Alcohol Intake, Beverage Choice, and Cancer: A Cohort Study in a Large Kaiser Permanente Population

Klatsky, Arthur L.; Li, Yan; Tran, H. Nicole; Baer, David; Udaltsova, Natalia; Armstrong, Mary Anne; Friedman, Gary D.

doi:10.7812/tpp/14-189

Cited by 23 publications

(16 citation statements)

References 36 publications

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“…In most analyses, we found risk estimates were generally below the null for subjects who were categorized as heavier drinkers (30 or more grams per day) of total alcohol, wine or liquor. In contrast, results from several large cohort studies and a recent comprehensive meta‐analysis indicated increased risk for heavier drinkers . As these studies included smokers, residual confounding by smoking in heavier drinkers may explain the observed increased risk of lung cancer.…”

Section: Discussionmentioning

confidence: 91%

“…As these studies included smokers, residual confounding by smoking in heavier drinkers may explain the observed increased risk of lung cancer. Two recent cohort studies and a meta‐analysis did not find heavier drinkers to be at higher risk for lung cancer among never smokers …”

Section: Discussionmentioning

confidence: 92%

“…In contrast, results from several large cohort studies and a recent comprehensive meta-analysis indicated increased risk for heavier drinkers. 8,11,18,19 As these studies included smokers, residual confounding by smoking in heavier drinkers may explain the observed increased risk of lung cancer. Two recent cohort studies and a meta-analysis did not find heavier drinkers to be at higher risk for lung cancer among never smokers.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, associations by histologic subtype and beverage type (e.g., wine, beer and liquor) have not been thoroughly investigated among never smokers. 8,10,11 In this study, we investigated the association of alcohol consumption and lung cancer risk in never smokers in a large pooled dataset of 22 studies from the International Lung Cancer Consortium (ILCCO) 12 and the SYNERGY project, 13 in order to obtain sufficient sample size to thoroughly examine this association stratified by histologic subtype and beverage type while minimizing the effect of residual confounding by smoking.…”

Section: Cancer Epidemiologymentioning

confidence: 99%

“…Although few previous studies have investigated the association between alcohol consumption and lung cancer risk in never smokers, they were limited in precision. Furthermore, associations by histologic subtype and beverage type (e.g., wine, beer and liquor) have not been thoroughly investigated among never smokers …”

mentioning

confidence: 99%

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

Fehringer

Brenner

Zhang

et al. 2017

Intl Journal of Cancer

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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.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 92%