Alcohol and lung cancer risk among never smokers: A pooled analysis from the international lung cancer consortium and the SYNERGY study

Abstract

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.

Body Mass Index (BMI), BMI Change, and Overall Survival in Patients With SCLC and NSCLC: A Pooled Analysis of the International Lung Cancer Consortium

“…Full details have been provided previously and are available at http://ilcco.iarc.fr. [43][44][45][46][47][48] To be included in the present pooled analysis, studies had to have data on BMI at lung cancer diagnosis, lung cancer type (SCLC versus NSCLC), date of diagnosis, stage at diagnosis, vital status at last follow-up, and date of death. Optional variables included BMI at periods other than at diagnosis.…”

Functional validity, role, and implications of heavy alcohol consumption genetic loci

“…However, the outcomes from the MR provide potential evidence of a causal relationship in our overall sample and when stratified by smoking status. Alcohol is a known carcinogen and is implicated in cancers of the liver, colon, rectum, head and neck, and breast, for example (31), while evidence for lung is variable (32,33). Lung cancer is a complex and multifactorial disease involving genetic and a range of measurable and nonmeasurable environmental and lifestyle factors.…”

Lung Cancer Risk in Never-Smokers of European Descent is Associated With Genetic Variation in the 5p15.33 TERT-CLPTM1Ll Region

“…High body mass index and alcohol exposure are common and may also explain a proportion of the lung cancer risk in never-smokers. 47,48 It is possible that there are rare variants influencing risk that could not be detected by a GWAS that focuses on common variants. Additionally, gene-gene interactions that are beyond the scope of this study may in part explain variability in the incidence of lung cancer in never-smokers.…”