Lifetime alcohol intake, drinking patterns over time and risk of stomach cancer: A pooled analysis of data from two prospective cohort studies. Issue 11 (22nd February 2021)

• Record Type: Journal Article
• Authors: Jayasekara, Harindra; MacInnis, Robert J.; Lujan‐Barroso, Leila; Mayen‐Chacon, Ana‐Lucia; Cross, Amanda J.; Wallner, Bengt; Palli, Domenico; Ricceri, Fulvio; Pala, Valeria; Panico, Salvatore; Tumino, Rosario; Kühn, Tilman; Kaaks, Rudolf; Tsilidis, Kostas; Sánchez, Maria‐Jose; Amiano, Pilar; Ardanaz, Eva; Chirlaque López, María Dolores; Merino, Susana; Rothwell, Joseph A.; Boutron‐Ruault, Marie‐Christine; Severi, Gianluca; Sternby, Hanna; Sonestedt, Emily; Bueno‐de‐Mesquita, Bas; Boeing, Heiner; Travis, Ruth; Sandanger, Torkjel M.; Trichopoulou, Antonia; Karakatsani, Anna; Peppa, Eleni; Tjønneland, Anne; Yang, Yi; Hodge, Allison M.; Mitchell, Hazel; Haydon, Andrew; Room, Robin; Hopper, John L.; Weiderpass, Elisabete; Gunter, Marc J.; Riboli, Elio; Giles, Graham G.; Milne, Roger L.; Agudo, Antonio; English, Dallas R.; Ferrari, Pietro;
• Is Part Of: International journal of cancer. Volume 148:Issue 11(2021)
• Page Start: 2759
• Page End: 2773
• Publication Date: 2021-02-22
• Subjects: cardia cancer -- EPIC -- lifetime alcohol intake -- MCCS -- noncardia cancer -- stomach cancer; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.33504
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract: 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. Abstract : What's new? Alcohol consumption has been causally linked to several cancers, but results for stomach cancer have been inconclusive. In this large, international study, the authors found a positive association between long‐term, heavy drinking and non‐cardia stomach cancer. This association persisted when data were adjusted for potentially confounding factors such as smoking, body mass index, and Helicobacter pylori infection. A weak inverse association was observed with cardia cancer, suggesting that there may be etiologic differences between non‐cardia vs. cardia subtypes.