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Alcohol consumption, cigarette smoking and risk of subtypes of oesophageal and gastric cancer: a prospective cohort study.

Abstract

OBJECTIVE

Alcohol consumption and cigarette smoking may be differentially associated with oesophageal squamous cell carcinoma (OSCC), oesophageal adenocarcinoma (OAC), gastric cardia adenocarcinoma (GCA) and gastric non-cardia adenocarcinoma (GNCA). However, because this was based on retrospective studies, these hypotheses were examined in a prospective cohort.

METHODS

The prospective Netherlands Cohort Study consists of 120 852 participants who completed a baseline questionnaire on diet and other cancer risk factors in 1986. After 16.3 years of follow-up, 107 OSCC, 145 OAC, 164 GCA and 491 GNCA cases were available for analysis using Cox proportional hazards models and the case-cohort approach.

RESULTS

The multivariable adjusted incidence rate ratio (RR) for OSCC was 4.61 (95% CI 2.24 to 9.50) for > or = 30 g ethanol/day compared with abstainers (p trend <0.001), while no associations with alcohol were found for OAC, GCA or GNCA. Compared with never smokers, current smokers had RRs varying from 1.60 for GCA to 2.63 for OSCC, and were statistically significant or borderline statistically significant. Frequency, duration and pack-years of smoking were independently associated with risk of all four cancers. A positive interaction was found between alcohol consumption and smoking status regarding OSCC risk. The RR for current smokers who consumed >15 g/day of ethanol was 8.05 (95% CI 3.89 to 16.60; p interaction = 0.65), when compared with never smokers who consumed <5 g/day of ethanol.

CONCLUSIONS

This prospective study found alcohol consumption to be associated with increased risk of only OSCC. Cigarette smoking was associated with risk of all four cancers.

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  • Authors+Show Affiliations

    ,

    GROW-School for Oncology and Developmental Biology, Department of Epidemiology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. Jessie.Steevens@epid.unimaas.nl

    , ,

    Source

    Gut 59:1 2010 Jan pg 39-48

    MeSH

    Adenocarcinoma
    Aged
    Alcohol Drinking
    Carcinoma, Squamous Cell
    Cardia
    Cocarcinogenesis
    Epidemiologic Methods
    Esophageal Neoplasms
    Feeding Behavior
    Female
    Humans
    Male
    Middle Aged
    Netherlands
    Smoking
    Stomach Neoplasms

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    19828467

    Citation

    Steevens, J, et al. "Alcohol Consumption, Cigarette Smoking and Risk of Subtypes of Oesophageal and Gastric Cancer: a Prospective Cohort Study." Gut, vol. 59, no. 1, 2010, pp. 39-48.
    Steevens J, Schouten LJ, Goldbohm RA, et al. Alcohol consumption, cigarette smoking and risk of subtypes of oesophageal and gastric cancer: a prospective cohort study. Gut. 2010;59(1):39-48.
    Steevens, J., Schouten, L. J., Goldbohm, R. A., & van den Brandt, P. A. (2010). Alcohol consumption, cigarette smoking and risk of subtypes of oesophageal and gastric cancer: a prospective cohort study. Gut, 59(1), pp. 39-48. doi:10.1136/gut.2009.191080.
    Steevens J, et al. Alcohol Consumption, Cigarette Smoking and Risk of Subtypes of Oesophageal and Gastric Cancer: a Prospective Cohort Study. Gut. 2010;59(1):39-48. PubMed PMID: 19828467.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Alcohol consumption, cigarette smoking and risk of subtypes of oesophageal and gastric cancer: a prospective cohort study. AU - Steevens,J, AU - Schouten,L J, AU - Goldbohm,R A, AU - van den Brandt,P A, PY - 2009/10/16/entrez PY - 2009/10/16/pubmed PY - 2010/4/9/medline SP - 39 EP - 48 JF - Gut JO - Gut VL - 59 IS - 1 N2 - OBJECTIVE: Alcohol consumption and cigarette smoking may be differentially associated with oesophageal squamous cell carcinoma (OSCC), oesophageal adenocarcinoma (OAC), gastric cardia adenocarcinoma (GCA) and gastric non-cardia adenocarcinoma (GNCA). However, because this was based on retrospective studies, these hypotheses were examined in a prospective cohort. METHODS: The prospective Netherlands Cohort Study consists of 120 852 participants who completed a baseline questionnaire on diet and other cancer risk factors in 1986. After 16.3 years of follow-up, 107 OSCC, 145 OAC, 164 GCA and 491 GNCA cases were available for analysis using Cox proportional hazards models and the case-cohort approach. RESULTS: The multivariable adjusted incidence rate ratio (RR) for OSCC was 4.61 (95% CI 2.24 to 9.50) for > or = 30 g ethanol/day compared with abstainers (p trend <0.001), while no associations with alcohol were found for OAC, GCA or GNCA. Compared with never smokers, current smokers had RRs varying from 1.60 for GCA to 2.63 for OSCC, and were statistically significant or borderline statistically significant. Frequency, duration and pack-years of smoking were independently associated with risk of all four cancers. A positive interaction was found between alcohol consumption and smoking status regarding OSCC risk. The RR for current smokers who consumed >15 g/day of ethanol was 8.05 (95% CI 3.89 to 16.60; p interaction = 0.65), when compared with never smokers who consumed <5 g/day of ethanol. CONCLUSIONS: This prospective study found alcohol consumption to be associated with increased risk of only OSCC. Cigarette smoking was associated with risk of all four cancers. SN - 1468-3288 UR - https://www.unboundmedicine.com/medline/citation/19828467/Alcohol_consumption_cigarette_smoking_and_risk_of_subtypes_of_oesophageal_and_gastric_cancer:_a_prospective_cohort_study_ L2 - http://gut.bmj.com/cgi/pmidlookup?view=long&amp;pmid=19828467 DB - PRIME DP - Unbound Medicine ER -