I. The relationship between alcohol consumption and cancer
(I) Background
Alcohol is made by fermenting carbohydrates, and its raw materials include fruits such as grapes, grains, and plant roots and tubers. Alcoholic beverages around the world are mainly divided into three categories: beer, fruit wine and white wine. Beer made with different ingredients, different processing techniques, containing 4% to 7% alcohol, with grapes and other types of fruit wines made with alcohol 10% to 15%, distilled alcoholic beverages, alcohol content of up to 30% to 50%.
”Soup liquid wake up acid”, the ancient people have a thorough understanding of wine. Such as the “medical recipe for the class” said: “wine, the grain of the liquid, rice Qu of Huaying, although it can benefit people, but also can damage people, why? Wine has a big heat, big poison, big cold condensation sea, but the wine is not ice, is its heat; drink easy to faint, easy to human nature, is its poison. If you avoid wind and cold, promote blood, eliminate evil, lead to the potential of medicine, nothing more than wine. If drunkenness is excessive, the amount of basin pouring bucket, poisonous gas attacking the heart, through the intestines and decaying intestines, faint will fallacy, the eyes do not see people, this is the loss of life.” It can be seen that the advantages and disadvantages of alcohol, the ancients have long been aware of, “wine can be disorderly” is a thousand-year-old saying.
But ethanol as a dietary component, in many countries consume a lot, China is more so. Many people have realized that smoking is an important factor in causing cancer, but alcohol consumption is also associated with a variety of cancer sites.
(II) Alcohol consumption and cancer
1.Ethanol and cancer
Ethanol is directly related to the occurrence and development of certain cancers. Since the 19th century, alcoholic beverages have been associated with flat cell carcinoma of the head and neck, and a study in the 1950s further showed that long-term whiskey drinkers who consumed more than 7 ounces (about 210 ml) of alcohol per day had a 10-fold increased risk of developing laryngeal cancer. Flat cell carcinomas of the mouth, tongue and pharynx were also increased by alcohol consumption. Studies from black residents of Washington, D.C. in the United States have shown that alcohol consumption increases the risk of esophageal cancer by 44 times, while smoking is not identified as a specific cause of esophageal cancer. Overall, the heavy use of alcohol and tobacco in Western countries can explain 80% of the causes of esophageal cancer, but if smoking is excluded, excessive alcohol intake alone can increase the risk of esophageal cancer by 20 times. Stomach cancer is not strongly associated with alcohol, but a French study showed that the risk of stomach cancer is 6.9 times higher with red wine consumption than in the general population, and the cardia seems to be more important. Liver cancer can increase the risk of developing it due to alcohol abuse, ranging from 1.5 times to 30 times. Chronic hepatitis B virus infection can increase the sensitivity of the liver to alcohol toxicity and accelerate the formation of hepatocellular carcinoma, although the actual mechanism or the causal relationship between them remains to be studied. For example, the risk of colon and rectal cancer among brewery workers in Denmark is about the same as that of the general population, while that of Irish brewery workers is 1.8 times higher than that of the general population. This may be related to the increased secretion of bile salts and dyslipidemia caused by alcohol. However, in general, the control of colon and rectal cancer is still dependent on the intake of fat and fiber. There seems to be a considerable association between lung cancer and alcoholism, but after excluding the correction of smoking factors, the association is insignificant. This association is negligible after excluding the correction of smoking. Smoking causes pulmonary epilepsy, and when combined with alcohol consumption, the risk of lung cancer increases by 50% and cannot be ignored. Why do alcoholic beverages promote cancer? Countries are actively researching, but the exact mechanism is not yet known. According to the analysis of current information, it may be because alcohol is both fat-soluble and water-soluble, and itself is part of heat energy, which helps other harmful substances enter the body while entering the body itself. Its metabolic process mainly takes place in the mitochondria of cells, and its metabolism produces peroxyl radicals and lipid peroxides that lead to oxidative damage to mitochondrial DNA, breaking the normal repair function of mitochondria and making damaged cells divide out of control. It is also believed that the main metabolite of alcohol, acetaldehyde, may be directly combined with the DNA of the cell nucleus, causing the teratogenic and carcinogenic effects of alcohol.
2.Wine, beer and cancer
The increased incidence of cancer in heavy drinkers is caused by the toxicity of alcohol, independent of the type of alcohol. Not only white wine, but also drinking only wine or beer cannot protect you from the poison of alcohol. Wine and beer still have the toxic effects of alcohol and have a mix of carcinogens. Studies have found that beer contains at least two trace carcinogens: hash oil and nitrosamines, important ingredients that make up the unique flavor of beer. British researchers have found that heavy beer consumption can triple the incidence of pancreatic cancer, as well as cause digestive tract cancer, thyroid cancer and melanoma. American cancer experts have also found that heavy beer drinkers are three times more likely to develop oral and esophageal cancers than those who drink hard liquor. Not long ago, a Danish cancer registry survey data showed that the death rate of esophageal, laryngeal, lung and liver cancers among brewery workers was much higher than that of other nationals. It turns out that Danish breweries have a practice of giving workers about four pints of beer for free, an amount that greatly exceeds the average daily consumption of beer by Danish men.
(iii) Alcohol consumption and smoking
In addition, drinking alcohol while smoking is more likely to cause cancer. Because the harmful carcinogenic substances in tobacco can dissolve in alcohol and adhere to the surface of the mucosal epithelium of the digestive tract, producing a more intense harmful effect on the mucosal epithelium.
(iv) Recommendations
There are two points worth noting for drinkers: firstly, the degree of alcohol consumption should be low rather than high, because alcohol is a risk factor for human cancer; secondly, the amount of alcohol consumption should be appropriate, healthy people can drink moderately, but must limit the consumption of alcohol to 2 or less times a day, and each time to 2 to 3 glasses.
II. The relationship between smoking and cancer
(A) Background
In ancient times, people in China were non-smokers. Tobacco was introduced into China at the end of the 16th century, during the Wanli period of the Ming Dynasty (1573-1620), and was first pronounced as “Tempa Kuk”, and the name was changed to tobacco around the end of the Ming Dynasty. According to historians, tobacco was introduced into China through three routes, one from the Philippines to Taiwan and Fujian, and then to the north; another from the South Seas to Guangdong; the third from Japan to Liaodong via Korea. It is generally believed that the earliest introduction to China was from the Philippines to Taiwan and Fujian provinces in China.
By the end of the Chongzhen period of the Ming Dynasty, smoking was prevalent. By the Qing Dynasty, the wind was even more prevalent. Since then, guests to first to smoke, then to tea, has become a world custom. Ming and Qing medicine has observed the toxic side effects of tobacco on the human body. Such as the “Diannan Materia Medica” in the record, tobacco “disturbed, unconscious”; “the herbal repertoire” recorded “occasionally eaten, its gas closed, smothered faint as death, it is not a good thing to know”. Traditional Chinese medicine Zhang Jinyue said: “smoke can disperse evil, but also will consume gas,” concluded that “smoke is also detrimental to people”.
Now, our country is the world’s largest cigarette sales, in recent years, the smoking rate of the population to the annual rate of 2%, especially the youth smokers increased a lot. In the developed countries of the world, such as the United States, over the past 30 years, the disparity in smoking rates has increased across socioeconomic status, especially among people with different levels of education. in the early 1960s, the disparity in smoking rates among people with different levels of education was small, and by 1990, this disparity was highly correlated with the risk of smoking, with the smoking rate among high school dropouts remaining relatively stable at 31.8%, while the smoking rate among college graduates smoking rate dropped significantly to 13.5%. Further, the highest rates of smoking are seen in the lowest socio-demographic members, who have an increased overall risk of developing cancer.
In industrialized countries, 1/3 of men over the age of 15 smoke; in third world countries it is almost 1/2. In industrialized countries, the number of female smokers is similar to that of men; in third world countries, 10% of women smoke, but this percentage is increasing.
(B) harmful substances of tobacco
Cigarette smoke from burning contains at least 2,000 harmful components, such as polycyclic aromatic hydrocarbons benzo(a)pyrene, benzanthracene, nitrosamines, polonium 210, cadmium, arsenic, β-naphthylamine and other carcinogenic effects. The carcinogens in cigarette smoke are cyanide, o-cresol, phenol, etc. When smoking, most of the cigarette smoke is inhaled into the lungs, and a small portion enters the digestive tract with saliva. Some of the harmful substances in cigarette smoke stay in the lungs, and some enter the blood circulation and flow to the whole body. Under the synergistic effect of carcinogens and carcinogenic substances, normal cells are damaged and cancer can be formed.
The harmful components in cigarette smoke include carbon monoxide, nicotine and other alkaloids, amines, nitrile, alcohols, phenols, alkanes, olefins, carbonyl compounds, nitrogen oxides, polycyclic aromatic hydrocarbons, heterocyclic compounds, heavy metal elements, organic pesticides??? etc. They have a variety of biological effects, including.
1, inflammatory irritation to the respiratory mucosa: such as aldehydes, nitrogen oxides, olefins.
2.Produce toxic effects on cells: such as nitrile, amines, heavy metal elements.
3.Produce addictive effects: such as nicotine and other alkaloids.
4.Carcinogenic effect on human body: such as polycyclic aromatic hydrocarbons of benzo(a)pyrene and cadmium, dimethylnitrosamine, β-naphthylamine, etc.
5, the human body has a pro-carcinogenic effect: such as phenolic compounds.
6, so that the red blood cells lose the ability to charge oxygen: such as carbon monoxide.
Evaluation of the harmful substances content of tobacco is usually used “smoke tar and carbon monoxide”, requiring each cigarette produced by the smoke tar in 15 mg or less, the actual measurement of the market smoke more than several times. According to 20 cigarettes a day, a quarter of which is inhaled into the body, the amount of smoke tar inhaled by smokers is about 120-200 mg per day. The combined effect of harmful substances in tobacco tar is a major threat to human cancer. A variety of carcinogenic substances that make up smoke tar are carcinogenic initiators when inhaled to a certain level, and carcinogenic agents and synergistic carcinogens can accelerate the carcinogenic effect.
(iii) Hazards of smoking
In November 1998, the World Health Organization Western Pacific Regional Office held the fourth “Tobacco or Health Working Conference”, which pointed out that the annual number of deaths due to smoking in Western Pacific countries is almost equal to the total number of deaths due to alcoholism, homicide, suicide, drug addiction, drowning, traffic accidents, industrial accidents and AIDS. Smoking can damage various tissues and organs of the body, causing cancer, hypertension, coronary heart disease, stroke, peptic ulcer, chronic bronchitis, emphysema, and many other diseases. The World Health Organization estimates that smoking kills up to 8,000 people worldwide every day. According to Professor Richard Peto of the Oxford University Cancer Institute, “One third of regular smokers will die from this habit, and half of them will only live to middle age”. In developed countries, smoking is associated with 85% of lung cancer deaths, 75% of total bronchitis and emphysema deaths, and 25% of total heart disease deaths. According to statistics, an average of 1 in 4 smokers in the UK die of lung cancer, and 1 in 3 deaths in middle age are due to lung cancer and smoking-induced heart disease. Studies have shown that 1/3 of all cancer cases are related to smoking. Levels of carcinogenic polycyclic aromatic hydrocarbon compounds begin to decline from lung tissue after the third month of smoking cessation, and do not reach the levels of nonsmokers until five years after quitting.
Adolescent smoking is more harmful because adolescents are growing and developing, the body’s systems and organs are not yet mature, the resistance to harmful factors in the environment is weak, the harmful particles in cigarette smoke easily reach the fine bronchi and alveoli, so the toxins are easily absorbed and the human tissue is more severely damaged. If you start smoking at the age of 20 to 26, the incidence of lung cancer is 10 times greater than that of non-smokers; if you start smoking at the age of 15 to 19, the incidence of lung cancer is 15 times greater; if you are younger than 15 and start smoking, the incidence of lung cancer is 17 times greater than that of non-smokers; the earlier you start smoking, the greater the incidence of lung cancer. The earlier you start smoking, the higher the mortality rate from smoking-related diseases in adulthood. Smoking among adolescents can also lead to lower academic performance.
Passive smoking (including contaminated air) has also been shown to be a cause of cancer in non-smokers and is especially harmful to children! Research has proven that if a husband smokes and his wife does not smoke within a family that lives together regularly, the chance of the wife getting lung cancer in the future is double to triple that of a wife whose husband does not smoke. The more the husband smokes, the greater the chance of the wife getting cancer. If someone in the family smokes, the children in the family are more likely to get bronchitis and pneumonia. In 1985, the Swedish courts decided that smoking by co-workers could cause lung cancer and death in co-workers, and called the phenomenon “occupational injury” for which the victim’s family could claim some financial compensation. According to statistics, the annual number of deaths caused by passive smoking is 1,000 in the United Kingdom and 4,000 to 5,000 in the United States.
According to May 1999, the Chinese Academy of Medical Sciences Institute of Oncology, Professor Liu Boqi and other published research results, in China in 1990, tobacco caused 600,000 deaths, by 2000 will reach 800,000, such as the current smoking situation, to the middle of the 21st century, there will be about 3 million deaths per year from tobacco. In Britain, for example, smoking has killed 1/3 of middle-aged people because many people have been smoking for many years.
(iv) Smoking-related cancers
Smokers, especially long-term heavy smokers, are susceptible to cancer. The cancer mortality rate of smokers is 2 times higher than that of non-smokers; and up to 4 times higher for heavy smokers. In the 1990s, about 1/4 of the total number of deaths in Beijing each year were due to cerebrovascular disease, and another 1/4 were due to cancer. In China, about 70% to 80% of lung cancer deaths are attributed to smoking in men, while about 30% in women are attributed to smoking and passive smoking. Among smokers, the occurrence of laryngeal, lip, tongue, esophageal, bladder and kidney cancers is several times higher than that of non-smokers. Almost 50% of male bladder and kidney cancer deaths are due to smoking, and the risk of bladder and kidney cancer in smokers is 2 to 3 times higher than in non-smokers. Of the 4600 cervical cancer deaths in the United States each year, 30% are due to smoking.
Recent studies have shown that insulin-like growth factors are associated with breast and rectal cancers, and the head of the research team at Christie Hospital in the United Kingdom, Andrew K. Renehan, has found that long-term smoking is associated with breast and rectal cancers. Dr. Andrew Renehan and others have found that long-term smoking affects insulin-like growth factor levels and is related to the length and amount of time smoked, with levels of insulin-like growth factors (IGFs) in the blood of smokers being much higher than those of non-smokers, and the difference between the blood levels of IGFs in the most addicted smokers and non-smokers being between 20% and 25%. Growth factors may promote the growth of cancer cells and protect abnormal cells from natural death, but further research is needed to demonstrate that smoking, insulin-like growth factor levels and cancer are all interrelated.
1. Lung cancer
It has been studied that smokers have an 8 to 12 times higher risk of lung cancer compared to non-smokers. Whether it is 8 or 12 times depends on how much or how little you smoke, and many people know this. If you smoke an average of 20 cigarettes a day, smokers who have smoked for 20 years have a 20 times higher risk of lung cancer than non-smokers. Those who start smoking at an age younger than 20 years old die 28 times more often from lung cancer than nonsmokers. According to American scientists, smokers have a shorter life expectancy than nonsmokers by about 20 years on average.
According to the research of China’s Cancer Prevention and Treatment Research Office, in the early 1990s, the mortality rate of lung cancer in China rose from 7.09/100,000 in the 1970s to 17.54/100,000 in the 1990s, an increase of one and a half times compared to the mid-1970s. The mortality rate of lung cancer in Jiangsu Province has increased 3.67 times in the past 20 years. In a sample of 74 cities, lung cancer deaths have accounted for the first place of all cancer deaths. In 1975, about 30,000 men died of lung cancer in China. If the smoking rate in China does not drop, 900,000 men will die of lung cancer each year by 2025, which is 30 times the rate of the 1970s.
2.Pancreatic cancer
After the epidemiology of American experts prone to pancreatic cancer that pancreatic cancer is related to smoking. The mechanism of this effect is that carcinogens in tobacco can reach the pancreas through the blood after being inhaled; inactive carcinogenic precursors can become active carcinogens, which are secreted into the bile and then reflexively reach the pancreatic ducts from the bile ducts; in addition, smoking can elevate blood lipids, thus increasing the risk of pancreatic cancer. The study confirmed that the risk of pancreatic cancer in smokers is 2 to 3 times greater than that in non-smokers.
3.Blood cancer
According to the American Journal of Cancer, the risk of blood cancer increases 1.78 times in smokers, and one out of every three blood cancer patients in the United States is a long-term smoker, and smokers account for more than 80% of the family members of blood cancer patients.
4.Bladder cancer
George Pruitt, a professor at Harvard Medical School in the United States, said that the risk of bladder cancer is higher than the risk of smoking. Dr. Pruitt pointed out that bladder cancer and smokers have a close relationship. According to the American Cancer Society estimates, 49% of male patients with bladder cancer and 10% of female patients are caused by smoking. Bladder cancer is the fifth most common cancer in men and the tenth most common cancer in women in the United States, with 13,000 people expected to die from the disease each year in the United States.
(E) Quit Smoking
Can you not get lung cancer if you don’t smoke? Some people say, “Someone in our organization never smokes, so how can he or she get lung cancer? More people say that someone who smokes has never had lung cancer even though he or she has smoked all his or her life. This is true, there are many people who have smoked for their whole life without getting lung cancer. According to statistics, about 60% of Chinese men over the age of 16 smoke, and I don’t think it’s true that these people will have lung cancer in the future. The risk is indeed 10 times higher for smokers compared to non-smokers. If you look at the many smokers, how many of them have lung cancer? You seem to be sure that there is no problem, but if you go to the lung cancer ward of my hospital and ask you to smoke, right? If you ask them, eight and a half out of ten are smokers, all of them are smokers.
Quitting smoking is good for cancer prevention, and it is better to quit early than late. It is especially important for patients with early stage tumors and tumors closely related to smoking to quit smoking, which is beneficial to cure and consolidate the effect of treatment. If precancerous lesions or early cancers have developed in someone due to smoking, it is unlikely that they will all disappear in the short term after stopping smoking. Therefore, if the cancer appears within a short period of time after quitting smoking it is never caused by quitting, but is the result of long-term smoking before quitting. However, the benefit of quitting smoking for this person is that it slows down the process of cancer development and facilitates treatment. So, no matter how long you have been smoking, it is good for you to quit. It also prevents the second cancer caused by smoking again. For example, in malignant tumors of the head and neck, quitting smoking after diagnosis can reduce the incidence of second primary cancers, recurrence of lesions, and radiation therapy-induced morbidity. For cancer patients, smoking cessation may also reduce complications associated with anesthesia, surgery, radiation therapy, and chemotherapy. In general, patient cessation rates increase with disease severity; long-term cessation rates (12 months) for cardiac and oncology patients range from approximately 25% to 70%, and recent studies also suggest that cessation rates are at the upper end of this range. For smoking-related cancers (lung, head and neck), long-term quit rates without outside help are higher (40% to 70%).
In the United States, physicians have become a powerful factor in intervening with most Americans to quit, and the National Cancer Institute (NCI) has even proposed a 4A program to assist patients in quitting: Ask, Advise, Assist, Arrange. A free cancer telephone hotline has been set up to help patients quit smoking.
Since the early 1960s, the U.S. has promoted smoking cessation and the government has enacted laws about it. To date, the smoking rate among adults in the United States has dropped from 42 percent to 25 percent, and about 50 million smokers have quit, halting the country’s rising incidence of lung cancer in men. According to WHO Director General Mahler announced in 1988: Canada has 5.5 million people quit smoking, the United Kingdom has 10 million people quit smoking, the United States at that time 40 million people have quit smoking. Currently, the smoking rate in industrialized countries is declining at a rate of about 1% per year, while the smoking rate in third world countries is increasing at a rate of 1% to 2% per year.
Discourage smoking, anti-smoking, quit smoking is to prevent cancer, obstructive pulmonary disease, stroke, coronary heart disease and other diseases, to extend the life of important measures. For the sake of health, everyone is advocated to quit smoking. The key to quitting smoking is firstly awareness, secondly determination and thirdly persistence. Therefore, the key to quitting smoking is in yourself. As for the market to quit smoking candy, smoking cessation drugs, smoking cessation perfume, smoking cessation mouthwash or chewing gum containing nicotine, etc. only some auxiliary role.