ALCOHOL-CONSUMPTION AND RISK OF ESOPHAGEAL CANCER IN JAPAN - A CASE-CONTROL STUDY IN 7 HOSPITALS

In a multi-center case-control study, we evaluated the risk of esophag eal cancer in the Japanese population. All patients and controls were inpatients in the surgical departments of seven hospitals nationwide. Patients eligible for the study were those newly diagnosed as having p rimary esophageal cancer. One control per case was selected from among patients admitted to the same hospital, and 141 male pairs were analy zed using logistic regression analysis. The results showed dose-respon se relation between the risk of esophageal cancer and both the quantit y (g/week) and frequency (times/week) of alcohol drinking (P value for trend = 0.0001). Although a statistically significant risk increase w as shown among moderate to heavy smokers (15 less-than-or-equal-to cig arette/day < 25) (odds ratio, 4.35 : 95% confidence interval, 1.81-10. 49), the dose-response for cigarette smoking was unclear (P value for trend = 0.07). No combined effect of alcohol drinking and cigarette sm oking was found. A frequent intake of fruit was associated with a decr eased risk (P value for trend = 0.02). After adjustment for alcohol co nsumption, cigarette smoking and fruit intake were found not to be ass ociated with the risk, whereas a preference for high-temperature food and drink showed a statistically significant positive association (P v alue for trend = 0.02). Drinkers who consumed shochu most frequently s howed a three-fold increased risk over that for beer consumers, althou gh the association disappeared after adjusting for the amount of alcoh ol consumed. The present results confirm alcohol intake and a preferen ce for high-temperature food to be associated with an increased risk o f esophageal cancer and show the amount of alcohol consumed, rather th an the type of alcoholic beverage, to be the main risk determinant.