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Alcohol and lung cancer risk among never smokers: A pooled analysis from the international lung cancer consortium and the SYNERGY study
Author(s) -
Fehringer Gordon,
Brenner Darren R.,
Zhang ZuoFeng,
Lee YuanChin Amy,
Matsuo Keitaro,
Ito Hidemi,
Lan Qing,
Vineis Paolo,
Johansson Mattias,
Overvad Kim,
Riboli Elio,
Trichopoulou Antonia,
Sacerdote Carlotta,
Stucker Isabelle,
Boffetta Paolo,
Brennan Paul,
Christiani David. C.,
Hong YunChul,
Landi Maria Teresa,
Morgenstern Hal,
Schwartz Ann G.,
Wenzlaff Angela S.,
Rennert Gad,
McLaughlin John R.,
Harris Curtis C.,
OlivoMarston Susan,
Orlow Irene,
Park Bernard J.,
Zauderer Marjorie,
Barros Dios Juan M.,
Ruano Raviña Alberto,
Siemiatycki Jack,
Koushik Anita,
Lazarus Philip,
FernándezSomoano Ana,
Tardon Adonina,
Le Marchand Loic,
Brenner Hermann,
Saum KaiUwe,
Duell Eric J.,
Andrew Angeline S.,
SzeszeniaDabrowska Neonila,
Lissowska Jolanta,
Zaridze David,
Rudnai Peter,
Fabianova Eleonora,
Mates Dana,
Foretova Lenka,
Janout Vladimir,
Bencko Vladimir,
Holcatova Ivana,
Pesatori Angela Cecilia,
Consonni Dario,
Olsson Ann,
Straif Kurt,
Hung Rayjean J.
Publication year - 2017
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.30618
Subject(s) - medicine , lung cancer , confounding , relative risk , cohort , wine , cancer , cohort study , environmental health , case control study , demography , surgery , food science , confidence interval , biology , sociology
It is not clear whether alcohol consumption is associated with lung cancer risk. The relationship is likely confounded by smoking, complicating the interpretation of previous studies. We examined the association of alcohol consumption and lung cancer risk in a large pooled international sample, minimizing potential confounding of tobacco consumption by restricting analyses to never smokers. Our study included 22 case‐control and cohort studies with a total of 2548 never‐smoking lung cancer patients and 9362 never‐smoking controls from North America, Europe and Asia within the International Lung Cancer Consortium (ILCCO) and SYNERGY Consortium. Alcohol consumption was categorized into amounts consumed (grams per day) and also modelled as a continuous variable using restricted cubic splines for potential non‐linearity. Analyses by histologic sub‐type were included. Associations by type of alcohol consumed (wine, beer and liquor) were also investigated. Alcohol consumption was inversely associated with lung cancer risk with evidence most strongly supporting lower risk for light and moderate drinkers relative to non‐drinkers (>0–4.9 g per day: OR = 0.80, 95% CI = 0.70–0.90; 5–9.9 g per day: OR = 0.82, 95% CI = 0.69–0.99; 10–19.9 g per day: OR = 0.79, 95% CI = 0.65–0.96). Inverse associations were found for consumption of wine and liquor, but not beer. The results indicate that alcohol consumption is inversely associated with lung cancer risk, particularly among subjects with low to moderate consumption levels, and among wine and liquor drinkers, but not beer drinkers. Although our results should have no relevant bias from the confounding effect of smoking we cannot preclude that confounding by other factors contributed to the observed associations. Confounding in relation to the non‐drinker reference category may be of particular importance.