Castellsagué X, Muñoz N, De Stefani E, Victora C G, Quintana M J, Castelletto R, Rolón P A
Institut Català d'Oncologia, Servei d'Epidemiologia i Registre del Càncer, L'Hospitalet de Llobregat (Barcelona), Spain.
Cancer Causes Control. 2000 Oct;11(9):813-8. doi: 10.1023/a:1008984922453.
To explore the effectiveness of alcohol drinking and tobacco smoking cessation in reducing esophageal cancer risk, taking into account the key characteristics of each habit and the simultaneous exposure to both habits.
Data from a series of five hospital-based case-control studies of incident squamous-cell carcinoma of the esophagus conducted by the International Agency for Research on Cancer (IARC, Lyon, France) in high-risk areas in South America were combined and analyzed by multivariate logistic regression procedures. A total of 2063 men (655 case patients and 1408 control subjects) were included in the pooled analysis.
For either habit, the risk of esophageal cancer decreased rapidly, strongly and significantly with longer periods of abstention. The risk reduction was statistically significant regardless of the intensity and duration of each habit and the type of tobacco or alcoholic drink consumed. For subjects exposed to both risk factors, the protective effect of quitting both habits appeared to be synergistic, reaching, after only five to nine years of simultaneous cessation of both exposures, a 70% risk reduction, a reduction that clearly overlapped with the risk intervals of both never-smokers and never-drinkers. The risk benefit of merely quitting alcohol drinking was delayed (>10 years of cessation) unless it was also accompanied by a few years of smoking cessation.
Our findings solidly demonstrate for the first time the effectiveness of smoking and drinking cessation in reducing esophageal cancer risk. For the large proportion of subjects in the general population exposed to both risk factors, our results further emphasize the importance of smoking cessation to effectively reduce cancer risk.
考虑饮酒和吸烟习惯的关键特征以及同时接触这两种习惯的情况，探讨戒酒和戒烟在降低食管癌风险方面的有效性。
对国际癌症研究机构（IARC，法国里昂）在南美洲高危地区进行的一系列五项基于医院的食管癌鳞状细胞癌病例对照研究的数据进行合并，并通过多变量逻辑回归程序进行分析。汇总分析共纳入2063名男性（655例病例患者和1408名对照受试者）。
对于任何一种习惯，随着戒酒或戒烟时间延长，食管癌风险迅速、显著且大幅降低。无论每种习惯的强度和持续时间以及所消费烟草或酒精饮料的类型如何，风险降低均具有统计学意义。对于同时接触两种风险因素的受试者，同时戒掉两种习惯的保护作用似乎具有协同性，在同时停止两种暴露仅五至九年后，风险降低70%，这一降低幅度与从不吸烟者和从不饮酒者的风险区间明显重叠。仅戒酒的风险获益会延迟（戒酒超过10年），除非同时伴有几年的戒烟。
我们的研究结果首次有力证明了戒烟和戒酒在降低食管癌风险方面的有效性。对于普通人群中很大一部分同时接触两种风险因素的受试者，我们的结果进一步强调了戒烟对有效降低癌症风险的重要性。
