Abstract
BackgroundThe association of alcohol drinking with bladder cancer risk remains unclear in East Asian populations. Aldehyde dehydrogenase 2 (ALDH2) enzyme oxidizes alcohol-metabolized carcinogenic acetaldehyde into acetate. It is well known that the inactive ALDH2 carriers, specific to East Asian populations, have an increased risk of several cancer types because of increased exposure to acetaldehyde after alcohol consumption. The aim of this study was to examine the association between alcohol drinking and bladder cancer risk using data from ten population-based prospective cohort studies in Japan, where approximately 40% of the population has inactive ALDH2 enzyme.MethodsWe analyzed 340,497 Japanese participants with average follow-up of 13.4 years. The association between alcohol drinking and bladder cancer risk was evaluated using Cox regression models within each study, and random-effects models were used to estimate pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs).ResultsDuring 4,729,071 person-years, 936 men and 325 women were newly diagnosed with bladder cancer. Our results showed no evidence of significant association between alcohol drinking and bladder cancer risk even among men who consumed alcohol of ≥69 g/week, with HR of 1.02 (95% CI, 0.79–1.33). The null result was observed consistently among women.ConclusionsOur findings do not support an association between alcohol drinking and bladder cancer risk in the Japanese, at least without consideration of the polymorphisms of alcohol-metabolizing enzymes.
Highlights
According to the GLOBOCAN 2018 database, bladder cancer is the 10th most common cancer worldwide, responsible for an estimated 549,000 new cases and 200,000 deaths in 2018.1 Cigarette smoking is a leading risk factor for bladder cancer, accounting for about 50% of all cases.[2,3] smoking cessation has been recommended to prevent bladder cancer
We examined the association of alcohol drinking with bladder cancer from a pooled analysis of ten population-based cohort studies in Japan, where approximately 40% of the population has inactive Aldehyde dehydrogenase 2 (ALDH2) enzyme, despite some variation across areas.[10,11]
When adjusted for age, area and smoking, no evidence of increased bladder cancer risk was observed for regular drinking (Table 1)
Summary
According to the GLOBOCAN 2018 database, bladder cancer is the 10th most common cancer worldwide, responsible for an estimated 549,000 new cases and 200,000 deaths in 2018.1 Cigarette smoking is a leading risk factor for bladder cancer, accounting for about 50% of all cases.[2,3] smoking cessation has been recommended to prevent bladder cancer. Despite efforts to promote smoking cessation, the age-standardized incidence of bladder cancer among Japanese men has been increasing, from 10.6 per 100,000 in 2005 to 14.7 per 100,000 in 2010.1 Further primary prevention through identifying a modifiable risk factor other than cigarette smoking and avoiding its exposure is essential to decrease bladder cancer incidence. The association of alcohol drinking with bladder cancer risk remains unclear in East Asian populations. It is well known that the inactive ALDH2 carriers, specific to East Asian populations, have an increased risk of several cancer types because of increased exposure to acetaldehyde after alcohol consumption. The aim of this study was to examine the association between alcohol drinking and bladder cancer risk using data from ten population-based prospective cohort studies in Japan, where approximately 40% of the population has inactive ALDH2 enzyme
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