Lancet子刊:2020年近四成新发癌症与饮酒有关! 就算适度饮酒也会致癌!

2021-07-19 MedSci原创 MedSci原创

饮酒与包括癌症在内的各种伤害和疾病有关,是全球疾病负担的主要风险因素。

饮酒与包括癌症在内的各种伤害和疾病有关,是全球疾病负担的主要风险因素。饮酒与上呼吸道癌症(口腔、咽、喉和食道癌)以及结肠癌、直肠癌、肝癌和女性乳腺癌有因果关系。2020年,这些癌症共导致全球630万例病例和330万例死亡。

既往曾有关于酒精对癌症负担的影响的数据。但是随着时间的推移,世界各地区的酒精消费模式继续发生变化。在许多欧洲国家,特别是东欧国家,人均酒精消费有所下降,而在亚洲国家,如中国、印度和越南,以及撒哈拉以南非洲的许多国家,酒精使用呈上升趋势。

随着饮酒量的这些变化和最近的癌症发病率数据,有理由对酒精引起的癌症负担进行新的估计。为此,来自美英法德等多国的公共卫生专家通过使用2020年癌症发病率、近期相对风险估计值和酒精导致的癌症负担。此外,研究人员还评估了不同程度饮酒量对酒精所致癌症总负担的贡献。结果发表在《柳叶刀》子刊Lancet Oncology杂志上。

在这项以人群为基础的研究中,研究人员使用终生戒酒的理论最小风险暴露和全球酒精与健康信息系统2010年的酒精消费估计值(假设酒精消费和癌症诊断之间有10年的潜伏期)计算的人群归因分数(PAFs),结合作为WCRF持续更新项目一部分的系统文献综述的相应相对风险估计值,应用于GLOBOCAN 2020年的癌症发病率数据,以估计可归因于酒精的新癌症病例。

其中,中度(<20g/d)、危险(20-60 g/d)和重度(>60g/d)饮酒对总酒精所致癌症负担的贡献,以及每天增加10g(最多150g)的贡献。95%的不确定性区间(UIs)是使用类似蒙特卡罗的方法估计的。

在全球范围内,估计2020年所有新发癌症病例中有741300例(95% UI 558500–951200)或41%(31%–53%)可归因于饮酒,而56.87万例男性新发癌症(76.7%;95% UI 422500–731100)可归因于酒精的癌症病例。

按酒精消费类别、性别和世界区域划分的人口归属比例

其中,以食管癌(189700例[110900–274600])、肝癌(154700例[433700–281500])和乳腺癌(98300例[68200–130500])因酒精导致的癌症病例最多。部分分配系数最低的是北非(0.3%[95% UI 0.1%–3.3%])和西亚(0.7%[0.5%–1.2%]),最高的是东亚(5.7%[3.6%–7.9%])和中东欧(5.6%[4.6%-6.6%])。

进一步分析显示,酒精所致癌症的最大负担是大量饮酒(346400[46.7%;95% UI 227900–489400]病例)和危险饮酒(291800[39.4%;227700–333100]例),而适度饮酒导致103100(13.9%;82600–207200)例。同时,每天多饮酒10克即可导致新增41300 (35400–145800)例。

每天饮酒增加10克,全球酒精导致的男女性癌症病例数

由此可见,该研究的相关发现强调了有效的政策和干预措施的必要性,以提高对与饮酒相关的癌症风险的认识,并减少总体饮酒量,以防止酒精引起的癌症的负担。

 

参考文献:

Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study. https://doi.org/10.1016/S1470-2045(21)00279-5

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    2022-03-20 医者仁者

    #饮酒#百病之源

    0

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    2021-07-30 howi
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    2021-07-21 jambiya
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    2021-07-19 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

拓展阅读

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