Alcohol rehabilitation and cancer risk: a nationwide hospital cohort study in France.

IF 25.4 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Lancet Public Health Pub Date : 2024-07-01 DOI:10.1016/S2468-2667(24)00107-5
Michaël Schwarzinger, Carina Ferreira-Borges, Maria Neufeld, François Alla, Jürgen Rehm
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Abstract

Background: Even though alcohol consumption is an established risk factor for cancer, evidence regarding the effect of a reduction or cessation of alcohol consumption on cancer incidence is scarce. Our main study aim was to assess the effect of alcohol rehabilitation and abstinence on cancer incidence in people with alcohol dependence.

Methods: We conducted a nationwide hospital retrospective cohort study which included all adults residing in mainland France and discharged in 2018-21. Multivariable Cox proportional hazards models were used to estimate the effect of rehabilitation treatment at hospital or a history of abstinence versus alcohol dependence without rehabilitation or abstinence on the risk for incident alcohol-associated cancers by sex, controlled for potential confounding risk factors.

Findings: 10 260 056 men and 13 739 369 women were discharged from French hospitals in 2018-21. Alcohol dependence was identified in 645 720 (6·3%) men and 219 323 (1·6%) women. Alcohol dependence was strongly related to alcohol-associated cancer sites in both sexes (hepatocellular carcinoma and oral, pharyngeal, laryngeal, oesophageal, and colorectal cancers), except for breast cancer. Rehabilitation treatment or abstinence was associated with significantly lower risks compared with alcohol dependence without rehabilitation or abstinence (adjusted hazard ratios: 0·58, 99·89% CI 0·56-0·60 in men and 0·62, 0·57-0·66 in women). Relative risk reductions were significant for each alcohol-associated cancer site in both sexes and supported by all subgroup and sensitivity analyses.

Interpretation: Our study results support the clear benefits of alcohol rehabilitation and abstinence in reducing the risk for alcohol-associated cancers. As only two in five patients with alcohol dependence were recorded with a history of rehabilitation treatment or abstinence, a large untapped potential exists for reducing cancer incidence.

Funding: European Union's EU4Health programme.

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酒精康复与癌症风险:法国全国医院队列研究。
背景:尽管饮酒是癌症的既定风险因素,但有关减少或停止饮酒对癌症发病率影响的证据却很少。我们的主要研究目的是评估酒精康复和戒酒对酒精依赖者癌症发病率的影响:我们在全国范围内开展了一项医院回顾性队列研究,研究对象包括居住在法国本土、2018-21年出院的所有成年人。在控制了潜在混杂风险因素的情况下,采用多变量考克斯比例危险模型估算了在医院接受康复治疗或有禁欲史与未接受康复治疗或禁欲的酒精依赖者对不同性别酒精相关癌症发病风险的影响:2018-21年间,10 260 056名男性和13 739 369名女性从法国医院出院。其中645 720名男性(6-3%)和219 323名女性(1-6%)被确认为酒精依赖。酒精依赖与酒精相关的男女癌症部位(肝细胞癌以及口腔癌、咽癌、喉癌、食道癌和结直肠癌)密切相关,但乳腺癌除外。与没有康复或戒酒的酒精依赖者相比,康复治疗或戒酒的风险明显较低(调整后危险比:0-58,99-89%):男性为 0-58,99-89% CI 为 0-56-0-60;女性为 0-62,0-57-0-66)。在男女两性中,与酒精相关的每种癌症部位的相对风险均显著降低,所有亚组分析和敏感性分析均支持这一结果:我们的研究结果表明,酒精康复和戒酒对降低酒精相关癌症风险有明显的益处。由于只有五分之二的酒精依赖症患者有康复治疗或戒酒史,因此在降低癌症发病率方面还有很大的潜力有待挖掘:资金来源:欧盟的 EU4Health 计划。
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来源期刊
Lancet Public Health
Lancet Public Health Medicine-Public Health, Environmental and Occupational Health
CiteScore
55.60
自引率
0.80%
发文量
305
审稿时长
8 weeks
期刊介绍: The Lancet Public Health is committed to tackling the most pressing issues across all aspects of public health. We have a strong commitment to using science to improve health equity and social justice. In line with the values and vision of The Lancet, we take a broad and inclusive approach to public health and are interested in interdisciplinary research. We publish a range of content types that can advance public health policies and outcomes. These include Articles, Review, Comment, and Correspondence. Learn more about the types of papers we publish.
期刊最新文献
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