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Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia.
J Natl Cancer Inst 1997; 89(17):1277-84JNCI

Abstract

BACKGROUND

Incidence rates for adenocarcinomas of the esophagus and gastric cardia have risen steeply over the last few decades. To determine risk factors for these tumors, we conducted a multicenter, population-based, case-control study.

METHODS

The study included 554 subjects newly diagnosed with esophageal or gastric cardia adenocarcinomas, 589 subjects newly diagnosed with esophageal squamous cell carcinoma or other gastric adenocarcinomas, and 695 control subjects. Estimates of risk (odds ratios [ORs] and corresponding 95% confidence intervals [CIs]) were calculated for the four tumor types separately and for esophageal and gastric cardia adenocarcinomas combined.

RESULTS

Risk of esophageal and gastric cardia adenocarcinomas combined was increased among current cigarette smokers (OR = 2.4; 95% = 1.7-3.4), with little reduction observed until 30 years after smoking cessation; this risk rose with increasing intensity and duration of smoking. Risk of these tumors was not related to beer (OR = 0.8; 95% CI = 0.6-1.1) or liquor (OR = 1.1; 95% CI = 0.8-1.4) consumption, but it was reduced for drinking wine (OR = 0.6; 95% CI = 0.5-0.8). Similar ORs were obtained for the development of noncardia gastric adenocarcinomas in relation to tobacco and alcohol use, but higher ORs were obtained for the development of esophageal squamous cell carcinomas. For all four tumor types, risks were higher among those with low income or education.

CONCLUSIONS

Smoking is a major risk factor for esophageal and gastric cardia adenocarcinomas, accounting for approximately 40% of cases.

IMPLICATIONS

Because of the long lag time before risk of these tumors is reduced among ex-smokers, smoking may affect early stage carcinogenesis. The increase in smoking prevalence during the first two thirds of this century may be reflected in the rising incidence of these tumors in the past few decades among older individuals. The recent decrease in smoking may not yet have had an impact.

Authors+Show Affiliations

Division of Epidemiology, Columbia School of Public Health, New York, NY, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9293918

Citation

Gammon, M D., et al. "Tobacco, Alcohol, and Socioeconomic Status and Adenocarcinomas of the Esophagus and Gastric Cardia." Journal of the National Cancer Institute, vol. 89, no. 17, 1997, pp. 1277-84.
Gammon MD, Schoenberg JB, Ahsan H, et al. Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst. 1997;89(17):1277-84.
Gammon, M. D., Schoenberg, J. B., Ahsan, H., Risch, H. A., Vaughan, T. L., Chow, W. H., ... Fraumeni, J. F. (1997). Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia. Journal of the National Cancer Institute, 89(17), pp. 1277-84.
Gammon MD, et al. Tobacco, Alcohol, and Socioeconomic Status and Adenocarcinomas of the Esophagus and Gastric Cardia. J Natl Cancer Inst. 1997 Sep 3;89(17):1277-84. PubMed PMID: 9293918.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia. AU - Gammon,M D, AU - Schoenberg,J B, AU - Ahsan,H, AU - Risch,H A, AU - Vaughan,T L, AU - Chow,W H, AU - Rotterdam,H, AU - West,A B, AU - Dubrow,R, AU - Stanford,J L, AU - Mayne,S T, AU - Farrow,D C, AU - Niwa,S, AU - Blot,W J, AU - Fraumeni,J F,Jr PY - 1997/9/18/pubmed PY - 2001/3/28/medline PY - 1997/9/18/entrez SP - 1277 EP - 84 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 89 IS - 17 N2 - BACKGROUND: Incidence rates for adenocarcinomas of the esophagus and gastric cardia have risen steeply over the last few decades. To determine risk factors for these tumors, we conducted a multicenter, population-based, case-control study. METHODS: The study included 554 subjects newly diagnosed with esophageal or gastric cardia adenocarcinomas, 589 subjects newly diagnosed with esophageal squamous cell carcinoma or other gastric adenocarcinomas, and 695 control subjects. Estimates of risk (odds ratios [ORs] and corresponding 95% confidence intervals [CIs]) were calculated for the four tumor types separately and for esophageal and gastric cardia adenocarcinomas combined. RESULTS: Risk of esophageal and gastric cardia adenocarcinomas combined was increased among current cigarette smokers (OR = 2.4; 95% = 1.7-3.4), with little reduction observed until 30 years after smoking cessation; this risk rose with increasing intensity and duration of smoking. Risk of these tumors was not related to beer (OR = 0.8; 95% CI = 0.6-1.1) or liquor (OR = 1.1; 95% CI = 0.8-1.4) consumption, but it was reduced for drinking wine (OR = 0.6; 95% CI = 0.5-0.8). Similar ORs were obtained for the development of noncardia gastric adenocarcinomas in relation to tobacco and alcohol use, but higher ORs were obtained for the development of esophageal squamous cell carcinomas. For all four tumor types, risks were higher among those with low income or education. CONCLUSIONS: Smoking is a major risk factor for esophageal and gastric cardia adenocarcinomas, accounting for approximately 40% of cases. IMPLICATIONS: Because of the long lag time before risk of these tumors is reduced among ex-smokers, smoking may affect early stage carcinogenesis. The increase in smoking prevalence during the first two thirds of this century may be reflected in the rising incidence of these tumors in the past few decades among older individuals. The recent decrease in smoking may not yet have had an impact. SN - 0027-8874 UR - https://www.unboundmedicine.com/medline/citation/9293918/Tobacco_alcohol_and_socioeconomic_status_and_adenocarcinomas_of_the_esophagus_and_gastric_cardia_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/89.17.1277 DB - PRIME DP - Unbound Medicine ER -