Dataset Information

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 (>0-4.9 g per day: OR?=?0.80, 95% CI?=?0.70-0.90; 5-9.9 g per day: OR?=?0.82, 95% CI?=?0.69-0.99; 10-19.9 g 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.

SUBMITTER: Fehringer G

PROVIDER: S-EPMC5356930 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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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 Gordon G Brenner Darren R DR Zhang Zuo-Feng ZF Lee Yuan-Chin Amy YA Matsuo Keitaro K Ito Hidemi H Lan Qing Q Vineis Paolo P Johansson Mattias M Overvad Kim K Riboli Elio E Trichopoulou Antonia A Sacerdote Carlotta C Stucker Isabelle I Boffetta Paolo P Brennan Paul P Christiani David C DC Hong Yun-Chul YC Landi Maria Teresa MT Morgenstern Hal H Schwartz Ann G AG Wenzlaff Angela S AS Rennert Gad G McLaughlin John R JR Harris Curtis C CC Olivo-Marston Susan S Orlow Irene I Park Bernard J BJ Zauderer Marjorie M Barros Dios Juan M JM Ruano Raviña Alberto A Siemiatycki Jack J Koushik Anita A Lazarus Philip P Fernández-Somoano Ana A Tardon Adonina A Le Marchand Loic L Brenner Hermann H Saum Kai-Uwe KU Duell Eric J EJ Andrew Angeline S AS Szeszenia-Dabrowska Neonila N Lissowska Jolanta J Zaridze David D Rudnai Peter P Fabianova Eleonora E Mates Dana D Foretova Lenka L Janout Vladimir V Bencko Vladimir V Holcatova Ivana I Pesatori Angela Cecilia AC Consonni Dario D Olsson Ann A Straif Kurt K Hung Rayjean J RJ

International journal of cancer 20170227 9

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 patie ...[more]

PMID: 28120396

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Project description:BackgroundMost lung cancer risk prediction models were developed in European and North-American cohorts of smokers aged ≥ 55 years, while less is known about risk profiles in Asia, especially for never smokers or individuals aged < 50 years. Hence, we aimed to develop and validate a lung cancer risk estimate tool for ever and never smokers across a wide age range.MethodsBased on the China Kadoorie Biobank cohort, we first systematically selected the predictors and explored the nonlinear association of predictors with lung cancer risk using restricted cubic splines. Then, we separately developed risk prediction models to construct a lung cancer risk score (LCRS) in 159,715 ever smokers and 336,526 never smokers. The LCRS was further validated in an independent cohort over a median follow-up of 13.6 years, consisting of 14,153 never smokers and 5,890 ever smokers.ResultsA total of 13 and 9 routinely available predictors were identified for ever and never smokers, respectively. Of these predictors, cigarettes per day and quit years showed nonlinear associations with lung cancer risk (Pnon-linear < 0.001). The curve of lung cancer incidence increased rapidly above 20 cigarettes per day and then was relatively flat until approximately 30 cigarettes per day. We also observed that lung cancer risk declined sharply within the first 5 years of quitting, and then continued to decrease but at a slower rate in the subsequent years. The 6-year area under the receiver operating curve for the ever and never smokers' models were respectively 0.778 and 0.733 in the derivation cohort, and 0.774 and 0.759 in the validation cohort. In the validation cohort, the 10-year cumulative incidence of lung cancer was 0.39% and 2.57% for ever smokers with low (< 166.2) and intermediate-high LCRS (≥ 166.2), respectively. Never smokers with a high LCRS (≥ 21.2) had a higher 10-year cumulative incidence rate than those with a low LCRS (< 21.2; 1.05% vs. 0.22%). An online risk evaluation tool (LCKEY; http://ccra.njmu.edu.cn/lckey/web) was developed to facilitate the use of LCRS.ConclusionsThe LCRS can be an effective risk assessment tool designed for ever and never smokers aged 30 to 80 years.

Dataset Information

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

Publications

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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