创作:XLyasby 审核:RZN 2022年09月04日
  • 纳入4513746名饮酒者(51.5%为男性),6.4年随访期间共计215676人患癌,酒精相关癌症占37.2%;
  • 相较于维持饮酒量组,饮酒量增加组具有更高的患癌风险,其中重度饮酒组>中度组>轻度组>不饮酒组;
  • 相较于维持饮酒量组,减少饮酒量(特别是重度变成轻中度)可降低患癌风险;
  • 相较于维持饮酒量组,轻度饮酒者戒酒后,患癌风险降低,中重度饮酒者戒酒后短期内具有更高的患癌风险,但保持长期戒酒可消除升高的患癌风险,甚至降低风险。
癌症是全球第二大致死因素,尽管许多研究发现饮酒与癌症之间存在关联,但饮酒量的变化如何影响癌症的发病率尚不清楚。近期发表于JAMA Network Open的队列研究,探讨了增加、减少或停止饮酒量与酒精相关癌症和所有癌症发生之间的关系。研究发现,饮酒量增加与酒精相关癌症和所有癌症的风险增加有关,而持续性戒酒或减少饮酒量与酒精相关和所有癌症的风险降低有关。提示公众应减少饮酒量以预防癌症。

Association Between Changes in Alcohol Consumption and Cancer Risk



2022-08-24, Article

Abstract & Authors:展开

Importance: Although numerous studies have shown an association between alcohol consumption and cancer, how changes in drinking behavior increase or decrease the incidence of cancer is not well understood.
Objective: To investigate the association between the reduction, cessation, or increase of alcohol consumption and the development of alcohol-related cancers and all cancers.
Design, Setting, and Participants: This population-based cohort study analyzed adult beneficiaries in the Korean National Health Insurance Service. Participants (aged ≥40 years) included those who underwent a national health screening in both 2009 and 2011 and had available data on their drinking status. Data were analyzed from April 16 to July 6, 2020.
Exposures : Alcohol consumption level, which was self-reported by participants in health screening questionnaires, was categorized into none (0 g/d), mild (<15 g/d), moderate (15-29.9 g/d), and heavy (≥30 g/d) drinking. Based on changes in alcohol consumption level from 2009 to 2011, participants were categorized into the following groups: nondrinker, sustainer, increaser, quitter, and reducer.
Main Outcomes and Measures : The primary outcome was newly diagnosed alcohol-related cancers (including cancers of the head and neck, esophagus, colorectum, liver, larynx, and female breast), and the secondary outcome was all newly diagnosed cancers (except for thyroid cancer).
Results: Among the 4 513 746 participants (mean [SD] age, 53.6 [9.6] years; 2 324 172 [51.5%] men), the incidence rate of cancer was 7.7 per 1000 person-years during a median (IQR) follow-up of 6.4 (6.1-6.6) years. Compared with the sustainer groups at each drinking level, the increaser groups had a higher risk of alcohol-related cancers and all cancers. The increased alcohol-related cancer incidence was associated with dose; those who changed from nondrinking to mild (adjusted hazard ratio [aHR], 1.03; 95% CI, 1.00-1.06), moderate (aHR, 1.10; 95% CI, 1.02-1.18), or heavy (aHR, 1.34; 95% CI, 1.23-1.45) drinking levels had an associated higher risk than those who did not drink. Those with mild drinking levels who quit drinking had a lower risk of alcohol-related cancer (aHR, 0.96; 95% CI, 0.92-0.99) than those who sustained their drinking levels. Those with moderate (aHR, 1.07; 95% CI, 1.03-1.12) or heavy (aHR, 1.07; 95% CI, 1.02-1.12) drinking levels who quit drinking had a higher all cancer incidence than those who sustained their levels, but when quitting was sustained, this increase in risk disappeared. Compared with sustained heavy drinking, reduced heavy drinking levels to moderate levels (alcohol-related cancer: aHR, 0.91 [95% CI, 0.86-0.97]; all cancers: aHR, 0.96 [95% CI, 0.92-0.99]) or mild levels (alcohol-related cancer: aHR, 0.92 [95% CI, 0.86-0.98]; all cancers: aHR, 0.92 [95% CI, 0.89-0.96]) were associated with decreased cancer risk.
Conclusions and Relevance : Results of this study showed that increased alcohol consumption was associated with higher risks for alcohol-related and all cancers, whereas sustained quitting and reduced drinking were associated with lower risks of alcohol-related and all cancers. Alcohol cessation and reduction should be reinforced for the prevention of cancer.

First Authors:
Jung Eun Yoo

Correspondence Authors:
Kyungdo Han,Dong Wook Shin

All Authors:
Jung Eun Yoo,Kyungdo Han,Dong Wook Shin,Dahye Kim,Bong-seong Kim,Sohyun Chun,Keun Hye Jeon,Wonyoung Jung,Jinsung Park,Jin Ho Park,Kui Son Choi,Joo Sung Kim