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Do beliefs about alcohol and cancer risk vary by alcoholic beverage type and heart disease risk beliefs?

A recent study showed that awareness of the alcohol-cancer link was low, varied by beverage type, and was higher among those recognizing that alcohol use increased heart disease risk, according to recently published data (Cancer Epidemiol Biomarkers Prev 2022; doi: 10.1158/1055-9965.EPI-22-0420). These findings, according to the study authors, "underscore the need to educate U.S. adults about the alcohol-cancer link, including raising awareness that drinking all alcoholic beverage types increases cancer risk." To assess Americans' awareness on this topic, the research team analyzed data from the 2020 Health Information National Trends Survey 5 Cycle 4, which encompasses survey responses from 3,865 adults. Respondents were asked, "In your opinion, how much does drinking the following types of alcohol affect the risk of getting cancer?" Responses were recorded for wine, beer, and liquor. Further questions assessed the respondents' awareness of links between alcohol and heart disease. Participants were also asked about their current alcohol intake. The data showed that awareness of the alcohol-cancer link was highest for liquor, with 31.2 percent of U.S. adults being aware of the risk, followed by beer (24.9%) and wine (20.3%). Ten percent of U.S. adults said wine decreases cancer risk, 2.2 percent said beer decreases risk, and 1.7 percent said liquor decreases risk, according to study authors. The majority of U.S. adults (>50%) reported not knowing how these beverages affected cancer risk. U.S. adults who were aware that alcoholic beverages increased heart disease risk had higher adjusted predicted probabilities of being aware of the alcohol-cancer link, the findings demonstrated. Heart disease awareness followed similar patterns to cancer awareness, with 38.9 percent, 36.4 percent, and 25.1 percent of U.S. adults believing that liquor, beer, and wine, respectively, increased heart disease risk. The data also revealed that older adults demonstrated lower awareness of alcohol as a risk factor for cancer. Drinking status was not associated with awareness, with similar rates for non-drinkers, drinkers, and heavier drinkers. The investigators recommended the following interventions to raise awareness: mass media campaigns, cancer warning labels, and patient-provider communications.


AUTHOR COMMENTARY: "All types of alcoholic beverages, including wine, increase cancer risk," said senior author William M.P. Klein, PhD, Associate Director of the National Cancer Institute's Behavioral Research Program. "This study's findings underscore the need to develop interventions for educating the public about the cancer risks of alcohol use, particularly in the prevailing context of national dialogue about the purported heart health benefits of wine. Educating the public about how alcohol increases cancer risk will not only empower consumers to make more informed decisions, but may also prevent and reduce excessive alcohol use, as well as cancer morbidity and mortality."



Germline variants in DNA damage repair genes and HOXB13 among Black patients with early-onset prostate cancer

Variants in DNA damage repair (DDR) genes and HOXB13 may be important cancer risk factors for Black men diagnosed with early-onset prostate cancer, according to a recent study, which also found that they are more frequently observed in men with a family history of cancer (JCO Precis Oncol 2022; doi:10.1200/PO.22.00460). The study authors performed whole-exome sequencing of germline DNA from a population-based cohort of Black men diagnosed with prostate cancer at age 62 years or younger. The focus was on DNA damage repair genes and HOXB13, a gene the research team found to be associated with hereditary prostate cancer in White men. Among 743 Black prostate cancer patients, the researchers identified 26 variants in 14 genes that could cause disease among 30 men, approximately 4 percent of the patients studied. The study authors also identified 33 unique variants of unknown significance in 16 genes among 39 men. Due to the rarity of these variants in the population, the investigators noted that most associations between clinical characteristics did not achieve statistical significance. "However, our results suggest that carriers for P or LP (P/LP) variants were more likely to have a first-degree relative diagnosed with DDR gene-associated cancer, have a higher prostate-specific antigen at time of diagnosis, and be diagnosed with metastatic disease."


AUTHOR COMMENTARY: "Our results reveal that men who had certain genetic variants were more likely to have a close relative diagnosed with cancer, have a higher prostate-specific antigen at time of diagnosis, and have more severe cases," said senior author Kathleen Cooney, MD, Chair of the Duke Department of Medicine. "We need to take a closer look at genetic associations to learn more about the susceptibility Black men have to developing prostate cancer. This could potentially reduce health disparities."



State variation in squamous cell carcinoma of the anus incidence and mortality, and association with HIV/AIDS and smoking in the United States

From 2001-2005 to 2014-2018, squamous cell carcinoma of the anus (SCCA) incidence and mortality nearly doubled among men and women aged 50 years or older living in Midwest and Southeast, according to data published in the Journal of Clinical Oncology (2022; doi: 10.1200/JCO.22.01390). The study authors noted that state variation in AIDS and smoking patterns may explain variation in SCCA incidence. They emphasized the need for improved and targeted prevention to combat the rise in SCCA incidence and mitigate magnifying geographic disparities. The investigators used the U.S. Cancer Statistics and the National Center for Health Statistics datasets to estimate state-level SCCA incidence and mortality rates. They calculated rate ratios to compare incidence and mortality in 2014-2018 versus 2001-2005. Nationally, the study authors reported that SCCA incidence and mortality rates (per 100,000) increased among men and women ages 50 years and older, but decreased among men ages younger than 50 years and were stable among similar-aged women. "In state-level analysis, a marked increase in incidence (>= 1.5-fold for men and >= two-fold for women) and mortality (>= two-fold) for persons age >= 50 years was largely concentrated in the Midwestern and Southeastern states," according to the findings. The study authors also observed that state-level SCCA incidence rates in recent years (2014-2018) in men were correlated with state-level AIDS prevalence patterns. Among women, they found a correlation between state-level SCCA incidence rates and smoking prevalence.


AUTHOR COMMENTARY: "Anal cancer is often neglected and stigmatized. Also, it has been historically perceived as a rare malignancy," said Ashish Deshmukh, PhD, a researcher at MUSC Hollings Cancer Center. "For now, HPV vaccination really is the best available measure to prevent six cancers, including cervical, vaginal, vulvar, penile, anal, and throat cancer. Hollings' HPV vaccination van that reaches rural and underserved communities is an important asset for the state."


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