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This systematic review and meta-analysis searched five databases, synthesizing cohort and case-control evidence to estimate combined effects and multiplicative interactions. Among included studies, interaction and synergistic patterns intensified with heavier 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question did this study address?","Question",{"text":112,"@type":113},"It assessed how alcohol consumption and smoking interact to influence cancer risk across different exposure levels and cancer types.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What evidence was included in the meta-analysis?",{"text":117,"@type":113},"The analysis included 24 studies (4 cohort and 20 case-control) identified from 4,452 records.",{"name":119,"@type":110,"acceptedAnswer":120},"How did the combined effects vary by exposure level and cancer type?",{"text":121,"@type":113},"Synergistic interactions increased with greater consumption, with stronger interaction effects reported for head and neck cancers, including oral and laryngeal cancers.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},333436,1790080644,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},549758252649,"https://ap-avatar.wpscdn.com/avatar/8000253669c5317157?_k=1778319167496531819","J Korean Med Sci. 2024 Jun 10;39(22):e185 [https://doi.org/10.3346/jkms.2024.39.e185](https://doi.org/10.3346/jkms.2024.39.e185)[ ](https://doi.org/10.3346/jkms.2024.39.e185)eISSN 1598-6357·pISSN 1011-8934  \nOriginal Article  \nPublic Health & Preventive Medicine  \nReceived: Dec 16, 2023  \nAccepted: May 7, 2024  \nPublished online: May 28, 2024  \nAddress for Correspondence:  \nHyesook Park, PhD  \nDepartment of Preventive Medicine, College of Medicine, Ewha Womans University, 25 Magokdong-ro 2-gil, Gangseo-gu, Seoul 07804, Korea.  \nEmail: [hpark@ewha.ac.kr](hpark@ewha.ac.kr)  \n© 2024 The Korean Academy of Medical Sciences.  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([https://](https://)[ ](https://)[creativecommons.org/licenses/by-nc/4.0/](creativecommons.org/licenses/by-nc/4.0/)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nORCID iDs  \nSeunghee Jun  [https://orcid.org/0000-0002-0530-8720](https://orcid.org/0000-0002-0530-8720)[ ](https://orcid.org/0000-0002-0530-8720)Hyunjin Park  [https://orcid.org/0000-0001-6536-8787](https://orcid.org/0000-0001-6536-8787)[ ](https://orcid.org/0000-0001-6536-8787)[Ui-Jeong Kim](Ui-Jeong Kim)  [https://orcid.org/0000-0001-8362-2232](https://orcid.org/0000-0001-8362-2232)[ ](https://orcid.org/0000-0001-8362-2232)Hye Ah Lee  [https://orcid.org/0000-0002-4051-0350](https://orcid.org/0000-0002-4051-0350)[ ](https://orcid.org/0000-0002-4051-0350)Bomi Park  [https://orcid.org/0000-0001-5834-9975](https://orcid.org/0000-0001-5834-9975)[ ](https://orcid.org/0000-0001-5834-9975)Soon Young Lee  [https://orcid.org/0000-0002-3160-577X](https://orcid.org/0000-0002-3160-577X)[ ](https://orcid.org/0000-0002-3160-577X)Sun HaJee  [https://orcid.org/0000-0001-9519-3068](https://orcid.org/0000-0001-9519-3068)[ ](https://orcid.org/0000-0001-9519-3068)Hyesook Park  [https://orcid.org/0000-0002-9359-6522](https://orcid.org/0000-0002-9359-6522)  \nThe Combined Effects of Alcohol Consumption and Smoking on Cancer Risk by Exposure Level: A Systematic Review and Meta-Analysis  \nSeunghee Jun ,1,2 Hyunjin Park ,1,2 Ui-Jeong Kim ,1 Hye Ah Lee ,3 Bomi Park ,4 Soon Young Lee ,5 Sun Ha Jee ,6 and Hyesook Park  1,2  \n1Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea 2Graduate Program in System Health Science and Engineering, Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea  \n3Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Korea  \n4Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, Korea 5Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea 6Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea  \nABSTRACT  \nBackground: Alcohol consumption is a major risk factor for cancer, and when combined with smoking, the risk increases. Nevertheless, few studies have comprehensively evaluated the combined effects of alcohol consumption and smoking on the risk ofvarious cancer types. Therefore, to assess these effects, we conducted a systematic review and meta-analysis. Methods: We performed a systematic search of five literature databases, focusing on cohort and case-control studies. Considering exposure levels, we quantified the combined effects of alcohol consumption and smoking on cancer risk and assessed multiplicative interaction effects. Results: Of 4,452 studies identified, 24 (4 cohort studies and 20 case-control studies) were included in the meta-analysis. We detected interaction effect of light alcohol and moderate smoking on head and neck cancer risk (relative risk [RR], 4.26; 95% confidence interval [CI], 2.50–7.26; I2 = 65%). A synergistic interaction was observed in heavy alco","cbCaig0pCXSgOzkm","https://ap.wps.com/l/cbCaig0pCXSgOzkm","pdf",1331482,15,"English","# Abstract\n# Introduction\n# Methods\n# Results\n# Conclusion","[{\"question\":\"What question did this study address?\",\"answer\":\"It assessed how alcohol consumption and smoking interact to influence cancer risk across different exposure levels and cancer types.\"},{\"question\":\"What evidence was included in the meta-analysis?\",\"answer\":\"The analysis included 24 studies (4 cohort and 20 case-control) identified from 4,452 records.\"},{\"question\":\"How did the combined effects vary by exposure level and cancer type?\",\"answer\":\"Synergistic interactions increased with greater consumption, with stronger interaction effects reported for head and neck cancers, including oral and laryngeal cancers.\"}]","The Combined Effects of Alcohol Consumption and Smoking on Cancer Risk by Exposure Level - A Systematic Review and Meta-Analysis | PDF",1790002425,38]