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Cancer Epidemiol. 2018 Nov 13;58:25-32. doi: 10.1016/j.canep.2018.10.006. [Epub ahead of print]

Alcohol consumption and lung cancer risk: A pooled analysis from the International Lung Cancer Consortium and the SYNERGY study.

Author information

1
Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada; Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada.
2
Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada.
3
Department of Epidemiology, School of Public Health, UCLA, Los Angeles, USA.
4
Department of Family and Preventive Medicine, School of Medicine, University of Utah, and Huntsman Cancer Institute, Salt Lake City, USA.
5
Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Japan.
6
Division of Cancer Information and Contorl, Aichi Cancer Centre Research Institute, Japan.
7
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.
8
Department of Environmental Epidemiology, INSERM U170, Villejuif, France.
9
The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA.
10
Genetic Epidemiology Group, International Agency for Research on Cancer (IARC), Lyon, France.
11
Harvard School of Public Health, Massachusetts General Hospital/Harvard Medical School, Boston, USA.
12
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea.
13
Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH after National Cancer Institute, Bethesda, USA.
14
Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, USA.
15
Karmanos Cancer Institute, Wayne State University, Detroit, USA.
16
Department of Community Medicine and Epidemiology, Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Haifa, Israel.
17
Public Health Ontario, Toronto, Canada.
18
Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, USA.
19
Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA.
20
Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
21
Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; CIBER de Epidemiology y Salud Publica, Madrid, Spain.
22
CRCHUM (Centre de recherche du CHUM) and Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada.
23
Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, USA.
24
University Institute of Oncology (IUOPA), University of Oviedo, and CIBERESP, Spain.
25
Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA.
26
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
27
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
28
Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncoly (ICO-IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
29
Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United Kingdom.
30
Epidemiology Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
31
Environment and Radiation Section, International Agency for Research on Cancer, Lyon, France; Institute of Environmental Medicine, Stockholm, Sweden.
32
IARC Monographs Section, International Agency for Research on Cancer, Lyon, France. Electronic address: StraifK@iarc.fr.

Abstract

BACKGROUND:

There is inadequate evidence to determine whether there is an effect of alcohol consumption on lung cancer risk. We conducted a pooled analysis of data from the International Lung Cancer Consortium and the SYNERGY study to investigate this possible association by type of beverage with adjustment for other potential confounders.

METHODS:

Twenty one case-control studies and one cohort study with alcohol-intake data obtained from questionnaires were included in this pooled analysis (19,149 cases and 362,340 controls). Adjusted odds ratios (OR) or hazard ratios (HR) with corresponding 95% confidence intervals (CI) were estimated for each measure of alcohol consumption. Effect estimates were combined using random or fixed-effects models where appropriate. Associations were examined for overall lung cancer and by histological type.

RESULTS:

We observed an inverse association between overall risk of lung cancer and consumption of alcoholic beverages compared to non-drinkers, but the association was not monotonic. The lowest risk was observed for persons who consumed 10-19.9 g/day ethanol (OR vs. non-drinkers = 0.78; 95% CI: 0.67, 0.91), where 1 drink is approximately 12-15 g. This J-shaped association was most prominent for squamous cell carcinoma (SCC). The association with all lung cancer varied little by type of alcoholic beverage, but there were notable differences for SCC. We observed an association with beer intake (OR for ≥20 g/day vs nondrinker = 1.42; 95% CI: 1.06, 1.90).

CONCLUSIONS:

Whether the non-monotonic associations we observed or the positive association between beer drinking and squamous cell carcinoma reflect real effects await future analyses and insights about possible biological mechanisms.

KEYWORDS:

Alcohol; Lung cancer; Pooled analysis

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