Cigarette smoking, alcohol consumption and subsequent gastric cancer risk by subsite and histologic type

Authors

  • Shizuka Sasazuki,

    1. Epidemiology and Biostatistics Division, National Cancer Center Research Institute East, Kashiwa City, Japan
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  • Satoshi Sasaki,

    1. Epidemiology and Biostatistics Division, National Cancer Center Research Institute East, Kashiwa City, Japan
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  • Shoichiro Tsugane,

    Corresponding author
    1. Epidemiology and Biostatistics Division, National Cancer Center Research Institute East, Kashiwa City, Japan
    • Epidemiology and Biostatistics Division, National Cancer Center Research Institute East, 6-5-1 Kashiwanoha, Kashiwa-City, Chiba 277-8577, Japan
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    • Fax: +81-4-7134-6862

  • Japanese Public Health Center Study Group

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    • The Japan Public Health Center Study Cohort I Group is composed of the members listed above as well as the following: J. Ogata, S. Baba, National Center for Circulatory Diseases, Suita; K. Miyakawa, F. Saito, A. Koizumi, Iwate Prefectural Ninohe Public Health Center, Ninohe; Y. Miyajima, N. Suzuki, S. Nagasawa, Akita Prefectural Yokote Public Health Center, Yokote; H. Sanada, Y. Hatayama, F. Kobayashi, H. Uchino, Y. Shirai, T. Kondo, Nagano Prefectural Saku Public Health Center, Saku; Y. Kishimoto, E. Takara, M. Kinjo, T. Fukuyama, Okinawa Prefectural Ishikawa Public Health Center, Ishikawa; S. Matsushima, S. Natsukawa, Saku General Hospital, Usuda; S. Watanabe, M. Akabane, Tokyo University of Agriculture, Tokyo; M. Konishi, Ehime University, Matsuyama; S. Tominaga, Aichi Cancer Center Research Institute, Nagoya; M. Iida, S. Sato, Center for Adult Diseases, Osaka; the late M. Yamaguchi, Y. Matsumura, National Institute of Health and Nutrition, Tokyo; Y. Tsubono, Tohoku University, Sendai; H. Iso, Tsukuba University, Tsukuba; H. Sugimura, Hamamatsu University, Hamamatsu; M. Kabuto, National Institute for Environmental Studies; Tsukuba.


Abstract

The effect of cigarette smoking or alcohol consumption on the risk of gastric cancer has not been clarified. We investigated this relationship, considering the anatomic subsite and histologic type of gastric cancer. A total of 19,657 men (aged 40–59 years at baseline), who responded to the baseline questionnaire and reported no serious illness at that time, were followed for 10 years, from January 1990 to December 1999. Gastric cancer was confirmed histologically in 293 men. Smoking was associated with an increased risk of the differentiated type of distal gastric cancer; compared to the group who never smoked, the adjusted rate ratios (RRs) of gastric cancer for past and current smokers were 2.0 (95% CI 1.1–3.7) and 2.1 (95% CI 1.2–3.6), respectively. No association was observed between cigarette smoking and risk of the undifferentiated type of distal gastric cancer except for a suggestive association with cardia cancer. For alcohol consumption, elevated risk was suggested only for cardia cancer of all histologic types, though the relationship failed to reach significance. Among those who drank alcohol at least once per week, RRs for ethanol intake of 2.7–161.0, 162.0–322.0 and 322.5+ g/week compared to those who drank 0–3 times/month were 2.5 (95% CI 0.7–9.5), 3.3 (0.9–11.6) and 3.0 (0.8–11.1), respectively (ptrend = 0.66). In conclusion, our results confirm that smoking is related to gastric cancer of the differentiated type. Further studies with more cases are needed to detect a positive association between cigarette smoking or alcohol consumption and cardia cancer. © 2002 Wiley-Liss, Inc.

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