Prediagnosis alcohol intake and metachronous cancer risk in cancer survivors: A prospective cohort study. Issue 4 (5th May 2021)

• Record Type: Journal Article
• Authors: Jayasekara, Harindra; Hodge, Allison M.; Haydon, Andrew; Room, Robin; Hopper, John L.; English, Dallas R.; Smith‐Warner, Stephanie A.; Giles, Graham G.; Milne, Roger L.; MacInnis, Robert J.
• Is Part Of: International journal of cancer. Volume 149:Issue 4(2021)
• Page Start: 827
• Page End: 838
• Publication Date: 2021-05-05
• Subjects: cohort study -- lifetime alcohol intake -- metachronous cancer -- risk factor; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.33603
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract: Alcohol consumption is a known cause of cancer, but its role in the etiology of second primary (metachronous) cancer is uncertain. Associations between alcohol intake up until study enrollment (prediagnosis) and risk of metachronous cancer were estimated using 9435 participants in the Melbourne Collaborative Cohort Study who were diagnosed with their first invasive cancer after enrollment (1990‐1994). Follow‐up was from date of first invasive cancer until diagnosis of metachronous cancer, death or censor date (February 2018), whichever came first. Alcohol intake for 10‐year periods from age 20 until decade encompassing baseline using recalled beverage‐specific frequency and quantity was used to calculate baseline and lifetime intakes, and group‐based intake trajectories. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for potential confounders. After a mean follow‐up of 7 years, 1512 metachronous cancers were identified. A 10 g/d increment in prediagnosis lifetime alcohol intake (HR = 1.03, 95% CI = 1.00‐1.06; P value = .02) and an intake of ≥60 g/d (HR = 1.32, 95% CI = 1.01‐1.73) were associated with increased metachronous cancer risk. We observed positive associations (per 10 g/d increment) for metachronous colorectal (HR = 1.07, 95% CI = 1.00‐1.14), upper aero‐digestive tract (UADT) (HR = 1.16, 95% CI = 1.00‐1.34) and kidney cancer (HR = 1.24, 95% CI = 1.10‐1.39). Although these findings were partly explained by effects of smoking, the association for kidney cancer remained unchanged when current smokers or obese individuals were excluded. Alcohol intake trajectories over the life course confirmed associations with metachronous cancer risk. Prediagnosis long‐term alcohol intake, and particularly heavy drinking, may increase the risk of metachronous cancer, particularly of the colorectum, UADT and kidney. Abstract : What's new Alcohol consumption is an important risk factor for certain cancer types. Whether alcohol also has a role in the development of second primary tumors known as metachronous cancers, however, is uncertain. Here, an investigation of pre‐diagnosis long‐term alcohol intake and metachronous cancer in nearly 10, 000 cancer survivors reveals associations between increasing alcohol consumption and metachronous cancers of the colorectum, upper aero‐digestive tract, and kidney. The associations were partly modified by smoking behavior. These findings offer new insights into risk factors for subsequent cancers in cancer survivors.