Rogers A E, Conner M W
Adv Exp Med Biol. 1986;206:473-95. doi: 10.1007/978-1-4613-1835-4_34.
The cancers consistently associated with ingestion of alcohol, the head and neck cancers, are also associated with tobacco use and arise from epithelia that are in direct contact with both agents. Tobacco smoking-related cancers at sites not directly in contact with alcoholic beverages, that is, lung, bladder, and perhaps pancreas, do not consistently show a relationship to alcohol consumption, although lung and pancreatic tumors are associated in some studies. Liver cancer was thought to be strongly related to alcohol consumption on epidemiological grounds and because of its relationship to cirrhosis. As knowledge of the viral etiology of some cirrhoses has evolved and as methods to detect viruses have developed, the significant association between hepatitis B virus and hepatocellular carcinoma has become clear. Alcohol and hepatitis B virus may interact in the etiology of the disease and have important separate roles as well. There are epidemiologic and experimental data showing that malnutrition (resulting from poor food choice), economic deprivation, or alcoholism contributes to the risk for head, neck, and liver cancers. Colon cancers occur about equally in men and women, are found in well-nourished populations, and are not associated with tobacco smoking. Rectal cancers show a preponderance of cases in men but are frequently found in women as well and are not thought to be associated with smoking or malnutrition. The association between colorectal cancers and alcohol consumption, when it is found, apparently occurs at even relatively low alcohol intakes and is often stronger for consumption of beer than of other beverages. Nutritional and metabolic mechanisms proposed for the influence of alcohol on carcinogenesis are supported by studies in human subjects and laboratory animals. Animal models are needed in which effects of ethanol on carcinogenesis can be consistently demonstrated and which can then be used to examine mechanisms.
与饮酒始终相关的癌症，即头颈癌，也与吸烟有关，且起源于直接接触这两种致癌物的上皮组织。与吸烟相关但不直接接触酒精饮料部位的癌症，即肺癌、膀胱癌，或许还有胰腺癌，虽然在一些研究中肺癌和胰腺癌有关联，但与饮酒并不始终存在关联。从流行病学角度以及鉴于其与肝硬化的关系，肝癌曾被认为与饮酒密切相关。随着对某些肝硬化病毒病因的认识不断发展以及病毒检测方法的进步，乙型肝炎病毒与肝细胞癌之间的显著关联已变得清晰。酒精和乙型肝炎病毒在该疾病的病因中可能相互作用，且各自也发挥着重要作用。有流行病学和实验数据表明，营养不良（因食物选择不当所致）、经济贫困或酗酒会增加患头颈癌和肝癌的风险。结肠癌在男性和女性中的发病率大致相同，在营养良好的人群中出现，且与吸烟无关。直肠癌男性病例居多，但女性中也较为常见，且一般认为与吸烟或营养不良无关。当发现结直肠癌与饮酒有关联时，这种关联显然在酒精摄入量相对较低时就已出现，而且啤酒消费与结直肠癌的关联往往比其他饮料更强。关于酒精对致癌作用影响的营养和代谢机制，在人体和实验动物研究中均得到了支持。需要建立动物模型，以便能够持续证明乙醇对致癌作用的影响，并用于研究相关机制。
