Alcohol, tobacco and oesophageal cancer: effects of the duration of consumption, mean intake and current and former consumption.
Alcohol, tobacco and oesophageal cancer: effects of the duration of consumption, mean intake and current and former consumption.
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DOI：
10.1038/bjc.1997.236
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发表时间：
1997
影响因子：
8.8
通讯作者：
Gignoux M
中科院分区：
文献类型：
--
作者：
Launoy G;Milan CH;Faivre J;Pienkowski P;Milan CI;Gignoux M
许多流行病学研究表明，酒精和烟草消费是西方国家食管癌的主要危险因素。在这些研究中，酒精和烟草的消费几乎总是以当前的平均摄入量来衡量。本病例对照研究通过评估一生总摄入量、平均每周摄入量、消费持续时间以及以前和现在的消费量来调查酒精和烟草消费与食管癌风险之间的关系。在1991年至1994年期间，从法国三所大学医院（卡昂、第戎和图卢兹）中选择了208例病例和399例对照受试者。符合条件的情况下，年龄小于85岁的男性承认这些医院之一，组织学证实的食管鳞状细胞癌。在访谈过程中，记录了完整的烟草和酒精消费史。我们的研究结果表明，饮酒和吸烟以不同的方式影响食管癌的风险。在酒精的情况下，比值比和平均每周摄入量之间的关系是线性的，风险仅取决于平均每周摄入量，与前和当前的消费有类似的影响。关于烟草，比值比和平均每周摄入量之间的关系是对数线性的;风险主要取决于消费的持续时间和以前的消费比当前消费的影响较小。我们的研究表明，一生总摄入量不是酒精或烟草暴露的正确衡量标准：对于给定的一生烟草消费量，在较长时间内适度摄入比在较短时间内大量摄入的风险更高，相反，对于给定的一生酒精消费量，在较短时间内大量摄入比在较长时间内适度摄入的风险更高。我们的研究结果证实了与低酒精摄入量相关的风险非常低，即使是长期摄入。相反，如果长期吸烟，即使平均摄入量很低，与吸烟相关的风险也会急剧增加。我们的研究结果还表明，即使是重度吸烟者也可能从戒烟中受益。
Numerous epidemiological studies have shown that alcohol and tobacco consumption are the main risk factors for oesophageal cancer in Western countries. In these studies, the consumption of both alcohol and tobacco has almost always been measured as current mean intake. The present case-control study investigates the association between alcohol and tobacco consumption and the risk of oesophageal cancer by assessing exposure as total lifetime intake, mean weekly intake, duration of consumption and former and current consumption. Between 1991 and 1994, 208 cases and 399 control subjects were selected from three French university hospitals (Caen, Dijon and Toulouse). Eligible cases were men aged less than 85 years admitted to one of these hospitals with histologically proven squamous cell carcinoma of the oesophagus. During the interview, complete tobacco and alcohol consumption histories were recorded. Our findings suggest that alcohol consumption and tobacco consumption influence the risk of oesophageal cancer in different ways. In the case of alcohol, the relationship between the odds ratio and mean weekly intake was linear, the risk depending solely on mean weekly intake, with former and current consumption having similar effects. With regard to tobacco, the relationship between the odds ratio and mean weekly intake was log-linear; the risk depended mainly on the duration of consumption and former consumption had a lesser effect than current consumption. Our study suggests that total lifetime intake is not a correct measure of exposure for either alcohol or tobacco: for a given lifetime consumption of tobacco, a moderate intake during a long period carries a higher risk than a high intake during a shorter period and, conversely, for a given lifetime consumption of alcohol, a high intake during a shorter period carries a higher risk than a moderate intake during a longer period. Our results confirm the very low risk associated with a low alcohol intake, even over long periods. In contrast, there is a steep increase in the risk associated with smoking at even low mean intakes if these are continued over long periods. Our findings also suggest that even heavy smokers may benefit from quitting.