title: Estimates of alcohol-related oesophageal cancer burden in Japan: systematic review and meta-analyses.
abstract: OBJECTIVE
  To refine estimates of the burden of alcohol-related oesophageal cancer in Japan.
  
  
  METHODS
  We searched PubMed for published reviews and original studies on alcohol intake, aldehyde dehydrogenase polymorphisms, and risk for oesophageal cancer in Japan, published before 2014. We conducted random-effects meta-analyses, including subgroup analyses by aldehyde dehydrogenase variants. We estimated deaths and loss of disability-adjusted life years (DALYs) from oesophageal cancer using exposure distributions for alcohol based on age, sex and relative risks per unit of exposure.
  
  
  RESULTS
  We identified 14 relevant studies. Three cohort studies and four case-control studies had dose-response data. Evidence from cohort studies showed that people who consumed the equivalent of 100 g/day of pure alcohol had an 11.71 fold, (95% confidence interval, CI: 2.67-51.32) risk of oesophageal cancer compared to those who never consumed alcohol. Evidence from case-control studies showed that the increase in risk was 33.11 fold (95% CI: 8.15-134.43) in the population at large. The difference by study design is explained by the 159 fold (95% CI: 27.2-938.2) risk among those with an inactive aldehyde dehydrogenase enzyme variant. Applying these dose-response estimates to the national profile of alcohol intake yielded 5279 oesophageal cancer deaths and 102,988 DALYs lost - almost double the estimates produced by the most recent global burden of disease exercise.
  
  
  CONCLUSIONS
  Use of global dose-response data results in an underestimate of the burden of disease from oesophageal cancer in Japan. Where possible, national burden of disease studies should use results from the population concerned.
authors.affiliation: Centre for Addiction and Mental Health (CAMH), Social and Epidemiological Research Department, Room T523, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada .
authors.forename: Michael
authors.initials: M
authors.lastname: Roerecke
authors.affiliation: Centre for Addiction and Mental Health (CAMH), Social and Epidemiological Research Department, Room T523, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada .
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Shield
authors.affiliation: National Hospital Organization, Kurihama Medical and Addiction Center, Yokosuka, Japan .
authors.forename: Susumu
authors.initials: S
authors.lastname: Higuchi
authors.affiliation: National Hospital Organization, Kurihama Medical and Addiction Center, Yokosuka, Japan .
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshimura
authors.affiliation: Centre for Addiction and Mental Health (CAMH), Social and Epidemiological Research Department, Room T523, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada .
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Larsen
authors.affiliation: Ryerson University, Toronto, Canada .
authors.forename: Maximilien X
authors.initials: MX
authors.lastname: Rehm
authors.affiliation: Centre for Addiction and Mental Health (CAMH), Social and Epidemiological Research Department, Room T523, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada .
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D000426:Alcohol Dehydrogenase / Q000009:adverse effects* / Q000235:genetics; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D000431:Ethanol / Q000009:adverse effects; D006801:Humans; D007564:Japan / Q000453:epidemiology; D019057:Quality-Adjusted Life Years; D012307:Risk Factors
chemical_list: D000431:Ethanol; D000426:Alcohol Dehydrogenase