Alcohol drinking and risks of total and site-specific cancers in China: A 10-year prospective study of 0.5 million adults.
Alcohol drinking and risks of total and site-specific cancers in China: A 10-year prospective study of 0.5 million adults.
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DOI：
10.1002/ijc.33538
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发表时间：
2021-08-01
影响因子：
6.4
通讯作者：
China Kadoorie Biobank (CKB) Collaborative Group
中科院分区：
文献类型：
--
作者：
Im PK;Millwood IY;Kartsonaki C;Chen Y;Guo Y;Du H;Bian Z;Lan J;Feng S;Yu C;Lv J;Walters RG;Li L;Yang L;Chen Z;China Kadoorie Biobank (CKB) Collaborative Group
饮酒与几种特定部位癌症的风险增加有关，但其在许多其他癌症中的作用仍不确定。来自中国的证据更为有限，中国的癌症发病率、饮酒习惯和酒精耐受性与西方人群有很大不同。2004年至2008年，中国嘉朵里生物样本库从10个不同地区招募了51.2万名年龄在30岁至79岁之间的成年人，通过标准化问卷记录了酒精消费模式。根据饮料类型、每次饮酒的量和饮酒频率，以每周纯酒精的克数来估计自我报告的饮酒量。经过10年的随访，26961人患上了癌症。Cox回归用于估计饮酒与特定部位癌症发病率之间的校正风险比（hr）和95%置信区间（CIs）。总体而言，33% （n = 69 734）的男性在基线时经常饮酒（即≥每周）。在目前经常饮酒的男性中，酒精摄入量与食道癌（655例；危险度= 1.98[95%可信区间1.79‐2.18]，每280 g/周）、口腔和咽喉癌（236例；1.74例[1.48‐2.05]）、肝脏癌（573例；1.52例[1.31‐1.76]）、结肠直肠癌（575例；1.19例[1.00‐1.43]）、胆囊癌（107例；1.60例[1.16‐2.22]）和肺癌（1017例；1.25例[1.10‐1.42]）的风险呈剂量反应正相关，在从不吸烟和曾经吸烟的男性中也是如此。在对总酒精摄入量进行调整后，每天饮酒者患食道癌的风险比不每天饮酒者高，不吃饭喝酒时患肝癌的风险也更高。报告饮酒后脸红的男性患食道癌和肺癌的风险高于未饮酒的男性。在这些男性人群中，饮酒占癌症病例的7%。在女性中，只有2%的人经常饮酒，饮酒与癌症风险之间没有明确的联系。在中国男性中，饮酒与多个部位的癌症风险增加有关，某些饮酒模式（例如，每天喝酒，不吃饭）和低酒精耐受性进一步加剧了风险。有什么新鲜事吗?中国的癌症发病率、饮酒模式和酒精耐受性与西方不同，因此需要对酒精在癌症病因学中的作用进行全面评估。在这项大型前瞻性研究中，经常饮酒者在先前被认为与酒精相关的几个部位（即食道、口腔和咽喉、肝脏和结肠直肠）以及肺和胆囊中患癌症的风险增加。某些饮酒模式（例如，每天饮酒或不吃饭）和低酒精耐受性进一步加剧了风险。研究结果表明，降低人群饮酒量是预防癌症的重要策略。
Alcohol drinking is associated with increased risks of several site‐specific cancers, but its role in many other cancers remains inconclusive. Evidence is more limited from China, where cancer rates, drinking patterns and alcohol tolerability differ importantly from Western populations. The prospective China Kadoorie Biobank recruited >512 000 adults aged 30 to 79 years from 10 diverse areas during 2004 to 2008, recording alcohol consumption patterns by a standardised questionnaire. Self‐reported alcohol consumption was estimated as grams of pure alcohol per week based on beverage type, amount consumed per occasion and drinking frequency. After 10 years of follow‐up, 26 961 individuals developed cancer. Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) relating alcohol consumption to incidence of site‐specific cancers. Overall, 33% (n = 69 734) of men drank alcohol regularly (ie, ≥weekly) at baseline. Among male current regular drinkers, alcohol intake showed positive dose‐response associations with risks of cancers in the oesophagus (655 events; HR = 1.98 [95%CI 1.79‐2.18], per 280 g/wk), mouth and throat (236; 1.74 [1.48‐2.05]), liver (573; 1.52 [1.31‐1.76]), colon‐rectum (575; 1.19 [1.00‐1.43]), gallbladder (107; 1.60 [1.16‐2.22]) and lung (1017; 1.25 [1.10‐1.42]), similarly among never‐ and ever‐regular smokers. After adjustment for total alcohol intake, there were greater risks of oesophageal cancer in daily drinkers than nondaily drinkers and of liver cancer when drinking without meals. The risks of oesophageal cancer and lung cancer were greater in men reporting flushing after drinking than not. In this male population, alcohol drinking accounted for 7% of cancer cases. Among women, only 2% drank regularly, with no clear associations between alcohol consumption and cancer risk. Among Chinese men, alcohol drinking is associated with increased risks of cancer at multiple sites, with certain drinking patterns (eg, daily, drinking without meals) and low alcohol tolerance further exacerbating the risks. What's new? A comprehensive assessment of the role of alcohol in cancer aetiology is needed in China, where cancer rates, drinking patterns, and alcohol tolerability differ from those in the West. In this large prospective study, regular alcohol drinkers had increased risks of cancers in several sites previously considered to be alcohol‐related (i.e., oesophagus, mouth and throat, liver and colon‐rectum) as well as in the lung and gallbladder. Certain drinking patterns (e.g., drinking daily or without meals) and low alcohol tolerance further exacerbated the risks. The findings suggest that lowering population‐levels of alcohol consumption is an important strategy for cancer prevention.
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DOI：
10.1136/bmj.h4238
发表时间：
2015-08-18
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Cao Y;Willett WC;Rimm EB;Stampfer MJ;Giovannucci EL
通讯作者：
Giovannucci EL
影响因子：
11
作者：
Chang JS;Hsiao JR;Chen CH
通讯作者：
Chen CH
影响因子：
2.6
作者：
Brenner, Darren R.;Fehringer, Gord;Straif, Kurt
通讯作者：
Straif, Kurt
影响因子：
24.5
作者：
Bellentani, S;Saccoccio, G;Sassatelli, R
通讯作者：
Sassatelli, R
影响因子：
13.6
作者：
Chen, K;Jiang, QT;Zheng, S
通讯作者：
Zheng, S