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      Alcohol Use and Cancers of the Gastrointestinal Tract. Epidemiology and Preventive Implications

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          Abstract

          Introduction: Alcohol is a carcinogen for human cancer. This contribution summarizes the relationships between alcohol use and gastrointestinal cancers, and implications for prevention.

          Methods: Comparative risk assessment and narrative literature review.

          Results: The following gastrointestinal cancer sites were found to be causally impacted by alcohol use: lip and oral cavity, pharynx other than nasopharynx, esophagus, colon and rectum, and liver. Globally, 368,000 deaths (304,000 men and 64,000 women) and more than 10 million disability-adjusted life years (DALYs) lost (10.1 million; 8.4 million men and 1.6 million women) in 2016 were attributable to alcohol use, making up about 10% of all deaths and DALYs lost due to these cancers, respectively. There are effective and cost-effective alcohol control policies available to reduce this burden, namely the best buys of increasing taxation, reducing availability, and banning advertisement. In addition, public knowledge about the alcohol-cancer link should be increased.

          Discussion: There are a number of assumptions underlying these estimates, but overall all of them seem to be conservative.

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          Most cited references 25

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          The occurrence of lung cancer in man.

           Vadim Levin (1952)
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            Light alcohol drinking and cancer: a meta-analysis.

            There is convincing evidence that alcohol consumption increases the risk of cancer of the colorectum, breast, larynx, liver, esophagus, oral cavity and pharynx. Most of the data derive from studies that focused on the effect of moderate/high alcohol intakes, while little is known about light alcohol drinking (up to 1 drink/day). We evaluated the association between light drinking and cancer of the colorectum, breast, larynx, liver, esophagus, oral cavity and pharynx, through a meta-analytic approach. We searched epidemiological studies using PubMed, ISI Web of Science and EMBASE, published before December 2010. We included 222 articles comprising ∼92 000 light drinkers and 60 000 non-drinkers with cancer. Light drinking was associated with the risk of oropharyngeal cancer [relative risk, RR = 1.17; 95% confidence interval (CI) 1.06-1.29], esophageal squamous cell carcinoma (SCC) (RR = 1.30; 95% CI 1.09-1.56) and female breast cancer (RR = 1.05; 95% CI 1.02-1.08). We estimated that ∼5000 deaths from oropharyngeal cancer, 24 000 from esophageal SCC and 5000 from breast cancer were attributable to light drinking in 2004 worldwide. No association was found for colorectum, liver and larynx tumors. Light drinking increases the risk of cancer of oral cavity and pharynx, esophagus and female breast.
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              The Alcohol Flushing Response: An Unrecognized Risk Factor for Esophageal Cancer from Alcohol Consumption

              Philip Brooks and colleagues discuss evidence linking the alcohol flushing response (predominantly due to ALDH2 deficiency) with a much higher risk of esophageal cancer from alcohol consumption.
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                Author and article information

                Contributors
                Journal
                Front Oncol
                Front Oncol
                Front. Oncol.
                Frontiers in Oncology
                Frontiers Media S.A.
                2234-943X
                25 March 2020
                2020
                : 10
                Affiliations
                1Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research , Toronto, ON, Canada
                2Dalla Lana School of Public Health, University of Toronto , Toronto, ON, Canada
                3Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute , Toronto, ON, Canada
                4Department of Psychiatry, University of Toronto , Toronto, ON, Canada
                5Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, School of Science, Technische Universität Dresden , Dresden, Germany
                6Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University , Moscow, Russia
                Author notes

                Edited by: Helmut Seitz, Heidelberg University, Germany

                Reviewed by: Manuela Marron, Leibniz Institute for Prevention Research and Epidemiology (LG), Germany; Carlo La Vecchia, University of Milan, Italy

                *Correspondence: Jürgen Rehm jtrehm@ 123456gmail.com

                This article was submitted to Cancer Epidemiology and Prevention, a section of the journal Frontiers in Oncology

                Article
                10.3389/fonc.2020.00403
                7109294
                Copyright © 2020 Rehm and Shield.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 2, Tables: 2, Equations: 0, References: 49, Pages: 6, Words: 3975
                Funding
                Funded by: Canadian Institutes of Health Research 10.13039/501100000024
                Categories
                Oncology
                Original Research

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