Cancer screening of upper aerodigestive tract in Japanese alcoholics with reference to drinking and smoking habits and aldehyde dehydrogenase-2 genotype

Akira Yokoyama, Tai Ohmori, Taro Muramatsu, Susumu Higuchi, Tetsuji Yokoyama, Sachio Matsushita, Michinaga Matsumoto, Katsuya Maruyama, Motoi Hayashida, Hiromasa Ishi

Research output: Contribution to journalArticle

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Abstract

In this study, 1,000 Japanese male alcoholics were consecutively screened by upper gastrointestinal endoscopy with esophageal iodine staining. Associations among cancer-detection rates, drinking and smoking habits, and aldehyde dehydrogenase-2 (ALDH2) genotypes were evaluated. A total of 53 patients (5.3%) had histologically confirmed cancer. Esophageal cancer was diagnosed in 36, gastric cancer in 17, and oropharyngolaryngeal cancer in 9 patients: 8 of the esophageal-cancer patients were multiple-cancer patients, with additional cancer(s) in the stomach and/or oropharyngolaryngeal region. Multiple logistic regression revealed that use of stronger alcoholic beverages (whisky or shochu) in contrast with lighter beverages (sake or beer) and smoking of 50 pack-years or more increased the risks for esophageal (odds ratio 3.2 and 2.8 respectively), oropharyngolaryngeal (4.8 and 5.1 respectively) and multiple cancer (10.5 and 11.8 respectively). The inactive form of ALDH2, encoded by the gene ALDH2*1/2*2 prevalent in Orientals, exposes them to higher blood levels of acetaldehyde, a recognized animal carcinogen, after drinking. This inactive ALDH2 was detected in 19/36 (52.8%) patients with esophageal cancer, in 5/9 (55.6%) patients with oropharyngolaryngeal cancer, and in 7/8 (87.5%) patients with multiple cancer. All of these gene frequencies far exceeded that in a large alcoholic cohort (80/655, 12.2%). The triple combination of the risk factors of the inactive ALDH2, stronger alcoholic beverages and heavy smoking was more commonly associated with multiple-cancer patients than with patients with esophageal cancer alone (62.5% vs. 7.1%). These results show that the 3 risk factors are important for the development of upper-aerodigestive-tract cancer in Japanese alcoholics. For these high-risk drinkers, regimented screening appears to be indicated.

Original languageEnglish
Pages (from-to)313-316
Number of pages4
JournalInternational Journal of Cancer
Volume68
Issue number3
DOIs
Publication statusPublished - 1996
Externally publishedYes

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Aldehyde Dehydrogenase
Alcoholics
Early Detection of Cancer
Drinking
Habits
Smoking
Genotype
Neoplasms
Esophageal Neoplasms
Alcoholic Beverages
Gastrointestinal Endoscopy
Acetaldehyde
Beverages
Gene Frequency
Iodine
Carcinogens
Stomach Neoplasms
Stomach
Logistic Models
Odds Ratio

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Cancer screening of upper aerodigestive tract in Japanese alcoholics with reference to drinking and smoking habits and aldehyde dehydrogenase-2 genotype. / Yokoyama, Akira; Ohmori, Tai; Muramatsu, Taro; Higuchi, Susumu; Yokoyama, Tetsuji; Matsushita, Sachio; Matsumoto, Michinaga; Maruyama, Katsuya; Hayashida, Motoi; Ishi, Hiromasa.

In: International Journal of Cancer, Vol. 68, No. 3, 1996, p. 313-316.

Research output: Contribution to journalArticle

Yokoyama, Akira ; Ohmori, Tai ; Muramatsu, Taro ; Higuchi, Susumu ; Yokoyama, Tetsuji ; Matsushita, Sachio ; Matsumoto, Michinaga ; Maruyama, Katsuya ; Hayashida, Motoi ; Ishi, Hiromasa. / Cancer screening of upper aerodigestive tract in Japanese alcoholics with reference to drinking and smoking habits and aldehyde dehydrogenase-2 genotype. In: International Journal of Cancer. 1996 ; Vol. 68, No. 3. pp. 313-316.
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abstract = "In this study, 1,000 Japanese male alcoholics were consecutively screened by upper gastrointestinal endoscopy with esophageal iodine staining. Associations among cancer-detection rates, drinking and smoking habits, and aldehyde dehydrogenase-2 (ALDH2) genotypes were evaluated. A total of 53 patients (5.3{\%}) had histologically confirmed cancer. Esophageal cancer was diagnosed in 36, gastric cancer in 17, and oropharyngolaryngeal cancer in 9 patients: 8 of the esophageal-cancer patients were multiple-cancer patients, with additional cancer(s) in the stomach and/or oropharyngolaryngeal region. Multiple logistic regression revealed that use of stronger alcoholic beverages (whisky or shochu) in contrast with lighter beverages (sake or beer) and smoking of 50 pack-years or more increased the risks for esophageal (odds ratio 3.2 and 2.8 respectively), oropharyngolaryngeal (4.8 and 5.1 respectively) and multiple cancer (10.5 and 11.8 respectively). The inactive form of ALDH2, encoded by the gene ALDH2*1/2*2 prevalent in Orientals, exposes them to higher blood levels of acetaldehyde, a recognized animal carcinogen, after drinking. This inactive ALDH2 was detected in 19/36 (52.8{\%}) patients with esophageal cancer, in 5/9 (55.6{\%}) patients with oropharyngolaryngeal cancer, and in 7/8 (87.5{\%}) patients with multiple cancer. All of these gene frequencies far exceeded that in a large alcoholic cohort (80/655, 12.2{\%}). The triple combination of the risk factors of the inactive ALDH2, stronger alcoholic beverages and heavy smoking was more commonly associated with multiple-cancer patients than with patients with esophageal cancer alone (62.5{\%} vs. 7.1{\%}). These results show that the 3 risk factors are important for the development of upper-aerodigestive-tract cancer in Japanese alcoholics. For these high-risk drinkers, regimented screening appears to be indicated.",
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AU - Yokoyama, Tetsuji

AU - Matsushita, Sachio

AU - Matsumoto, Michinaga

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