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Alcohol consumption and risk of lung cancer: A pooled analysis of cohort studies

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Author: Freudenheim, J.L. · Ritz, J. · Smith-Warner, S.A. · Albanes, D. · Bandera, E.V. · Brandt, P.A. van den · Colditz, G. · Feskanich, D. · Goldbohm, R.A. · Harnack, L. · Miller, A.B. · Rimm, E. · Rohan, T.E. · Sellers, T.A. · Virtamo, J. · Willett, W.C. · Hunter, D.J.
Type:article
Date:2005
Institution: TNO Kwaliteit van Leven
Source:American Journal of Clinical Nutrition, 3, 82, 657-667
Identifier: 239012
Keywords: Health · Food and Chemical Risk Analysis · Alcohol consumption · Diet · Epidemiology · Lung neoplasms · Meta-analysis · alcohol consumption · article · cancer risk · cohort analysis · controlled study · female · human · lung cancer · male · smoking · chemically induced disorder · clinical trial · confidence interval · dose response · drinking behavior · lung tumor · meta analysis · prospective study · risk factor · sex difference · alcohol · Alcohol Drinking · Cohort Studies · Confidence Intervals · Dose-Response Relationship, Drug · Ethanol · Female · Humans · Lung Neoplasms · Male · Prospective Studies · Risk Factors · Sex Factors · Smoking

Abstract

Background: Although smoking is the primary cause of lung cancer, much is unknown about lung cancer etiology, including risk determinants for nonsmokers and modifying factors for smokers. Objective: We hypothesized that alcohol consumption contributes to lung cancer risk. Design: We conducted a pooled analysis using standardized exposure and covariate data from 7 prospective studies with 399 767 participants and 3137 lung cancer cases. Study-specific relative risks (RRs) and CIs were estimated and then combined to calculate pooled multivariate RRs by using a random-effects model. Results: We found a slightly greater risk for the consumption of ≥30 g alcohol/d than for that of 0 g alcohol/d in men (RR: 1.21; 95% CI: 0.91, 1.61; P for trend = 0.03) and in women (RR: 1.16; 95% CI: 0.94, 1.43; P for trend = 0.03). In male never smokers, the RR for consumption of ≥ 15 g alcohol/d rather than 0 g alcohol/d was 6.38 (95% CI: 2.74, 14.9; P for trend < 0.001). In women, there were few never-smoking cases and no evidence of greater risk (RR: 1.35; 95% CI: 0.64, 2.87). Because of possible residual confounding by smoking, we performed sensitivity analyses by reclassifying the never smokers in the highest drinking category as former smokers. Resulting associations for alcohol consumption were somewhat attenuated, but P for trend = 0.05 for men, which was near the original P = 0.03. Conclusions: A slightly greater risk of lung cancer was associated with the consumption of ≥30 g alcohol/d than with no alcohol consumption. Alcohol consumption was strongly associated with greater risk in male never smokers. Residual confounding by smoking may explain part of the observed relation. © 2005 American Society for Clinical Nutrition.