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The potential for reducing alcohol consumption to prevent esophageal cancer morbidity in Asian heavy drinkers: a systematic review and meta-analysis

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Abstract

Alcohol consumption is a major risk factor for esophageal cancer. In Asia, heavy drinkers are considered to have a higher risk of esophageal cancer than nondrinkers and light drinkers. However, no study has shown an association between alcohol reduction and the morbidity of esophageal cancer in Asian heavy drinkers. Therefore, this study investigated the significance of reducing alcohol consumption to prevent esophageal cancer in Asian heavy drinkers by conducting a systematic review and meta-analysis. The MEDLINE (PubMed) and ICHUSHI (Japana Centra Revuo Medicina) databases were searched from January 1995 to December 2020. The hazard ratio (HR) and 95% confidence interval (CI) were calculated using a random-effects model. I2 statistics were used to detect heterogeneity. This study included 21 articles in the qualitative synthesis. Light drinkers and heavy drinkers were categorized based on alcohol consumption amount as ≤ 25 ethanol g/day and ≥ 66 ethanol g/day, respectively, as described in many previous studies, and five cohort studies were eligible for this meta-analysis. The HR of esophageal cancer among heavy drinkers versus nondrinkers was 4.18 (95% CI 2.34–7.47, I2 = 74%). On the other hand, the HR of esophageal cancer among light drinkers was 1.82 compared with nondrinkers (95% CI 1.57–2.10, I2 = 0%). Heavy drinkers have a higher esophageal cancer incidence than light drinkers and nondrinker. It is possible that alcohol reduction may decrease the risk of esophageal cancer in Asian heavy drinkers.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 E2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Yuto Kubo, Tomoki Makino & Yuichiro Doki

  2. Department of Surgery, Keio University School of Medicine, Tokyo, Japan

    Yuko Kitagawa, Hirofumi Kawakubo & Satoru Matsuda

  3. Department of Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan

    Tatsuya Miyazaki

  4. Division of Gastroenterological Surgery, Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, Japan

    Makoto Sohda, Makoto Sakai & Hiroshi Saeki

  5. Division of Epidemiology, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan

    Taiki Yamaji

  6. Department of Radiology, Yamagata University Graduate School of Medicine, Yamagata, Japan

    Kenji Nemoto

  7. Department of Endoscopy, Saku Central Hospital Advanced Care Center, Nagano, Japan

    Tsuneo Oyama

  8. Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Manabu Muto

  9. Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan

    Hiroya Takeuchi & Eisuke Booka

  10. Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan

    Yasushi Toh

  11. Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan

    Hisahiro Matsubara

  12. Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

    Masayuki Mano

  13. Department of Gastrointestinal Tract Surgery, Fukushima Medical University, Fukushima, Japan

    Koji Kono

  14. Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan

    Ken Kato

  15. Department of Hemodialysis and Surgery, Chemotherapy Research Institute, International University of Health and Welfare, Ichikawa, Japan

    Masahiro Yoshida

  16. Department of General Surgery, Kawasaki Medical School, Okayama, Japan

    Tomoki Yamatsuji

  17. Kiryu Kousei General Hospital, Gunma, Japan

    Hiroyuki Kato

  18. Department of Radiation Oncology, Showa University School of Medicine, Tokyo, Japan

    Yoshinori Ito

  19. National Institutes for Quantum and Radiological Science and Technology, QST Hospital, Chiba, Japan

    Hitoshi Ishikawa

  20. Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan

    Ryu Ishihara

  21. Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan

    Takahiro Tsushima

  22. Department of Pathology, The Cancer Institute Hospital of Japanese Foundation For Cancer Research, Tokyo, Japan

    Hiroshi Kawachi

  23. Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare School of Medicine, Chiba, Japan

    Takashi Oyama

  24. Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan

    Takashi Kojima

  25. Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Gunma, Japan

    Shiko Kuribayashi

Authors
  1. Yuto Kubo
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  2. Yuko Kitagawa
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  30. Tomoki Makino
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  31. Satoru Matsuda
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  32. Yuichiro Doki
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The Esophageal Cancer Practice Guidelines Preparation Committee

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Correspondence to Yuto Kubo.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and its later versions. This article does not contain any studies with human or animal subjects performed by any author(s).

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10388_2021_892_MOESM3_ESM.tiff

Supplementary Fig. 1. Forest plot for the association between light drinking and esophageal cancer, excluding studies that had very large weights in the meta-analysis (TIFF 26370 KB)

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Kubo, Y., Kitagawa, Y., Miyazaki, T. et al. The potential for reducing alcohol consumption to prevent esophageal cancer morbidity in Asian heavy drinkers: a systematic review and meta-analysis. Esophagus 19, 39–46 (2022). https://doi.org/10.1007/s10388-021-00892-4

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