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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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posted on 2021-04-12, 04:06 authored by Harindra JayasekaraHarindra Jayasekara, RJ MacInnis, L Lujan-Barroso, AL Mayen-Chacon, AJ Cross, B Wallner, D Palli, F Ricceri, V Pala, S Panico, R Tumino, T Kühn, R Kaaks, K Tsilidis, MJ Sánchez, P Amiano, E Ardanaz, MD Chirlaque López, S Merino, JA Rothwell, MC Boutron-Ruault, G Severi, H Sternby, E Sonestedt, B Bueno-de-Mesquita, H Boeing, R Travis, TM Sandanger, A Trichopoulou, A Karakatsani, E Peppa, A Tjønneland, Y Yang, AM Hodge, H Mitchell, A Haydon, Robin RoomRobin Room, JL Hopper, E Weiderpass, MJ Gunter, E Riboli, GG Giles, RL Milne, A Agudo, DR English, P 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 =.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. homogeneity


Australian National Health and Medical Research Council, Grant/Award Numbers: 1074383, 209057, 396414, GNT1163120; Cancer Council Victoria (Australia); Cancer Research UK, Grant/Award Numbers: C570/A16491, C8221/A19170, C864/A14136; Catalan Institute of Oncology - ICO (Spain); Danish Cancer Society; Deutsche Krebshilfe, the Deutsches Krebsforschungszentrum (Germany); Dutch Ministry of Public Health, Welfare and Sports; European Commission (Directorate General for Health and Consumer Affairs); Foundation for Alcohol Research and Education (Australia); French Ministry of Health, Grant/Award Number: Grant GR-IARC-2003-09-12-01; Health Research Fund (FIS) -Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra; Hellenic Health Foundation (Greece); Hellenic Ministry of Health and Social Solidarity (Greece); Institut National de la Sante et de la Recherche Medicale (France); Italian Association for Research on Cancer and the National Research Council (Italy); Ligue Contre le Cancer (France); LK Research Funds, Dutch Prevention Funds, the Dutch Zorg Onderzoek Nederland; Medical Research Council (UK), Grant/Award Numbers: MC-UU_12015/1, MR/M012190/1, MR/N003284/1; 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, the British Heart Foundation, the Department of Health, the Food Standards Agency and the Wellcome Trust (UK); Swedish Cancer Society, the Swedish Scientific Council and the Regional Government of Skane (Sweden); the Federal Ministry of Education and Research (Germany); VicHealth (Australia); World Cancer Research Fund and Statistics Netherlands (the Netherlands); the Institut Gustave Roussy


Publication Date



International Journal of Cancer






p2759-2773 (15pp.)





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