Alcohol Drinking Cessation and the Risk of Laryngeal and Pharyngeal Cancers: A Systematic Review and Meta-Analysis

Objective

To evaluate the effect of alcohol cessation on the risk of developing laryngeal and pharyngeal cancers, combining available evidence in the scientific literature in a meta-analysis.

Methods

A systematic literature review was conducted, and a meta-analysis was applied on the retrieved studies. The generalised least squares method was used to estimate the trend from dose-response data to assess changes in the risks of laryngeal and pharyngeal cancers after drinking cessation.

Results

A total of 9 case-control studies were included in the meta-analysis (4 and 8 estimates for laryngeal and pharyngeal cancers, respectively). On average, alcohol drinking cessation was associated with a 2% yearly reduction in the risk of developing laryngeal and pharyngeal cancers. There was a considerable heterogeneity between the studies of pharyngeal cancer, but this was mostly due to two studies. The increased risk of laryngeal and pharyngeal cancers caused by alcohol was reversible; the time periods until the risks became equal to those of never drinkers were 36 (95% CI 11–106) and 39 (95% CI 13–103) years, respectively. Moreover, 5 years of drinking cessation was associated with a reduction of around 15% in the alcohol-related elevated risk of laryngeal and pharyngeal cancers.

Conclusion

Although a long time period is required to completely eliminate the alcohol-related elevated risk of laryngeal and pharyngeal cancers, a substantial risk reduction can be seen in the short term (5–10 years), and drinking cessation should therefore be encouraged to reduce the incidence of these cancers.     

Social capital externalities and mortality in Sweden

We conceptualize social capital as an aggregate factor affecting health production and analyze the effect of community social capital (CSC) externalities on individual mortality risk in Sweden. The study was based on a random sample from the adult Swedish population of approximately 95,000 individuals who were followed up for 4-21 years. Two municipality-level variable--registered election participation rate and registered crime rate--were used to be a proxy for CSC. The impact of CSC on mortality was estimated with an extended Cox model, controlling for the initial health status and a number of individual characteristics. The results indicate that both proxies of CSC were associated with individual risk from all-cause mortality for males older than 65+ (p=0.013 and p=0.008) but not for females. A higher election participation rate negatively and significantly associated with the mortality risk from cancer for males (p=0.007), and may also have exerted protective associations for cardiovascular mortality (p=0.134) and deaths due to "suicide" (p=0.186) or "other external causes" (p=0.055). Similar associations were observed for the crime rate variable. The findings were robust to alternative specifications examined in the sensitivity analysis.     

Deaths rise in good economic times: Evidence from the OECD

This study uses aggregate data for 23 Organization for Economic Cooperation and Development (OECD) countries over the 1960-1997 period to examine the relationship between macroeconomic conditions and deaths. The main finding is that total mortality and deaths from several common causes rise when labor markets strengthen. For instance, controlling for year effects, location fixed-effects (FE), country-specific time trends and demographic characteristics, a 1% point decrease in the national unemployment rate is associated with growth of 0.4% in total mortality and the following increases in cause-specific mortality: 0.4% for cardiovascular disease, 1.1% for influenza/pneumonia, 1.8% for liver disease, 2.1% for motor vehicle deaths, and 0.8% for other accidents. These effects are particularly pronounced for countries with weak social insurance systems, as proxied by public social expenditure as a share of GDP. The findings are consistent with evidence provided by other recent research and cast doubt on the hypothesis that economic downturns have negative effects on physical health.