Wienecke Antje, Barnes Benjamin, Neuhauser Hannelore, Kraywinkel Klaus
Department of Epidemiology and Health Monitoring, German Centre for Cancer Registry Data, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany,
Cancer Causes Control. 2015 Jun;26(6):903-11. doi: 10.1007/s10552-015-0566-8. Epub 2015 Mar 24.
Germany lacks an up-to-date assessment of the cancer burden attributable to alcohol. Therefore, cancer incidence attributable to this exposure was estimated for colorectal, liver, breast, and upper aerodigestive tract (UADT) cancer. Additionally, the impact of alcohol on UADT cancer was analyzed by smoking status, to account for synergistic interactions between these two risk factors.
Alcohol consumption and smoking prevalence from a nationwide survey in Germany 2008-2011 were combined with relative risks of incident cancer from meta-analyses to obtain population attributable risks (PARs), indicating the proportion of cancers that could be avoided by eliminating a risk factor. Each PAR was multiplied with the respective cancer incidence for 2010 to calculate the absolute number of attributable cases.
In Germany, for the year 2010, approximately 13,000 incident cancer cases could be attributed to alcohol consumption (3% of total cases). PAR was highest for esophageal cancer (men: 47.6% and women: 35.8%) and lowest for colorectal cancer in men (9.7%) and breast cancer in women (6.6%). Among women, moderate consumption levels account for the greatest PAR overall, whereas heavy drinking contributes considerably to overall PAR among men. Additionally, moderate-to-heavy drinking among smokers substantially contributes to the overall PAR of UADT cancers compared to drinking among non-smokers.
In Germany, a substantial proportion of cases of common cancers can be attributed to alcohol consumption, even when consumed at moderate levels. Alcohol consumption with concurrent tobacco smoking is especially important for cancers of the UADT. These findings strengthen the rationale for prevention measures that address exposure at all levels.
德国缺乏对酒精所致癌症负担的最新评估。因此，估计了酒精暴露所致的结直肠癌、肝癌、乳腺癌和上消化道（UADT）癌的发病率。此外，还按吸烟状况分析了酒精对UADT癌的影响，以说明这两种风险因素之间的协同相互作用。
将2008 - 2011年德国全国性调查中的酒精消费量和吸烟率与荟萃分析得出的癌症发病相对风险相结合，以获得人群归因风险（PARs），即消除一种风险因素可避免的癌症比例。将每个PAR与2010年各自的癌症发病率相乘，以计算归因病例的绝对数量。
在德国，2010年约13000例癌症发病可归因于酒精消费（占总病例的3%）。食管癌的PAR最高（男性：47.6%，女性：35.8%），男性结直肠癌（9.7%）和女性乳腺癌（6.6%）的PAR最低。在女性中，总体而言适度饮酒水平导致的PAR最大，而重度饮酒对男性的总体PAR贡献相当大。此外，与不吸烟者饮酒相比，吸烟者中的中度至重度饮酒对UADT癌的总体PAR贡献很大。
在德国，相当一部分常见癌症病例可归因于酒精消费，即使是适度饮酒。同时饮酒和吸烟对UADT癌尤为重要。这些发现强化了针对各级暴露采取预防措施的理论依据。
