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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Cardia cancerEPICLifetime alcohol intakeMCCSNoncardia cancerStomach cancer
Jayasekara, H., MacInnis, R. J., Barroso, L. L., Mayen‐Chacon, A. L., Cross, A. J., Wallner, B., ... & Ferrari, P. (2021). Lifetime alcohol intake, drinking patterns over time, and risk of stomach cancer: a pooled analysis of data from two prospective cohort studies. International journal of cancer. [DOI: 10.1002/ijc.33504]
SponsorshipNational Health and Medical Research Council of Australia 1074383 209057 396414 GNT1163120; Canadian Institutes of Health Research (CIHR) Cancer Council Victoria; Cancer Research UK C570/A16491 C8221/A19170 C864/A14136; Catalan Institute of Oncology - ICO (Spain); Danish Cancer Society; Deutsche Krebshilfe; Deutsches Krebsforschungszentrum (Germany); Dutch Ministry of Public Health, Welfare and Sports; European Commission European Commission Joint Research Centre; Foundation for Alcohol Research and Education (Australia); French Ministry of Health GR-IARC-2003-09-12-01; Health Research Fund (FIS) -Instituto de Salud Carlos III (ISCIII); Junta de Andalucía; Regional Government of Asturias; Basque Government; Regional Government of Murcia; Regional Government of Navarra; Hellenic Health Foundation (Greece); Hellenic Ministry of Health and Social Solidarity (Greece); Institut National de la Sante et de la Recherche Medicale (Inserm); Consiglio Nazionale delle Ricerche (CNR); Associazione Italiana per la Ricerca sul Cancro (AIRC); Ligue Contre le Cancer (France); LK Research Funds; Dutch Prevention Funds; Netherlands Organization for Scientific Research (NWO); UK Research & Innovation (UKRI) Medical Research Council UK (MRC) MC-UU_12015/1 MR/M012190/1 MR/N003284/; Mutuelle Generale de l'Education Nationale; National Institute for Public Health and the Environment (RIVM) (the Netherlands); Netherlands Cancer Registry; Stavros Niarchos Foundation (Greece); Stroke Association (UK); British Heart Foundation; Department of Health (UK); Food Standards Agency (UK); Wellcome Trust; Swedish Cancer Society; Swedish Scientific Council (Sweden); Regional Government of Skane (Sweden); Federal Ministry of Education & Research (BMBF); VicHealth (Australia); World Cancer Research Fund and Statistics Netherlands (the Netherlands); Institut Gustave Roussy
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.