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

Full 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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Author information

Author/s: Freedman, Neal D (ND); Abnet, Christian C (CC); Leitzmann, Michael F (MF); Mouw, Traci (T); Subar, Amy F (AF); Hollenbeck, Albert R (AR); Schatzkin, Arthur (A);

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

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Intramural

Journal: American journal of epidemiology (Am J Epidemiol), published in United States. (Language: eng)

Reference: 2007-Jun; vol 165 (issue 12) : pp 1424-33

Dates: Created 2007/05/31; Completed 2007/07/31;

PMID: 17420181, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adenocarcinoma - epidemiology; etiology; pathology
Alcohol Drinking - adverse effects
Carcinoma, Squamous Cell - epidemiology; etiology; pathology
Confounding Factors (Epidemiology)
Esophageal Neoplasms - epidemiology; etiology; pathology
Female
Humans
Incidence
Male

Male
Middle Aged
Proportional Hazards Models
Prospective Studies
Registries
Risk Factors
Smoking - adverse effects
Stomach Neoplasms - epidemiology; etiology; pathology
United States - epidemiology

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