scholarly journals Alcohol intake, tobacco smoking, and esophageal adenocarcinoma survival: a molecular pathology epidemiology cohort study

2019 ◽  
Vol 31 (1) ◽  
pp. 1-11
Author(s):  
R. Stephen McCain ◽  
Damian T. McManus ◽  
Stephen McQuaid ◽  
Jacqueline A. James ◽  
Manuel Salto-Tellez ◽  
...  

Abstract Purpose To investigate the association between cigarette smoking, alcohol consumption, and esophageal adenocarcinoma survival, including stratified analysis by selected prognostic biomarkers. Methods A population-representative sample of 130 esophageal adenocarcinoma patients (n = 130) treated at the Northern Ireland Cancer Centre between 2004 and 2012. Cox proportional hazards models were applied to evaluate associations between smoking status, alcohol intake, and survival. Secondary analyses investigated these associations across categories of p53, HER2, CD8, and GLUT-1 biomarker expression. Results In esophageal adenocarcinoma patients, there was a significantly increased risk of cancer-specific mortality in ever, compared to never, alcohol drinkers in unadjusted (HR 1.96 95% CI 1.13–3.38) but not adjusted (HR 1.70 95% CI 0.95–3.04) analysis. This increased risk of death observed for alcohol consumers was more evident in patients with normal p53 expression, GLUT-1 positive or CD-8 positive tumors. There were no significant associations between survival and smoking status in esophageal adenocarcinoma patients. Conclusions In esophageal adenocarcinoma patients, cigarette smoking or alcohol consumption was not associated with a significant difference in survival in comparison with never smokers and never drinkers in fully adjusted analysis. However, in some biomarker-selected subgroups, ever-alcohol consumption was associated with a worsened survival in comparison with never drinkers. Larger studies are needed to investigate these findings, as these lifestyle habits may not only be linked to cancer risk but also cancer survival.

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Alexandra Gonçalves ◽  
Pardeep S Jhund ◽  
Brian Claggett ◽  
Wayne Rosamond ◽  
Anita Deswal ◽  
...  

Introduction: Alcohol is a known cardiac toxin, yet the nature of the association between alcohol consumption and the development of heart failure (HF) in the community, and whether this relationship is different in men and women, is unclear. Therefore we assessed the association between alcohol intake and the development of HF or death in men and women in the Atherosclerosis Risk in Communities (ARIC) Study. Methods: We examined 14,993 participants in ARIC without prevalent HF at baseline (1987-89) who were followed through 2009 (median of 20.6 years). Self-reported alcohol consumption was defined as the number of drinks per day (1 drink=14g of alcohol). Using Cox proportional hazards models, we examined the association of alcohol intake with the composite outcome of death or hospitalization for HF, stratified by sex, adjusting for age, diabetes, hypertension, coronary heart disease, body mass index, total cholesterol, physical activity, education level, smoking status, and incident myocardial infarction as a time varying covariate. Results: The risk for HF or death in men was lowest among those who consumed 0-1 drink/day (HR 0.81, 95% CI, 0.72-0.90) compared with those who did not consume alcohol. In contrast, in women the risk associated with consuming 1 or 2 drinks/day was not significantly different from the non-drinkers (0-1 drink HR 1.03, 95% CI 0.89-1.20; 1-2 drinks, HR 1.09, 95% CI 0.81-1.46, P for interaction by sex 0.01). Drinking ≥3 drinks/day increased the risk of HF or death by 40% in men (HR 1.44, 95% CI 1.20-1.72) but more than doubled the risk in women (HR 2.44, 95% CI 1.34-4.47). Conclusion: Consumption of ≥3 alcoholic drinks/day is associated with increased risk for death/HF in both men and women, with a higher risk in women, even adjusting for body size and other covariates. Compared to alcohol abstinence, low alcohol consumption was associated with a lower risk of death/HF in men but not in women. These findings suggest that the toxic and protective effects of alcohol may be different in men and women.


2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Nur Zeinomar ◽  
◽  
Julia A. Knight ◽  
Jeanine M. Genkinger ◽  
Kelly-Anne Phillips ◽  
...  

Abstract Background Alcohol consumption and cigarette smoking are associated with an increased risk of breast cancer (BC), but it is unclear whether these associations vary by a woman’s familial BC risk. Methods Using the Prospective Family Study Cohort, we evaluated associations between alcohol consumption, cigarette smoking, and BC risk. We used multivariable Cox proportional hazard models to estimate hazard ratios (HR) and 95% confidence intervals (CI). We examined whether associations were modified by familial risk profile (FRP), defined as the 1-year incidence of BC predicted by Breast Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA), a pedigree-based algorithm. Results We observed 1009 incident BC cases in 17,435 women during a median follow-up of 10.4 years. We found no overall association of smoking or alcohol consumption with BC risk (current smokers compared with never smokers HR 1.02, 95% CI 0.85–1.23; consuming ≥ 7 drinks/week compared with non-regular drinkers HR 1.10, 95% CI 0.92–1.32), but we did observe differences in associations based on FRP and by estrogen receptor (ER) status. Women with lower FRP had an increased risk of ER-positive BC associated with consuming ≥ 7 drinks/week (compared to non-regular drinkers), whereas there was no association for women with higher FRP. For example, women at the 10th percentile of FRP (5-year BOADICEA = 0.15%) had an estimated HR of 1.46 (95% CI 1.07–1.99), whereas there was no association for women at the 90th percentile (5-year BOADICEA = 4.2%) (HR 1.07, 95% CI 0.80–1.44). While the associations with smoking were not modified by FRP, we observed a positive multiplicative interaction by FRP (pinteraction = 0.01) for smoking status in women who also consumed alcohol, but not in women who were non-regular drinkers. Conclusions Moderate alcohol intake was associated with increased BC risk, particularly for women with ER-positive BC, but only for those at lower predicted familial BC risk (5-year BOADICEA < 1.25). For women with a high FRP (5-year BOADICEA ≥ 6.5%) who also consumed alcohol, being a current smoker was associated with increased BC risk.


2021 ◽  
Vol 80 (3) ◽  
pp. 1013-1023
Author(s):  
Adrienne L. Johnson ◽  
Naomi C. Nystrom ◽  
Megan E. Piper ◽  
Jessica Cook ◽  
Derek L. Norton ◽  
...  

Background: To fully characterize the risk for dementia associated with cigarette smoking, studies must consider competing risks that hinder the observation of dementia or modify the chance that dementia occurs (i.e., death). Extant research examining the competing risks fails to account for the occurrence of death following dementia, limiting our understanding of the relation between smoking and dementia. Objective: Examine the impact of smoking status, lifetime smoking exposure, and duration of abstinence on incident dementia, death following dementia, and death without dementia. Methods: Multi-state models estimated hazard ratios (HR) for 95% confidence interval (CI) of 10,681 cognitively healthy adults for transition from baseline to dementia, baseline to death, and dementia to death based on smoking status, lifetime cigarette exposure, and abstinence duration. Results: Compared to never smokers, current smokers had increased risk of dementia (HR = 1.66; 95% CI 1.18– 2.32; p = 0.004), and death from baseline (HR = 2.98; 95% CI 2.24– 3.98; p < 0.001) and incident dementia (HR = 1.88; 95% CI 1.08– 3.27; p = 0.03). Pack years increased risk of death from baseline (HR = 1.01; 95% CI 1.00– 1.01; p < 0.001), but not dementia risk (HR = 1.00; 95% CI 1.00– 1.00; p = 0.78) or death following dementia (HR = 1.01; 95% CI 1.00– 1.01; p = 0.05). Recent quitters (quit < 10 years), compared to never smokers, had increased risk of death after baseline (HR = 2.31; 95% CI 1.55– 3.43; p < 0.001), but not dementia (HR = 1.17; 95% CI 0.73– 1.88; p = 0.52) or death following dementia (HR = 1.01; 95% CI 0.42– 2.41; p = 0.99). Conclusion: Current smoking increases the risk for dementia and death, but dementia is better attributed to smoking recency than lifetime exposure. Smoking cessation at any age might reduce these risks for cognitively healthy individuals.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Philip Aagaard

Introduction: Early repolarization (ER) associated with sudden cardiac death is based on the presence of >1mm J-point elevations in inferior and/or lateral leads with horizontal/downsloping ST-segments. Automated ECG readings of early repolarization (AER) obtained in clinical practice, on the other hand, are defined by ST segment elevation (ascending/upsloping ST-segments) in addition to J-point elevation. Nonetheless, such automated readings may cause alarm. Methods: We therefore assessed the prevalence and prognostic significance of AER in 238,456 individuals aged 18-75 years. The study was performed at a tertiary medical center serving a racially diverse urban population with a large proportion of Hispanics (43%). The first recorded ECG of each individual during 2000-2012 was included. Patients with ventricular paced rhythm or acute coronary syndrome at the time of acquisition were excluded from the analysis. All automated ECG interpretations were reviewed for accuracy by a board certified cardiologist. The primary endpoint was death during a median follow up of 8.0±2.6 years. Results: AER was present in 3,450 (1.6%) subjects. The prevalence varied significantly with race: African Americans 2.2%, Caucasians 0.9%, and Hispanics 1.5% (p<0.01), and sex: male 2.4% vs. female 0.6% (p<0.001). In a Cox-proportional Hazards model (Figure 1) controlling for age, smoking status, heart rate, QTc, systolic blood pressure, LDL-cholesterol, BMI, and CAD, there was no significant difference in mortality regardless of race or sex (RR 0.98 (95% CI: 0.89-1.07). This was true even if J-waves were present. Conclusion: The prevalence of AER in Hispanics was intermediate to that of African Americans and Caucasians. This ECG finding was not associated with an increased risk of death, regardless of race or sex, and should not trigger additional diagnostic testing.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10555-10555
Author(s):  
S. Singh ◽  
K. Asomaning ◽  
M. H. Kulke ◽  
W. Zhou ◽  
R. Zhai ◽  
...  

10555 Background: The 2G allele of the MMP1 -1607 1G/2G promoter polymorphism creates an Ets binding site that leads to increased transcriptional and enzyme activity, particularly in the presence of growth factors and cytokines. This polymorphism has been associated with greater risk of cancer (e.g., renal cell, lung and oral cancers, glioblastomas) and cancer invasiveness (e.g., melanoma, cervical, lung and colorectal cancer). The aim of the current study was to evaluate the role of this MMP 1G/2G polymorphism in the risk of esophageal adenocarcinoma (EA). Methods: We evaluated 323 histologically confirmed EA cases and 464 healthy controls frequency-matched for age and gender. Genotyping of the MMP1 1G/2G promoter polymorphism involved a Taqman approach. All EAs had endoscopic evidence showing that the center of the tumors were located at or above the gastroesophageal junction. Odds Ratios (OR) were calculated using multivariate logistic regression, adjusted for age, gender, smoking status, and body-mass index (BMI) at the age of 18 years (to represent a healthy adult BMI). Results: Genotype frequencies were: 33% (1G/1G), 47% (1G/2G) & 20% (2G/2G) in controls; in cases, 26% (1G/1G), 50% (1G/2G) & 24% (2G/2G). 88% of cases were male. The MMP1 2G/2G and 1G/2G genotypes conferred a greater risk of EA, with adjusted ORs of 1.50 (95%CI=1.0–2.3) and 1.34 (95%CI=0.9–1.9), respectively, when compared with the wildtype 1G/1G genotype. The 2G allele (2G/2G + 1G/2G) conferred an adjusted OR of 1.38 (95%CI=1.0–1.9). By stage, the adjusted ORs for the 2G allele were 1.26 (95%CI=0.8–2.1), 1.45 (95%CI=0.9–2.3), & 1.54 (95%CI=0.9–2.7) for node negative, node-positive, and metastatic disease, respectively. Conclusions: The 2G allele of the MMP1 -1607 1G/2G polymorphism was associated with an increased risk of EA in this analysis. In addition, there was a non-significant trend towards conferring greater risk in the more advanced stages of EA, suggesting a possible role of this polymorphism in the invasiveness of this cancer. No significant financial relationships to disclose.


2021 ◽  
Vol 1 (1) ◽  
pp. 32-45
Author(s):  
Diyan Yunanto Setyaji ◽  
Hiasinta Anatasia Purnawijayanti

Central obesity is more predictive of measuring the risk of type 2 diabetes compared to anthropometric indicators of general obesity. The results of previous studies are still inconsistent and the causal relationship that had not been well explained between the determinant factors and the increasing incidence of diabetes mellitus. This study aims to determine the relationship between alcohol consumption and smoking habits in increasing the risk of diabetes mellitus in adult males and females who are central obesity in Indonesia. The analysis presented in this study was based on the data from a population-based, cross-sectional, nationally representative survey (Indonesian Basic Health Research 2018/RISKESDAS 2018). In total, 12726 men and 18637 women aged 18–65 years were enrolled. A validated questionnaire, smoking card, and alcohol card were used for the assessments. There was a significant difference (p <0.000) in the proportion of diabetes mellitus incidence between men and women in both age groups who consumed less than 1 pack of cigarettes or more than 1 pack per day. The age difference for the sexes did not show a statistically significant association with alcohol consumption of either under 5 servings or above 5 servings per day for the incidence of diabetes mellitus. Women with central obesity had an adjusted prevalence ratio of 1.7 times higher for diabetes mellitus than men. There were negative multiplicative interactions between sexes and smoking status (interaction PR = 0.685; 95% CI = 0.52-0.88) and cigarette exposure (0.65; 0.52-0.80) in women. The effects of alcohol consumption and their interactions with sex did not have a significant relationship. There is an increased risk of diabetes mellitus especially in women with central obesity. Alcohol consumption by people with central obesity has an interaction with gender in an increased risk of diabetes mellitus which is higher in women than men.


2020 ◽  
Vol 9 (12) ◽  
Author(s):  
Adebamike A. Oshunbade ◽  
Wondwosen K. Yimer ◽  
Karen A. Valle ◽  
Donald Clark ◽  
Daisuke Kamimura ◽  
...  

Background Blacks are disproportionately affected by stroke compared with whites; however, less is known about the relationship between stroke and cigarette smoking in blacks. Therefore, we evaluated the relationship between cigarette smoking and all incident stroke in the JHS (Jackson Heart Study). Methods and Results JHS participants without a history of stroke (n=4410) were classified by self‐reported baseline smoking status into current, past (smoked at least 400 cigarettes/life), or never smokers at baseline (2000–2004). Current smokers were further classified by smoking intensity (number of cigarettes smoked per day [1–19 and ≥20]) and followed up for incident stroke (through 2015). Hazard ratios (HRs) for incident stroke for current and past smoking compared with never smoking were estimated with adjusted Cox proportional hazard regression models. After adjusting for cardiovascular risk factors, the risk for stroke in current smokers was significantly higher compared with never smokers (HR, 2.48; 95% CI, 1.60–3.83) but there was no significant difference between past smokers and never smokers (HR, 1.10; 95% CI, 0.74–1.64). There was a dose‐dependent increased risk of stroke with smoking intensity (HR, 2.28 [95% CI, 1.38–3.86] and HR, 2.78 [95% CI, 1.47–5.28] for current smokers smoking 1–19 and ≥20 cigarettes/day, respectively). Conclusions In a large cohort of blacks, current cigarette smoking was associated with a dose‐dependent higher risk of all stroke. In addition, past smokers did not have a significantly increased risk of all stroke compared with never smokers, which suggests that smoking cessation may have potential benefits in reducing the incidence of stroke in blacks.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Soo-Youn An ◽  
So Young Kim ◽  
Dong Jun Oh ◽  
Chanyang Min ◽  
Songyoung Sim ◽  
...  

Abstract The purpose of this study was to evaluate the relationships of smoking, alcohol consumption, and obesity with thyroid cancer in Korean residents. The Korean National Health Insurance Service-Health Screening Cohort includes individuals ≥ 40 years who were assessed from 2002 to 2013. In total, 4977 thyroid cancer participants were matched with respect to age, sex, income, and region of residence with 19,908 controls at a ratio of 1:4. Crude and adjusted (for the Charlson comorbidity index, smoking status, frequency of alcohol consumption, and obesity) odds ratios (ORs) were analyzed using conditional logistic regression analyses. Additionally, 95% confidence intervals (CIs) were calculated. The adjusted OR of smoking for thyroid cancer was 0.62 (95% CI 0.54–0.72, P < 0.001), and that of alcohol consumption was 0.83 (95% CI 0.75–0.92, P < 0.001). The adjusted ORs of the BMI categories were 1.13 (95% CI 1.05–1.22, P = 0.002) for obese I, and 1.24 (95% CI 1.04–1.47, P = 0.014) for obese II. The ORs of smoking and alcohol consumption were lower, and those of overweight and obesity were higher in thyroid cancer patients than in individuals in the control group.


2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 259-259
Author(s):  
Alexander Tward ◽  
Jonathan David Tward

259 Background: Exposure of Vietnam War Veterans to the defoliant Agent Orange (AO) has been linked to increased tumor stage of Veterans diagnosed with prostate cancer. However, information on the effect of exposure to treatment outcomes is lacking. The goal of this study was to evaluate oncologic outcomes in Veterans based on AO exposure history, accounting for known prognostic covariates not previously studied. Methods: United States military Veterans diagnosed with prostate adenocarcinoma born between the years 1930-1956 were identified from a large professionally curated institutional database. Evaluable patients had to have known AO exposure status, age, NCCN risk group, Charlson comorbidity score, smoking status, and whether initial therapy was surgical, radiation, or systemic. Risk of death, metastasis, and progression stratified by the type of initial therapy received was analyzed using Cox regression. Results: There were 70 AO exposed and 561 non-exposed Veterans identified, with a median follow-up of 10.0 years. AO exposure Veterans (AOeV) were significantly younger (64.0 versus 65.7 years, p=0.013) at diagnosis and presented at more advanced stages (e.g. Stage 4: 14.3% versus 2.5%) than non-exposed Veterans (non-AOeV). There was no difference for overall survival (HR=0.86, p=0.576, metastasis-free survival (HR=1.5, p=0.212), or progression-free survival (HR=0.67, p 0.060) between AOeV versus non-AOeV in analyses stratified by treatment received accounting for other prognostic covariates. Cigarette smoking was associated with a 2- 3-fold increased risk of death over those who quit or never smoked. Conclusions: Although AOeV do present at younger age and higher clinical stages than non-AOeV, the oncologic outcomes after accounting for treatments received and other prognostic covariates are similar. The implication is that AOeV are more likely to be recommended multimodality or systemic therapies at presentation.


Author(s):  
Tahira Kootbodien ◽  
Kerry Wilson ◽  
Nonhlanhla Tlotleng ◽  
Vusi Ntlebi ◽  
Felix Made ◽  
...  

Work-related tuberculosis (TB) remains a public health concern in low- and middle-income countries. The use of vital registration data for monitoring TB deaths by occupation has been unexplored in South Africa. Using underlying cause of death and occupation data for 2011 to 2015 from Statistics South Africa, age-standardised mortality rates (ASMRs) were calculated for all persons of working age (15 to 64 years) by the direct method using the World Health Organization (WHO) standard population. Multivariate logistic regression analysis was performed to calculate mortality odds ratios (MORs) for occupation groups, adjusting for age, sex, year of death, province of death, and smoking status. Of the 221,058 deaths recorded with occupation data, 13% were due to TB. ASMR for TB mortality decreased from 165.9 to 88.8 per 100,000 population from 2011 to 2015. An increased risk of death by TB was observed among elementary occupations: agricultural labourers (MORadj = 3.58, 95% Confidence Interval (CI) 2.96–4.32), cleaners (MORadj = 3.44, 95% CI 2.91–4.09), and refuse workers (MORadj = 3.41, 95% CI 2.88–4.03); among workers exposed to silica dust (MORadj = 3.37, 95% CI 2.83–4.02); and among skilled agricultural workers (MORadj = 3.31, 95% CI 2.65–4.19). High-risk TB occupations can be identified from mortality data. Therefore, TB prevention and treatment policies should be prioritised in these occupations.


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