23 November 2020 In Cancer

Since 1988, alcohol has been classified as a Group 1 carcinogen, the highest level of risk, by the International Agency for Research on Cancer (IARC). In fact, alcohol consumption is the third leading risk factor for disease and mortality in Europe. It accounts for 4.65 % of the global burden of both injury and disease, making it one of the most preventable causes of injury and death. Tissues in closest contact with alcohol when it is ingested, such as those of the oral cavity, pharynx, esophagus and larynx, have at greater risk of becoming cancerous than other body tissues.

The consumption of alcohol is also associated with an increased risk of stomach, colon, rectum, liver, female breast and ovarian cancers. Conversely, recent studies suggest that red wine components inhibit colony formation of human breast cancer and esophageal carcinoma cells, suggesting that wine-derived phenolic compounds may be inhibitory, in contrast to the alcohol component of wine.

Because of a lack of systematic studies dealing with the different types of cancer and alcoholic beverages and wine in particular, in this narrative review we summarize the general risk of cancer linked to the consumption of alcoholic beverages, including wine, according to type of cancer, with 140 extracted relevant references from 1966 to 2020. Mostly epidemiological studies concerning large cohorts have been selected.

For the cancers of the upper aerodigestive tract, liver, colorectum, breast cancer, pancreatic, prostate, an excessive consumption and/or misuse of alcoholic beverages is correlated with increased risk. Conversely a probable decreased risk has been found for renal/kidney cancers, as well as for Non-Hodgkin lymphomas, such as thyroid lymphomas, associated with the moderate consumption of alcoholic beverages. There is no evidence of ovarian, gastric, head and neck, and lung cancer being linked to the moderate consumption of alcoholic beverages. Cancer is a multifactorial disease, and many factors contribute to effects on health status, usually being both genetic and environmental.

Habits (smoking, dietary/lifestyle pattern/ habits, physical activity), should also be taken into account when defining appropriate consumption frequencies for different types of alcoholic drink (wine, beer, spirits). Further research is needed related to wine consumption in the context of a healthy dietary and lifestyle pattern given health-promoting constituents of wine and its effects on cancer incidence.

23 November 2020 In Cancer

AIMS: Meta-analyses have suggested a dose-response relationship between level of alcohol use and risk of prostate cancer, but the populations in the included studies are predominantly Caucasian. Many Chinese language studies have not been included in published reviews and/or meta-analyses. The present meta–analysis accessed research reports in both English and Chinese language sources in order to investigate this relationship specifically among Chinese people.

METHODS: Searches in five large Chinese biomedical bibliographic databases were made for case–control and cohort studies of alcohol consumption and prostate cancer incidence and death (ICD–10: C61) up to May 2017. Studies were coded for design, outcome, drinker and non-drinkers, extent of control for confounding and other study characteristics. Mixed models were used to estimate relative risk (RR) of incidence or death from prostate cancer due to alcohol consumption with study level controls for designs, drinker bias and types of drinkers.

FINDINGS: A total of 415 studies were identified of which 25 (20 in Chinese from five Chinese databases and 5 in English from published meta-analyses) satisfied inclusion criteria providing 36 risk estimates of prostate cancer for drinkers versus non-drinkers. There was a total of 36 OR estimates; 27 using patients as controls and 9 using healthy people. Nine studies (14 OR estimates) specified reference abstainers as “never drank” or “no drinking”. Adjusted RR estimates indicated a significantly increased risk of prostate cancer among drinkers (RR=1.46, 95% CI: 1.40 – 1.52, t-test P<0.001) compared to non-drinkers. Dose-response relationships (t-test P<0.001) were evident in three studies that assessed level of alcohol intake.

CONCLUSIONS: There is a significantly higher risk of prostate cancer incidence among Chinese drinkers than non-drinkers, with some evidence of a dose-response relationship. However, almost all the identified studies suffered from former and/or occasional drinker biases. Few studies had adequate measures of level of alcohol intake and further well-designed studies are required.

23 November 2020 In Cancer

PURPOSE: The aim of current systematic review was to update the body of evidence on associations between adherence to the Mediterranean diet (MedDiet) and risk of cancer mortality, site-specific cancer in the general population; all-cause, and cancer mortality as well as cancer reoccurrence among cancer survivors.

METHODS: A literature search for randomized controlled trials (RCTs), case-control and cohort studies published up to April 2020 was performed using PubMed and Scopus. Study-specific risk estimates for the highest versus lowest adherence to the MedDiet category were pooled using random-effects meta-analyses. Certainty of evidence from cohort studies and RCTs was evaluated using the NutriGrade scoring system.

RESULTS: The updated search revealed 44 studies not identified in the previous review. Altogether, 117 studies including 3,202,496 participants were enclosed for meta-analysis. The highest adherence to MedDiet was inversely associated with cancer mortality (RRcohort: 0.87, 95% CI 0.82, 0.92; N = 18 studies), all-cause mortality among cancer survivors (RRcohort: 0.75, 95% CI 0.66, 0.86; N = 8), breast (RRobservational: 0.94, 95% CI 0.90, 0.97; N = 23), colorectal (RRobservational: 0.83, 95% CI 0.76, 0.90; N = 17), head and neck (RRobservational: 0.56, 95% CI 0.44, 0.72; N = 9), respiratory (RRcohort: 0.84, 95% CI 0.76, 0.94; N = 5), gastric (RRobservational: 0.70, 95% CI 0.61, 0.80; N = 7), bladder (RRobservational: 0.87, 95% CI 0.76, 0.98; N = 4), and liver cancer (RRobservational: 0.64, 95% CI 0.54, 0.75; N = 4). Adhering to MedDiet did not modify risk of blood, esophageal, pancreatic and prostate cancer risk.

CONCLUSION: In conclusion, our results suggest that highest adherence to the MedDiet was related to lower risk of cancer mortality in the general population, and all-cause mortality among cancer survivors as well as colorectal, head and neck, respiratory, gastric, liver and bladder cancer risks. Moderate certainty of evidence from cohort studies suggest an inverse association for cancer mortality and colorectal cancer, but most of the comparisons were rated as low or very low certainty of evidence.

23 November 2020 In Cancer

In 2016, alcohol consumption was one of the leading risk factors for cancer development and cancer death globally, causing an estimated 376 200 cancer deaths, representing 4.2% of all cancer deaths, and 10.3 million cancer disability-adjusted life years lost, representing 4.2% of all cancer disability-adjusted life years lost.

The impact of alcohol consumption on cancer in 2016 varied by age group; the proportion of cancer deaths attributable to alcohol consumption ranged from 13.9% of cancer deaths among people aged 30-34 years to 2.7% of cancer deaths among people aged 80-84 years.

The burden of cancers caused by alcohol consumption might be decreased through (i) individual-level and societal-level interventions that reduce alcohol consumption, and (ii) measures that target those risk factors that interact with alcohol consumption to increase the risk of cancer or that directly affect the risk of alcohol-related cancers.

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