title: The influence of cigarette smoking, alcohol, and green tea consumption on the risk of carcinoma of the cardia and distal stomach in Shanghai, China.
abstract: BACKGROUND
  The divergent incidence patterns of gastric cardia and distal stomach cancer may suggest different etiologies. This study examined the role of cigarette smoking, alcohol drinking, and green tea consumption as risk factors for carcinoma by anatomic subsite of stomach.
  
  
  METHODS
  Newly-diagnosed stomach carcinoma patients (n = 1124) and frequency-matched population controls (n = 1451) were interviewed in person. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models.
  
  
  RESULTS
  Excess risks associated with cigarette smoking and alcohol consumption were observed largely among men. The adjusted ORs for all stomach cancer combined were 1.35 (CI: 1.06-1.71) for current smokers, and 1.26 (CI: 0.86-1.84) for ex-smokers. For tumors of the distal stomach, statistically significant positive dose-response trends were found for the number of cigarettes smoked per day, the duration and pack-years of smoking, and inverse trends for years of stopped smoking. For tumors of the gastric cardia, however, a monotonic association was found only for the number of cigarettes smoked per day (P=0.06). Alcohol consumption was not related to the risk of cardia cancer, while a moderate excess risk of distal stomach cancer (OR: 1.55; CI: 1.07-2.26) was observed among heavy alcohol drinkers. Green tea drinking was inversely associated with risk of stomach cancer arising from either subsite, with ORs of 0.77 (CI: 0.52-1.13) among female heavy drinkers, and 0.76 (CI: 0.55-1.27) among male heavy drinkers.
  
  
  CONCLUSIONS
  Our findings provide further evidence that cigarette smoking and, possibly, alcohol consumption increase the risk of stomach carcinoma, notably of the distal segment. An inverse association with green tea drinking was also observed.
authors.affiliation: Division of Epidemiology, Columbia University, School of Public Health, New York, USA.
authors.forename: B T
authors.initials: BT
authors.lastname: Ji
authors.forename: W H
authors.initials: WH
authors.lastname: Chow
authors.forename: G
authors.initials: G
authors.lastname: Yang
authors.forename: J K
authors.initials: JK
authors.lastname: McLaughlin
authors.forename: R N
authors.initials: RN
authors.lastname: Gao
authors.forename: W
authors.initials: W
authors.lastname: Zheng
authors.forename: X O
authors.initials: XO
authors.lastname: Shu
authors.forename: F
authors.initials: F
authors.lastname: Jin
authors.forename: J F
authors.initials: JF
authors.lastname: Fraumeni
authors.forename: Y T
authors.initials: YT
authors.lastname: Gao
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D016022:Case-Control Studies; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000209:etiology*; D013662:Tea
chemical_list: D013662:Tea