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Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis
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Seunghee Jun, Hyunjin Park, Ui-Jeong Kim, Eun Jeong Choi, Hye Ah Lee, Bomi Park, Soon Young Lee, Sun Ha Jee, Hyesook Park
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Epidemiol Health. 2023;e2023092. Published online October 16, 2023
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DOI: https://doi.org/10.4178/epih.e2023092
[Accepted]
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Abstract
OBJECTIVES Alcohol consumption is a well-established risk factor for cancer. Despite extensive research into the relationship between alcohol consumption and cancer risk, the effect of light alcohol consumption on cancer risk remains a topic of debate. To contribute to this discourse, we conducted a comprehensive systematic review and meta-analysis.
METHODS Our systematic review aimed to investigate the associations between different levels of alcohol consumption and the risk of several cancer types. We focused on analyzing prospective associations using data from 139 cohort studies. Among them, 106 studies were included in the meta-analysis after a quantitative synthesis.
RESULTS Our analysis did not find a significant association between light alcohol consumption and all-cause cancer risk (relative risk [RR]=1.02; 95% confidence interval [CI] 0.99–1.04), but we observed a dose-response relationship. Light alcohol consumption was significantly associated with higher risks of esophageal, colorectal, and breast cancers. Light to moderate drinking was associated with elevated risks of esophageal, colorectal, laryngeal, and breast cancers. Heavy drinking was also found to contribute to the risk of stomach, liver, pancreas, and prostate cancers, thereby increasing the risk of almost all types of cancer. Additionally, women generally had lower cancer risks compared to men.
CONCLUSIONS Our findings highlight that cancer risks extend beyond heavy alcohol consumption to include light alcohol consumption as well. These findings suggest that there is no safe level of alcohol consumption associated with cancer risk. Our results underscore the importance of public health interventions addressing alcohol consumption to mitigate cancer risks.
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Summary
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Multimorbidity adjusted years lost to disability rates calculated through Monte-Carlo simulation in Korea
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Yoonhee Shin
, Eun Jeong Choi , Bomi Park , Hye Ah Lee , Eun-Kyung Lee , Hyesook Park
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Epidemiol Health. 2022;44:e2022090. Published online October 17, 2022
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DOI: https://doi.org/10.4178/epih.e2022090
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OBJECTIVES To efficiently utilize limited health and medical resources, it is necessary to accurately measure the level of health, which requires estimating the multimorbidity-corrected burden of disease.
METHODS This study used 2015 and 2016 data from the National Health Insurance Service, and employed the list of diseases defined in a Korean study of the burden of disease, the criteria for prevalence, and the “cause–sequelae–health state” disease system. When calculating the years lost to disability (YLD), multimorbidity was corrected using Monte-Carlo simulation.
RESULTS Correcting for multimorbidity changed YLD at all ages in Korea by -1.2% (95% confidence interval [CI], -24.1 to 3.6) in males and -12.4% (95% CI, -23.0 to 0.3) in females in 2015, and by -10.8% (95% CI, -24.1 to 4.6) in males and -11.1% (95% CI, -22.8 to 1.7) in females in 2016. The YLD rate for non-communicable diseases in males decreased more than that of other disease groups in both years, by -11.8% (95% CI, -19.5 to 3.6) and -11.5% (95% CI, -19.3 to -3.0), respectively. The overall YLD rate changed by -1.3% in the 5-year to 9-year age group, and the magnitude of this change remained similar until the 10-19-year age group, gradually decreased after 20 years of age, and steeply increased to more than 10% in those aged 60 and older.
CONCLUSIONS Calculations of YLD should adjust for multimorbidity, as the disease burden can otherwise be overestimated for the elderly, who tend to exhibit a high prevalence of multimorbidity.
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Summary
Korean summary
복합질환 유병률이 증가됨에 따라 인구의 건강수준 측정 시 복합질환을 고려하는 것은 중요하다. 이에 본 연구에서는 복합질환 유병상태를 고려한 YLD(장애로 인한 손실년수)를 산출하고, 복합질환 유병상태를 고려하지 않고 산출한 YLD값과 비교하여 질병부담 산출 시 복합질환 유병상태를 보정하는 것의 효과 크기를 추정하였다. 복합질환의 유병률이 높은 노령층에서 복합질환을 고려하지 않고 YLD를 계산 할 경우 질병부담이 과대 추정될 수 있어, 복합질환을 보정하여 YLD를 산출하는 것이 필요하다.
Key Message
For the elderly whose disease burden can be overestimated, the multimorbidity should be adjusted during YLD calculations.
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Cohort profile: the Ewha Birth and Growth Study
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Hye Ah Lee
, Bohyun Park , Jungwon Min , Eun Jeong Choi , Ui Jeong Kim , Hyun Jin Park , Eun Ae Park , Su Jin Cho , Hae Soon Kim , Hwayoung Lee , Young Ju Kim , Young Sun Hong , Eui-Jung Kim , Eun Hee Ha , Hyesook Park
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Epidemiol Health. 2021;43:e2021016. Published online February 22, 2021
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DOI: https://doi.org/10.4178/epih.e2021016
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Abstract
With the introduction of life-course epidemiology, researchers realized the importance of identifying risk factors in early life to prevent chronic diseases. This led to the establishment of the Ewha Birth and Growth Study in 2001; the study is a prospective birth cohort designed to provide evidence of early life risk factors for a child’s growth and health. Participants were recruited from those who visited Ewha Womans University Mokdong Hospital (a tertiary hospital in southwest Seoul, Korea) for prenatal care at 24-28 weeks of gestation. In total, 891 mothers enrolled in this study between 2001 and 2006 and their offspring (n=940) were followed-up. Regular check-up examinations of offspring were conducted at 3 years, 5 years, and 7 years of age and every year thereafter. To consider age-related health issues, extensive data were collected using questionnaires and measurements. In 2021, the study subjects will reach 19 years of age, and we are planning a check-up examination for early adulthood. About 20 years have passed since the cohort data were collected, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. Recently, we started reporting on topics related to adolescent health. The findings will facilitate identification of early life risk factors for chronic diseases and the development of interventions for diseases later in life.
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Summary
Korean summary
이화영아성장코호트는 만성질환 예방을 위한 생애초기 위험인자에 대한 근거를 제공하기 위해 2001년에 시작되었습니다. 이화영아성장코호트는 국내에서 선도적인 장기 추적관찰 연구로, 소아기 건강과 관련된 산전 및 출생 시 특징, 소아기 대사와 관련된 유전적 혹은 후성학적 특성, 내분비 장애물질 노출에 따른 영향, 소아기의 식이패턴과 같은 다양한 연구결과들을 발표하였습니다. 추후 청년기의 자료 수집을 계획하고 있으며, 우리의 연구결과는 만성질환 예방을 위한 중재 개발에 기여할 것으로 기대됩니다.
Key Message
To provide evidence of early life risk factors for the prevention of chronic diseases, the Ewha Birth and Growth Study was started in 2001. The Ewha Birth and Growth cohort is a leading long-term follow-up study in Korea, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. We are planning to collect data for early adulthood, and our findings will contribute to the development of interventions to prevent chronic diseases.
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Citations
Citations to this article as recorded by 
- Prospective association between phthalate exposure in childhood and liver function in adolescence: the Ewha Birth and Growth Cohort Study
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