Alcohol consumption, multiple Lugol-voiding lesions, and field cancerization

Area of Science:

• Oncology
• Gastroenterology
• Epidemiology

Background:

• Field cancerization explains multiple squamous cell carcinomas (SCC) in the upper aerodigestive tract, linked to alcohol and smoking.
• Multiple Lugol-voiding lesions in the esophagus are associated with increased SCC risk.

Purpose of the Study:

• To review the association between alcohol consumption, Lugol-voiding lesions, and field cancerization in esophageal SCC patients.
• To explore risk factors for metachronous SCC development after endoscopic resection.

Main Methods:

• Analysis of data from the prospective Japan Esophageal Cohort study.
• Surveillance included gastrointestinal endoscopy and otolaryngologist examinations.
• Assessment of genetic polymorphisms, Lugol-voiding lesion grade, risk appraisal scores, macrocytosis, and alcohol use disorders.

Main Results:

• Esophageal SCC and head and neck SCC post-resection were linked to alcohol metabolism genetic polymorphisms and Lugol-voiding lesion grade.
• High standardized incidence ratio of head and neck SCC observed in patients with prior esophageal SCC.
• Factors like macrocytosis and alcohol use disorder scores also correlated with SCC risk.

Conclusions:

• Drinking and smoking cessation are crucial for reducing metachronous esophageal SCC risk.
• Identifying field cancerization risk factors enables early diagnosis and minimally invasive treatment.
• Lifestyle guidance for alcohol and smoking is vital for decreasing esophageal SCC incidence and mortality.