Alcohol and lung cancer risk among never smokers: A pooled analysis from the international lung cancer consortium and the SYNERGY study.
Alcohol and lung cancer risk among never smokers: A pooled analysis from the international lung cancer consortium and the SYNERGY study.
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DOI：
10.1002/ijc.30618
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发表时间：
2017-05-01
影响因子：
6.4
通讯作者：
Hung RJ
中科院分区：
文献类型：
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作者：
Fehringer G;Brenner DR;Zhang ZF;Lee YA;Matsuo K;Ito H;Lan Q;Vineis P;Johansson M;Overvad K;Riboli E;Trichopoulou A;Sacerdote C;Stucker I;Boffetta P;Brennan P;Christiani DC;Hong YC;Landi MT;Morgenstern H;Schwartz AG;Wenzlaff AS;Rennert G;McLaughlin JR;Harris CC;Olivo-Marston S;Orlow I;Park BJ;Zauderer M;Barros Dios JM;Ruano Raviña A;Siemiatycki J;Koushik A;Lazarus P;Fernández-Somoano A;Tardon A;Le Marchand L;Brenner H;Saum KU;Duell EJ;Andrew AS;Szeszenia-Dabrowska N;Lissowska J;Zaridze D;Rudnai P;Fabianova E;Mates D;Foretova L;Janout V;Bencko V;Holcatova I;Pesatori AC;Consonni D;Olsson A;Straif K;Hung RJ
目前尚不清楚饮酒是否与肺癌风险有关。这种关系可能与吸烟混淆，使先前研究的解释复杂化。我们在一个大型国际汇总样本中检查了饮酒与肺癌风险的关系，通过限制对从不吸烟者的分析，最大限度地减少了烟草消费的潜在混淆。我们的研究包括22项病例对照和队列研究，共有2548名从不吸烟的肺癌患者和9362名从不吸烟的对照组，来自北美、欧洲和亚洲的国际肺癌联盟（ILCCO）和SYNERGY联盟。酒精消费量被分类为消费量（克/天），并使用限制三次样条作为潜在非线性的连续变量建模。按组织学分型进行分析。还调查了消费的酒精类型（葡萄酒、啤酒和烈性酒）的关联。饮酒与肺癌风险呈负相关，证据最强烈地支持轻度和中度饮酒者相对于不饮酒者的风险较低（每天0-4.9g: OR=0.80, 95% CI= 0.70-0.90；每天5-9.9g: OR=0.82, 95% CI= 0.69-0.99；每天10-19.9g: OR=0.79, 95% CI= 0.65-0.96）。饮用葡萄酒和烈性酒发现了负相关，但啤酒没有。结果表明，饮酒量与肺癌风险呈负相关，尤其是在低至中等饮酒量的受试者中，以及在葡萄酒和烈酒饮用者中，而不是啤酒饮用者中。虽然我们的结果不应该有吸烟混杂效应的相关偏差，但我们不能排除其他因素对观察到的关联有影响。与非饮酒者参考类别有关的混淆可能特别重要。
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 (>0–4.9g per day: OR=0.80, 95% CI=0.70–0.90; 5–9.9g per day: OR=0.82, 95% CI=0.69–0.99; 10–19.9g 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.