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Smoking and alcohol drinking in relation to risk of gastric cancer: a population-based, prospective cohort study.

Abstract

The relations between tobacco, alcohol and risk of gastric cancer need to be established, and any gain from preventive measures should be estimated. We conducted a population-based, prospective cohort study in Nord-Trondelag county in Norway. During 1984-1986, adult residents were invited to a health survey and they answered questionnaires that assessed exposure to tobacco and alcohol, together with potential confounding factors. The exposure assessment regarding alcohol was limited to a 14-day period. New gastric cancers that occurred during follow-up (1984-2002) were identified by linkage to the Norwegian Cancer Registry. Cox proportion hazards regression models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CI), adjusted for sex, education and body mass index. Follow-up of 1,117,648 person-years at risk among 69,962 cohort members revealed 251 gastric cancers, including 224 noncardia cancers. The risk was almost twice as high in daily smokers (HR = 1.88 [CI 95% = 1.33-2.67]) as in never smokers. Independent dose-response relations were found with earlier age at initiation (p = 0.02), frequency (p = 0.00) and duration of smoking (p = 0.00). Attributable risk (AR) of gastric cancer among current smokers was 8.7/100,000 person-years and the corresponding population AR was 18.4%. No statistically significant associations between various degrees of exposure to alcohol and risk of gastric cancer was revealed, but combined high use of cigarettes (>20/day) and alcohol (>5 occasions/14 days) increased the risk of noncardia gastric cancer nearly 5-fold (HR = 4.90 [95% CI = 1.90-12.62]), compared to nonusers. It is concluded that smoking is a dose-dependent risk factor for gastric cancer. Combined high exposure to smoking and alcohol further increases the risk. Successful preventive measures could considerably reduce the incidence of gastric cancer.

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  • Authors+Show Affiliations

    ,

    Unit of Esophageal and Gastric Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. krister.sjodahl@ki.se

    , , , , ,

    Source

    International journal of cancer 120:1 2007 Jan 01 pg 128-32

    MeSH

    Adolescent
    Adult
    Age Distribution
    Aged
    Aged, 80 and over
    Alcohol Drinking
    Cohort Studies
    Confidence Intervals
    Female
    Humans
    Japan
    Male
    Middle Aged
    Odds Ratio
    Population Surveillance
    Prospective Studies
    Risk Assessment
    Risk Factors
    Sex Distribution
    Smoking
    Stomach Neoplasms
    Survival Rate

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17036324

    Citation

    Sjödahl, Krister, et al. "Smoking and Alcohol Drinking in Relation to Risk of Gastric Cancer: a Population-based, Prospective Cohort Study." International Journal of Cancer, vol. 120, no. 1, 2007, pp. 128-32.
    Sjödahl K, Lu Y, Nilsen TI, et al. Smoking and alcohol drinking in relation to risk of gastric cancer: a population-based, prospective cohort study. Int J Cancer. 2007;120(1):128-32.
    Sjödahl, K., Lu, Y., Nilsen, T. I., Ye, W., Hveem, K., Vatten, L., & Lagergren, J. (2007). Smoking and alcohol drinking in relation to risk of gastric cancer: a population-based, prospective cohort study. International Journal of Cancer, 120(1), pp. 128-32.
    Sjödahl K, et al. Smoking and Alcohol Drinking in Relation to Risk of Gastric Cancer: a Population-based, Prospective Cohort Study. Int J Cancer. 2007 Jan 1;120(1):128-32. PubMed PMID: 17036324.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Smoking and alcohol drinking in relation to risk of gastric cancer: a population-based, prospective cohort study. AU - Sjödahl,Krister, AU - Lu,Yunxia, AU - Nilsen,Tom I L, AU - Ye,Weimin, AU - Hveem,Kristian, AU - Vatten,Lars, AU - Lagergren,Jesper, PY - 2006/10/13/pubmed PY - 2007/2/9/medline PY - 2006/10/13/entrez SP - 128 EP - 32 JF - International journal of cancer JO - Int. J. Cancer VL - 120 IS - 1 N2 - The relations between tobacco, alcohol and risk of gastric cancer need to be established, and any gain from preventive measures should be estimated. We conducted a population-based, prospective cohort study in Nord-Trondelag county in Norway. During 1984-1986, adult residents were invited to a health survey and they answered questionnaires that assessed exposure to tobacco and alcohol, together with potential confounding factors. The exposure assessment regarding alcohol was limited to a 14-day period. New gastric cancers that occurred during follow-up (1984-2002) were identified by linkage to the Norwegian Cancer Registry. Cox proportion hazards regression models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CI), adjusted for sex, education and body mass index. Follow-up of 1,117,648 person-years at risk among 69,962 cohort members revealed 251 gastric cancers, including 224 noncardia cancers. The risk was almost twice as high in daily smokers (HR = 1.88 [CI 95% = 1.33-2.67]) as in never smokers. Independent dose-response relations were found with earlier age at initiation (p = 0.02), frequency (p = 0.00) and duration of smoking (p = 0.00). Attributable risk (AR) of gastric cancer among current smokers was 8.7/100,000 person-years and the corresponding population AR was 18.4%. No statistically significant associations between various degrees of exposure to alcohol and risk of gastric cancer was revealed, but combined high use of cigarettes (>20/day) and alcohol (>5 occasions/14 days) increased the risk of noncardia gastric cancer nearly 5-fold (HR = 4.90 [95% CI = 1.90-12.62]), compared to nonusers. It is concluded that smoking is a dose-dependent risk factor for gastric cancer. Combined high exposure to smoking and alcohol further increases the risk. Successful preventive measures could considerably reduce the incidence of gastric cancer. SN - 0020-7136 UR - https://www.unboundmedicine.com/medline/citation/17036324/Smoking_and_alcohol_drinking_in_relation_to_risk_of_gastric_cancer:_a_population_based_prospective_cohort_study_ L2 - https://doi.org/10.1002/ijc.22157 DB - PRIME DP - Unbound Medicine ER -