Lifetime alcohol intake, drinking patterns over time and risk of stomach cancer: A pooled analysis of data from two prospective cohort studies

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  • Harindra Jayasekara
  • Robert J. MacInnis
  • Leila Lujan-Barroso
  • Ana-Lucia Mayen-Chacon
  • Amanda J. Cross
  • Bengt Wallner
  • Domenico Palli
  • Fulvio Ricceri
  • Valeria Pala
  • Salvatore Panico
  • Rosario Tumino
  • Tilman Kuehn
  • Rudolf Kaaks
  • Kostas Tsilidis
  • Maria-Jose Sanchez
  • Pilar Amiano
  • Eva Ardanaz
  • Maria Dolores Chirlaque Lopez
  • Susana Merino
  • Joseph A. Rothwell
  • Marie-Christine Boutron-Ruault
  • Gianluca Severi
  • Hanna Sternby
  • Emily Sonestedt
  • Bas Bueno-de-Mesquita
  • Heiner Boeing
  • Ruth Travis
  • Torkjel M. Sandanger
  • Antonia Trichopoulou
  • Anna Karakatsani
  • Eleni Peppa
  • Yi Yang
  • Allison M. Hodge
  • Hazel Mitchell
  • Andrew Haydon
  • Robin Room
  • John L. Hopper
  • Elisabete Weiderpass
  • Marc J. Gunter
  • Elio Riboli
  • Graham G. Giles
  • Roger L. Milne
  • Antonio Agudo
  • Dallas R. English
  • Pietro Ferrari

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.

Original languageEnglish
JournalInternational Journal of Cancer
Volume148
Issue number11
Pages (from-to)2759-2773
Number of pages15
ISSN0020-7136
DOIs
Publication statusPublished - 2021

    Research areas

  • cardia cancer, EPIC, lifetime alcohol intake, MCCS, noncardia cancer, stomach cancer

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