Alcohol and tobacco use in relation to gastric cancer: a prospective study of men in Shanghai, China.
Alcohol and tobacco use in relation to gastric cancer: a prospective study of men in Shanghai, China.
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DOI：
10.1158/1055-9965.epi-10-0362
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发表时间：
2010-09
期刊：
影响因子：
--
通讯作者：
Yuan JM
中科院分区：
文献类型：
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作者：
Moy KA;Fan Y;Wang R;Gao YT;Yu MC;Yuan JM
吸烟和饮酒与胃癌相关的流行病学调查结果不一致。精心设计的前瞻性研究很少考察它们之间的关系。在一项基于人群的前瞻性队列研究中，研究人员检查了吸烟/饮酒与胃癌风险之间的关系，该队列包括1986-1989年间在中国上海登记的18244名中老年男性。经过长达20年的随访，确定了391例胃癌病例。采用Cox比例风险回归模型估计风险比（hr）和相应的95%置信区间（ci）。在调整了酒精摄入和其他混杂因素后，与不吸烟者相比，曾经吸烟者患胃癌的风险显著增加（HR, 1.59; 95% CI, 1.27-1.99）。在不饮酒者中，吸烟者患胃癌的风险增加80% （HR, 1.81; 95% CI,1.36, 2.41）。相反，在所有受试者中，重度饮酒者患胃癌的风险有统计学意义上的增加（HR, 1.46; 95% CI, 1.05-2.04），而从不吸烟者的风险增加了80%，统计学上无统计学意义。进一步调整幽门螺杆菌血清学、血清β -胡萝卜素和维生素C水平以及尿中总异硫酸盐水平与谷胱甘肽s -转移酶（GST） M1和GSTT1基因型并没有实质性地改变吸烟/饮酒与胃癌风险之间的关系。这些结果表明，吸烟和饮酒可能对这一高危人群的胃癌发展有独立的影响。改变这些生活方式可以降低胃癌的发病率。
Epidemiological findings of tobacco and alcohol use in relation to gastric cancer are inconsistent. Well-designed prospective studies examining their relationship are sparse. The association between cigarette smoking/alcohol intake and gastric cancer risk was examined in a population-based prospective cohort of 18,244 middle-aged and older men in Shanghai, China, who were enrolled in the study during 1986–1989. After up to 20 years of follow-up, 391 incident gastric cancer cases were identified. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Ever smokers experienced a statistically significant increased risk of gastric cancer (HR, 1.59; 95% CI, 1.27–1.99) compared with nonsmokers after adjustment for alcohol intake and other confounders. Among nondrinkers, smokers experienced 80% increased risk of gastric cancer (HR, 1.81; 95% CI,1.36, 2.41). Conversely heavy drinkers experienced a statistically significant increase in risk of gastric cancer (HR, 1.46; 95% CI, 1.05–2.04) among all subjects and a statistically non-significant 80% increased risk among never smokers. Further adjustment for Helicobacter pylori serology, serum levels of beta-carotene and vitamin C, and urinary level of total isothiocyanates in combination with glutathione S-transferase (GST) M1 and GSTT1 genotypes did not materially change the associations between smoking/alcohol consumption and gastric cancer risk. These results suggest that cigarette smoking and alcohol consumption may exert independent effects on the development of gastric cancer in this high-risk population. Modification of these lifestyle choices may reduce the incidence of gastric cancer.