Effect of Alcohol Consumption, Cigarette Smoking and Flushing Response on Esophageal Cancer Risk: A Population-Based Cohort Study (JPHC Study)

Cancer Lett. 2009 Mar 18;275(2):240-6. doi: 10.1016/j.canlet.2008.10.020. Epub 2008 Nov 25.


We examined the effect of alcohol consumption, cigarette smoking and flushing response on esophageal squamous cell carcinoma (ESCC) in a large-scale population-based cohort study. 44,970 middle-aged and older Japanese men were followed. A total of 215 cases of ESCC were newly diagnosed. Alcohol consumption and cigarette smoking are strongly associated with the incidence of ESCC. Heavy alcohol consumption increased the risk of ESCC especially among heavy smokers with the flushing response (HR = 3.41, 95% CI = 2.10-5.51). Strong effect modification was detected in heavy smokers. Our results suggest that heavy alcohol consumption together with heavy smoking may increase the risk of ESCC particularly in individuals with the flushing response.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alcohol Drinking*
  • Cohort Studies
  • Esophageal Neoplasms / epidemiology*
  • Flushing*
  • Humans
  • Population Surveillance
  • Risk Factors
  • Smoking*
  • Tobacco*