The rate of developing esophageal squamous cell carcinoma (ESCC) nearly doubles in those who both smoke and drink compared to those who only smoke or drink, according to new research published in The American Journal of Gastroenterology. Although multiple studies have identified risk factors for the development of ESCC, notably, exposure to alcohol and tobacco, this research is the first meta-analysis to look at the interaction between alcohol and tobacco in the risk of ESCC, a class of esophageal cancer that begins in the flat cells lining the esophagus.
"Our study suggests that not only do alcohol and tobacco play an important role in the development of esophageal cancer, the combination of their use markedly increases their potency as carcinogens. As a result, we as physicians should focus efforts directed at controlling the burden of esophageal cancer on those who consume both of these substances," said lead author Anoop Prabhu, MD, Advanced Endoscopy Fellow at the Icahn School of Medicine at Mount Sinai, in New York, NY.
Dr. Prabhu, and authors Drs. Kenneth O. Obi and Joel H. Rubenstein at the University of Michigan Medical School, performed a systematic literature search in multiple electronic databases and looked at population-based case-control or cohort studies of ESCC that assessed the effects of tobaccos and/or alcohol. A synergy factor was calculated from each study to estimate the interaction on a multiplicative scale between tobacco and alcohol on the outcome of ESCC.
"Our systematic review confirmed the expected exposure-dependent relationship of both alcohol and tobacco with the risk of ESCC, as alcohol use and tobacco use were both independent risk factors for the development of ESCC," stated Dr. Prabhu.
According to the National Cancer Institute, it is estimated in 2014 there will be over 18,000 new cases of esophageal cancer in the United States, and over 15,000 deaths from the disease.
- Anoop Prabhu, Kenneth O Obi, Joel H Rubenstein. The Synergistic Effects of Alcohol and Tobacco Consumption on the Risk of Esophageal Squamous Cell Carcinoma: A Meta-Analysis. The American Journal of Gastroenterology, 2014; DOI: 10.1038/ajg.2014.71
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