Even light drinkers may be at increased risk of GI cancers

Reuters Health - 18/08/2021  - When it comes to the link between GI cancers and alcohol consumption, if drinking occurs on a daily basis there may be no safe amount, a new study suggests.

Moreover, the analysis of data from nearly 12 million Koreans, including 319,202 who developed a GI cancer, revealed that when people drank the same weekly amount of alcohol, daily consumption was more likely than bingeing to be associated with cancer, according to the report published in JAMA Network Open.

"Drinking patterns vary significantly from person to person," said the study's first author, Dr. Jung Eun Yoo, a professor in the department of family medicine at the Healthcare System Gangnam Center and Seoul National University Hospital. "Some people consume one to two drinks of beer, wine, or whisky every day - frequent drinking - while other people enjoy several drinks at the bar or a party on the weekend only - episodic binge drinking."

"We showed that frequent drinking was more strongly associated with the risk of GI cancer than binge drinking, and that this pattern was generally consistent across all gastrointestinal cancer sites," Dr. Yoo said in an email. "Patients should be careful with their drinking habits including chronic low-dose alcohol consumption."

The findings may spark changes in recommendations.

"Current guidelines on alcohol consumption specify only average levels of consumption (average number of drinks consumed in a week)," Dr. Yoo said. "The American Cancer Society recommends that people who drink alcohol limit their intake to no more than two drinks per day for men and one drink a day for women, and the European Code Against Cancer recommends limiting or cutting out alcohol consumption. In addition to amount per occasion, our study provides a rationale for an emphasis on frequency of drinking to prevent cancer. Alcohol users who enjoy a glass of wine or beer during dinner every day may develop more cancer than people who occasionally consumed several drinks."

To examine the potential impact of alcohol on GI cancer risk, Dr. Yoo and her colleagues turned to data from National Health Insurance, the major insurer in the Republic of Korea, which covers approximately 97% of the population. Along with health information, such as past medical history, smoking status, BMI and the results of lab tests, the NHI also keeps track of demographic information, including age, gender, place of residence and income level) and links to a death registry database.

The researchers' population-based retrospective cohort study focused on 11,737,467 participants without cancer who underwent a national health screening from January 1, 2009 to December 31, 2010. Dr. Yoo and her colleagues followed the participants from the year after their health screening date until they received a diagnosis of GI cancer, death, or December 31, 2017. The median follow-up duration was 6.4 years.

Alcohol exposure data came from a self-adminstered questionnaire that documented frequency (number of days per week) and quantity (amount consumed per occasion). The researchers calculated weekly alcohol consumption as grams of alcohol per occasion multiplied by the frequency per week. Weekly consumption was classified into one of four groups: nondrinker (0 g/week); mild drinker (0-104 g/week; moderate drinker (105-209 g/week); and heavy drinker (210 g/week or more).

Compared with nondrinkers, the risk of GI cancer was higher for mild drinkers (adjusted hazard ratio 1.04), moderate drinkers (aHR 1.14), and heavy drinkers (aHR 1.28). The risk of GI cancer increased linearly with the frequency of drinking in a dose-dependent manner (aHR 1.39 for individuals who drink every day).

In contrast, the risk of GI cancer appeared to increase with consumption up to five to seven units per occasion (aHR, 1.15), and then leveled off for consumption of 8-14 units per occasion or greater (aHR 1.11). Given similar weekly alcohol consumption levels, the risk of GI cancer increased with a higher frequency of drinking and decreased with a higher amount per occasion. Risk patterns for six specific cancers were generally similar those for all GI cancers.

SOURCE: https://bit.ly/3k88Vyq and https://bit.ly/3z3s2Qv JAMA Network Open, online August 18, 2021.

By Linda Carroll

 



Posted on 18 August 202124 August 2021