Lifetime alcohol intake, drinking patterns over time and risk of stomach cancer: A pooled analysis of data from two prospective cohort studies

Harindra Jayasekara , Robert Jeffrey Macinnis , Leila Lujan-Barroso , Ana Lucia Mayen-Chacon (1) , Amanda Jane Cross , Bengt Wallner , Domenico Palli , Fulvio Ricceri , Valeria Pala , Salvatore Panico , Rosario Tumino , Tilman Kühn , Rudolf Kaaks , Konstantinos K. Tsilidis , Maria José Sánchez , Pilar Amiano , Eva E. Ardanaz , María Dolores Chirlaque López , Susana Merino , Joseph A. Rothwell (2, 3) , Marie Christine Boutron-Ruault (2, 3) , Gianluca Severi (2, 3) , Hanna Sternby , Emily Sonestedt , Bas H. Bueno-De-Mesquita , Heiner Boeing , Ruth C. Travis , Torkjel Manning Sandanger , Antonia D. Trichopoulou , Anna Karakatsani , Eleni Peppa , Anne Tjønneland , Yi Yang , Allison Hodge , Hazel Mitchell , Andrew M.M. Haydon , Robin G.W. Room , John Llewelyn Hopper , Elisabete Weiderpass (1) , Marc J. Gunter (1) , Elio Riboli , Graham G. Giles , Roger L. Milne , Antonio T. Agudo , Dallas R. English , Pietro Ferrari (1)

1 CIRC - Centre international de Recherche sur le Cancer
2 CESP - Centre de recherche en épidémiologie et santé des populations
3 IGR - Institut Gustave Roussy

Alcohol consumption is causally linked to several cancers but the evidence for stomach cancer is inconclusive. In our study, the association between long-term alcohol intake and risk of stomach cancer and its subtypes was evaluated. We performed a pooled analysis of data collected at baseline from 491 714 participants in the European Prospective Investigation into Cancer and Nutrition and the Melbourne Collaborative Cohort Study. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for incident stomach cancer in relation to lifetime alcohol intake and group-based life course intake trajectories, adjusted for potential confounders including Helicobacter pylori infection. In all, 1225 incident stomach cancers (78% noncardia) were diagnosed over 7 094 637 person-years; 984 in 382 957 study participants with lifetime alcohol intake data (5 455 507 person-years). Although lifetime alcohol intake was not associated with overall stomach cancer risk, we observed a weak positive association with noncardia cancer (HR = 1.03, 95% CI: 1.00-1.06 per 10 g/d increment), with a HR of 1.50 (95% CI: 1.08-2.09) for ≥60 g/d compared to 0.1 to 4.9 g/d. A weak inverse association with cardia cancer (HR = 0.93, 95% CI: 0.87-1.00) was also observed. HRs of 1.48 (95% CI: 1.10-1.99) for noncardia and 0.51 (95% CI: 0.26-1.03) for cardia cancer were observed for a life course trajectory characterized by heavy decreasing intake compared to light stable intake (Phomogeneity =.02). These associations did not differ appreciably by smoking or H pylori infection status. Limiting alcohol use during lifetime, particularly avoiding heavy use during early adulthood, might help prevent noncardia stomach cancer. Heterogeneous associations observed for cardia and noncardia cancers may indicate etiologic differences.

Mots clés: cardia cancer; EPIC; lifetime alcohol intake; MCCS; noncardia cancer; stomach cancer

Domaines: Cancer; Hépatologie et Gastroentérologie; Alimentation et Nutrition; Santé publique et épidémiologie

Harindra Jayasekara, Robert Jeffrey Macinnis, Leila Lujan-Barroso, Ana Lucia Mayen-Chacon, Amanda Jane Cross, et al.. Lifetime alcohol intake, drinking patterns over time and risk of stomach cancer: A pooled analysis of data from two prospective cohort studies. International Journal of Cancer, 2021, 148 (11), pp.2759-2773. ⟨10.1002/ijc.33504⟩. ⟨hal-03287365⟩