Alcohol intake and pancreatic cancer risk: An analysis from 30 prospective studies across Asia, Australia, Europe, and North America.
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Naudin Sabine, Wang Molin, Dimou Niki, Ebrahimi Elmira, Genkinger Jeanine, Adami Hans-Olov, Albanes Demetrius, Babic Ana, Barnett Matt, Bogumil David, Cai Hui, Chen Chu, Eliassen A Heather, Freudenheim Jo L, Gierach Gretchen, Giovannucci Edward L, Gunter Marc J, Håkansson Niclas, Hirabayashi Mayo, Hou Tao, Huang Brian Z, Huang Wen-Yi, Jayasekara Harindra, Jones Michael E, Katzke Verena A, Koh Woon-Puay, Lacey James V, Lagerros Ylva Trolle, Larsson Susanna C, Liao Linda M, Lo Kenneth, Loftfield Erikka, MacInnis Robert J, Männistö Satu, McCullough Marjorie L, Miller Anthony, Milne Roger L, Moore Steven C, Mucci Lorelei A, Neuhouser Marian L, Patel Alpa V, Platz Elizabeth A, Prizment Anna, Robien Kim, Rohan Thomas E, Sacerdote Carlotta, Sandin Sven, Sawada Norie, Schoemaker Minouk, Shu Xiao-Ou, Sinha Rashmi, Snetselaar Linda, Stampfer Meir J, Stolzenberg-Solomon Rachael, Thomson Cynthia A, Tjønneland Anne, Um Caroline Y, van den Brandt Piet A, Visvanathan Kala, Wang Sophia S, Wang Renwei, Weiderpass Elisabete, Weinstein Stephanie J, White Emily, Willett Walter, Woslk Alicja, Wolpin Brian M, Yaun Shiaw-Shyuan S, Yuan Chen, Yuan Jian-Min, Zheng Wei, Brennan Paul, Smith-Warner Stephanie A, Ferrari Pietro
Аннотация
METHODS AND FINDINGS: Population-based individual-level data was pooled from 30 cohorts across four continents, including Asia, Australia, Europe, and North America. A total of 2,494,432 participants without cancer at baseline (62% women, 84% European ancestries, 70% alcohol drinkers [alcohol intake ≥ 0.1 g/day], 47% never smokers) were recruited between 1980 and 2013 at the median age of 57 years and 10,067 incident pancreatic cancer cases were recorded. In age- and sex-stratified Cox proportional hazards models adjusted for smoking history, diabetes status, body mass index, height, education, race and ethnicity, and physical activity, pancreatic cancer hazard ratios (HR) and 95% confidence intervals (CI) were estimated for categories of alcohol intake and in continuous for a 10 g/day increase. Potential heterogeneity by sex, smoking status, geographic regions, and type of alcoholic beverage was investigated. Alcohol intake was positively associated with pancreatic cancer risk, with HR30-to-<60 g/day and HR≥60 g/day equal to 1.12 (95% CI [1.03,1.21]) and 1.32 (95% CI [1.18,1.47]), respectively, compared to intake of 0.1 to <5 g/day. A 10 g/day increment of alcohol intake was associated with a 3% increased pancreatic cancer risk overall (HR: 1.03; 95% CI [1.02,1.04]; pvalue < 0.001) and among never smokers (HR: 1.03; 95% CI [1.01,1.06]; pvalue = 0.006), with no evidence of heterogeneity by sex (pheterogeneity = 0.274) or smoking status (pheterogeneity = 0.624). Associations were consistent in Europe-Australia (HR10 g/day = 1.03, 95% CI [1.00,1.05]; pvalue = 0.042) and North America (HR10 g/day = 1.03, 95% CI [1.02,1.05]; pvalue < 0.001), while no association was observed in cohorts from Asia (HR10 g/day = 1.00, 95% CI [0.96,1.03]; pvalue = 0.800; pheterogeneity = 0.003). Positive associations with pancreatic cancer risk were found for alcohol intake from beer (HR10 g/day = 1.02, 95% CI [1.00,1.04]; pvalue = 0.015) and spirits/liquor (HR10 g/day = 1.04, 95% CI [1.03,1.06]; pvalue < 0.001), but not wine (HR10 g/day = 1.00, 95% CI [0.98,1.03]; pvalue = 0.827). The differential associations across geographic regions and types of alcoholic beverages might reflect differences in drinking habits and deserve more investigations.
CONCLUSIONS: Findings from this large-scale pooled analysis support a modest positive association between alcohol intake and pancreatic cancer risk, irrespective of sex and smoking status. Associations were particularly evident for baseline alcohol intake of at least 15 g/day in women and 30 g/day in men.