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Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan.
Int J Cancer 2005; 113(3):475-82IJ

Abstract

A multicenter case-control study was conducted in northern and southern Taiwan to clarify the independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer. A total of 513 patients with newly diagnosed and histopathologically confirmed squamous cell carcinoma of the esophagus and 818 gender, age and study hospital-matched controls were included. We found a significant dose-response relationship between the duration and intensity of consumption of the 3 substances and the development of this neoplasm in this site. Although the amount of alcohol consumed had a stronger effect on the risk of esophageal cancer than the number of years it was consumed, however, the number of years one smoked had a stronger effect on the risk than the amount of cigarettes consumed. The strongest risk factor of esophageal cancer was alcohol intake, with highest risk (OR = 13.9) being for those who consumed more than 900 g/day-year. Combined exposure to any 2 of 3 substances brought the risks up to 8.8-19.7 fold and, to all 3 substances, to 41.2-fold. A multiplicative interaction effect for alcohol drinkers who smoked on cancer risk was detected, whereas an additive interaction effect was found among drinkers who chewed. The combined effect of all 3 substances accounted for 83.7% of the attributable fraction of contracting esophageal cancer in this population. In conclusion, these results suggest that the intensity and the length of time alcohol and tobacco are used play different roles in the etiology of esophageal cancer. Alcohol separately interacts with tobacco and betel quid in a differently synergistic way in determining the development of this site of cancer.

Authors+Show Affiliations

Graduate Institute of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15455377

Citation

Lee, Chien-Hung, et al. "Independent and Combined Effects of Alcohol Intake, Tobacco Smoking and Betel Quid Chewing On the Risk of Esophageal Cancer in Taiwan." International Journal of Cancer, vol. 113, no. 3, 2005, pp. 475-82.
Lee CH, Lee JM, Wu DC, et al. Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan. Int J Cancer. 2005;113(3):475-82.
Lee, C. H., Lee, J. M., Wu, D. C., Hsu, H. K., Kao, E. L., Huang, H. L., ... Wu, M. T. (2005). Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan. International Journal of Cancer, 113(3), pp. 475-82.
Lee CH, et al. Independent and Combined Effects of Alcohol Intake, Tobacco Smoking and Betel Quid Chewing On the Risk of Esophageal Cancer in Taiwan. Int J Cancer. 2005 Jan 20;113(3):475-82. PubMed PMID: 15455377.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan. AU - Lee,Chien-Hung, AU - Lee,Jang-Ming, AU - Wu,Deng-Chyang, AU - Hsu,Hon-Ki, AU - Kao,Ein-Long, AU - Huang,Hsiao-Ling, AU - Wang,Tsu-Nai, AU - Huang,Meng-Chuan, AU - Wu,Ming-Tsang, PY - 2004/9/30/pubmed PY - 2005/1/19/medline PY - 2004/9/30/entrez SP - 475 EP - 82 JF - International journal of cancer JO - Int. J. Cancer VL - 113 IS - 3 N2 - A multicenter case-control study was conducted in northern and southern Taiwan to clarify the independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer. A total of 513 patients with newly diagnosed and histopathologically confirmed squamous cell carcinoma of the esophagus and 818 gender, age and study hospital-matched controls were included. We found a significant dose-response relationship between the duration and intensity of consumption of the 3 substances and the development of this neoplasm in this site. Although the amount of alcohol consumed had a stronger effect on the risk of esophageal cancer than the number of years it was consumed, however, the number of years one smoked had a stronger effect on the risk than the amount of cigarettes consumed. The strongest risk factor of esophageal cancer was alcohol intake, with highest risk (OR = 13.9) being for those who consumed more than 900 g/day-year. Combined exposure to any 2 of 3 substances brought the risks up to 8.8-19.7 fold and, to all 3 substances, to 41.2-fold. A multiplicative interaction effect for alcohol drinkers who smoked on cancer risk was detected, whereas an additive interaction effect was found among drinkers who chewed. The combined effect of all 3 substances accounted for 83.7% of the attributable fraction of contracting esophageal cancer in this population. In conclusion, these results suggest that the intensity and the length of time alcohol and tobacco are used play different roles in the etiology of esophageal cancer. Alcohol separately interacts with tobacco and betel quid in a differently synergistic way in determining the development of this site of cancer. SN - 0020-7136 UR - https://www.unboundmedicine.com/medline/citation/15455377/Independent_and_combined_effects_of_alcohol_intake_tobacco_smoking_and_betel_quid_chewing_on_the_risk_of_esophageal_cancer_in_Taiwan_ L2 - https://doi.org/10.1002/ijc.20619 DB - PRIME DP - Unbound Medicine ER -