TY - JOUR
T1 - Lifetime alcohol intake, drinking patterns over time, and risk of stomach cancer: a pooled analysis of data from two prospective cohort studies
AU - Jayasekara, Harindra
AU - MacInnis, Robert J
AU - Barroso, Leila Lujan
AU - Mayen-Chacon, Ana-Lucia
AU - Cross, Amanda J
AU - Wallner, Bengt
AU - Palli, Domenico
AU - Ricceri, Fulvio
AU - Pala, Valeria
AU - Panico, Salvatore
AU - Tumino, Rosario
AU - Kühn, Tilman
AU - Kaaks, Rudolf
AU - Tsilidis, Kostas
AU - Sánchez, Maria-Jose
AU - Amiano, Pilar
AU - Ardanaz, Eva
AU - López, María Dolores Chirlaque
AU - Merino, Susana
AU - Rothwell, Joseph A
AU - Boutron-Ruault, Marie-Christine
AU - Severi, Gianluca
AU - Sternby, Hanna
AU - Sonestedt, Emily
AU - Bueno-de-Mesquita, Bas
AU - Boeing, Heiner
AU - Travis, Ruth
AU - Sandanger, Torkjel M
AU - Trichopoulou, Antonia
AU - Karakatsani, Anna
AU - Peppa, Eleni
AU - Tjønneland, Anne
AU - Hodge, Allison M
AU - Mitchell, Hazel
AU - Haydon, Andrew
AU - Room, Robin
AU - Hopper, John L
AU - Weiderpass, Elisabete
AU - Gunter, Marc J
AU - Riboli, Elio
AU - Giles, Graham G
AU - Milne, Roger L
AU - Agudo, Antonio
AU - English, Dallas R
AU - Ferrari, Pietro
N1 - This article is protected by copyright. All rights reserved.
PY - 2021/2/7
Y1 - 2021/2/7
N2 - Alcohol consumption is causally linked to several cancers but the evidence for stomach cancer is inconclusive. In our study, the association between long-term alcohol intake and risk of stomach cancer and its subtypes was evaluated. We performed a pooled analysis of data collected at baseline from 491,714 participants in the European Prospective Investigation into Cancer and Nutrition and the Melbourne Collaborative Cohort Study. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated for incident stomach cancer in relation to lifetime alcohol intake and group-based life course intake trajectories, adjusted for potential confounders including Helicobacter pylori infection. 1,225 incident stomach cancers (78% non-cardia) were diagnosed over 7,094,637 person-years; 984 in 382,957 study participants with lifetime alcohol intake data (5,455,507 person-years). Although lifetime alcohol intake was not associated with overall stomach cancer risk, we observed a weak positive association with non-cardia cancer (HR=1.03, 95% CI: 1.00-1.06 per 10 g/day increment), with a HR of 1.50 (95% CI: 1.08-2.09) for ≥60 g/day compared with 0.1-4.9 g/day. A weak inverse association with cardia cancer (HR=0.93, 95% CI: 0.87-1.00) was also observed. HRs of 1.48 (95% CI: 1.10-1.99) for non-cardia and 0.51 (95% CI: 0.26-1.03) for cardia cancer were observed for a life course trajectory characterized by heavy decreasing intake compared with light stable intake (phomogeneity =0.02). These associations did not differ appreciably by smoking or Helicobacter pylori infection status. Limiting alcohol use during lifetime, particularly avoiding heavy use during early adulthood, might help prevent non-cardia stomach cancer. Heterogeneous associations observed for cardia and non-cardia cancers may indicate etiologic differences.
AB - Alcohol consumption is causally linked to several cancers but the evidence for stomach cancer is inconclusive. In our study, the association between long-term alcohol intake and risk of stomach cancer and its subtypes was evaluated. We performed a pooled analysis of data collected at baseline from 491,714 participants in the European Prospective Investigation into Cancer and Nutrition and the Melbourne Collaborative Cohort Study. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated for incident stomach cancer in relation to lifetime alcohol intake and group-based life course intake trajectories, adjusted for potential confounders including Helicobacter pylori infection. 1,225 incident stomach cancers (78% non-cardia) were diagnosed over 7,094,637 person-years; 984 in 382,957 study participants with lifetime alcohol intake data (5,455,507 person-years). Although lifetime alcohol intake was not associated with overall stomach cancer risk, we observed a weak positive association with non-cardia cancer (HR=1.03, 95% CI: 1.00-1.06 per 10 g/day increment), with a HR of 1.50 (95% CI: 1.08-2.09) for ≥60 g/day compared with 0.1-4.9 g/day. A weak inverse association with cardia cancer (HR=0.93, 95% CI: 0.87-1.00) was also observed. HRs of 1.48 (95% CI: 1.10-1.99) for non-cardia and 0.51 (95% CI: 0.26-1.03) for cardia cancer were observed for a life course trajectory characterized by heavy decreasing intake compared with light stable intake (phomogeneity =0.02). These associations did not differ appreciably by smoking or Helicobacter pylori infection status. Limiting alcohol use during lifetime, particularly avoiding heavy use during early adulthood, might help prevent non-cardia stomach cancer. Heterogeneous associations observed for cardia and non-cardia cancers may indicate etiologic differences.
U2 - 10.1002/ijc.33504
DO - 10.1002/ijc.33504
M3 - Article
C2 - 33554339
SN - 0020-7136
JO - International Journal of Cancer
JF - International Journal of Cancer
ER -
