Study: Combination of alcohol, tobacco increases risk of esophageal cancer

Do you have patients who smoke and drink? Those patients who do both activities have almost double the rate of developing esophageal squamous cell carcinoma (ESCC) as compared with those who only do one of those, according to new research published in the American Journal of Gastroenterology (April 23, 2014).

This is the first meta-analysis to look at the interaction between alcohol and tobacco in the risk of ESCC, a class of esophageal cancer that begins in the flat cells lining the esophagus, according to the American College of Gastroenterology.

"Our study suggests that not only do alcohol and tobacco play an important role in the development of esophageal cancer, the combination of their use markedly increases their potency as carcinogens," said lead author Anoop Prabhu, MD, endoscopy fellow at the Icahn School of Medicine at Mount Sinai in New York City. "As a result, we should focus efforts directed at controlling the burden of esophageal cancer on those who consume both of these substances."

Researchers performed a systematic literature search in multiple electronic databases and looked at population-based case-control or cohort studies of ESCC that assessed the effects of tobaccos and/or alcohol. A synergy factor was calculated from each study to estimate the interaction on a multiplicative scale between tobacco and alcohol on the outcome of ESCC.

"Our systematic review confirmed the expected exposure-dependent relationship of both alcohol and tobacco with the risk of ESCC, as alcohol use and tobacco use were both independent risk factors for the development of ESCC," Dr. Prabhu said.

According to the National Cancer Institute, there will be more than 18,000 new cases of esophageal cancer in the U.S. in 2014, and more than 15,000 deaths from the disease.

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