Alcoholism and Risk of Lung Cancer in Observational Studies: A Systematic Review

Abstract

ObjectivesHeavy drinking increases the risk of many chronic diseases. Alcoholics are those with an alcohol use disorder (AUD), characterized by excessive consumption of alcohol, alcohol abuse behavior and/or dependence. In addition, they often have micronutrient deficiencies due to poor diet, which increases their risk for lung cancer and other chronic diseases. Heavy drinking was reported to be a possible risk factor for lung cancer, although smokers also tend to be drinkers. Given that previous reviews often included alcoholics, not clinically diagnosed, we conducted a systematic review to summarize the current evidence on associations of clinically diagnosed AUD with risk of lung cancer incidence or mortality reported in observational studies.MethodsFirst, in January of 2022, we conducted a systematic literature review via PubMed using the search terms: alcoholism, lung cancer, and risk or morbidity or mortality. The search was limited to human studies published in English from 2000 to present. The inclusion criteria were original observational studies with clinical diagnoses of AUD or treatment for alcoholism and lung cancer incidence or mortality in a non-lung cancer population. Second, we selected original studies included in a previous meta-analysis of alcoholics and lung cancer by Korte et al. published in 2002 that met the inclusion criteria.ResultsA total of 1250 articles were retrieved via PubMed, of which three met the inclusion criteria. From the Korte's meta-analysis, six out of eleven articles met inclusion criteria. These nine articles included a total of 3,050 lung cancer cases with over 234,715 participants (mostly white males) from nine studies conducted in 1925–2012. For all studies, alcoholics had an increased risk of lung cancer compared to non-alcoholics by 2% to 300%, which were statistically significant in five studies. The majority did not adjust for smoking or other lifestyle factors.ConclusionsOverall, an increased risk of lung cancer was observed among those with AUD compared with those without AUD. These associations are complicated by smoking and poor diet, which most studies did not account for. Future research needs to consider these factors and include more non-white and female participants.Funding SourcesThis study was funded by the Summer Undergraduate Research Experience Science Program at Oregon State University.