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Alcohol drinking and primary liver cancer: A pooled analysis of four Japanese cohort studies
Author(s) -
Shimazu Taichi,
Sasazuki Shizuka,
Wakai Kenji,
Tamakoshi Akiko,
Tsuji Ichiro,
Sugawara Yumi,
Matsuo Keitaro,
Nagata Chisato,
Mizoue Tetsuya,
Tanaka Keitaro,
Inoue Manami,
Tsugane Shoichiro
Publication year - 2011
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.26255
Subject(s) - medicine , hazard ratio , prospective cohort study , confidence interval , proportional hazards model , liver cancer , alcohol , cancer , cohort study , population , incidence (geometry) , cohort , demography , environmental health , biology , biochemistry , physics , optics , sociology
Because studies of the association between alcohol intake and the risk of primary liver cancer use varying cut‐off points to classify alcohol intake, it is difficult to precisely quantify this association by meta‐analysis of published data. Furthermore, there are limited data for women in prospective studies of the dose‐specific relation of alcohol intake and the risk of primary liver cancer. We analyzed original data from 4 population‐based prospective cohort studies encompassing 174,719 participants (89,863 men and 84,856 women). After adjustment for a common set of variables, we used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of primary liver cancer incidence according to alcohol intake. We conducted a meta‐analysis of the HRs derived from each study. During 1,964,136 person‐years of follow‐up, 804 primary liver cancer cases (605 men and 199 women) were identified. In male drinkers, the multivariate‐adjusted HRs (95% CI) for alcohol intakes of 0.1–22.9, 23.0–45.9, 46.0–68.9, 69.0–91.9 and ≥92.0 g/day, as compared to occasional drinkers, were 0.88 (0.57–1.36), 1.06 (0.70–1.62), 1.07 (0.69–1.66), 1.76 (1.08–2.87) and 1.66 (0.98–2.82), respectively ( p for trend = 0.015). In women, we observed a significantly increased risk among those who drank ≥23.0 g/day, as compared to occasional drinkers (HR: 3.60; 95% CI: 1.22–10.66). This pooled analysis of data from large prospective studies in Japan indicates that avoidance of (1) heavy alcohol drinking (≥69.0 g alcohol/day) in men and (2) moderate drinking (≥23.0 g alcohol/day) in women may reduce the risk of primary liver cancer.