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 - Kuehn, Tilman

AU - Kaaks, Rudolf

AU - Tsilidis, Kostas

AU - Sanchez, Maria-Jose

AU - Amiano, Pilar

AU - Ardanaz, Eva

AU - Chirlaque Lopez, Maria 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 - Tjonneland, 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

PY - 2021

Y1 - 2021

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 (P-homogeneity = .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 (P-homogeneity = .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 - cardia cancer

KW - EPIC

KW - lifetime alcohol intake

KW - MCCS

KW - noncardia cancer

KW - stomach cancer

U2 - 10.1002/ijc.33504

DO - 10.1002/ijc.33504

M3 - Journal article

C2 - 33554339

VL - 148

SP - 2759

EP - 2773

JO - Acta - Unio Internationalis Contra Cancrum

JF - Acta - Unio Internationalis Contra Cancrum

SN - 0898-6924

IS - 11

ER -