Estimates of alcohol-related oesophageal cancer burden in Japan: systematic review and meta-analyses.

Abstract

OBJECTIVE:

To refine estimates of the burden of alcohol-related oesophageal cancer in Japan.

METHODS:

We searched PubMed for published reviews and original studies on alcohol intake, aldehyde dehydrogenase polymorphisms, and risk for oesophageal cancer in Japan, published before 2014. We conducted random-effects meta-analyses, including subgroup analyses by aldehyde dehydrogenase variants. We estimated deaths and loss of disability-adjusted life years (DALYs) from oesophageal cancer using exposure distributions for alcohol based on age, sex and relative risks per unit of exposure.

FINDINGS:

We identified 14 relevant studies. Three cohort studies and four case-control studies had dose-response data. Evidence from cohort studies showed that people who consumed the equivalent of 100 g/day of pure alcohol had an 11.71 fold, (95% confidence interval, CI: 2.67-51.32) risk of oesophageal cancer compared to those who never consumed alcohol. Evidence from case-control studies showed that the increase in risk was 33.11 fold (95% CI: 8.15-134.43) in the population at large. The difference by study design is explained by the 159 fold (95% CI: 27.2-938.2) risk among those with an inactive aldehyde dehydrogenase enzyme variant. Applying these dose-response estimates to the national profile of alcohol intake yielded 5279 oesophageal cancer deaths and 102,988 DALYs lost - almost double the estimates produced by the most recent global burden of disease exercise.

CONCLUSION:

Use of global dose-response data results in an underestimate of the burden of disease from oesophageal cancer in Japan. Where possible, national burden of disease studies should use results from the population concerned.

• Authors: Michael Roerecke, Kevin D Shield, Susumu Higuchi, Atsushi Yoshimura, Elisabeth Larsen, Maximilien X Rehm, Jürgen Rehm
• Journal: Bulletin of the World Health Organization (Bull World Health Organ) Vol. 93 Issue 5 Pg. 329-338C (May 01 2015) ISSN: 1564-0604 [Electronic] Switzerland
• PMID: 26229204 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)

Chemical References

• Ethanol
• Alcohol Dehydrogenase

Topics

• Alcohol Dehydrogenase (adverse effects, genetics)
• Alcohol Drinking (adverse effects, epidemiology)
• Esophageal Neoplasms (epidemiology, etiology)
• Ethanol (adverse effects)
• Humans
• Japan (epidemiology)
• Quality-Adjusted Life Years
• Risk Factors