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Research Summary

Heavy Beer Consumption Is a Risk Factor for Gastric Cancer

The etiological role of alcohol in gastric cancer is uncertain: although it is suspected to be a risk factor, alcohol also appears to reduce Helicobacter pylori (H. pylori) infection. Investigators used data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study to evaluate the association between baseline alcohol consumption and the risk of gastric cancer. People who drank very light amounts* (0.1–4.9 g, or less than half a drink** daily) were compared with those who drank more (5–≥60 g daily). Among 478,459 participants who contributed >4 million person-years, there were 444 incident cases of gastric cancer. In Cox proportional hazards models,

  • alcohol consumption of ≥60 g per day was associated with gastric cancer (hazard ratio [HR], 1.7) but only with intestinal-type and noncardia gastric cancers.
  • after adjusting for beverage type, beer (but not wine or liquor) consumption of ≥30 g per day was associated with gastric cancer (HR, 1.8).
  • the association between alcohol and gastric cancer was independent of smoking status and H. pylori infection and was more apparent in men than in women.

*Nondrinkers were not used as the referent group because 56% of those who reported no alcohol consumption at baseline were former drinkers.
**Standard drink = 13.5 g alcohol in this study.

Comments:

This prospective cohort study suggests there is an increased risk of intestinal-type and noncardia gastric cancer with heavy alcohol consumption. However, why these cancers were associated with beer consumption only, and whether there was a threshold level of exposure or a linear association, was not clear from the analyses. Nonetheless, the results raise concerns that 2–3 standard servings of beer a day could increase gastric cancer risk, particularly in men. Daniel Fuster, MD, PhD† & Richard Saitz, MD, MPH
†Contributing Editorial Intern and Research Scholar, Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA.

Reference:

Duell EJ, Travier N, Lujan-Barroso L, et al. Alcohol consumption and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Am J Clin Nutr. 2011;94(5):1266–1275.

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