25 August 2020 In Cancer

BACKGROUND: Even light to moderate alcohol consumption has been shown to increase cancer incidence. However, this association has not been well characterized in Japan.

METHODS: Based on a nationwide, hospital-based data set (2005-2016), a multicenter case-control study was conducted (63,232 cancer cases and 63,232 controls matched for sex, age, admission date, and admitting hospital). The total amount of lifetime alcohol consumption (drink-years) was recalled for each patient by multiplication of the daily amount of standardized alcohol use (drinks per day) and the duration of drinking (years). Odds ratios (ORs) were estimated for overall and specific cancer sites via conditional logistic regression with restricted cubic splines, with adjustments made for smoking, occupational class, and comorbidities. Lifetime abstainers served as the reference group.

RESULTS: Spline curves showed a dose-response association with overall cancer risk: the minimum risk was at 0 drink-years, and the OR at 10 drink-years was 1.05 (95% confidence interval [CI], 1.04-1.06). In comparison with lifetime abstainers, the OR for >0 to 20 drink-years was 1.06 (95% CI, 1.01-1.11). Those who drank 2 drinks or fewer per day had elevated odds for overall cancer risk across all duration-of-drinking categories. The same patterns were observed at light to moderate levels of drinking for most gastrointestinal/aerodigestive cancers as well as breast and prostate cancers. Analyses stratified by sex, different drinking/smoking behaviors, and occupational class mostly showed the same patterns for overall cancer incidence associated with light to moderate levels of drinking.

CONCLUSIONS: In Japan, even light to moderate alcohol consumption appears to be associated with elevated cancer risks.

25 August 2020 In Cancer

Alcohol drinking is a risk factor for cancer. The degree of risk is increased in subjects showing the flushing response, which is due to aldehyde dehydrogenase 2 (ALDH2) polymorphism. The attributable risk of alcohol drinking for cancer in Japan has not been sufficiently investigated with consideration of flushing response. We followed 78,825 Japanese in JPHC study cohort II. The association between alcohol consumption and cancer incidence was assessed according to self-reported flushing response using Cox proportional hazards regression models.

The population-attributable fraction (PAF) of cancer incidence was also estimated. During 1993-2013 (average follow-up, 16.8 years), 8486 incident cancers (included 4386 alcohol-related cancers) were reported. Half of men and 36% of women had flushing response. In men with flushing response, moderate or higher alcohol drinking increased the risk of alcohol-related cancers compared with non-drinkers (150-299 g/week, HR 1.63, 95% CI, 1.43-1.99; 300-449 g/week, HR 2.02 95% CI, 1.67-2.44; >/=450 g/week, HR 1.75, 95% CI, 1.39-2.21).

When flushing response was considered in comparisons between non-drinkers and non-flushers, non-flushing heavy drinkers had a slightly higher PAF than flushers (all cancers: flushers, 2.0% and non-flushers, 2.2%; alcohol-related cancers: flushers, 3.8% and non-flushers, 5.8%).

Although the risk of alcohol-related cancer in men with flushing response increased with increasing alcohol consumption, heavy drinkers were also at high risk regardless of flushing response. Considering the PAF of alcohol consumption on cancer, efforts to discourage heavy alcohol consumption to reduce the incidence of alcohol-related cancers appear warranted regardless of flushing response.

27 March 2020 In Cancer

Alcohol drinking is a risk factor for cancer. The degree of risk is increased in subjects showing the flushing response, which is due to aldehyde dehydrogenase 2 (ALDH2) polymorphism. The attributable risk of alcohol drinking for cancer in Japan has not been sufficiently investigated with consideration of flushing response. We followed 78,825 Japanese in JPHC study cohort II. The association between alcohol consumption and cancer incidence was assessed according to self-reported flushing response using Cox proportional hazards regression models. The population-attributable fraction (PAF) of cancer incidence was also estimated. During 1993-2013 (average follow-up, 16.8 years), 8486 incident cancers (included 4386 alcohol-related cancers) were reported. Half of men and 36% of women had flushing response. In men with flushing response, moderate or higher alcohol drinking increased the risk of alcohol-related cancers compared with non-drinkers (150-299 g/week, HR 1.63, 95% CI, 1.43-1.99; 300-449 g/week, HR 2.02 95% CI, 1.67-2.44; >/=450 g/week, HR 1.75, 95% CI, 1.39-2.21). When flushing response was considered in comparisons between non-drinkers and non-flushers, non-flushing heavy drinkers had a slightly higher PAF than flushers (all cancers: flushers, 2.0% and non-flushers, 2.2%; alcohol-related cancers: flushers, 3.8% and non-flushers, 5.8%). Although the risk of alcohol-related cancer in men with flushing response increased with increasing alcohol consumption, heavy drinkers were also at high risk regardless of flushing response. Considering the PAF of alcohol consumption on cancer, efforts to discourage heavy alcohol consumption to reduce the incidence of alcohol-related cancers appear warranted regardless of flushing response.

29 October 2018 In Cancer

AIMS: The aim of this study was to clarify the relationship between drinking and metabolically healthy status in men with normal weight, overweight and obesity.

METHODS: The subjects were Japanese men aged from 35 to 60 years (n=31781) and they were divided by daily amount of drinking (g ethanol) into light (< 22), moderate (>/=22 and <44), heavy (>/=44 and <66) and very heavy (>/=66) drinkers. Metabolically healthy subjects were defined as those without hypertension, dyslipidemia and diabetes.

RESULTS: The percentage of metabolically healthy subjects was much lower in the overweight (BMI>/=25 and <30) and obese (BMI>/=30) groups than in the normal weight group (BMI>/=18.5 and <25) and was much lower in the obese group than in the overweight group. In each of the normal weight and overweight groups, percentages of metabolically healthy subjects were significantly lower in heavy and very heavy drinkers than in nondrinkers and were marginally significantly higher in light drinkers than in nondrinkers. The above associations between drinking and metabolically healthy status were confirmed by logistic regression analysis. In the obese group, the percentage of metabolically healthy subjects was significantly lower in regular drinkers (including all drinker categories) than in nondrinkers, and metabolically healthy subjects were rare (0.56%) among regular drinkers.

CONCLUSIONS: Regardless of absence and presence of overweight or obesity, excessive alcohol drinking is inversely associated with metabolically healthy status and should be avoided for prevention of cardiovascular disease.

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