Yaegashi Yumi, Onoda Toshiyuki, Morioka Seiji, Hashimoto Tsutomu, Takeshita Tatsuya, Sakata Kiyomi, Tamakoshi Akiko
Department of Hygiene and Preventive Medicine, Iwate Medical University, Iwate, Japan E-mail :
Asian Pac J Cancer Prev. 2014;15(2):1023-9. doi: 10.7314/apjcp.2014.15.2.1023.
The purpose of our study was to elucidate the joint effects of combined smoking and alcohol intake on esophageal cancer mortality in Japanese men through a large cohort study with a 20-year follow-up period.
The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) was established in the late 1980s, including 46,395 men and 64,190 women aged 40 years and older and younger than 80. Follow-up of these participants was conducted until 2009. We used the Cox proportional hazards model to analyze data for 42,408 people excluding female participants, 411 people with histories of malignant neoplasms, and 3,576 with unclear smoking and drinking data.
The joint effects of age at start of smoking and amount of alcohol consumed per day were compared with non-smokers and non-drinkers or those consuming less than one unit of alcohol per day. The mortality risk was 9.33 (95% confidence interval, 2.55-34.2) for those who started smoking between ages 10 and 19 years and drinking at least three units of alcohol per day. Regarding the joint effects of cumulative amount of smoking and alcohol intake, the risk was high when both smoking and alcohol intake were above a certain level.
In this Japanese cohort study, increased cancer mortality risks were observed, especially for people who both started smoking early and drank alcohol. Quitting smoking or not starting to smoke at any age and reducing alcohol consumption are important for preventing esophageal cancer in Japan.
我们研究的目的是通过一项长达20年随访期的大型队列研究，阐明吸烟与饮酒相结合对日本男性食管癌死亡率的联合影响。
日本癌症风险评估协作队列研究（JACC研究）于20世纪80年代末建立，纳入了46395名年龄在40岁及以上且小于80岁的男性和64190名女性。对这些参与者进行随访直至2009年。我们使用Cox比例风险模型分析了42408人的数据，这些人排除了女性参与者、411名有恶性肿瘤病史的人以及3576名吸烟和饮酒数据不明确的人。
将开始吸烟的年龄和每日饮酒量的联合影响与不吸烟者、不饮酒者或每日饮酒量少于一个单位的人进行比较。对于那些在10至19岁开始吸烟且每天至少饮用三个单位酒精的人，死亡风险为9.33（95%置信区间，2.55 - 34.2）。关于吸烟累积量和酒精摄入量的联合影响，当吸烟和酒精摄入量都高于一定水平时，风险较高。
在这项日本队列研究中，观察到癌症死亡率风险增加，尤其是对于那些既早开始吸烟又饮酒的人。在日本，任何年龄戒烟或不开始吸烟以及减少酒精消费对于预防食管癌都很重要。
