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Japanese Journal of Clinical Oncology Advance Access originally published online on March 1, 2007
Japanese Journal of Clinical Oncology 2007 37(3):168-174; doi:10.1093/jjco/hyl146
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© 2007 Foundation for Promotion of Cancer Research

Alcohol Drinking and Lung Cancer Risk: An Evaluation Based on a Systematic Review of Epidemiologic Evidence among the Japanese Population

Kenji Wakai1,, Chisato Nagata2, Tetsuya Mizoue3, Keitaro Tanaka4, Yoshikazu Nishino5, Ichiro Tsuji6, Manami Inoue7, Shoichiro Tsugane for the Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan7,*

1 Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya
2 Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu
3 Department of Epidemiology, Research Institute, International Medical Center of Japan, Tokyo
4 Department of Preventive Medicine, Saga Medical School, Faculty of Medicine, Saga University, Saga
5 Division of Epidemiology, Miyagi Cancer Center Research Institute, Natori, Miyagi
6 Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai
7 Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan

For reprints and all correspondence: Kenji Wakai, Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan. E-mail: wakai{at}aichi-cc.jp

Received August 23, 2006; accepted October 23, 2006

Background: The relationship between alcohol consumption and risk of lung cancer is controversial. Based on a systematic review of epidemiologic evidence, we evaluated this association among the Japanese population, who may be more susceptible to alcohol-related diseases than Western populations.

Methods: Original data were obtained from MEDLINE searches using PubMed or from searches of the Ichushi database, complemented with manual searches. The evaluation of associations was based on the strength of evidence and the magnitude of association, together with biological plausibility as previously evaluated by the International Agency for Research on Cancer.

Results: We identified seven cohort studies and two case-control studies. One cohort study demonstrated a strong positive association between alcohol drinking and the risk of female lung cancer, but the association almost disappeared after adjustment for smoking. The other eight studies showed a weak positive or no association. Although smoking is the best-established risk factor for lung cancer, only five cohort studies presented smoking-adjusted risks out of all nine identified. Furthermore, only two studies explicitly reported the risk estimate for ex-drinkers who may have quit alcohol drinking after the development or diagnosis of the disease and have an apparently higher risk.

Conclusion: We conclude that the epidemiologic evidence on the association between alcohol drinking and lung cancer risk remains insufficient in terms of both the number and methodological quality of studies among the Japanese population.

Key Words: systematic review • epidemiology • alcohol drinking • lung neoplasms • Japanese

* Research group members: Shoichiro Tsugane (principal investigator), Manami Inoue, Shizuka Sasazuki, Motoki Iwasaki, Tetsuya Otani, National Cancer Center, Tokyo; Ichiro Tsuji (2004–), Yoshitaka Tsubono (2003), Taichi Shimazu, Tohoku University, Sendai; Yoshikazu Nishino, Miyagi Cancer Center, Natori, Miyagi; Tetsuya Mizoue, International Medical Center of Japan, Tokyo; Chisato Nagata, Gifu University, Gifu; Kenji Wakai, Aichi Cancer Center, Nagoya; and Keitaro Tanaka, Saga University, Saga, Japan


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