Alcohol intake, tobacco smoking, and esophageal adenocarcinoma survival: a molecular pathology epidemiology cohort study

R. Stephen McCain*, Damian T. McManus, Stephen McQuaid, Jacqueline A. James, Manuel Salto-Tellez, Nathan B. Reid, Stephanie Craig, Chintapuza Chisambo, Victoria Bingham, Eamon McCarron, Eileen Parkes, Richard C. Turkington, Helen G. Coleman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
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To investigate the association between cigarette smoking, alcohol consumption, and esophageal adenocarcinoma survival, including stratified analysis by selected prognostic biomarkers.

A population-representative sample of 130 esophageal adenocarcinoma patients (n = 130) treated at the Northern Ireland Cancer Centre between 2004 and 2012. Cox proportional hazards models were applied to evaluate associations between smoking status, alcohol intake, and survival. Secondary analyses investigated these associations across categories of p53, HER2, CD8, and GLUT-1 biomarker expression.

In esophageal adenocarcinoma patients, there was a significantly increased risk of cancer-specific mortality in ever, compared to never, alcohol drinkers in unadjusted (HR 1.96 95% CI 1.13–3.38) but not adjusted (HR 1.70 95% CI 0.95–3.04) analysis. This increased risk of death observed for alcohol consumers was more evident in patients with normal p53 expression, GLUT-1 positive or CD-8 positive tumors. There were no significant associations between survival and smoking status in esophageal adenocarcinoma patients.

In esophageal adenocarcinoma patients, cigarette smoking or alcohol consumption was not associated with a significant difference in survival in comparison with never smokers and never drinkers in fully adjusted analysis. However, in some biomarker-selected subgroups, ever-alcohol consumption was associated with a worsened survival in comparison with never drinkers. Larger studies are needed to investigate these findings, as these lifestyle habits may not only be linked to cancer risk but also cancer survival.
Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalCancer Causes and Control
Issue number1
Early online date30 Nov 2019
Publication statusPublished - Jan 2020


  • Adenocarcinoma/mortality
  • Adult
  • Aged
  • Alcohol Drinking/adverse effects
  • CD8 Antigens/metabolism
  • Chemotherapy, Adjuvant
  • Cohort Studies
  • Esophageal Neoplasms/mortality
  • Female
  • Glucose Transporter Type 1/metabolism
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Northern Ireland
  • Pathology, Molecular
  • Prognosis
  • Proportional Hazards Models
  • Receptor, ErbB-2/metabolism
  • Risk Factors
  • Smoking/adverse effects
  • Tissue Array Analysis
  • Tobacco Smoking
  • Tumor Suppressor Protein p53/metabolism

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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