Alcohol is a risk factor for cancer of the oral cavity, pharynx, oesophagus, colorectum, liver, larynx and female breast, whereas its impact on other cancers remains controversial.
We investigated ...the effect of alcohol on 23 cancer types through a meta-analytic approach. We used dose-response meta-regression models and investigated potential sources of heterogeneity.
A total of 572 studies, including 486 538 cancer cases, were identified. Relative risks (RRs) for heavy drinkers compared with nondrinkers and occasional drinkers were 5.13 for oral and pharyngeal cancer, 4.95 for oesophageal squamous cell carcinoma, 1.44 for colorectal, 2.65 for laryngeal and 1.61 for breast cancer; for those neoplasms there was a clear dose-risk relationship. Heavy drinkers also had a significantly higher risk of cancer of the stomach (RR 1.21), liver (2.07), gallbladder (2.64), pancreas (1.19) and lung (1.15). There was indication of a positive association between alcohol consumption and risk of melanoma and prostate cancer. Alcohol consumption and risk of Hodgkin's and Non-Hodgkin's lymphomas were inversely associated.
Alcohol increases risk of cancer of oral cavity and pharynx, oesophagus, colorectum, liver, larynx and female breast. There is accumulating evidence that alcohol drinking is associated with some other cancers such as pancreas and prostate cancer and melanoma.
Despite several studies support a positive association between heavy alcohol consumption and liver cancer risk, a consistent dose–risk relationship has not yet been established. We carried out a ...systematic review and a meta-analysis of the association between alcohol intake and liver cancer occurrence, following the Meta-analysis Of Observational Studies in Epidemiology guidelines. We searched for cohort and nested case–control studies on the general population published before April 2013, using PubMed and EMBASE. Summary meta-analytic relative risks (RRs) were estimated using random-effect models. We included 16 articles (19 cohorts) for a total of 4445 incident cases and 5550 deaths from liver cancer. Compared with non-drinking, the pooled RRs were 0.91 (95% confidence interval, CI, 0.81–1.02) for moderate drinking (<3 drinks per day) and 1.16 (95% CI, 1.01–1.34) for heavy drinking (≥3 drinks per day), with significant heterogeneity among studies. The dose–risk curve suggested a linear relationship with increasing alcohol intake in drinkers, with estimated excess risk of 46% for 50g of ethanol per day and 66% for 100g per day. This systematic review suggests a moderate detrimental role of consumption of 3 or more alcoholic drinks per day on liver cancer, and a lack of association with moderate drinking. Our results have to be taken with due caution on account of the possible limitations of the original studies included in the meta-analysis.
Objectives
To compare the performance metrics of two different strategies of lung cancer screening by low-dose computed tomography (LDCT), namely, annual (LDCT1) or biennial (LDCT2) screen.
Methods
...Recall rate, detection rate, interval cancers, sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) were compared between LDCT1 and LDCT2 arms of the MILD trial over the first seven (T0-T6; median follow-up 7.3 years) and four rounds (T0-T3; median follow-up 7.3 years), respectively.
Results
1152 LDCT1 and 1151 LDCT2 participants underwent a total of 6893 and 4715 LDCT scans, respectively. The overall recall rate was higher in LDCT2 arm (6.97 %) than in LDCT1 arm (5.81 %) (
p
= 0.01), which was counterbalanced by the overall lower number of LDCT scans. No difference was observed for the overall detection rate (0.56 % in both arms). The two LDCT arms had similar specificity (99.2 % in both arms), sensitivity (73.5 %, in LDCT2 vs. 68.5 % in LDCT1,
p
= 0.62), PPV (42.4 %, in LDCT2, vs. 40.6 %, in LDCT1,
p
= 0.83) and NPV (99.8 %, in LDCT2 vs. 99.7 %, in LDCT1,
p
= 0.71).
Conclusion
Biennial screen may save about one third of LDCT scans with similar performance indicators as compared to annual screening
.
Key Points
•
Biennial LDCT screening may be as efficient as the annual screening.
•
Annual and biennial LDCT screening have similar frequency of interval lung cancers.
•
Biennial screening may save about one third of LDCT scans.
Background
Epidemiological data on infant feeding practices and allergic diseases are controversial. The purpose of this study was to explore the association of early weaning with the occurrence of ...atopic dermatitis (AD).
Methods
We conducted a matched case–control study on incident physician‐diagnosed AD in early childhood including 451 cases and 451 controls. Data on several factors, including feeding practices, were collected through an interviewer‐administered questionnaire. Odds ratios (OR) and the corresponding 95% confidence intervals (CIs) were estimated through logistic regression models, conditioned on study center, age, sex, and period of interview, and adjusted for potential confounders.
Results
Early weaning, defined as the introduction of solid foods at 4 or 5 months of age, was inversely related to the risk of AD, with children weaned at 4 months having lower AD risk (OR = 0.41, 95% CI, 0.20–0.87) compared to those exclusively breastfed. Similar results were observed for weaning started at 5 months of age (OR = 0.39, 95% CI, 0.18–0.83). This association persisted when children with and without family history of allergy were considered separately. Prolonged partial breastfeeding (breastmilk plus milk formulas) was not associated with AD. Consistently, the introduction of a high number of different solid foods reduced the risk of AD (P trend = 0.02 at 4 months of age and P trend = 0.04 at 5 months).
Conclusion
Our data provide evidence against the preventing role of prolonged exclusive (but not partial) breastfeeding in AD occurrence and confirm recent results indicating a beneficial role of early weaning in AD.
Bronchial thermoplasty (BT) is a non-pharmacological intervention for severe asthma whose mechanism of action is not completely explained by a reduction of airway smooth muscle (ASM). In this study ...we analyzed the effect of BT on nerve fibers and inflammatory components in the bronchial mucosa at 1 year.
Endobronchial biopsies were obtained from 12 subjects (mean age 47 ± 11.3 years, 50% male) with severe asthma. Biopsies were performed at baseline (T0) and after 1 (T1), 2 (T2) and 12 (T12) months post-BT, and studied with immunocytochemistry and microscopy methods. Clinical data including Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Questionnaire (ACQ) scores, exacerbations, hospitalizations, oral corticosteroids use were also collected at the same time points.
A statistically significant reduction at T1, T2 and T12 of nerve fibers was observed in the submucosa and in ASM compared to T0. Among inflammatory cells, only CD68 showed significant changes at all time points. Improvement of all clinical outcomes was documented and persisted at the end of follow up.
A reduction of nerve fibers in epithelium and in ASM occurs earlier and persists at one year after BT. We propose that nerve ablation may contribute to mediate the beneficial effects of BT in severe asthma.
Registered on April 2, 2013 at ClinicalTrials.gov Identifier: NCT01839591 .
The Mediterranean diet has a beneficial role on various neoplasms, but data are scanty on oral cavity and pharyngeal (OCP) cancer.
We analysed data from a case-control study carried out between 1997 ...and 2009 in Italy and Switzerland, including 768 incident, histologically confirmed OCP cancer cases and 2078 hospital controls. Adherence to the Mediterranean diet was measured using the Mediterranean Diet Score (MDS) based on the major characteristics of the Mediterranean diet, and two other scores, the Mediterranean Dietary Pattern Adherence Index (MDP) and the Mediterranean Adequacy Index (MAI).
We estimated the odds ratios (ORs), and the corresponding 95% confidence intervals (CI), for increasing levels of the scores (i.e., increasing adherence) using multiple logistic regression models. We found a reduced risk of OCP cancer for increasing levels of the MDS, the ORs for subjects with six or more MDS components compared with two or less being 0.20 (95% CI 0.14-0.28, P-value for trend <0.0001). The ORs for the highest vs the lowest quintile were 0.20 (95% CI 0.14-0.28) for the MDP score (score 66.2 or more vs less than 57.9), and 0.48 (95% CI 0.33-0.69) for the MAI score (score value 2.1 or more vs value less 0.92), with significant trends of decreasing risk for both scores. The favourable effect of the Mediterranean diet was apparently stronger in younger subjects, in those with a higher level of education, and in ex-smokers, although it was observed in other strata as well.
Our study provides strong evidence of a beneficial role of the Mediterranean diet on OCP cancer.
Data of epidemiological studies on the relation between coffee drinking and upper aerodigestive tract cancer risk are scattered and inconclusive. We therefore conducted systematic meta-analyses of ...observational studies published before October 2009.
We combined relative risks (RR) with 95% confidence intervals (CI) for cancers of the oral cavity/pharynx (OP) and larynx, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC), comparing the highest versus the lowest categories of coffee consumption, using random-effects models.
For OP cancer, the pooled RR was 0.64 (95% CI 0.51–0.80) for highest versus lowest coffee drinking, based on a total of 2633 cases from one cohort and eight case–control studies, with no significant heterogeneity across studies. The RRs were 0.61 (95% CI 0.41–0.89) for European, 0.58 (95% CI 0.36–0.94) for American and 0.74 (95% CI 0.48–1.15) for Asian studies, where coffee consumption is lower. The corresponding RRs were 1.56 (95% CI 0.60–4.02) for laryngeal cancer (732 cases from three case–control studies), 0.87 (95% CI 0.65–1.17) for ESCC (2115 cases from one cohort and six case–control studies) and 1.18 (95% CI 0.81–1.71) for EAC (415 cases from three case–control studies).
Coffee drinking is inversely related to OP cancer risk, while there is no relation with laryngeal cancer, ESCC and EAC.
Since when in 1981 a case–control study showed a positive association between coffee and pancreatic cancer, several studies reported inconsistent results on this issue.
We conducted a systematic ...bibliography search updated March 2011 to identify observational studies providing quantitative estimates for pancreatic cancer risk in relation to coffee consumption. We used a meta-analytic approach to estimate overall relative risk (RR) and 95% confidence interval (CI) for the highest versus the lowest coffee consumption categories, using random-effects models.
Based on 37 case–control and 17 cohort studies (10 594 cases), the pooled RR for the highest versus lowest intake was 1.13 (95% CI 0.99–1.29). Considering only the smoking-adjusting studies, the pooled RRs were 1.10 (95% CI 0.92–1.31) for the 22 case–control, 1.04 (95% CI 0.80–1.36) for the 15 cohort, and 1.08 (95% CI 0.94–1.25) for all studies. The pooled RR for the increment of one cup of coffee per day was 1.03 (95% CI 0.99–1.06) for the 28 smoking-adjusting studies reporting three or more coffee consumption categories. No significant heterogeneity was observed across strata of study design, sex, geographic region, and other selected characteristics.
This meta-analysis provides quantitative evidence that coffee consumption is not appreciably related to pancreatic cancer risk, even at high intakes.
To quantify the magnitude of the association between alcohol and oral and pharyngeal cancer (OPC) by sex, smoking habits, type of alcoholic beverage and other factors.
We combined findings from all ...case-control and cohort studies published until September 2010 and present in this article the results classified by these factors, using a meta-analytic approach. Summary relative risks (RRs) were obtained using random-effects models; heterogeneity was assessed using the χ(2) test.
The association between alcohol and OPC risk was similar in men and women, with similar dose-response relationships. No notable differences were found with respect to geographic area and other factors, both for drinking overall and heavy (≥4 drinks/day) drinking. Among never/non-current smokers, the pooled RRs were 1.32 (95% confidence interval, CI, 1.05-1.67) for drinking, and 2.54 (95% CI, 1.80-3.58) for heavy drinking. The corresponding RRs in smokers were 2.92 (95% CI, 2.31-3.70) and 6.32 (95% CI, 5.05-7.90). The pooled RRs for any drinking irrespective of smoking were 2.12 (95% CI, 1.37-3.29) for wine-, 2.43 (95% CI, 1.92-3.07) for beer- and 2.30 (95% CI, 1.78-2.98) for spirits-only drinking. The corresponding RRs for heavy drinking were 4.92 (95% CI, 2.80-8.65), 4.20 (95% CI, 1.43-12.38) and 5.20 (95% CI, 2.77-9.78).
The alcohol-related RRs are similar with respect to sex, geographic area and type of alcoholic beverage. The association between alcohol and OPC is stronger in smokers than in non-smokers.
Background/Objectives: The aim of this study is to investigate whether adherence to the Mediterranean diet changed during the period 1991–2006 in an Italian population. Subjects/Methods: We derived ...data from the comparison groups of a network of case–control studies on cancer and acute myocardial infarction conducted in the greater Milan area between 1991 and 2006. Subjects were 3247 adults (1969 women, 1278 men; median age 59 years) admitted to major teaching and general hospitals for a wide spectrum of acute conditions unrelated to long-term modifications of diet. Trained interviewers collected data on selected socioeconomic and demographic characteristics, lifestyle habits and other personal and familial factors. Information on diet was collected through an interviewer-administered, reproducible and validated food-frequency questionnaire. We computed a Mediterranean diet score (MDS) on the basis of nine a priori defined peculiar characteristics of the Mediterranean dietary pattern. Results: In multiple linear regression models, adjusted for age, education, place of birth and residence, and total energy intake, there was no significant association between the period of interview and MDS in both sexes. Subjects aged 55–64 years, those with high education, and those born in central and southern Italy showed the highest adherence to the Mediterranean diet in both sexes. Conclusions: In this population, adherence to the Mediterranean diet showed no significant change over the last 15 years.
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