results A total of 135 103 participants (median [IQR] age, 64.0 [62.0-67.0] years; 67 693 [50.1%] women) were included. In the total analytical sample, compared with occasional drinking, high-risk drinking was associated with higher all-cause (hazard ratio [HR], 1.33; 95% CI, 1.24-1.42), cancer (HR, 1.39; 95% CI, 1.26-1.53), and cardiovascular (HR, 1.21; 95% CI, 1.04-1.41) mortality; moderate-risk drinking was associated with higher all-cause (HR, 1.10; 95% CI, 1.03-1.18) and cancer (HR, 1.15; 95% CI, 1.05-1.27) mortality, and low-risk drinking was associated with higher cancer mortality (HR, 1.11; 95% CI, 1.01-1.22). While no associations were found for low- or moderate-risk drinking patterns vs occasional drinking among individuals without socioeconomic or health-related risk factors, low-risk drinking was associated with higher cancer mortality (HR, 1.15; 95% CI, 1.01-1.30) and moderate-risk drinking with higher all-cause (HR, 1.10; 95% CI, 1.01-1.19) and cancer (HR, 1.19; 95% CI, 1.05-1.35) mortality among those with health-related risk factors; low-risk and moderate-risk drinking patterns were associated with higher mortality from all causes (low risk: HR, 1.14; 95% CI, 1.01-1.28; moderate risk: HR, 1.17; 95% CI, 1.03-1.32) and cancer (low risk: HR, 1.25; 95% CI, 1.04-1.50; moderate risk: HR, 1.36; 95% CI, 1.13-1.63) among those with socioeconomic risk factors. Wine preference (>80% of alcohol from wine) and drinking with meals showed small protective associations with mortality, especially from cancer, but only in drinkers with socioeconomic or health-related risk factors and was associated with attenuating the excess mortality associated with high-, moderate- and even low-risk drinking. Conclusions and Relevance In this cohort study of older drinkers from the UK, even low-risk drinking was associated with higher mortality among older adults with health-related or socioeconomic risk factors. The attenuation of mortality observed for wine preference and drinking only during meals requires further investigation, as it may mostly reflect the effect of healthier lifestyles, slower alcohol absorption, or nonalcoholic components of beverages.
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Affiliation(s)
- Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Department of Environmental Health and Nutrition, Harvard T.H. Chan School of Public Health. Boston, Massachusetts
- Madrid Institute for Advanced Studies Food Institute, Campus of International Excellence Universidad Autónoma de Madrid + Spanish National Research Council, Madrid, Spain
| | - Esther García-Esquinas
- Center for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Iñaki Galán
- Center for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Madrid Institute for Advanced Studies Food Institute, Campus of International Excellence Universidad Autónoma de Madrid + Spanish National Research Council, Madrid, Spain
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Weng TL, Meng LC, Peng LN, Lin MH, Hsiao FY, Chen LK. The Impact of Social Vulnerability on Alcohol Consumption and Mortality: A 20-year Age, Sex-stratified Analysis from the Taiwan Longitudinal Study of Aging. J Am Med Dir Assoc 2024; 25:105008. [PMID: 38688459 DOI: 10.1016/j.jamda.2024.03.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE This study aimed to use the Social Vulnerability Index (SVI) to encapsulate the complex and multidimensional nature of social determinants and their influence on alcohol intake and mortality in middle-aged and older individuals. DESIGN Cohort study. SETTING AND PARTICIPANTS Data were obtained from the Taiwan Longitudinal Study on Aging (TLSA), with 3945 study participants aged 50 years and older. METHODS The TLSA questionnaire defined SVI (51 items including living conditions, social support, socially oriented activities of daily living, social engagement and leisure, empowerment of life, satisfaction about life, and socioeconomic status) and alcohol intake (behavior as well as type and frequency of alcohol intake). Multivariate Cox proportional hazard models were used to estimate the association between alcohol intake and mortality, stratified by sex and SVI groups. RESULTS Men with high social vulnerability and high alcohol intake exhibit an elevated mortality risk [adjusted hazard ratio (aHR), 1.51; 95% CI, 1.01-2.24], whereas notably, women in similar social circumstances but with moderate alcohol intake face a quintupled mortality risk (>35 g/wk; aHR, 5.67; 95% CI, 2.37-13.61). The impact of alcohol and social vulnerability on mortality was more pronounced in men younger than 65. Among them, those with high social vulnerability and moderate (35-140 g/wk; aHR, 2.83; 95% CI, 1.50-5.36) to high (>140 g/wk; aHR, 2.24; 95% CI, 1.15-4.35) alcohol intake was associated with an increased risk of mortality. CONCLUSIONS AND IMPLICATIONS Various factors throughout the life course of both men and women significantly impact the risk of all-cause mortality due to alcohol intake, underscoring the importance of social vulnerability as a determinant of both alcohol intake behavior and mortality risk.
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Affiliation(s)
- Tzu-Ling Weng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Lin-Chieh Meng
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Ning Peng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ming-Hsien Lin
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Fei-Yuan Hsiao
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan.
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Li M, Zhang X, Chen K, Miao Y, Xu Y, Sun Y, Jiang M, Liu M, Gao Y, Xue X, Li X. Alcohol Exposure and Disease Associations: A Mendelian Randomization and Meta-Analysis on Weekly Consumption and Problematic Drinking. Nutrients 2024; 16:1517. [PMID: 38794754 PMCID: PMC11123792 DOI: 10.3390/nu16101517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/10/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Alcohol consumption significantly impacts disease burden and has been linked to various diseases in observational studies. However, comprehensive meta-analyses using Mendelian randomization (MR) to examine drinking patterns are limited. We aimed to evaluate the health risks of alcohol use by integrating findings from MR studies. A thorough search was conducted for MR studies focused on alcohol exposure. We utilized two sets of instrumental variables-alcohol consumption and problematic alcohol use-and summary statistics from the FinnGen consortium R9 release to perform de novo MR analyses. Our meta-analysis encompassed 64 published and 151 de novo MR analyses across 76 distinct primary outcomes. Results show that a genetic predisposition to alcohol consumption, independent of smoking, significantly correlates with a decreased risk of Parkinson's disease, prostate hyperplasia, and rheumatoid arthritis. It was also associated with an increased risk of chronic pancreatitis, colorectal cancer, and head and neck cancers. Additionally, a genetic predisposition to problematic alcohol use is strongly associated with increased risks of alcoholic liver disease, cirrhosis, both acute and chronic pancreatitis, and pneumonia. Evidence from our MR study supports the notion that alcohol consumption and problematic alcohol use are causally associated with a range of diseases, predominantly by increasing the risk.
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Affiliation(s)
- Mengyao Li
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention, China Medical University, Ministry of Education, Shenyang 110122, China; (M.L.); (X.Z.); (K.C.); (Y.M.); (Y.X.); (Y.S.); (M.J.); (M.L.); (Y.G.)
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China
| | - Xuying Zhang
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention, China Medical University, Ministry of Education, Shenyang 110122, China; (M.L.); (X.Z.); (K.C.); (Y.M.); (Y.X.); (Y.S.); (M.J.); (M.L.); (Y.G.)
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China
| | - Kailei Chen
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention, China Medical University, Ministry of Education, Shenyang 110122, China; (M.L.); (X.Z.); (K.C.); (Y.M.); (Y.X.); (Y.S.); (M.J.); (M.L.); (Y.G.)
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China
| | - Yang Miao
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention, China Medical University, Ministry of Education, Shenyang 110122, China; (M.L.); (X.Z.); (K.C.); (Y.M.); (Y.X.); (Y.S.); (M.J.); (M.L.); (Y.G.)
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China
| | - Yaxin Xu
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention, China Medical University, Ministry of Education, Shenyang 110122, China; (M.L.); (X.Z.); (K.C.); (Y.M.); (Y.X.); (Y.S.); (M.J.); (M.L.); (Y.G.)
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China
| | - Yishuo Sun
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention, China Medical University, Ministry of Education, Shenyang 110122, China; (M.L.); (X.Z.); (K.C.); (Y.M.); (Y.X.); (Y.S.); (M.J.); (M.L.); (Y.G.)
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China
| | - Mengxian Jiang
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention, China Medical University, Ministry of Education, Shenyang 110122, China; (M.L.); (X.Z.); (K.C.); (Y.M.); (Y.X.); (Y.S.); (M.J.); (M.L.); (Y.G.)
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China
| | - Mengcao Liu
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention, China Medical University, Ministry of Education, Shenyang 110122, China; (M.L.); (X.Z.); (K.C.); (Y.M.); (Y.X.); (Y.S.); (M.J.); (M.L.); (Y.G.)
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China
| | - Yan Gao
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention, China Medical University, Ministry of Education, Shenyang 110122, China; (M.L.); (X.Z.); (K.C.); (Y.M.); (Y.X.); (Y.S.); (M.J.); (M.L.); (Y.G.)
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China
| | - Xiaoxia Xue
- Science Experiment Center, China Medical University, Shenyang 110122, China;
| | - Xuelian Li
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention, China Medical University, Ministry of Education, Shenyang 110122, China; (M.L.); (X.Z.); (K.C.); (Y.M.); (Y.X.); (Y.S.); (M.J.); (M.L.); (Y.G.)
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China
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Kokts-Porietis RL, Morielli AR, McNeil J, Benham JL, Courneya KS, Cook LS, Friedenreich CM. Prospective cohort of pre- and post-diagnosis alcohol consumption and cigarette smoking on survival outcomes: an Alberta Endometrial Cancer Cohort Study. Cancer Causes Control 2024; 35:121-132. [PMID: 37596424 DOI: 10.1007/s10552-023-01777-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 08/09/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE To examine the independent and joint relationships between cigarette smoking and alcohol consumption with survival outcomes after endometrial cancer diagnosis. METHODS Pre- and post-diagnosis smoking and drinking histories were obtained from endometrial cancer survivors diagnosed between 2002 and 2006 during in-person interviews at-diagnosis and at ~ 3 years post-diagnosis. Participants were followed until death or January 2022. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with Cox proportional hazards regression for associations with disease-free survival (DFS) and overall survival (OS). RESULTS During a median 16.9 years of follow-up (IQR = 15.5-18.1 years), 152 of the 540 participants had a DFS event (recurrence: n = 73; deaths: n = 79) and 134 died overall. Most participants in this cohort were current drinkers (pre = 61.3%; post = 64.7%) while few were current cigarette smokers (pre = 12.8%; post = 11.5%). Pre-diagnosis alcohol consumption was not associated with survival, yet post-diagnosis alcohol intake ≥ 2 drinks/week was associated with worse OS compared with lifetime abstention (HR = 2.36, 95%CI = 1.00-5.54) as well as light intake (HR = 3.87, 95% CI = 1.67-8.96). Increased/consistently high alcohol intake patterns were associated with worse OS (HR = 2.91, 95% CI = 1.15-7.37) compared with patterns of decreased/ceased intake patterns after diagnosis. A harmful dose-response relationship per each additional pre-diagnosis smoking pack-year with OS was noted among ever smokers. In this cohort, smoking and alcohol individually were not associated with DFS and combined pre-diagnosis smoking and alcohol intakes were not associated with either outcome. CONCLUSION Endometrial cancer survivors with higher alcohol intakes after diagnosis had poorer OS compared with women who had limited exposure. Larger studies powered to investigate the individual and joint impacts of cigarette smoking and alcohol use patterns are warranted to provide additional clarity on these modifiable prognostic factors.
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Affiliation(s)
- Renée L Kokts-Porietis
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Andria R Morielli
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Jessica McNeil
- Department of Kinesiology, Faculty of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Jamie L Benham
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Linda S Cook
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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Jun S, Park H, Kim UJ, Choi EJ, Lee HA, Park B, Lee SY, Jee SH, Park H. Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis. Epidemiol Health 2023; 45:e2023092. [PMID: 37905315 PMCID: PMC10867516 DOI: 10.4178/epih.e2023092] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/13/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVES Alcohol consumption is a well-established risk factor for cancer. Despite extensive research into the relationship between alcohol consumption and cancer risk, the effect of light alcohol consumption on cancer risk remains a topic of debate. To contribute to this discourse, we conducted a comprehensive systematic review and meta-analysis. METHODS Our systematic review aimed to investigate the associations between different levels of alcohol consumption and the risk of several cancer types. We focused on analyzing prospective associations using data from 139 cohort studies. Among them, 106 studies were included in the meta-analysis after a quantitative synthesis. RESULTS Our analysis did not find a significant association between light alcohol consumption and all-cause cancer risk (relative risk, 1.02; 95% confidence interval, 0.99 to 1.04), but we observed a dose-response relationship. Light alcohol consumption was significantly associated with higher risks of esophageal, colorectal, and breast cancers. Light to moderate drinking was associated with elevated risks of esophageal, colorectal, laryngeal, and breast cancers. Heavy drinking was also found to contribute to the risk of stomach, liver, pancreas, and prostate cancers, thereby increasing the risk of almost all types of cancer. Additionally, females generally had lower cancer risks compared to males. CONCLUSIONS Our findings highlight that cancer risks extend beyond heavy alcohol consumption to include light alcohol consumption as well. These findings suggest that there is no safe level of alcohol consumption associated with cancer risk. Our results underscore the importance of public health interventions addressing alcohol consumption to mitigate cancer risks.
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Affiliation(s)
- Seunghee Jun
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyunjin Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ui-Jeong Kim
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Eun Jeong Choi
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Bomi Park
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Soon Young Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Sun Ha Jee
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University College of Medicine, Seoul, Korea
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Reynales-Shigematsu LM, Barnoya J, Cavalcante T, Aburto TC, Romieu I, Stern MC, Barquera S, Corvalán C, Hallal PC, Canelo-Aybar C, Alvarado-Villacorta R, Espina C, Feliu A, Rivera JA. Latin America and the Caribbean Code Against Cancer 1st edition: Tobacco and nicotine-related products, secondhand smoke, and alcohol and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102413. [PMID: 37852726 DOI: 10.1016/j.canep.2023.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 10/20/2023]
Abstract
Tobacco, secondhand smoke (SHS), and alcohol, all carcinogens, are leading preventable cancer risk factors in Latin America and the Caribbean (LAC). Since 2000, smoking and SHS exposure have significantly decreased in the region. Yet alcohol consumption remains high. The entry of nicotine-related products such as electronic cigarettes (e-cigs) threatens achievements made in tobacco control and chronic diseases prevention, including cancer. E-cigs use is likely associated with smoking initiation among adolescents who had never smoked and dual use with combustible tobacco products. Therefore, the LAC Code Against Cancer recommends to the public actions they can take to reduce their risk of cancer: 1. Don't smoke or use any type of tobacco. If you do, quitting is possible, with professional help if needed. Don't use e-cigarettes either, as they lead to tobacco use. 2. Make your home a smoke-free place. Respect and promote laws that ensure smoke-free spaces to protect our health. and 3. Avoid drinking alcoholic beverages. This helps prevent several types of cancer. The Code recommends to policymakers a package of cost-effective policies based on the MPOWER and SAFER to prevent cancer at the population level. It also recommends that primary care health professionals: 1. Ask all their patients and their families whether they smoke or vape, inform them about the harms of smoking and vaping, and promote tobacco and nicotine related products cessation strategies among users. 2. Inform about the harms of exposure to SHS, especially among children, and promote smoke-free environments, and 3. Prevent alcohol use by their patients and their families, use tools to assess use, intensity, and frequency, and apply brief counseling intervention to support alcohol abstinence in primary care.
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Affiliation(s)
- Luz Myriam Reynales-Shigematsu
- Tobacco Control and Preventive Department. Center for Population Health Research. National Institute of Public Health. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos CP 62100, Mexico.
| | - Joaquin Barnoya
- Integra Cancer Institute, Guatemala, 9ª calle 4-52 zona 10, Guatemala, Guatemala
| | - Tania Cavalcante
- Instituto Nacional del Cáncer, INCA, Brasil.Pr. da Cruz Vermelha, 23 - Centro, Rio de Janeiro, RJ 20230-130, Brazil
| | - Tania C Aburto
- Center for Research on Nutrition and Health, National Institute of Public Health, CP 62100 Cuernavaca, Mexico
| | - Isabelle Romieu
- Center for Population Health Research, National Institute of Public Health, CP 62100, Cuernavaca, Mexico
| | - Mariana C Stern
- Department of Preventive Medicine and Urology, Keck School of Medicine of USC, 90033 Los Angeles, USA
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, CP 62100 Cuernavaca, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Macul, Chile
| | - Pedro C Hallal
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, United States
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberossssamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Rosa Alvarado-Villacorta
- Department of Clinical Epidemiology and Public Health, Iberossssamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07, France
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07, France
| | - Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, CP 62100, Cuernavaca, Mexico
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Wang C, Chiu S, Wu S, Pan L, Yen Y, Lai Y, Chen C. Treatment and mortality risk of older adults with non-small cell cancer in Taiwan: A population-based cohort study. Thorac Cancer 2023; 14:2687-2695. [PMID: 37551918 PMCID: PMC10493478 DOI: 10.1111/1759-7714.15055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Older patients tend to have decreased physical functions and more comorbidities than younger patients. At present, the best management for very elderly patients with lung cancer is not known. In this study, we aimed to investigate treatment and mortality risk of older adults with non-small cell cancer (NSCLC) in Taiwan. METHODS This study analyzed data from the Taiwan Cancer Registry database. Patients aged ≥80 years with newly diagnosed NSCLC between 2010 and 2017 were included. Treatment options were categorized as curative, palliative, and no treatment. Patients were followed up until death or December 31, 2020. Univariable and multivariable Cox proportional hazards models were used to estimate mortality risk, and Kaplan-Meier survival curves were drawn. RESULTS A total of 11 941 patients, aged ≥80 years, with newly diagnosed NSCLC between 2010 and 2017 were identified from the Taiwan Cancer Registry and followed up until 2020. The mean age was 84.4 ± 3.7 years old, and 7468 (62.54%) were men. The Kaplan-Meier survival curves showed significant differences across the three treatment options (log-rank p < 0.001). Results from multivariate Cox regression demonstrated that patients on palliative treatment (adjusted HR: 0.52, 95% CI: 0.48-0.56, p < 0.001) and curative treatment (adjusted HR: 0.45, 95% CI: 0.42-0.48, p < 0.001) had a significantly lower mortality risk than those with no treatment. The subgroup analyses stratified by cancer stages also showed consistent findings. CONCLUSION Elderly patients with NSCLC had significantly decreased mortality risk when receiving curative or palliative treatment compared with those without treatment. In the future, further studies are warranted to investigate complications and quality of life of elderly patients with NSCLC during palliative or curative treatment.
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Affiliation(s)
- Chun‐Chieh Wang
- Division of Chest Medicine, Department of Internal MedicinePuli Branch of Taichung Veterans General HospitalNantouTaiwan
- Department of EldercareCentral Taiwan University of Science and TechnologyTaichungTaiwan
| | - Shao‐Wen Chiu
- Healthcare Technology Business Division, Healthcare DepartmentInternational Integrated SystemsTaipeiTaiwan
| | - Shang‐Jung Wu
- Department of NursingPuli Branch of Taichung Veterans General HospitalNantouTaiwan
| | - Lung‐Kwang Pan
- Department of Medical Imaging and Radiological ScienceCentral Taiwan University of Science and TechnologyTaichungTaiwan
| | - Yung‐Feng Yen
- Section of Infectious Diseases, Taipei City Hospital, Taipei City GovernmentTaipeiTaiwan
- Institute of Hospital and Health Care AdministrationNational Yang‐Ming UniversityTaipeiTaiwan
- Department of Health Care ManagementNational Taipei University of Nursing and Health SciencesTaipeiTaiwan
| | - Yun‐Ju Lai
- Department of Health Care ManagementNational Taipei University of Nursing and Health SciencesTaipeiTaiwan
- School of MedicineNational Yang‐Ming UniversityTaipeiTaiwan
- Department of Exercise Health ScienceNational Taiwan University of SportTaichungTaiwan
- Division of Endocrinology and Metabolism, Department of Internal MedicinePuli Branch of Taichung Veterans General HospitalNantouTaiwan
| | - Chu‐Chieh Chen
- Department of Health Care ManagementNational Taipei University of Nursing and Health SciencesTaipeiTaiwan
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9
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Suter F, Pestoni G, Sych J, Rohrmann S, Braun J. Alcohol consumption: context and association with mortality in Switzerland. Eur J Nutr 2023; 62:1331-1344. [PMID: 36564527 PMCID: PMC10030531 DOI: 10.1007/s00394-022-03073-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/12/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE Non-communicable diseases generate the largest number of avoidable deaths often caused by risk factors such as alcohol, smoking, and unhealthy diets. Our study investigates the association between amount and context of alcohol consumption and mortality from major non-communicable diseases in Switzerland. METHODS Generalized linear regression models were fitted on data of the cross-sectional population-based National Nutrition Survey menuCH (2014-2015, n = 2057). Mortality rates based on the Swiss mortality data (2015-2018) were modeled by the alcohol consumption group considering the amount and context (i.e., during or outside mealtime) of alcohol consumption and potential confounders. The models were checked for spatial autocorrelation using Moran's I statistic. Integrated nested Laplace approximation (INLA) models were fitted when evidence for missing spatial information was found. RESULTS Higher mortality rates were detected among drinkers compared to non-drinkers for all-cancer (rate ratio (RR) ranging from 1.01 to 1.07) and upper aero-digestive tract cancer (RR ranging from 1.15 to 1.20) mortality. Global Moran's I statistic revealed spatial autocorrelation at the Swiss district level for all-cancer mortality. An INLA model led to the identification of three districts with a significant decrease and four districts with a significant increase in all-cancer mortality. CONCLUSION Significant associations of alcohol consumption with all-cancer and upper aero-digestive tract cancer mortality were detected. Our study results indicate the need for further studies to improve the next alcohol-prevention scheme and to lower the number of avoidable deaths in Switzerland.
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Affiliation(s)
- Flurina Suter
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Giulia Pestoni
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
- Nutrition Group, Health Department, Swiss Distance University of Applied Sciences, Zurich, Switzerland
| | - Janice Sych
- Institute of Food and Beverage Innovation, ZHAW School of Life Sciences and Facility Management, Waedenswil, Switzerland
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.
| | - Julia Braun
- Divisions of Epidemiology and Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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10
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D’Ecclesiis O, Pastore E, Gandini S, Caini S, Marvaso G, Jereczek-Fossa BA, Corrao G, Raimondi S, Bellerba F, Ciceri S, Latella M, Cavalcabò NDB, Bendinelli B, Saieva C, Fontana M, Gnagnarella P. Association between Alcohol Intake and Prostate Cancer Mortality and Survival. Nutrients 2023; 15:nu15040925. [PMID: 36839283 PMCID: PMC9965886 DOI: 10.3390/nu15040925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
We conducted a systematic review and meta-analysis to investigate the role of alcohol consumption with the prognosis of prostate cancer (PCa). Published reports were gathered on 15 October 2022, from PUBMED/MEDLINE and EMBASE. We found 19 independent eligible studies on the association between consumption of alcoholic beverages and the risk of fatal PCa (n = 5), PCa mortality (n = 5) in healthy subjects, and PCa patients' survival (n = 7) or surrogates thereof (n = 2). We used random effects meta-analysis to obtain a summary risk estimate (SRE) and 95% confidence intervals (95%CI) for incidence of fatal PCa and PCa mortality. The meta-analysis revealed no association between alcohol consumption and fatal prostate cancer incidence risk in healthy subjects with an indication for publication bias, but omitting the study that mainly increased the between-study heterogeneity, the SRE becomes significant (SRE 1.33, 95%CI 1.12-1.58), and the heterogeneity disappeared (I2 = 0%) with no indication of publication bias. No association of alcohol consumption was found with mortality risk in PCa patients (SRE 0.97, 95%CI 0.92-1.03) and PCa mortality risk in healthy subjects (SRE 1.03, 95%CI 0.82-1.30). In conclusion, this study suggests that there is some evidence of an association between high alcohol consumption and an increased risk of incidence of fatal prostate cancer in healthy subjects. Given the inconsistencies this result warrants further confirmation.
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Affiliation(s)
- Oriana D’Ecclesiis
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy
| | - Elisa Pastore
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy
- Correspondence:
| | - Saverio Caini
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Giulia Marvaso
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Barbara A. Jereczek-Fossa
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Giulia Corrao
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Sara Raimondi
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy
| | - Federica Bellerba
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy
| | - Silvia Ciceri
- Division of Epidemiology and Biostatistics, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Marialetizia Latella
- Division of Epidemiology and Biostatistics, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Nora de Bonfioli Cavalcabò
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Benedetta Bendinelli
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Calogero Saieva
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Miriam Fontana
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, European Institute of Oncology, IRCCS, 20141 Milan, Italy
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11
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Oh JK, Han M, Kim B, Park EY. Adherence to Cancer Prevention Guidelines and Cancer Incidence and Mortality: A Population-Based Cohort Study. Cancer Res Treat 2023; 55:15-27. [PMID: 35344651 PMCID: PMC9873327 DOI: 10.4143/crt.2021.1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/21/2022] [Indexed: 02/04/2023] Open
Abstract
PURPOSE This study aimed to estimate the risk of cancer incidence and mortality according to adherence to lifestyle-related cancer prevention guidelines. MATERIALS AND METHODS Men and women who participated in the general health screening program in 2002 and 2003 provided by the National Health Insurance Service were included (n=8,325,492). Self-reported smoking, alcohol consumption, and physical activity habits and directly measured body mass index were collected. The participants were followed up until the date of cancer onset or death or 31 December 2018. The Cox proportional hazard model was used to evaluate the hazard ratio (HR) for cancer incidence and mortality according to different combinations of lifestyle behaviors. RESULTS Only 6% of men and 15% of women engaged in healthy behavior at baseline, such as not smoking, not drinking alcohol, being moderately or highly physically active, and within a normal body mass index range. Compared to the best combination of healthy lifestyle behaviors, the weak and moderate associations with increased all cancer incidence (HR < 1.7) and mortality (HR < 2.5) were observed in those with heavy alcohol consumption and in former or current smokers. HRs of cancer mortality were significantly increased among current smokers in most combinations. CONCLUSION Compared to full adherence to cancer prevention recommendations, unhealthy behaviors increase cancer risk. As few people meet these recommendations, there is a great opportunity for cancer prevention.
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Affiliation(s)
- Jin-Kyoung Oh
- Division of Cancer Prevention, National Cancer Center, Goyang,
Korea,Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang,
Korea
| | - Minji Han
- Division of Cancer Prevention, National Cancer Center, Goyang,
Korea
| | - Byungmi Kim
- Division of Cancer Prevention, National Cancer Center, Goyang,
Korea
| | - Eun Young Park
- Division of Cancer Prevention, National Cancer Center, Goyang,
Korea
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12
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Liu X, Zhang W, Ji W, Zheng K, Zhao Y, He Y, Cui J, Li W. Effect of Alcohol Intake on Inflammatory Status and Prognosis in Cancer Patients. J Inflamm Res 2022; 15:5815-5826. [PMID: 36238771 PMCID: PMC9553310 DOI: 10.2147/jir.s376248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
Purpose To explore the effect of alcohol on the inflammatory status and prognosis of patients with malignancy. Patients and Methods The clinical data of patients with malignant tumor who were admitted to the First Hospital of Jilin University from November 2011 to December 2018 were collected including basic clinical information, anthropometric indicators, body composition analysis, and serological indicators. Univariate and multivariate Cox proportional hazards models were performed to find predictors of survival. A nomogram was generated to indicate the interrelationships between the variables in the prediction model and the extent to which alcohol consumption affects prognosis. The C-index and calibration curves were used to verify the predictive accuracy of the scoring system. Results A total of 2929 cancer patients were included in this study, of which 552 (18.8%) patients had alcohol consumption habits and 2377 (81.2%) patients had no alcohol history. Patients in the Alcohol group had significantly shorter overall survival (OS) than the Non-Alcohol group, and further sub-analysis indicated alcohol consumption was significantly associated with prognosis of advanced breast cancer (HR = 4.617, 95% CI 1.361–15.664, p=0.014), and early stage hepatocellular carcinoma (HCC) without viral hepatitis (HR = 8.933, 95% CI 1.444–55.275, p = 0.019). Multivariate Cox regression models also demonstrated that daily alcohol intake was a risk factor of survival benefits (HR = 1.256, 95% CI 1.016–1.554, p = 0.036). Finally, a nomogram was constructed and the c-index of this scoring system is 0.751. The 3- and 5-year calibration curves of the model show a high agreement between the predicted probability and the actual observed survival rate. Conclusion Alcohol intake was demonstrated associates with patient outcomes. A human component-prognosis scoring system was established to predict the survival benefits of cancer patients.
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Affiliation(s)
- Xiangliang Liu
- The First Hospital of Jilin University, Changchun, People’s Republic of China
| | - Wenxin Zhang
- Zhongnan Hospital, Wuhan University, Wuhan, People’s Republic of China
| | - Wei Ji
- The First Hospital of Jilin University, Changchun, People’s Republic of China
| | - Kaiwen Zheng
- The First Hospital of Jilin University, Changchun, People’s Republic of China
| | - Yixin Zhao
- The First Hospital of Jilin University, Changchun, People’s Republic of China
| | - Yuwei He
- The First Hospital of Jilin University, Changchun, People’s Republic of China
| | - Jiuwei Cui
- The First Hospital of Jilin University, Changchun, People’s Republic of China,Correspondence: Jiuwei Cui; Wei Li, Jilin University, Xinmin St No. 126, Changchun, 130021, People’s Republic of China, Tel +8613844095420; +8613206282295, Fax +86 431-85619254, Email ;
| | - Wei Li
- The First Hospital of Jilin University, Changchun, People’s Republic of China
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13
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Oh JK, Park E, Kim B, Choi YJ, Yun EH, Lim MK, Im JS, Park EY. Awareness of and practice toward cancer prevention recommendations: results of the Korean National Cancer Prevention Awareness and Practice Survey in 2021. Epidemiol Health 2022; 44:e2022068. [PMID: 36049500 PMCID: PMC9943633 DOI: 10.4178/epih.e2022068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/26/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES This study reports data regarding the awareness and practice of cancer prevention among Koreans in 2021 and behavioral changes during the coronavirus disease 2019 (COVID-19) pandemic. METHODS We collected Cancer Prevention Awareness and Practice Survey data through face-to-face interview surveys using a structured questionnaire completed by 4,000 randomly selected men and women aged between 20 years and 74 years in 17 provinces. We examined the awareness and practice of 10 cancer prevention recommendations and evaluated their associations with potential risk factors through multiple logistic regression analysis adjusted for age, gender, residence, marital status, education, and income. RESULTS Eighty percent of participants knew that cancer is preventable, while 45% practiced cancer prevention. Cancer prevention practice tended to be more common among older participants (adjusted odds ratio [aOR], 1.39 per 10-year increment; 95% confidence interval [CI], 1.29 to 1.49) and less common among rural inhabitants (aOR, 0.66; 95% CI, 0.51 to 0.86) than among urban residents and among single people (aOR, 0.55; 95% CI, 0.45 to 0.66) than among married people. Practices were the highest for avoiding burned or charred foods (87.6%) and lowest for vaccination against human papillomavirus (14.5%). Refusal to follow recommendations was most common for avoiding alcohol consumption (7.9%). The most difficult recommendations to follow were (1) regular exercise (57.7%); (2) maintaining a healthy body weight (46.1%); and (3) avoiding alcohol (40.1%). The most significant COVID-19-related changes were less exercise (32.5%) and increased body weight (25.6%). CONCLUSIONS The awareness of cancer prevention was high, but the practice was low. Recommendations targeting awareness and practice need to be further promoted.
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Affiliation(s)
- Jin-Kyoung Oh
- National Cancer Control Institute, National Cancer Center, Goyang, Korea,Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Eunjung Park
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Byungmi Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea,Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Yoon-Jung Choi
- National Cancer Control Institute, National Cancer Center, Goyang, Korea,Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - E Hwa Yun
- National Cancer Control Institute, National Cancer Center, Goyang, Korea,Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Min Kyung Lim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea,Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Jeong-Soo Im
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eun Young Park
- National Cancer Control Institute, National Cancer Center, Goyang, Korea,Correspondence: Eun Young Park National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea E-mail:
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14
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Alcohol Drinking Pattern and Risk of Head and Neck Cancer: A Nationwide Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111204. [PMID: 34769724 PMCID: PMC8582646 DOI: 10.3390/ijerph182111204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 11/21/2022]
Abstract
Alcohol consumption is a major risk factor for head and neck cancer (HNC), yet little data exist examining drinking patterns and HNC risk. In this population-based, retrospective cohort study, 11,737,467 subjects were recruited from the Korean National Health Insurance Service database. The risks of overall HNC and HNC subtypes according to average alcohol consumption, drinking frequency, and daily amount were examined using Cox proportional hazard models. Over the median follow-up of 6.4 years, 15,832 HNC cases were identified. HNC risk linearly increased with drinking frequency (p-trend < 0.01; adjusted hazard ratio [aHR] 1.55, 95% confidence interval [CI] 1.45–1.67 in subjects who drank 7 days/week). HNC risk also increased according to daily amount of alcohol consumption (p-trend < 0.01), but plateaued from 5–7 units/occasion (aHR 1.25, 95% CI 1.19–1.31) to >14 units/occasion (aHR 1.26, 95% CI 1.13–1.40). When stratified by average alcohol consumption, drinking frequency, but not daily amount, showed a linear relationship with HNC risk in moderate and heavy drinkers. When comparing the HNC subtypes, similar tendencies were observed in cancers of the oral cavity, pharynx, and larynx, but not in the salivary gland. In conclusion, drinking frequency is a stronger risk factor for HNC, especially for cancer of the oral cavity, pharynx, and larynx, than the daily amount of alcohol consumption.
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