Drinking hot tea associated with a 5-fold increased risk for esophageal cancer

1. Drinking hot tea associated with a 5-fold increased risk for esophageal cancer in high-risk individuals

Abstract: http://annals.org/aim/article/doi/10.7326/M17-2000

Editorial: http://annals.org/aim/article/doi/10.7326/M17-3370

FREE Summary for Patients: http://annals.org/aim/article/doi/10.7326/P17-9054

URLs go live when the embargo lifts

Consuming hot tea at high temperatures is associated with an increased risk for esophageal cancer in those who also drink alcohol and smoke cigarettes. The findings, based on long-term follow-up in more than 450,000 participants, are published in Annals of Internal Medicine.

Esophageal cancer is increasing in prevalence and has poor survival rates, particularly in less-developed regions and for men. China is among the countries with the highest esophageal cancer incidence. Tea drinkers, especially Chinese men, are more likely to also smoke and drink alcohol. Tobacco smoking and alcohol consumption, as well as the chemical compounds and adverse thermal effect of hot tea, considerably complicate the association between tea drinking and cancer risk.

Researchers for the National Natural Science Foundation of China and National Key Research and Development Program surveyed participants enrolled in the China Kadoorie Biobank (CKB) study, excluding those previously diagnosed with cancer or who reduced their tea drinking, alcohol intake, or cigarette smoking, to determine if high-temperature tea drinking was associated with increased risk for esophageal cancer. The authors followed 456,155 participants aged 30 to 79 for a media follow-up period of 9.2 years. They found a synergistic association between hot tea drinking with excessive alcohol consumption or smoking and the risk for esophageal cancer. Participants who drank high-temperature tea, consumed alcohol excessively, and smoked had an esophageal cancer risk more than 5 times greater than those who had none of those 3 habits. However, the absence of both excessive alcohol consumption and smoking, daily tea drinking was not associated with esophageal cancer risk.

According to the study authors, these findings suggest that abstaining from hot tea may be beneficial for persons who drink alcohol excessively or smoke.

Media contacts: For an embargoed PDF, please contact Angela Collom. The lead author, Jun Lv, PhD, can be contacted directly at lvjun@bjmu.edu.cn.

2. New ACIP Adult Immunization Schedule recommends changes to shingles and MMR vaccines

Abstract: http://annals.org/aim/article/doi/10.7326/M17-3439

URLs go live when the embargo lifts

The Advisory Committee on Immunization Practices (ACIP) released its 2018 Recommended Immunization Schedule for adults with changes to the administration of the herpes zoster and measles, mumps, and rubella (MMR) vaccines. The schedule includes a colorful cover page with references, resources, approved acronyms, and instructions for specific patient populations. The schedule is published in Annals of Internal Medicine.

In October 2017, the U.S. Food and Drug Administration approved the use of recombinant zoster vaccine (RZV) for adults aged 50 and older for the prevention of herpes zoster, or shingles. ACIP recommends the RZV for prevention of shingles and related complications for immunocompetent adults aged 50 and older; those who previously received the zoster vaccine live (ZVL); and either RZV or ZVL for adults 60 and older, with a preference for RZV. As for the MMR vaccine, ACIP now recommends an additional dose of MMR for adults identified to be at increased risk during a mumps outbreak.

While the new schedule is clean and streamlined for ease of reference, physicians should pay careful attention to the details found in the footnotes. The footnotes clarify who needs what vaccine, when, and at what dose.

The complete schedule, including footnote changes, is being simultaneously published in Annals of Internal Medicine and on the Centers for Disease Control and Prevention (CDC) web site. The CDC's ACIP is comprised of the American College of Physicians (ACP) and 16 other medical societies representing various medical practice areas. Each year, the ACIP reviews the CDC's Recommended Adult Immunization Schedule to ensure the schedule reflects current clinical recommendations for licensed vaccines. The recommendations are intended to guide physicians and other clinicians about the appropriate vaccines for their adult patients.

Note: For an embargoed PDF, please contact Angela Collom. To interview ACP's liaison to ACIP, Sandra Adamson Fryhofer, MD, MACP, please contact her directly at Sandra@drsandrafryhofer.com or 404-816-8660.

3. To reduce overdose deaths, the U.S. needs to pilot the use of supervised injection facilities

Abstract: http://annals.org/aim/article/doi/10.7326/M18-0258

URLs go live when the embargo lifts

The authors of a new commentary published in Annals of Internal Medicine come out strong in support of supervised injection facilities, or SIFs. They say that SIFs save lives by bringing addiction out of the shadows. The evidence suggests they may be right.

SIFs offer sterile injecting equipment and a hygienic environment for medically supervised injection of drugs obtained off-site. They also offer education about reducing harms, access to life-saving naloxone, and connection to primary health care services, counseling, and treatment for substance use disorders. Approximately 100 SIFs in 11 countries across Europe, North America, and Australia have been studied for decades. Over 100 peer-reviewed studies on SIFs offer compelling evidence that they reduce mortality, reduce overdose, and increase safer injection behaviors, while increasing access to addiction treatment. At the same time, research has shown that SIFs do not increase public disorder or attract drug-related crime to an area or increase relapse rates.

The authors suggest that it's time for the United States to pilot the use of SIFs as part of a multi-pronged approach to reducing opioid overdose deaths. Piloting SIFs would allow researchers to study the impact of such facilities while providing despairing communities with an additional strategy to mitigate overdose deaths and connect people to treatment.

Media contacts: For an embargoed PDF, please contact Angela Collom. To interview the lead author, Jessie M. Gaeta, MD, please contact Vicki Ritterband at vicki@ritterbandcommunications.com or 617-795-0180.

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Angela Collom
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