title: Is there an association between alcohol intake or smoking and small bowel adenocarcinoma? Results from a European multi-center case-control study.
abstract: OBJECTIVE
  To discover whether tobacco smoking and intake of different types of alcoholic drinks are associated with small bowel adenocarcinoma (SBA).
  
  
  METHODS
  A population-based European multi-center case-control study was conducted from 1995 to 1997.
  
  
  RESULTS
  After a histological review using uniform diagnostic criteria, 47 (33%) of the 142 identified cases of SBA were excluded due to reclassification as either tumors of the papilla of Vater (n = 22), stromal tumors, or metastases; 95 cases were accepted for study. In all, 70 cases of SBA together with 2070 controls matched by age, sex, and region were interviewed. A high intake (more than 24 g alcohol per day) of beer or spirits was associated with SBA, an odds ratio (OR) of 3.5 and 95% confidence intervals (CI) of 1.5-8.0 and 3.4 (95% CI 1.3-9.2), respectively). There was no association with wine intake or total alcohol intake. Tobacco smoking was probably unrelated to SBA.
  
  
  CONCLUSIONS
  A high intake of beer or spirits seems to be a risk factor for SBA. Since this association was not seen for wine drinkers, protective components of wine may counterbalance a carcinogenic effect of alcohol on the small bowel. Alternatively, the result may be confounded by other factors, e.g. dietary factors.
authors.affiliation: Department of Epidemiology and Social Medicine, University of Aarhus, Denmark. L.kaerlev@dadlnet.dk
authors.forename: L
authors.initials: L
authors.lastname: Kaerlev
authors.forename: P S
authors.initials: PS
authors.lastname: Teglbjaerg
authors.forename: S
authors.initials: S
authors.lastname: Sabroe
authors.forename: H A
authors.initials: HA
authors.lastname: Kolstad
authors.forename: W
authors.initials: W
authors.lastname: Ahrens
authors.forename: M
authors.initials: M
authors.lastname: Eriksson
authors.forename: P
authors.initials: P
authors.lastname: Guénel
authors.forename: L
authors.initials: L
authors.lastname: Hardell
authors.forename: G
authors.initials: G
authors.lastname: Launoy
authors.forename: E
authors.initials: E
authors.lastname: Merler
authors.forename: F
authors.initials: F
authors.lastname: Merletti
authors.forename: A
authors.initials: A
authors.lastname: Stang
authors.forename: J
authors.initials: J
authors.lastname: Olsen
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology*; D016022:Case-Control Studies; D016001:Confidence Intervals; D005060:Europe; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D007421:Intestine, Small / Q000166:cytology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D016017:Odds Ratio; D011159:Population Surveillance / Q000379:methods; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*