**9. Alcohol, cigarette smoking, and cancer**

In 2017, the American Society of Clinical Oncology announced that alcohol drinking had been established as a risk factor for cancer, and avoiding excessive

**129**

Japanese population.

**Figure 2.**

smoking is mandatory (**Figure 2**).

**10. Aspirin and cancer**

*Etiology of Cancer Associated Thromboembolism (CAT), and Diet, Lifestyle and Medicine…*

drinking was important to prevent cancer [50]. The development of pharyngeal, laryngeal, esophageal, liver, breast, and colorectal cancer was obviously related to alcohol drinking. The incidence of esophageal cancer was 1.3 times higher for small drinkers, 2.2 times for moderate drinkers, and 5 times for heavy drinkers than nondrinkers. Ethanol itself is not carcinogenic, but acetaldehyde, its metabolite, binds to DNA and proteins to be carcinogenic and mutagenic. It is proven that administration of large amount of ethanol or acetaldehyde causes cancer in animal experiments [51]. Acetaldehyde is metabolized by aldehyde dehydrogenase 2 (ALDH2). Higher percentage of Japanese people has inactive form of ALDH2 compared to the Western. It might result in adverse effects of alcohol drinking on carcinogenesis in

*Effects of diets and lifestyle on cancer and venous thromboembolism (VTE). Fish, vegetables, and fruits may decrease the incidences of both cancer and VTE. Cigarette smoking and obesity increase the incidences of both cancer and VTE. Drinking alcohol and consuming lean and processed meat increase the incidence of cancer.* 

Smoking is a well-known risk factor for cancer. The International Agency for Research on Cancer (IRAC) assessed causal relationships in 2009 and stated that smoking is related to oral, pharyngeal, laryngeal, esophageal, lung, gastric, colon, liver, pancreatic, renal cell, renal pelvis, ureter, bladder, cervical, and ovarian cancer and chronic myelogenous leukemia. Passive smoking is a risk factor for lung cancer [52]. To prevent cancer of yourself, your family, and your colleagues, no

Aspirin is a widely used antiplatelet drug that inhibits platelets' cyclooxygenase (COX), resulting in decreased platelet aggregation. Numerous studies have demonstrated the effects of aspirin on the secondary prevention of arterial thrombosis, and several studies have investigated the effects of aspirin use for the primary prevention of atherosclerotic diseases. Meta-analyses of these studies have shown that daily regular aspirin use reduce the incidence of colon cancer, mortality of colon cancer, and metastasis of colon cancer. The incidence or mortality of other types of cancer might also be reduced [53–55]. Increased COX expression results in tumor growth and progression, and inhibition of COX reduces carcinogenesis in animal experiments. Platelets are known to play an important role in tumor metastasis [56]. These might be related to the inhibitory effects of aspirin on cancer reported in meta-analyses. On the other hand, some recent reports have shown that

*DOI: http://dx.doi.org/10.5772/intechopen.92379*

*Whole grain and dietary fiber decrease the incidence of cancer.*

*Etiology of Cancer Associated Thromboembolism (CAT), and Diet, Lifestyle and Medicine… DOI: http://dx.doi.org/10.5772/intechopen.92379*

**Figure 2.**

*New Insights into Metabolic Syndrome*

in the development of VTE.

and cancer mortality.

**8. Diet, nutrition, and cancer**

**7. Factors associated with carcinogenesis**

thrombosis might also be useful to prevent VTE. Furthermore, consumption of grape suppresses thrombin generation and enhances fibrinolysis [44]. Diets with 20, 30, and 50% of their calories on protein, lipids, and carbohydrates for 12 months result in reduction of abdominal circumference, increased HDL-C, decreased fibrinogen, and significantly increased interleukin-10 in those with metabolic syndrome [45]. These reports suggest that diet and nutrition might directly affect the blood coagulation and fibrinolysis which play an important role

Several reports related to the alcohol consumption and VTE have also been published. Women consuming alcohol daily were at 26% lower risk of VTE than non-consumers [46], and the analysis of three large US cohorts showed no evidence of an association of alcohol consumption amount or frequency with PE risk [47].

The accumulation of various genetic abnormalities in normal cells causes carcinogenesis. Some cancers are caused by congenital genetic abnormalities, but most genetic abnormalities causing cancers are acquired abnormalities. It is estimated that smoking contributes to 20% of cancers and 23% of cancer deaths and infection with helicobacter pylori, hepatitis virus, etc. contributes to 21% of cancers and 22% of cancer deaths in Japanese population, and these are thought to be the main risk factors for cancer in Japanese population. Drinking alcohol contributes to 6% of both cancers and cancer deaths, and it is also a significant risk factor for cancer in Japanese population. Consumption of salt more than 6 g per day, deficiency of fruit intake, and deficiency of vegetable intake also contribute to 1.6, 0.7, and 0.6% of cancers and 1.4, 0.8, and 0.6% of cancer deaths, respectively [48]. Diet and nutrition seem to have some effects on the development of cancer

According to a report "Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective" published by World Cancer Research Fund and American Institute for Cancer Research, it is convincing that adult body fatness has increased risks of esophageal, pancreatic, liver, colorectal, postmenopausal breast, endometrial, and kidney cancer. As for diets and nutrition, there exist causal relationships between aflatoxin and liver cancer, lean and processed meat and colon cancer, arsenic in drinking water and lung cancer, and high-dose beta-carotene supplements and lung cancer. On the other hand, whole grains and food containing dietary fiber decrease colorectal cancer. Non-starchy vegetables and fruits decrease aerodigestive cancer and some other cancers [49]. It is not fully understood how each diet and nutrition has effects on carcinogenesis, a diet with enough vegetables and fruits, less lean and processed meat, reduced carbohydrate and fat to prevent

obesity, and low in salt might be useful to reduce cancer incidence.

In 2017, the American Society of Clinical Oncology announced that alcohol drinking had been established as a risk factor for cancer, and avoiding excessive

**9. Alcohol, cigarette smoking, and cancer**

These findings suggest that alcohol drinking is not a risk factor for VTE.

**128**

*Effects of diets and lifestyle on cancer and venous thromboembolism (VTE). Fish, vegetables, and fruits may decrease the incidences of both cancer and VTE. Cigarette smoking and obesity increase the incidences of both cancer and VTE. Drinking alcohol and consuming lean and processed meat increase the incidence of cancer. Whole grain and dietary fiber decrease the incidence of cancer.*

drinking was important to prevent cancer [50]. The development of pharyngeal, laryngeal, esophageal, liver, breast, and colorectal cancer was obviously related to alcohol drinking. The incidence of esophageal cancer was 1.3 times higher for small drinkers, 2.2 times for moderate drinkers, and 5 times for heavy drinkers than nondrinkers. Ethanol itself is not carcinogenic, but acetaldehyde, its metabolite, binds to DNA and proteins to be carcinogenic and mutagenic. It is proven that administration of large amount of ethanol or acetaldehyde causes cancer in animal experiments [51]. Acetaldehyde is metabolized by aldehyde dehydrogenase 2 (ALDH2). Higher percentage of Japanese people has inactive form of ALDH2 compared to the Western. It might result in adverse effects of alcohol drinking on carcinogenesis in Japanese population.

Smoking is a well-known risk factor for cancer. The International Agency for Research on Cancer (IRAC) assessed causal relationships in 2009 and stated that smoking is related to oral, pharyngeal, laryngeal, esophageal, lung, gastric, colon, liver, pancreatic, renal cell, renal pelvis, ureter, bladder, cervical, and ovarian cancer and chronic myelogenous leukemia. Passive smoking is a risk factor for lung cancer [52]. To prevent cancer of yourself, your family, and your colleagues, no smoking is mandatory (**Figure 2**).

## **10. Aspirin and cancer**

Aspirin is a widely used antiplatelet drug that inhibits platelets' cyclooxygenase (COX), resulting in decreased platelet aggregation. Numerous studies have demonstrated the effects of aspirin on the secondary prevention of arterial thrombosis, and several studies have investigated the effects of aspirin use for the primary prevention of atherosclerotic diseases. Meta-analyses of these studies have shown that daily regular aspirin use reduce the incidence of colon cancer, mortality of colon cancer, and metastasis of colon cancer. The incidence or mortality of other types of cancer might also be reduced [53–55]. Increased COX expression results in tumor growth and progression, and inhibition of COX reduces carcinogenesis in animal experiments. Platelets are known to play an important role in tumor metastasis [56]. These might be related to the inhibitory effects of aspirin on cancer reported in meta-analyses. On the other hand, some recent reports have shown that



**Table 3.**

*Effects of aspirin on cancer incidence and cancer mortality.*

regular aspirin use does not decrease cancer incidence or cancer mortality [57–59] (**Table 3**). Further studies are needed to confirm the effects of aspirin on cancer incidence and cancer mortality.
