TY - JOUR
T1 - Lifetime alcohol intake, drinking patterns over time and risk of stomach cancer
T2 - A pooled analysis of data from two prospective cohort studies
AU - Jayasekara, Harindra
AU - MacInnis, Robert J.
AU - Lujan-Barroso, Leila
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 - Chirlaque López, María Dolores
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 - Yang, Yi
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 - Publisher Copyright:
© 2021 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
PY - 2021/6/1
Y1 - 2021/6/1
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 (HRs) and 95% confidence intervals (CIs) 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. In all, 1225 incident stomach cancers (78% noncardia) 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 noncardia cancer (HR = 1.03, 95% CI: 1.00-1.06 per 10 g/d increment), with a HR of 1.50 (95% CI: 1.08-2.09) for ≥60 g/d compared to 0.1 to 4.9 g/d. 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 noncardia 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 to light stable intake (Phomogeneity =.02). These associations did not differ appreciably by smoking or H pylori infection status. Limiting alcohol use during lifetime, particularly avoiding heavy use during early adulthood, might help prevent noncardia stomach cancer. Heterogeneous associations observed for cardia and noncardia 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 (HRs) and 95% confidence intervals (CIs) 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. In all, 1225 incident stomach cancers (78% noncardia) 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 noncardia cancer (HR = 1.03, 95% CI: 1.00-1.06 per 10 g/d increment), with a HR of 1.50 (95% CI: 1.08-2.09) for ≥60 g/d compared to 0.1 to 4.9 g/d. 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 noncardia 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 to light stable intake (Phomogeneity =.02). These associations did not differ appreciably by smoking or H pylori infection status. Limiting alcohol use during lifetime, particularly avoiding heavy use during early adulthood, might help prevent noncardia stomach cancer. Heterogeneous associations observed for cardia and noncardia cancers may indicate etiologic differences.
KW - EPIC
KW - MCCS
KW - cardia cancer
KW - lifetime alcohol intake
KW - noncardia cancer
KW - stomach cancer
UR - http://www.scopus.com/inward/record.url?scp=85101271312&partnerID=8YFLogxK
U2 - 10.1002/ijc.33504
DO - 10.1002/ijc.33504
M3 - Article
C2 - 33554339
AN - SCOPUS:85101271312
SN - 0020-7136
VL - 148
SP - 2759
EP - 2773
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 11
ER -