The Alcohol Use Disorders Identification Test and the risk of metachronous cancer after endoscopic resection of esophageal cancer

Akira Yokoyama, Chikatoshi Katada, Tetsuji Yokoyama, Kohei Takizawa, Tomonori Yano, Ichiro Oda, Yuichi Shimizu, Hiroyoshi Nakanishi, Tomoyuki Koike, Motohiro Hirao, Hiroyuki Okada, Takako Yoshii, Atsushi Katagiri, Takenori Yamanouchi, Yasumasa Matsuo, Hirofumi Kawakubo, Nozomu Kobayashi, Hideki Ishikawa, Manabu Muto

Research output: Contribution to journalArticle

Abstract

Follow-up studies of Japanese patients who had undergone endoscopic resection (ER) for early esophageal squamous cell carcinoma (ESCC) have reported a high prevalence of metachronous SCC in the upper aerodigestive tract (UAT). This prospective multicenter cohort study followed up 330 Japanese patients after ER of ESCC for a median of 49.4 months. The Alcohol Use Disorders Identification Test (AUDIT) for the 12-month period prior to study registration revealed high frequencies of high-risk drinking behaviors: 84 (25.4%) subjects had AUDIT scores of ≥15 points (suspected alcohol dependence) and 121 (36.7%) subjects had AUDIT scores of 8-14 points (hazardous drinking). Seventy-four subjects were metachronously diagnosed with ESCC, and 20 subjects with head and neck SCC (HNSCC). AUDIT scores ≥15 were associated with increases in the total number of HNSCCs per 100 person-years (0.4 for 0-7, 1.2 for 8-14 and 7.1 for ≥15; P < 0.0001). AUDIT scores were progressively associated with the grade of esophageal Lugol-voiding lesions (LVLs), a predictor of field cancerization in the UAT. Both an AUDIT score of ≥15 points and the presence of multiple LVLs were independent predictors of metachronous HNSCC [multivariate hazard ratio (95% confidence interval) = 6.98 (1.31-37.09) and 3.19 (1.19-8.54), respectively]. However, a high AUDIT score was not a predictor of metachronous ESCC. In conclusion, high AUDIT scores were markedly frequent in this population and increased the risk of metachronous HNSCC. The assessment of drinking behavior using the AUDIT and the completion of interventions for alcohol problems should be incorporated into the treatment strategy of ESCC. The name of the clinical trial register and the clinical trial registration number: Japan Esophageal Cohort Study, UMIN000001676.

Original languageEnglish
Pages (from-to)1049-1056
Number of pages8
JournalCarcinogenesis
Volume41
Issue number8
DOIs
Publication statusPublished - 2020 Aug 12

ASJC Scopus subject areas

  • Cancer Research

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  • Cite this

    Yokoyama, A., Katada, C., Yokoyama, T., Takizawa, K., Yano, T., Oda, I., Shimizu, Y., Nakanishi, H., Koike, T., Hirao, M., Okada, H., Yoshii, T., Katagiri, A., Yamanouchi, T., Matsuo, Y., Kawakubo, H., Kobayashi, N., Ishikawa, H., & Muto, M. (2020). The Alcohol Use Disorders Identification Test and the risk of metachronous cancer after endoscopic resection of esophageal cancer. Carcinogenesis, 41(8), 1049-1056. https://doi.org/10.1093/carcin/bgaa022