(HealthDay News) — The combined use of alcohol and tobacco has a synergistic effect on the risk of developing esophageal squamous cell carcinoma (ESCC), according to research published in online April 22 in the American Journal of Gastroenterology.

Anoop Prabhu, M.D., of the University of Michigan in Ann Arbor, and colleagues conducted a systematic review of the literature to identify population-based case-control or cohort studies evaluating the effects of alcohol and/or tobacco on the risk of ESCC. The researchers performed meta-analyses using data from five eligible studies.

The researchers found that users of alcohol or tobacco were 20 to 30 percent more likely to develop ESCC. Users of both alcohol and tobacco have an approximately three-fold risk of developing ESCC (summary-adjusted odds ratio, 3.28; 95 percent confidence interval [CI], 2.11 to 5.08; Cochrane’s Q P value = 0.05). The summary synergy factor for ever-use of both alcohol and tobacco was 1.85 (95 percent CI, 1.45 to 2.38; Cochrane’s Q P value = 0.49).

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“Individuals who used both tobacco and alcohol had almost twice the risk of ESCC than that expected from their combined use if there was no synergy,” the authors write. “Efforts for controlling the burden of ESCC should focus on individuals who use both alcohol and tobacco.”

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