Alcohol as a Risk Factor for Cancer: Existing Evidence in a Global Perspective

Elisabete Weiderpass,Nina Roswall 대한예방의학회 2015 Journal of Preventive Medicine and Public Health Vol.48 No.1

The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization’s prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.

Lifestyle and Cancer Risk

Elisabete Weiderpass 대한예방의학회 2010 Journal of Preventive Medicine and Public Health Vol.43 No.6

The main behavioural and environmental risk factors for cancer mortality in the world are related to diet and physical inactivity, use of addictive substances, sexual and reproductive health, exposure to air pollution and use of contaminated needles. The population attributable fraction for all cancer sites worldwide considering the joint effect of these factors is about 35% (34 % for low- and middle-income countries and 37% for high-income countries). Seventy-one percent of lung cancer deaths are caused by tobacco use (lung cancer is the leading cause of cancer death globally). The combined effects of tobacco use, low fruit and vegetable intake, urban air pollution, and indoor smoke from household use of solid fuels cause 76% of lung cancer deaths. Exposure to these behavioural and environmental factors is preventable;modifications in lifestyle could have a large impact in reducing the cancer burden worldwide. The evidence of association between lifestyle factors and cancer, as well as the main international recommendations for prevention are briefly reviewed and commented upon here.

Malignant Tumors of the Female Reproductive System

Weiderpass, Elisabete,Labreche, France Occupational Safety and Health Research Institute 2012 Safety and health at work Vol.3 No.3

This review summarizes the epidemiology of cancer of the female reproductive system and associated lifestyle factors. It also assesses the available evidence for occupational factors associated with these cancers. Cervical, endometrial, and ovarian cancers are relatively common, and cause significant cancer morbidity and mortality worldwide, whereas vulvar, vaginal, fallopian tube cancers, and choriocarcinomas are very rare. As several lifestyle factors are known to play a major role in the etiology of these cancers, very few published studies have investigated possible relationships with occupational factors. Some occupational exposures have been associated with increased risks of these cancers, but apart from the available evidence on the relationships between asbestos fibers and ovarian cancer, and tetrachloroethylene and cervical cancer, the data is rather scarce. Given the multifactorial nature of cancers of the female reproductive system, it is of the utmost importance to conduct occupational studies that will gather detailed data on potential individual confounding factors, in particular reproductive history and other factors that influence the body's hormonal environment, together with information on socio-economic status and lifestyle factors, including physical activity from multiple sources. Studies on the mechanisms of carcinogenesis in the female reproductive organs are also needed in order to elucidate the possible role of chemical exposures in the development of these cancers.

Lifestyle and Cancer Risk

Weiderpass, Elisabete The Korean Society for Preventive Medicine 2010 Journal of Preventive Medicine and Public Health Vol.43 No.6

The main behavioural and environmental risk factors for cancer mortality in the world are related to diet and physical inactivity, use of addictive substances, sexual and reproductive health, exposure to air pollution and use of contaminated needles. The population attributable fraction for all cancer sites worldwide considering the joint effect of these factors is about 35% (34 % for low- and middle-income countries and 37% for high-income countries). Seventy-one percent of lung cancer deaths are caused by tobacco use (lung cancer is the leading cause of cancer death globally). The combined effects of tobacco use, low fruit and vegetable intake, urban air pollution, and indoor smoke from household use of solid fuels cause 76% of lung cancer deaths. Exposure to these behavioural and environmental factors is preventable; modifications in lifestyle could have a large impact in reducing the cancer burden worldwide. The evidence of association between lifestyle factors and cancer, as well as the main international recommendations for prevention are briefly reviewed and commented upon here.

Risk Factors for Breast Cancer, Including Occupational Exposures

Weiderpass, Elisabete,Meo, Margrethe,Vainio, Harri Occupational Safety and Health Research Institute 2011 Safety and health at work Vol.2 No.1

The knowledge on the etiology of breast cancer has advanced substantially in recent years, and several etiological factors are now firmly established. However, very few new discoveries have been made in relation to occupational risk factors. The International Agency for Research on Cancer has evaluated over 900 different exposures or agents to-date to determine whether they are carcinogenic to humans. These evaluations are published as a series of Monographs (www.iarc.fr). For breast cancer the following substances have been classified as "carcinogenic to humans" (Group 1): alcoholic beverages, exposure to diethylstilbestrol, estrogen-progestogen contraceptives, estrogen-progestogen hormone replacement therapy and exposure to X-radiation and gamma-radiation (in special populations such as atomic bomb survivors, medical patients, and in-utero exposure). Ethylene oxide is also classified as a Group 1 carcinogen, although the evidence for carcinogenicity in epidemiologic studies, and specifically for the human breast, is limited. The classification "probably carcinogenic to humans" (Group 2A) includes estrogen hormone replacement therapy, tobacco smoking, and shift work involving circadian disruption, including work as a flight attendant. If the association between shift work and breast cancer, the most common female cancer, is confirmed, shift work could become the leading cause of occupational cancer in women.

Endometrial cancer in relation to coffee, tea, and caffeine consumption: a prospective cohort study among middle-aged women in Sweden.

Weiderpass, Elisabete,Sandin, Sven,Lof, Marie,Oh, Jin-Kyoung,Inoue, Manami,Shimazu, Taichi,Tsugane, Shoichiro,Adami, Hans-Olov Lawrence Erlbaum Associates, Publishers [etc.] 2014 Nutrition and cancer Vol.66 No.7

<P>This study aimed to add to prospective data on the possible inverse association between coffee consumption and endometrial cancer risk, already supported by several case-control studies. Coffee and tea consumption and possible confounding factors were assessed among 42,270 women aged 30-49 years at enrollment in 1991-1992 in the Swedish Women's Lifestyle and Health cohort study, with complete follow-up through 2009. We calculated caffeine intake per day; Cox proportional hazard models were used to estimate multivariable relative risks (mRR) for endometrial cancer with 95% confidence intervals (CIs). One hundred forty-four endometrial cancers were diagnosed during follow-up. Women with and without endometrial cancer had a similar mean daily coffee consumption (549 vs. 547 g), tea consumption (104 vs. 115 g), and caffeine intake (405 vs. 406 mg). Compared to those consuming <2 cups of coffee per day, women consuming >3 cups had a mRR of 1.56 (95% CI: 0.94-2.59; P for trend = 0.17). Compared with the lowest tertile of caffeine intake, the highest tertile had a mRR of 1.32 (95% CI: 0.87-1.99; P for trend = 0.27). Our study provides no convincing evidence of an association between coffee consumption, tea consumption, or caffeine intake and endometrial cancer risk among middle-aged women.</P>

엘리사베트 A. 실바(Elisabete A. Silva)_적응형 도시계획을 향하여

권희서,엘리사베트 A. 실바(Elisabete A. Silva) 국토연구원 2018 국토 : planning and policy Vol.437 No.-

ON THE IMPORTANCE OF USING APPROPRIATE SPECTRAL MODELS TO DERIVE PHYSICAL PROPERTIES OF GALAXIES

PACIFICI, CAMILLA,DA CUNHA, ELISABETE,CHARLOT, STEPHANE,YI, SUKYOUNG The Korean Astronomical Society 2015 天文學論叢 Vol.30 No.2

Interpreting ultraviolet-to-infrared (UV-to-IR) observations of galaxies in terms of constraints on physical parameters-such as stellar mass ($M_{\ast}$) and star formation rate (SFR)-requires spectral synthesis modelling. We investigate how increasing the level of sophistication of the standard simplifying assumptions of such models can improve estimates of galaxy physical parameters. To achieve this, we compile a sample of 1048 galaxies at redshifts 0.7 < z < 2.8 with accurate photometry at rest-frame UV to near-IR wavelengths from the 3D-HST Survey. We compare the spectral energy distributions of these galaxies with those from different model spectral libraries to derive estimates of the physical parameters. We find that spectral libraries including sophisticated descriptions of galaxy star formation histories (SFHs) and prescriptions for attenuation by dust and nebular emission provide a much better representation of the observations than 'classical' spectral libraries, in which galaxy SFHs are assumed to be exponentially declining functions of time, associated with a simple prescription for dust attenuation free of nebular emission. As a result, for the galaxies in our sample, $M_{\ast}$ derived using classical spectral libraries tends to be systematically overestimated and SFRs systematically underestimated relative to the values derived adopting a more realistic spectral library. We conclude that the sophisticated approach considered here is required to reliably interpret fundamental diagnostics of galaxy evolution.

Alcohol as a Risk Factor for Cancer: Existing Evidence in a Global Perspective

Roswall, Nina,Weiderpass, Elisabete The Korean Society for Preventive Medicine 2015 Journal of Preventive Medicine and Public Health Vol.48 No.1

The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization's prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.

Association between Body Mass Index and Gastric Cancer Risk According to Effect Modification by Helicobacter pylori Infection

장지은,조은정,황윤지,Elisabete Weiderpass,안충현,최정빈,장성훈,Hai-Rim Shin,임민경,유근영,박수경 대한암학회 2019 Cancer Research and Treatment Vol.51 No.3

Purpose Few studies investigated roles of body mass index (BMI) on gastric cancer (GC) risk according to Helicobacter pylori infection status. This study was conducted to evaluate associations between BMI and GC risk with consideration of H. pylori infection information. Materials and Methods We performed a case-cohort study (n=2,458) that consists of a subcohort (n=2,193 including 67 GC incident cases) randomly selected from the Korean Multicenter Cancer Cohort (KMCC) and 265 incident GC cases outside of the subcohort. H. pylori infection was assessed using an immunoblot assay. GC risk according to BMI was evaluated by calculating hazard ratios (HRs) and their 95% confidence intervals (95% CIs) using weighted Cox hazard regression model. Results Increased GC risk in lower BMI group (< 23 kg/m2) with marginal significance (HR, 1.32; 95% CI, 0.98 to 1.77) compared to the reference group (BMI of 23-24.9 kg/m2) was observed. In the H. pylori non-infection, both lower (< 23 kg/m2) and higher BMI (! 25 kg/m2) showed non-significantly increased GC risk (HR, 10.82; 95% CI, 1.25 to 93.60 and HR, 11.33; 95% CI, 1.13 to 113.66, respectively). However, these U-shaped associations between BMI and GC risk were not observed in the group who had ever been infected by H. pylori. Conclusion This study suggests the U-shaped associations between BMI and GC risk, especially in subjects who had never been infected by H. pylori.