Alcohol consumption and digestive tract cancer.
OBJECTIVE
The data indicating that alcohol is an important factor increasing the risk to develop gastrointestinal cancer are consolidating. The purpose of this review is to summarize current evidence.


RESULTS
Acetaldehyde is the first metabolite of ethanol metabolism and has direct carcinogenic and mutagenic effects by modifying DNA via generation of DNA adducts. Oxidative stress has a prominent role in triggering chronic inflammation and carcinogenesis through formation of reactive oxygen species. Recently published large prospective cohort studies with sufficient statistical power and meta-analyses could refine the knowledge regarding the impact of alcohol on gastrointestinal cancer. Functional genetic variants of alcohol-metabolizing enzymes proved to be associated with increased risk for esophageal and gastric cancer.The highest risk increase for malignancy was observed in the upper aerodigestive tract (oral cavity, pharynx, larynx) and esophagus (squamous cell carcinoma), weaker correlations were established regarding gastric, pancreatic, and colorectal neoplasias.


CONCLUSIONS
Alcohol overconsumption is a serious avoidable risk factor for the development of gastrointestinal tract cancer, both alone but even more in combination with other risk factors such as tobacco and obesity.
Gastrocentrum, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Stephan L
SL
Haas
Weimin
W
Ye
Johannes-Matthias
JM
Löhr
D000079:Acetaldehyde / Q000378:metabolism; D000428:Alcohol Drinking / Q000009:adverse effects*; D000437:Alcoholism / Q000150:complications*; D004247:DNA / Q000187:drug effects; D000431:Ethanol / Q000009:adverse effects* / Q000378:metabolism; D005770:Gastrointestinal Neoplasms / Q000139:chemically induced* / Q000235:genetics / Q000378:metabolism; D041981:Gastrointestinal Tract / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000139:chemically induced; D018384:Oxidative Stress
D000431:Ethanol; D004247:DNA; D000079:Acetaldehyde