Smoking and alcohol drinking in relation to risk of gastric cancer:: A population-based, prospective cohort study
Smoking and alcohol drinking in relation to risk of gastric cancer:: A population-based, prospective cohort study
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DOI：
10.1002/ijc.22157
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发表时间：
2007-01-01
影响因子：
6.4
通讯作者：
Lagergren, Jesper
中科院分区：
文献类型：
--
作者：
Sjodahl, Krister;Lu, Yunxia;Lagergren, Jesper
烟草、酒精和胃癌风险之间的关系需要确定，并且应该估计预防措施的任何收益。我们在挪威的Nord-Trondelag县进行了一项基于人群的前瞻性队列研究。在1984-1986年期间，成年居民被邀请参加一项健康调查，他们回答了评估烟草和酒精暴露以及潜在混杂因素的问卷。关于酒精的暴露评估限于14天。在随访期间（1984-2002年）发生的新发胃癌通过与挪威癌症登记处的联系确定。使用考克斯比例风险回归模型计算风险比（HR）和95%置信区间（CI），并根据性别、教育和体重指数进行调整。对69,962名队列成员中1,117,648人-年的风险进行随访，发现251例胃癌，包括224例非贲门癌。每日吸烟者的风险几乎是从不吸烟者的两倍（HR = 1.88 [CI 95% = 1.33-2.67]）。独立的剂量反应关系，发现在较早的年龄开始（p = 0.02），频率（p = 0.00）和吸烟的持续时间（p = 0.00）。目前吸烟者胃癌的归因风险（AR）为8.7/10万人年，相应人群AR为18.4%。不同程度的酒精暴露与胃癌风险之间无统计学显著相关性，但与不吸烟者相比，大量吸烟（> 20支/天）和饮酒（> 5次/14天）使非贲门部胃癌风险增加近5倍（HR = 4.90 [95%CI = 1.90-12.62]）。结论：吸烟是胃癌的剂量依赖性危险因素。吸烟和饮酒的高暴露量进一步增加了风险。成功的预防措施可以大大降低胃癌的发病率。(c)2006威利-利斯公司
The relations between tobacco, alcohol and risk of gastric cancer need to be established, and any gain from preventive measures should be estimated. We conducted a population-based, prospective cohort study in Nord-Trondelag county in Norway. During 1984-1986, adult residents were invited to a health survey and they answered questionnaires that assessed exposure to tobacco and alcohol, together with potential confounding factors. The exposure assessment regarding alcohol was limited to a 14-day period. New gastric cancers that occurred during follow-up (1984-2002) were identified by linkage to the Norwegian Cancer Registry. Cox proportion hazards regression models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CI), adjusted for sex, education and body mass index. Follow-up of 1,117,648 person-years at risk among 69,962 cohort members revealed 251 gastric cancers, including 224 noncardia cancers. The risk was almost twice as high in daily smokers (HR = 1.88 [CI 95% = 1.33-2.67]) as in never smokers. Independent dose-response relations were found with earlier age at initiation (p = 0.02), frequency (p = 0.00) and duration of smoking (p = 0.00). Attributable risk (AR) of gastric cancer among current smokers was 8.7/100,000 person-years and the corresponding population AR was 18.4%. No statistically significant associations between various degrees of exposure to alcohol and risk of gastric cancer was revealed, but combined high use of cigarettes (> 20/day) and alcohol (> 5 occasions/14 days) increased the risk of noncardia gastric cancer nearly 5-fold (HR = 4.90 [95% CI = 1.90-12.62]), compared to nonusers. It is concluded that smoking is a dose-dependent risk factor for gastric cancer. Combined high exposure to smoking and alcohol further increases the risk. successful preventive measures could considerably reduce the incidence of gastric cancer. (c) 2006 Wiley-Liss, Inc.