Does Heavy Drinking Increase the Risk of Lung Cancer among Smokers?

To assess the relationship between alcohol consumption, smoking, and lung cancer risk, investigators analyzed data from Italy’s population-based Environment and Genetics in Lung Cancer Etiology (EAGLE) case-control study. Between 2002 and 2005, 2100 patients with primary lung cancer were randomly selected from 13 Northern Italian hospitals and frequency-matched on sex, area of residence, and age with 2120 controls. Lifetime alcohol consumption and tobacco smoking were compared in 1855 patients and 2065 controls via personal interview and self-administered questionnaire.

• Overall, nondrinkers [odds ratio (OR), 1.42] and very heavy drinkers (≥60 g per day; OR, 1.44) had a significantly higher risk of lung cancer compared with very light drinkers (0.1–4.9 g per day).

• The alcohol effect was modified by smoking behavior, with no excess risk being observed in never smokers.

• Among ever smokers (the majority of patients), the highest ORs were seen among nondrinkers (OR, 1.55) and those consuming ≥60 g per day (OR, 1.40), with very light drinkers used as the referent group.

Comments:

Among never smokers, these authors found no effect of alcohol consumption on the risk of lung cancer in stratified analyses. Based on some of the analyses, the authors concluded that heavy alcohol consumption was a risk factor for the development of lung cancer, although they also stated that residual confounding by tobacco smoking could not be ruled out.

R. Curtis Ellison, MD

Reference:

Bagnardi V, Randi G, Lubin J, et al. Alcohol consumption and lung cancer risk in the Environment and Genetics in Lung Cancer Etiology (EAGLE) study. Am J Epidemiol. 2010;171(1):36–44.