Alcohol drinking and esophageal cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population

Jpn J Clin Oncol. 2011 May;41(5):677-92. doi: 10.1093/jjco/hyr026. Epub 2011 Mar 23.


Although alcohol drinking is considered as an important risk factor for esophageal cancer, the magnitude of the association might be varied among geographic areas. Therefore, we reviewed epidemiologic studies on the association between alcohol drinking and esophageal cancer among the Japanese population. Original data were obtained from MEDLINE, searched using PubMed or from searches of the Ichushi database, complemented with manual searches. Evaluation of associations was based on the strength of evidence ('convincing', 'probable', 'possible' or 'insufficient') and the magnitude of association ('strong', 'moderate', 'weak' or 'no association'), together with biological plausibility as previously evaluated by the International Agency of Research on Cancer. We identified four cohort studies and nine case-control studies. All cohort studies and case-control studies showed strong positive associations between esophageal cancer and alcohol drinking. All cohort studies and six case-control studies showed that alcohol drinking had the dose- or frequency-response relationships with esophageal cancer. In addition, four case-control studies showed that acetaldehyde dehydrogenase Glu504Lys polymorphism had strong effect modification with alcohol drinking. We conclude that there is convincing evidence that alcohol drinking increases the risk of esophageal cancer in the Japanese population.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / epidemiology*
  • Aldehyde Dehydrogenase / genetics
  • Aldehyde Dehydrogenase, Mitochondrial
  • Asian Continental Ancestry Group / statistics & numerical data*
  • Case-Control Studies
  • Cohort Studies
  • Confounding Factors, Epidemiologic
  • Esophageal Neoplasms / epidemiology*
  • Esophageal Neoplasms / etiology*
  • Female
  • Gene Frequency
  • Humans
  • Japan / epidemiology
  • Life Style
  • Male
  • Polymorphism, Single Nucleotide
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors


  • ALDH2 protein, human
  • Aldehyde Dehydrogenase
  • Aldehyde Dehydrogenase, Mitochondrial