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A prospective study of tobacco, alcohol, and the risk of esophageal and gastric cancer subtypes.

Abstract

Rates of esophageal adenocarcinoma and gastric cardia adenocarcinoma have increased, while rates of esophageal squamous cell carcinoma (ESCC) and gastric noncardia adenocarcinoma have decreased, suggesting distinct etiologies. The authors prospectively investigated the associations of alcohol and tobacco with these cancers in 474,606 US participants using Cox models adjusted for potential confounders. Between 1995/1996 and 2000, 97 incident cases of ESCC, 205 of esophageal adenocarcinoma, 188 of gastric cardia, and 187 of gastric noncardia cancer occurred. Compared with nonsmokers, current smokers were at increased risk for ESCC (hazard ratio (HR) = 9.27, 95% confidence interval (CI): 4.04, 21.29), esophageal adenocarcinoma (HR = 3.70, 95% CI: 2.20, 6.22), gastric cardia (HR = 2.86, 95% CI: 1.73, 4.70), and gastric noncardia (HR = 2.04, 95% CI: 1.32, 3.16). Assuming causality, ever smoking had population attributable risks of 77% (95% CI: 0.55, 0.89) for ESCC, 58% (95% CI: 0.38, 0.72) for esophageal adenocarcinoma, 47% (95% CI: 0.27, 0.63) for gastric cardia, and 19% (95% CI: 0.00, 0.37) for gastric noncardia. For drinkers of more than three alcoholic beverages per day, compared with those whose intake was up to one drink per day, the authors found significant associations between alcohol intake and ESCC risk (HR = 4.93, 95% CI: 2.69, 9.03) but not risk for esophageal, gastric cardia, or gastric noncardia adenocarcinoma.

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  • Authors+Show Affiliations

    ,

    Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.

    , , , , ,

    Source

    American journal of epidemiology 165:12 2007 Jun 15 pg 1424-33

    MeSH

    Adenocarcinoma
    Alcohol Drinking
    Carcinoma, Squamous Cell
    Confounding Factors (Epidemiology)
    Esophageal Neoplasms
    Female
    Humans
    Incidence
    Male
    Middle Aged
    Proportional Hazards Models
    Prospective Studies
    Registries
    Risk Factors
    Smoking
    Stomach Neoplasms
    United States

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Intramural

    Language

    eng

    PubMed ID

    17420181

    Citation

    Freedman, Neal D., et al. "A Prospective Study of Tobacco, Alcohol, and the Risk of Esophageal and Gastric Cancer Subtypes." American Journal of Epidemiology, vol. 165, no. 12, 2007, pp. 1424-33.
    Freedman ND, Abnet CC, Leitzmann MF, et al. A prospective study of tobacco, alcohol, and the risk of esophageal and gastric cancer subtypes. Am J Epidemiol. 2007;165(12):1424-33.
    Freedman, N. D., Abnet, C. C., Leitzmann, M. F., Mouw, T., Subar, A. F., Hollenbeck, A. R., & Schatzkin, A. (2007). A prospective study of tobacco, alcohol, and the risk of esophageal and gastric cancer subtypes. American Journal of Epidemiology, 165(12), pp. 1424-33.
    Freedman ND, et al. A Prospective Study of Tobacco, Alcohol, and the Risk of Esophageal and Gastric Cancer Subtypes. Am J Epidemiol. 2007 Jun 15;165(12):1424-33. PubMed PMID: 17420181.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A prospective study of tobacco, alcohol, and the risk of esophageal and gastric cancer subtypes. AU - Freedman,Neal D, AU - Abnet,Christian C, AU - Leitzmann,Michael F, AU - Mouw,Traci, AU - Subar,Amy F, AU - Hollenbeck,Albert R, AU - Schatzkin,Arthur, Y1 - 2007/04/09/ PY - 2007/4/11/pubmed PY - 2007/8/1/medline PY - 2007/4/11/entrez SP - 1424 EP - 33 JF - American journal of epidemiology JO - Am. J. Epidemiol. VL - 165 IS - 12 N2 - Rates of esophageal adenocarcinoma and gastric cardia adenocarcinoma have increased, while rates of esophageal squamous cell carcinoma (ESCC) and gastric noncardia adenocarcinoma have decreased, suggesting distinct etiologies. The authors prospectively investigated the associations of alcohol and tobacco with these cancers in 474,606 US participants using Cox models adjusted for potential confounders. Between 1995/1996 and 2000, 97 incident cases of ESCC, 205 of esophageal adenocarcinoma, 188 of gastric cardia, and 187 of gastric noncardia cancer occurred. Compared with nonsmokers, current smokers were at increased risk for ESCC (hazard ratio (HR) = 9.27, 95% confidence interval (CI): 4.04, 21.29), esophageal adenocarcinoma (HR = 3.70, 95% CI: 2.20, 6.22), gastric cardia (HR = 2.86, 95% CI: 1.73, 4.70), and gastric noncardia (HR = 2.04, 95% CI: 1.32, 3.16). Assuming causality, ever smoking had population attributable risks of 77% (95% CI: 0.55, 0.89) for ESCC, 58% (95% CI: 0.38, 0.72) for esophageal adenocarcinoma, 47% (95% CI: 0.27, 0.63) for gastric cardia, and 19% (95% CI: 0.00, 0.37) for gastric noncardia. For drinkers of more than three alcoholic beverages per day, compared with those whose intake was up to one drink per day, the authors found significant associations between alcohol intake and ESCC risk (HR = 4.93, 95% CI: 2.69, 9.03) but not risk for esophageal, gastric cardia, or gastric noncardia adenocarcinoma. SN - 0002-9262 UR - https://www.unboundmedicine.com/medline/citation/17420181/A_prospective_study_of_tobacco_alcohol_and_the_risk_of_esophageal_and_gastric_cancer_subtypes_ L2 - https://academic.oup.com/aje/article-lookup/doi/10.1093/aje/kwm051 DB - PRIME DP - Unbound Medicine ER -