title: Alcohol consumption and cancer of the gastrointestinal tract.
abstract: Excessive alcohol consumption and heavy smoking are the main risk factors for upper digestive tract cancers. Cancer risk is dose-dependent and alcohol and smoking have synergistic effects. Alcohol is not carcinogenic. However, its first metabolite-acetaldehyde-has recently been shown to be a local carcinogen in humans. Microbes representing normal human gut flora are able to produce acetaldehyde from ethanol. This results in high local acetaldehyde concentrations in the saliva and contents of the large intestine. Asian heavy drinkers with a genetic deficiency for detoxifying acetaldehyde form an exceptional human 'knockout' model for long-term acetaldehyde exposure. The risk of alcohol-related digestive tract cancers is particularly high among this population. All mechanisms that have an effect on salivary or intracolonic acetaldehyde concentration are of importance. The message for prevention is that one should take care to have good oral hygiene and to avoid smoking, heavy drinking and drinking to intoxication.
authors.affiliation: Research Unit of Substance Abuse Medicine, University Central Hospital of Helsinki, Biomedicum Helsinki, PL 700, 00029 HUS, Helsinki, Finland. mikko.salaspuro@helsinki.fi
authors.forename: Mikko P
authors.initials: MP
authors.lastname: Salaspuro
mesh_terms: D000079:Acetaldehyde / Q000378:metabolism / Q000633:toxicity; D000426:Alcohol Dehydrogenase / Q000235:genetics; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D000444:Aldehyde Dehydrogenase / Q000172:deficiency / Q000235:genetics; D000818:Animals; D016022:Case-Control Studies; D015331:Cohort Studies; D004064:Digestive System / Q000378:metabolism / Q000382:microbiology; D004067:Digestive System Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D000431:Ethanol / Q000378:metabolism / Q000633:toxicity; D005838:Genotype; D006801:Humans; D009910:Oral Hygiene; D012306:Risk; D012307:Risk Factors; D012463:Saliva / Q000378:metabolism; D012907:Smoking / Q000009:adverse effects; D013695:Temperance
chemical_list: D000431:Ethanol; D000426:Alcohol Dehydrogenase; D000444:Aldehyde Dehydrogenase; D000079:Acetaldehyde