The role of tobacco, snuff and alcohol use in the aetiology of cancer of the oesophagus and gastric cardia
Article first published online: 28 JAN 2000
Copyright © 2000 Wiley-Liss, Inc.
International Journal of Cancer
Volume 85, Issue 3, pages 340–346, 1 February 2000
How to Cite
Lagergren, J., Bergström, R., Lindgren, A. and Nyrén, O. (2000), The role of tobacco, snuff and alcohol use in the aetiology of cancer of the oesophagus and gastric cardia. Int. J. Cancer, 85: 340–346. doi: 10.1002/(SICI)1097-0215(20000201)85:3<340::AID-IJC8>3.0.CO;2-N
- Issue published online: 28 JAN 2000
- Article first published online: 28 JAN 2000
- Manuscript Revised: 4 AUG 1999
- Manuscript Received: 6 JUN 1999
- NCI. Grant Number: R01 CA57947–03
- Swedish Cancer Society (JL and ON)
While tobacco and alcohol are established risk factors for oesophageal squamous-cell carcinoma, their roles in the aetiology of the increasingly common oesophageal adenocarcinoma remains uncertain. We tested the association between tobacco, snuff and alcohol use and the risk of oesophageal and cardia cancer in a nationwide, population-based case-control study in Sweden. Face-to-face interviews were conducted with 618 (81% of all eligible) patients (189 oesophageal adenocarcinoma, 262 cardia adenocarcinoma and 167 oesophageal squamous-cell carcinoma) and 820 control subjects. Odds ratios (OR) were calculated by logistic regression with multivariate adjustments for potential confounding. The risk of oesophageal adenocarcinoma was not associated with snuff or alcohol use, and the association with smoking was weak or absent. Gastric cardia adenocarcinoma was dose-dependently associated with smoking (OR=4.2, 95% CI=2.5–7.0 among heavy smokers compared with never-smokers), but not with alcohol or snuff use. Oesophageal squamous-cell carcinoma was strongly associated with tobacco, moderately with alcohol, but not with snuff use; combined use of tobacco and alcohol entailed a strongly increased risk (OR=23.1, 95% CI=9.6–56.0 among heavy users compared with never-users). We conclude that tobacco smoking, a strong risk factor for oesophageal squamous-cell carcinoma and cardia adenocarcinoma, does not play an important role in the aetiology of oesophageal adenocarcinoma. None of the studied exposures can explain the increasing incidence of oesophageal adenocarcinoma. Int. J. Cancer 85:340–346, 2000. ©2000 Wiley-Liss, Inc.