Joint Effects of Smoking and Alcohol Drinking on Esophageal Cancer Mortality in Japanese Men: Findings from the Japan Collaborative Cohort Study

Yaegashi, Yumi,Onoda, Toshiyuki,Morioka, Seiji,Hashimoto, Tsutomu,Takeshita, Tatsuya,Sakata, Kiyomi,Tamakoshi, Akiko Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.2

Background: The purpose of our study was to elucidate the joint effects of combined smoking and alcohol intake on esophageal cancer mortality in Japanese men through a large cohort study with a 20-year follow-up period. Materials and Methods: The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) was established in the late 1980s, including 46,395 men and 64,190 women aged 40 years and older and younger than 80. Follow-up of these participants was conducted until 2009. We used the Cox proportional hazards model to analyze data for 42,408 people excluding female participants, 411 people with histories of malignant neoplasms, and 3,576 with unclear smoking and drinking data. Results: The joint effects of age at start of smoking and amount of alcohol consumed per day were compared with non-smokers and non-drinkers or those consuming less than one unit of alcohol per day. The mortality risk was 9.33 (95% confidence interval, 2.55-34.2) for those who started smoking between ages 10 and 19 years and drinking at least three units of alcohol per day. Regarding the joint effects of cumulative amount of smoking and alcohol intake, the risk was high when both smoking and alcohol intake were above a certain level. Conclusions: In this Japanese cohort study, increased cancer mortality risks were observed, especially for people who both started smoking early and drank alcohol. Quitting smoking or not starting to smoke at any age and reducing alcohol consumption are important for preventing esophageal cancer in Japan.

Physical Activity and Bladder Cancer Risk: Findings of the Japan Collaborative Cohort Study

Hang An,Keyang Liu,Kokoro Shirai,Ryo Kawasaki,Akiko Tamakoshi,Hiroyasu Iso 대한암학회 2024 Cancer Research and Treatment Vol.56 No.2

Purpose The association of physical activity with the risk of bladder cancer remains inconsistent among Asian populations. We aimed to examine the association in a large Japanese cohort.Materials and Methods In a population-based prospective cohort study, a total of 50,374 Japanese adults aged 40-79 years without a history of cancer or cardiovascular disease who had information on physical activity from self-administrated questionnaires were used for analysis. We performed Cox proportional hazard models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident bladder cancer after adjusting for several potential confounders.Results During the median 17.5 years of follow-up, 153 incident bladder cancers (116 men and 37 women) were identified. After the multivariable adjustment, HRs (95% CI) of bladder cancer concerning those with recreational sports participation of 1-2 hr/wk, 3-4 hr/wk, and 5 hr/wk and more were 0.67 (0.38-1.20), 0.79 (0.36-1.74), and 0.28 (0.09-0.89), respectively (p for trend=0.017). Compared with mostly sitting at the workplace, occupational physical activity of standing and walking were associated with a lower risk of bladder cancer (HR, 0.53 [95% CI, 0.32 to 0.85]). Hours of daily walking were not associated with the risk. The lower risk of bladder cancer was more evident for recreational sports (HR, 0.33 [95% CI, 0.10 to 1.00]), and for occupational standing and walking activity at work (HR, 0.57 [95% CI, 0.33 to 0.98]) among men.Conclusion Recreational sports participation and occupational physical activity were inversely associated with the risk of bladder cancer among Japanese, especially in men.

Association between type 2 diabetes and risk of cancer mortality: a pooled analysis of over 771,000 individuals in the Asia Cohort Consortium

Chen, Yu,Wu, Fen,Saito, Eiko,Lin, Yingsong,Song, Minkyo,Luu, Hung N.,Gupta, Prakash C.,Sawada, Norie,Tamakoshi, Akiko,Shu, Xiao-Ou,Koh, Woon-Puay,Xiang, Yong-Bing,Tomata, Yasutake,Sugiyama, Kemmyo,Par Springer-Verlag 2017 Diabetologia Vol.60 No.6

<P>Diabetes was associated with a 26% increased risk of death from any cancer in Asians. The pattern of associations with specific cancers suggests the need for better control (prevention, detection, management) of the growing epidemic of diabetes (as well as obesity), in order to reduce cancer mortality.</P>

Diabetes Mellitus and Risk of Colorectal Cancer Mortality in Japan: the Japan Collaborative Cohort Study

Tan, Ce,Mori, Mitsuru,Adachi, Yasushi,Wakai, Kenji,Suzuki, Sadao,Suzuki, Koji,Hashimoto, Shuji,Watanabe, Yoshiyuki,Tamakoshi, Akiko Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.10

Objective: Our aim was to estimate whether diabetes mellitus (DM) may be associated with an increased risk of colorectal cancer (CRC) mortality in Japan. Methods: The Japan Collaborative Cohort (JACC) Study is a nationwide prospective study, initiated in 1988, which involves 110,585 subjects (age range: from 40 to 79 years; 46,395 males and 64,190 females). Our present analysis population comprised 96,081 (40,510 men and 55,571 women) who provided details on DM history. The questionnaire also included age, sex, weight, height, family history of CRC, smoking, drinking and exercise habits, and education. Cox proportional-hazard regression was used to estimate the hazard ratio (HR). We used SPSS 21 software to analyze all data. Results: Among the participants with DM, we followed up for 71,174 person-years and 640. deaths from CRC were confirmed; and, among the non-diabetic participants, 785 CRC deaths were identified during 1,499,324 person-years. After adjusting for multivariate confounding factors, such as age, sex, body mass index (BMI), family history of colorectal cancer, smoking habit, drinking habit, physical activity (sports and walking) and education, DM was associated with an increased risk of CRC death (HR 1.4, 95% confidence interval [CI] 1.0-2.0). Diabetic women, but not diabetic men, experienced increased mortality from CRC (HR 1.7, 95% CI 1.0-3.0). Conclusion: The risk of CRC mortality is significantly increased in both sexes and women with diabetes, but no significant increase was seen for diabetic men among Japanese.

Ovarian cancer mortality among women aged 40-79 years in relation to reproductive factors and body mass index: latest evidence from the Japan Collaborative Cohort study

Md. Mobarak Hossain Khan,Aklimunnessa Khan,Masahiro Nojima,Sadao Suzuki,Yoshihisa Fujino,Shinkan Tokudome,Koji Tamakoshi,Mitsuru Mori,Akiko Tamakoshi 대한부인종양학회 2013 Journal of Gynecologic Oncology Vol.24 No.3

Objective: This study mainly aimed to investigate the association of ovarian cancer mortality with reproductive factors and body mass index among Japanese women aged 40-79 years. Methods: The source of the data was the Japan Collaborative Cohort (JACC) study which covered the period of 1988 to 2009. A representative sample of 64,185 women was used. Cox model was used to estimate the relative risk (RR) and 95% confidence interval (CI). Results: The total number of ovarian cancer deaths was 98, with a mortality rate of 9.30 per 100,000 person-years. Women with single marital status revealed significantly higher age-adjusted RR (RR, 4.11; 95% CI, 1.66 to 10.23; p=0.005) as compared to married women. The effect of single marital status was stronger among older women aged 50+ years (RR, 4.58; 95% CI, 1.65 to 12.72; p=0.003) than younger women. An elevated risk was found for both nulliparous and nullipregnant women. Similarly, an increased risk of ovarian cancer mortality was estimated among overweight among aged 50 years or less. Conclusion: Out of many factors only single marital status indicated a higher risk for ovarian cancer mortality. All other factors provided inconclusive results, which imply further epidemiological investigations.

Television Viewing Time and the Risk of Colorectal Cancer Mortality among Japanese Population: The JACC Study

Yuting Li,Ehab S. Eshak,Renzhe Cui,Kokoro Shirai,Keyang Liu,Hiroyasu Iso,Satoyo Ikehara,Akiko Tamakoshi,Shigekazu Ukawa,JACC Study Group 대한암학회 2021 Cancer Research and Treatment Vol.53 No.2

Purpose Sedentary behavior attributes to the increased risk of some cancers and all-cause mortality. The evidence is limited for the association between television (TV) viewing time, a major sedentary behavior, and risk of colorectal cancer death. We aimed to examine this association in Japanese population. Materials and Methods A prospective cohort study encompassed of 90,834 men and women aged 40-79 years with no prior history of colorectal cancer who completed a self-administered food frequency questionnaire, and provided their TV viewing information. The participants were followed-up from 1988-1990 to the end of 2009. The hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by the Cox proportional hazard regression for risk of colorectal cancer mortality according to TV viewing time. Results During the median 19.1-year follow-up period, we documented 749 (385 men and 364 women) colorectal cancer deaths. The multivariable-adjusted HRs for mortality from colorectal cancer were 1.11 (0.88-1.41) for 1.5 to < 3 hr/day, 1.14 (0.91-1.42) for 3 to < 4.5 hr/day and 1.33 (1.02-1.73) for ≥ 4.5 hr/day in comparison to < 1.5 hr/day TV watching; p-trend=0.038, and that for 1-hour increment in TV viewing time was 1.06 (1.01-1.11). Moreover, the multivariable-adjusted HR (95% CI) of colon cancer for 1-hour increment in TV viewing time was 1.07 (1.02-1.13). Age, body mass index, and level of leisure-physical activity did not show significant effect modifications on the observed associations. Conclusion TV viewing time is associated with the increased risk of colorectal cancer mortality among Japanese population, more specifically colon rather than rectal cancer.

Television Viewing Time and Breast Cancer Incidence for Japanese Premenopausal and Postmenopausal Women: The JACC Study

Jinhong Cao,Ehab Salah Eshak,Keyang Liu,Isao Muraki,Renzhe Cui,Hiroyasu Iso,Akiko Tamakoshi 대한암학회 2019 Cancer Research and Treatment Vol.51 No.4

Purpose The evidence on effects of TV viewing time among premenopausal and postmenopausal women for breast cancer risk remains controversial and limited. Materials and Methods A prospective study encompassing 33,276 (17,568 premenopausal, and 15,708 postmenopausal) women aged 40-79 years in whom TV viewing time, menstrual, and reproductive histories were determined by a self-administered questionnaire. The follow-up was from 1988 to 2009 and hazard ratios (HRs) with 95% confidence intervals (CIs) of breast cancer incidence were calculated for longer TV viewing time in reference to shorter TV viewing time by Cox proportional hazard models. Results During 16.8-year median follow-up, we found positive associations between TV viewing time and breast cancer incidence with a borderline significant trend among total women and a significant trend among postmenopausal women. Among total women, the multivariable HRs (95% CIs) for risk of breast cancer in reference to < 1.5 hr/day of TV viewing time were 0.89 (0.59-1.34) for 1.5 to < 3.0 hr/day, 1.19 (0.82-1.74) for 3.0 to < 4.5 hr/day, and 1.45 (0.91-2.32) for  4.5 hr/day (p for trend=0.053) and among postmenopausal women, the corresponding risk estimates were 1.10 (0.42-2.88), 2.54 (1.11-5.80), and 2.37 (0.92-6.10) (p for trend=0.009), respectively. Conclusion Prolonged TV viewing time was associated with increased risk of breast cancer, especially among postmenopausal women.

Weight Gain and Alcohol Drinking Associations with Breast Cancer Risk in Japanese Postmenopausal Women - Results from the Japan Collaborative Cohort (JACC) Study

Nitta, Junichi,Nojima, Masanori,Ohnishi, Hirofumi,Mori, Mitsuru,Wakai, Kenji,Suzuki, Sadao,Fujino, Yoshihisa,Lin, Yingsong,Tamakoshi, Koji,Tamakoshi, Akiko Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.3

Background: We investigated four factors, height, weight gain since age 20, physical activity, and alcohol drinking, for associations with risk of breast cancer (BC) according to menopausal status, using the latest data of the Japan Collaborative Cohort Study (JACC Study). Materials and Methods: We confined the analysis to 24 areas available of cancer incidence information, excluding women with a previous diagnosis of BC. Baseline data were collected from 38,610 (9,367 premenopausal, and 29,243 postmenopausal) women during 1988 and 1990. The study subjects were followed-up at the end of 2009, and 273 (84 premenopausal, and 189 postmenopausal) cases of BC were newly diagnosed in 501,907 person-years. The Cox model was used to estimate a hazards ratio (HR) and its 95% confidence interval (CI) of BC risk. Results: As a result of the multivariate analysis adjusting for age at baseline survey, age at menarche, number of live births, and, age at first delivery, weight gain since age 20 of 6.7 kg-9.9 kg, and ${\geq}10.0kg$ were significantly associated with increased risk for postmenopausal BC (HR=2.48, 95% CI 1.40-4.41, and, HR=2.94, 95% CI 1.84-4.70, respectively). Significantly increased trend of BC risk was also observed in weight gain since age 20 (p for trend, p<0.001). Amount of ethanol intake per day${\geq}15.0g$ was significantly associated with increased risk for postmenopausal BC in the multivariable-adjusted analysis (HR=2.74, 95% CI 1.32-5.70). Conclusions: Higher weight gain in adulthood and larger amounts of ethanol intake were significantly associated with increased risk of BC in Japanese postmenopausal women. None of the investigated factors were significantly associated with BC risk in Japanese premenopausal women.

Risk Factors for Upper and Lower Urinary Tract Cancer Death in a Japanese Population: Findings from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study)

Washio, Masakazu,Mori, Mitsuru,Mikami, Kazuya,Miki, Tsuneharu,Watanabe, Yoshiyuki,Nakao, Masahiro,Kubo, Tatsuhiko,Suzuki, Koji,Ozasa, Kotaro,Wakai, Kenji,Tamakoshi, Akiko Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.7

Background: The incidence of bladder cancer is lower in Asian than in Western countries. However, the crude incidence and mortality of bladder cancer have recently increased in Japan because of the increased number of senior citizens. We have already reported risk factors for urothelial cancer in a large population-based cohort study in Japan (JACC study). However, we did not evaluate the cancer risk in the upper and lower urinary tract separately in our previous study. Materials and Methods: Here we evaluated the risk of cancer death in the upper and lower urinary tracts, separately, using the database of the JACC study. The analytic cohort included 46,395 males and 64,190 females aged 40 to 79 years old. The Cox proportional hazard model was used to determine hazard ratios and their 95% confidence intervals. Results: Current smoking increased the risk of both upper and lower urinary tract cancer deaths. A history of kidney disease was associated with an increased risk of bladder cancer death, even after controlling for age, sex and smoking status. Conclusions: The present study confirmed that current smoking increases the risk of both upper and lower urinary tract cancer deaths and indicated the possibility that a history of kidney disease may be a risk factor for bladder cancer death in the Japanese population.

Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts

Zheng, Wei,McLerran, Dale F.,Rolland, Betsy A.,Fu, Zhenming,Boffetta, Paolo,He, Jiang,Gupta, Prakash Chandra,Ramadas, Kunnambath,Tsugane, Shoichiro,Irie, Fujiko,Tamakoshi, Akiko,Gao, Yu-Tang,Koh, Woon Public Library of Science 2014 PLoS medicine Vol.11 No.4

<▼1><P>Wei Zheng and colleagues quantify the burden of tobacco-smoking-related deaths for adults in Asia.</P><P><I>Please see later in the article for the Editors' Summary</I></P></▼1><▼2><P><B>Background</B></P><P>Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest.</P><P><B>Methods and Findings</B></P><P>We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan—accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37–1.51) and 1.48-fold (1.38–1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%–17.2%) and 3.3% (2.6%–4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000–1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: a 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.</P><P><B>Conclusions</B></P><P>Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented.</P><P><I>Please see later in the article for the Editors' Summary</I></P></▼2><▼3><P><B>Editors' Summary</B></P><P><B>Background</B></P><P>Every year, more than 5 million smokers die from tobacco-related diseases. Tobacco smoking is a major risk factor for cardiovascular disease (conditions that affect the heart and the circulation), respiratory disease (conditions that affect breathing), lung cancer, and several other types of cancer. All told, tobacco smoking kills up to half its users. The ongoing global “epidemic” of tobacco smoking and tobacco-related diseases initially affected people living in the US and other Western countries, where the prevalence of smoking (the proportion of the population that smokes) in men began to rise in the early 1900s, peaking in the 1960s. A similar epidemic occurred in women about 40 years later. Smoking-related deaths began to increase in the second half of the 20th century, and by the 1990s, tobacco smoking accounted for a third of all deaths and about half of cancer deaths among men in the US and other Western countries. More recently, increased awareness of the risks of smoking and the introduction of various tobacco control measures has led to a steady decline in tobacco use and in smoking-related diseases in many developed countries.</P><P><B>Why Was This Study Done?</B></P><P>Unfortunately, less well-developed tobacco control programs, inadequate public awareness of smoking risks, and tobacco company marketing have recently led to sharp increases in the prevalence of smoking in many low- and middle-income countries, particularly in Asia. More than 50% of men in many Asian countries are now smokers, about tw