The Alcohol Use Disorders Identification Test and the risk of metachronous cancer after endoscopic resection of esophageal cancer
Year: 2020
Type: article
Study design: Observational Study
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.
Source: Carcinogenesis
Authors: 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
Institutions: Kurihama Medical and Addiction Center, Kitasato University Hospital, Kitasato University, National Institute of Public Health, Shizuoka Cancer Center, National Cancer Center Hospital East, National Cancer Center Hospital, Hokkaido University, Ishikawa Prefectural Central Hospital, Tohoku University, Osaka National Hospital, Okayama University, Kanagawa Cancer Center, SHOWA Medical University, Kumamoto Medical Center, Kumamoto Regional Medical Center, St. Marianna University School of Medicine, Keio University, Tochigi Cancer Center, Kyoto Prefectural University of Medicine, Kyoto University Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,835
OpenAlex ID: W3012520060