06 May 2014 In Cancer




In order to provide a more precise quantification of the association between alcohol consumption and pancreatic cancer risk, we performed a meta-analysis of relevant dose-risk results. We conducted a PubMed search of all case-control (N=21) and cohort (N=11) studies published up to March 2009. We computed summary relative risk (RR) estimates using either fixed- or, in the presence of heterogeneity, random-effects models. The pooled RR was 0.92 (95% confidence interval, 95% CI, 0.86-0.97) for or = 3 drinks/day. The increased risk for heavy drinking was similar in women and men, but apparently stronger in cohort studies (RR=1.29), in studies with high quality index (RR=1.30), and did not appear to be explained by residual confounding by either history of pancreatitis or tobacco smoking. This meta-analysis provides strong evidence for the absence of a role of moderate drinking in pancreatic carcinogenesis, coupled to an increased risk for heavy alcohol drinking. Given the moderate increase in risk and the low prevalence of heavy drinkers in most populations, alcohol appears to be responsible only for a small fraction of all pancreatic cancers.




06 May 2014 In Cancer




AIMS: To update epidemiological data on alcohol and breast cancer, with special emphasis on light alcohol consumption, and to review mechanisms of alcohol mediated mammary carcinogenesis.

METHODS: For epidemiological data, in November 2011 we performed a literature search in various bibliographic databases, and we conducted a meta-analysis of data on light alcohol drinking. Relevant mechanistic studies were also reviewed to November 2011.

RESULTS: A significant increase of the order of 4% in the risk of breast cancer is already present at intakes of up to one alcoholic drink/day. Heavy alcohol consumption, defined as three or more drinks/day, is associated with an increased risk by 40-50%. This translates into up to 5% of breast cancers attributable to alcohol in northern Europe and North America for a total of approximately 50 000 alcohol-attributable cases of breast cancer worldwide. Up to 1-2% of breast cancers in Europe and North America are attributable to light drinking alone, given its larger prevalence in most female populations when compared with heavy drinking. Alcohol increases estrogen levels, and estrogens may exert its carcinogenic effect on breast tissue either via the ER or directly. Other mechanisms may include acetaldehyde, oxidative stress, epigenetic changes due to a disturbed methyl transfer and decreased retinoic acid concentrations associated with an altered cell cycle.

CONCLUSIONS: Women should not exceed one drink/day, and women at elevated risk for breast cancer should avoid alcohol or consume alcohol occasionally only.




14 November 2012 In Drinking & Driving

AIMS: The main objective of this article was to compare alcohol and tobacco consumption in the US and the Basque Country (the North of Spain) with particular attention to the association between alcohol and tobacco use. The consistency of findings was considered by analyzing data from two different years. These comparisons may provide a rational basis for exploring the associations between alcohol and cigarette use that are influenced by changes in use prevalences.

METHODS: Two epidemiological samples from the US, obtained in 1992 and 1996, and two from the Basque Country, obtained in the same years, were used. Sampling methodologies were similar. Questionnaires were self-administrated with the help of interviewers, and were used to define ever smokers, ex-smokers, current smokers, heavy smokers, ever drinkers, ex-drinkers, current drinkers and weekly drinkers. The associations between smoking and alcohol drinking were explored through logistic regressions.

RESULTS: The associations between current smoking and current drinking in the general population, and between ever smoking and weekly drinking among current drinkers appear very stable. In 1992 and 1996, US subjects who decided to try alcohol tended to try smoking and vice versa. In US Caucasians (particularly in 1996), heavy smoking was strongly associated with ever drinking among current smokers. In the Basque Country in 1992, there was a significant association between smoking cessation and drinking cessation among ever drinkers who also were ever smokers.

CONCLUSIONS: Our analyses suggest that some associations between alcohol drinking and smoking behaviours are likely to be detected in Western countries where alcohol and nicotine are legal and easily available. On the other hand, other associations may be detected only in certain social contexts. These social contexts make the associations in subpopulations who are vulnerable to addiction, influence the results in the general population. In social contexts that exert considerable social pressure to quit smoking, such as in US Caucasians (particularly in 1996), heavy smoking was strongly associated with ever drinking among current smokers. When a social environment strongly discourages smoking and alcohol initiation (as in the US in 1992 and 1996), subjects who decide to try alcohol tend to try smoking and vice versa. The lack of social stigmatization of smoking and drinking in the Basque Country in 1992 may help to explain the significant association between smoking cessation and drinking cessation among ever drinkers who also were ever smokers.

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