title: Alcohol consumption and risk of lung cancer: a pooled analysis of cohort studies.
abstract: BACKGROUND
  Although smoking is the primary cause of lung cancer, much is unknown about lung cancer etiology, including risk determinants for nonsmokers and modifying factors for smokers.
  
  
  OBJECTIVE
  We hypothesized that alcohol consumption contributes to lung cancer risk.
  
  
  METHODS
  We conducted a pooled analysis using standardized exposure and covariate data from 7 prospective studies with 399,767 participants and 3137 lung cancer cases. Study-specific relative risks (RRs) and CIs were estimated and then combined to calculate pooled multivariate RRs by using a random-effects model.
  
  
  RESULTS
  We found a slightly greater risk for the consumption of > or = 30 g alcohol/d than for that of 0 g alcohol/d in men (RR: 1.21; 95% CI: 0.91, 1.61; P for trend = 0.03) and in women (RR: 1.16; 95% CI: 0.94, 1.43; P for trend = 0.03). In male never smokers, the RR for consumption of > or = 15 g alcohol/d rather than 0 g alcohol/d was 6.38 (95% CI: 2.74, 14.9; P for trend < 0.001). In women, there were few never-smoking cases and no evidence of greater risk (RR: 1.35; 95% CI: 0.64, 2.87). Because of possible residual confounding by smoking, we performed sensitivity analyses by reclassifying the never smokers in the highest drinking category as former smokers. Resulting associations for alcohol consumption were somewhat attenuated, but P for trend = 0.05 for men, which was near the original P = 0.03.
  
  
  CONCLUSIONS
  A slightly greater risk of lung cancer was associated with the consumption of > or = 30 g alcohol/d than with no alcohol consumption. Alcohol consumption was strongly associated with greater risk in male never smokers. Residual confounding by smoking may explain part of the observed relation.
authors.affiliation: Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo, NY 14214, USA. jfreuden@buffalo.edu
authors.forename: Jo L
authors.initials: JL
authors.lastname: Freudenheim
authors.forename: John
authors.initials: J
authors.lastname: Ritz
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Smith-Warner
authors.forename: Demetrius
authors.initials: D
authors.lastname: Albanes
authors.forename: Elisa V
authors.initials: EV
authors.lastname: Bandera
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
authors.forename: Graham
authors.initials: G
authors.lastname: Colditz
authors.forename: Diane
authors.initials: D
authors.lastname: Feskanich
authors.forename: R Alexandra
authors.initials: RA
authors.lastname: Goldbohm
authors.forename: Lisa
authors.initials: L
authors.lastname: Harnack
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Miller
authors.forename: Eric
authors.initials: E
authors.lastname: Rimm
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Rohan
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Sellers
authors.forename: Jarmo
authors.initials: J
authors.lastname: Virtamo
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.forename: David J
authors.initials: DJ
authors.lastname: Hunter
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology
chemical_list: D000431:Ethanol