Frequent alcohol consumption poses more threat for GI cancer than increased intake: JAMA

Korea: In a recent study by Jung Eun Yoo, frequent drinking was revealed to be a more relevant risk factor for incident gastrointestinal (GI) cancer than the amount of alcohol taken each occasion. The findings of this study were published in the Journal of American Medical Association on 18th August 2021.

Although overall alcohol use is an established risk factor for GI cancers, few studies have attempted to analyze the pattern of alcohol consumption in relation to GI malignancies. To fill this knowledge gap, Dr. Jung Eun and the team aimed to evaluate the relative association of the frequency of drinking vs the amount of alcohol consumed per occasion with the development of GI cancers in a population-based retrospective cohort study. 

The researchers used data from the Korean Nationwide Health Insurance System database on 11 737 467 cancer-free patients who participated in a national health screening program between January 1, 2009, and December 31, 2010. Participants were tracked for a year following their health screening date until they were diagnosed with GI cancer, died, or died on December 31, 2017. The average period of follow-up was 6.4 years (interquartile range, 6.4-7.4 years). From January 1, 2019, to March 31, 2020, statistical analysis was carried out. Grouping was as follows, weekly alcohol intake (nondrinker [0 g/week], mild drinker [0-104 g/week], moderate drinker [105-209 g/week], and heavy drinker [210 g/week]), frequency of drinking, and the amount consumed each occasion.

• 319 202 (2.7%) of the 11 737 467 individuals got GI cancer. Mild drinkers, moderate drinkers, and strong drinkers all had a greater risk of GI cancer than nondrinkers.
• In a dose-dependent way, the risk of GI cancer increased linearly with the frequency of drinking. In contrast, the risk of GI cancer appeared to grow up to 5 to 7 units every occasion, and then the HRs were no higher for those who consumed more than 5 to 7 units per session.
• Given comparable weekly alcohol intake levels, the risk of GI cancer increased with increased frequency of drinking and reduced with increased quantity each occasion.
• The risk patterns for six particular malignancies were broadly comparable to the risk patterns for all GI cancers.

In conclusion, this study discovered a link between alcohol use and GI malignancies, such as stomach, pancreas, and biliary tract tumours, that had not been reported in earlier investigations. Furthermore, regular drinking was shown to be more significantly related with the risk of GI cancer than binge drinking, and this trend was found to be constant across all GI cancer locations. These data show that in addition to overall alcohol intake or quantity per event, individuals should be advised about regular low-dose alcohol usage.

Reference:

Yoo JE, Shin DW, Han K, et al. Association of the Frequency and Quantity of Alcohol Consumption With Gastrointestinal Cancer. JAMA Netw Open. 2021;4(8):e2120382. doi:10.1001/jamanetworkopen.2021.20382