@article{3102368,
    title = "Lifetime alcohol intake, drinking patterns over time and risk of stomach cancer: A pooled analysis of data from two prospective cohort studies",
    author = "Jayasekara, H. and MacInnis, R.J. and Lujan-Barroso, L. and Mayen-Chacon, A.-L. and Cross, A.J. and Wallner, B. and Palli, D. and Ricceri, F. and Pala, V. and Panico, S. and Tumino, R. and Kühn, T. and Kaaks, R. and Tsilidis, K. and Sánchez, M.-J. and Amiano, P. and Ardanaz, E. and Chirlaque López, M.D. and Merino, S. and Rothwell, J.A. and Boutron-Ruault, M.-C. and Severi, G. and Sternby, H. and Sonestedt, E. and Bueno-de-Mesquita, B. and Boeing, H. and Travis, R. and Sandanger, T.M. and Trichopoulou, A. and Karakatsani, A. and Peppa, E. and Tjønneland, A. and Yang, Y. and Hodge, A.M. and Mitchell, H. and Haydon, A. and Room, R. and Hopper, J.L. and Weiderpass, E. and Gunter, M.J. and Riboli, E. and Giles, G.G. and Milne, R.L. and Agudo, A. and English, D.R. and Ferrari, P.",
    journal = "International Journal  of Cancer",
    year = "2021",
    volume = "148",
    number = "11",
    pages = "2759-2773",
    publisher = "John Wiley and Sons Inc",
    issn = "0020-7136",
    doi = "10.1002/ijc.33504",
    keywords = "adult;  aged;  alcohol consumption;  Article;  cancer incidence;  cancer risk;  cardia;  cardia stomach cancer;  case control study;  Caucasian;  cohort analysis;  confidence interval;  controlled study;  data analysis;  diet;  disease association;  drinking behavior;  educational status;  female;  hazard ratio;  heavy drinking;  Helicobacter infection;  human;  illness trajectory;  major clinical study;  male;  medical history;  noncardia stomach cancer;  physical activity;  priority journal;  prospective study;  retrospective study;  risk factor;  smoking;  stomach cancer;  adverse event;  Australia;  clinical trial;  complication;  drinking behavior;  ethnology;  Europe;  Helicobacter infection;  Helicobacter pylori;  incidence;  middle aged;  multicenter study;  pathogenicity;  stomach tumor, Adult;  Aged;  Alcohol Drinking;  Australia;  Europe;  Female;  Helicobacter Infections;  Helicobacter pylori;  Humans;  Incidence;  Male;  Middle Aged;  Prospective Studies;  Smoking;  Stomach Neoplasms",
    abstract = "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. © 2021 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC."
}