Association Between Alcohol Consumption and Risk of Nasopharyngeal Carcinoma: A Comprehensive Meta‐Analysis of Epidemiological Studies

Abstract

Background: Alcohol consumption is increasing all over the world, but whether it is an independent factor affecting the occurrence of nasopharyngeal carcinoma (NPC) is inconsistent in many studies. We aimed to explore the association between alcohol consumption and NPC risk by integrating existing evidence in a meta-analysis.Methods: We searched for relevant articles published up to August 2018 in PubMed, Cochrane Library, Web of Science, and China National Knowledge infrastructure (CNKI). The Newcastle-Ottawa scale was used to assess the quality of the included studies. Odds ratios (ORs) or relative risks were pooled to estimate the associations between alcohol consumption and NPC risk.Results: The meta-analysis of cohort studies showed no significant association between alcohol consumption and NPC, but pooled results from case-control studies indicated that ever drinking increased the probability of NPC versus nondrinking (OR = 1.10; 95% confidence interval [CI]: 1.01, 1.19). As compared with nondrinkers, high-frequency drinking (≥7 times/wk) increased the NPC probability (OR = 1.29; 95% CI: 1.05, 1.53) and low-frequency drinking (<7 times/wk) decreased the probability (OR = 0.77; 95% CI: 0.60, 0.94), as did shorter duration of drinking (<20 years) (OR = 0.64; 95% CI: 0.49, 0.79). On subgroup analyses, significant pooled results were observed for studies with high quality, with hospital-based controls and with adjustment for confounding factors, smoking, age, and sex.Conclusions: The risk of NPC may increase with alcohol consumption. Ever drinking increased the risk versus nondrinking. Additionally, high-frequency drinking increased the risk, but low-frequency drinking decreased it to some extent. Further intensive studies based on well-designed methods are needed to examine the association.

The Evolving Epidemiology of Nasopharyngeal Carcinoma

“…The reported association between alcohol intake and NPC risk is inconsistent, with statistically null results in several studies, especially in high-incidence areas, but positive associations in other studies in high-and low-incidence populations (105,106). Two meta-analyses found a positive meta-RR for the highest versus the lowest category of alcohol intake in combined case-control studies, with a J-shaped exposure-response curve that, if real, may contribute to the inconsistency of results across study populations with different alcohol drinking habits (105,106). The lack of association between alcohol and NPC risk in two prospective cohort studies in Singapore (107) and Shanghai (108), however, suggests that bias may contribute to the positive findings in case-control studies.…”

Alcohol Drinking Pattern and Risk of Head and Neck Cancer: A Nationwide Cohort Study

“…Another case-control report, which included 240 cancer cases, has observed a linear relationship between drinking frequency and overall upper aerodigestive tract cancers (p for trend = 0.01) [14], whereas no association was observed between oral cancer subtype (n = 187) and drinking frequency in a study based on the same data [15]. There are few meta-analyses or systematic reviews on drinking frequency and overall HNC risk, but one meta-analysis of cohort studies has examined the association between nasopharyngeal cancer risk and drinking frequency [16]. Frequent drinking (≥7 times per week) was related to an increase in the risk of nasopharyngeal cancer (pooled odds ratio [OR] 1.29, 95% CI 1.05-1.53) in this analysis, whereas infrequent drinking (<7 times per week) showed the contrasting result (pooled OR 0.77, 95% CI 0.60-0.94).…”

Associations between ALDH Genetic Variants, Alcohol Consumption, and the Risk of Nasopharyngeal Carcinoma in an East Asian Population

“…Other research has reported that heavy alcohol consumption can increase the risk of certain cancer types, including HNC cancers and NPC [11]. In studies involving East Asian populations, the presence of genetic polymorphisms in ADH1B (rs1229984) and ALDH2 (rs671), as well as alcohol consumption, individually or in combination [13], increase the risk of breast cancer [36], HNC [17], and esophageal cancer [18,35].…”

“…The association between alcohol consumption and NPC risk is inconsistent in many studies [9,10]. Two meta-analyses have indicated that the risk of developing NPC may increase with alcohol consumption; in both meta-analyses, drinking and high-frequency drinking increased the risk of NPC [11,12].…”