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Decreased risk of esophageal cancer owing to cigarette and alcohol cessation in smokers and drinkers: a systematic review and meta-analysis

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Abstract

Smoking cigarettes and drinking alcoholic beverages are considered very important risk factors for adverse health effects, such as many types of cancer and cardiovascular disease. In this study, we evaluated the influence of smoking and drinking cessation on risk of esophageal cancer, by means of meta-analysis. We extracted 205 studies by conducting a systematic literature search. Thirty-five studies that estimated risk reduction following smoking cessation and 18 studies conducted following drinking cessation were identified in the literature review. Former smokers had a significantly lower summary risk ratio (RR) than current smokers [RR 0.74, 95% confidence interval (CI) 0.68–0.80]. In subgroup analysis of Japanese smokers, squamous cell carcinoma, and adenocarcinoma, RRs for former smokers versus current smokers were 0.65 (95% CI 0.51–0.83), 0.60 (95% CI 0.50–0.72), and 0.93 (95% CI 0.84–1.03), respectively. The summary RR between former alcohol drinkers and current drinkers was not significant (RR 1.09, 95% CI 0.94–1.26). In our analysis of time since drinking cessation, drinkers who had stopped consuming alcohol for 5 years or more had a significantly lower summary RR than current drinkers (RR 0.78, 95% CI 0.66–0.93). Summary RR for drinkers who stopped for 10 years or more versus current drinkers was 0.65 (95% CI 0.57–0.74). Our investigation found that smoking cessation lowers esophageal cancer incidence. We also found that esophageal cancer incidence risk could be decreased in current drinkers by cessation of alcohol consumption for 5 years or more.

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Abbreviations

IARC:

International Agency for Research on Cancer

SMD:

Standardized mean difference

CI:

Confidence intervals

RR:

Risk ratio

ALDH2:

Aldehyde dehydrogenase 2

AC:

Adenocarcinoma

SCC:

Squamous cell carcinoma

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Author information

Authors and Affiliations

  1. Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Tatsuya Miyazaki, Hiroyuki Kuwano, Makoto Sakai & Makoto Sohda

  2. Department of Surgery, Keio University School of Medicine, Tokyo, Japan

    Yuko Kitagawa, Hiroya Takeuchi, Hirofumi Kawakubo & Eisuke Booka

  3. Department of Gastroenterology, Gunma University Hospital, Gunma, Japan

    Motoyasu Kusano & Osamu Kawamura

  4. Department of Gastroenterology, Saku Central Hospital, Nagano, Japan

    Tuneo Oyama

  5. Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Manabu Muto

  6. Department of Surgery 1, Dokkyo Medical University, Tochigi, Japan

    Hiroyuki Kato & Masanobu Nakajima

  7. Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan

    Yasushi Toh

  8. Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan

    Yuichiro Doki

  9. Department of General Surgery, Kawasaki Medical School, Okayama, Japan

    Yoshio Naomoto

  10. Department of Radiation Oncology, Yamagata University School of Medicine, Yamagata, Japan

    Kenji Nemoto

  11. Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan

    Hisahiro Matsubara

  12. Department of Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Akio Yanagisawa

  13. Department of Radiology, Graduate School of Medicine, Chiba University, Chiba, Japan

    Takashi Uno

  14. Gastrointestinal Medical Oncology Division, National Cancer Center, Tokyo, Japan

    Ken Kato

  15. Department of Hemodialysis and Surgery, Chemotherapy Research Institute, International University of Health and Welfare, Ichikawa, Japan

    Masahiro Yoshida

  16. Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan

    Minoru Fukuchi

Authors
  1. Tatsuya Miyazaki
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  2. Yuko Kitagawa
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  3. Hiroyuki Kuwano
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  4. Motoyasu Kusano
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  7. Hiroyuki Kato
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  8. Hiroya Takeuchi
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  9. Yasushi Toh
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  10. Yuichiro Doki
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  11. Yoshio Naomoto
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  16. Ken Kato
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  24. Masanobu Nakajima
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Consortia

The Committee for the “Guidelines for diagnosis and treatment of carcinoma of the esophagus” of the Japan Esophageal Society

Contributions

Sysetematic review and meta-analysis: TM, MF, MS, and MS. Management: YK and HK. Discussion and advice: YK, HK, MK, TO, MM, HK, HT, YT, TD, YN, KN, HM, AY, TU, KK, MY, HK, EB, OK, and MN.

Corresponding author

Correspondence to Tatsuya Miyazaki.

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Ethical Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1964 and later versions.

Conflict of interest

All authors declare that they have no potential conflicts of interest in this manuscript.

Funding

Funding of this study depends on the Japan Esophageal Society.

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Miyazaki, T., Kitagawa, Y., Kuwano, H. et al. Decreased risk of esophageal cancer owing to cigarette and alcohol cessation in smokers and drinkers: a systematic review and meta-analysis. Esophagus 14, 290–302 (2017). https://doi.org/10.1007/s10388-017-0582-8

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