title: Changes in alcohol intake and risk of upper digestive tract cancer.
abstract: BACKGROUND
  Alcohol intake measured at one point in time is a strong predictor for later development of cancer of the oral cavity, pharynx, larynx and esophagus. In this prospective cohort study, we examined whether changes in individual alcohol intake resulted in subsequent altered risk of these cancers.
  
  
  METHODS
  In the Copenhagen City Heart Study we assessed alcohol intake among 4 896 men and 6 239 women who participated at both the first (1976-1978) and second (1981-1983) examination of the study. Alcohol intake changes on risk of upper digestive tract cancer 1981-2002 were examined by a Cox model adjusted for potential confounders.
  
  
  RESULTS
  Despite a small number of cases (n = 105), alcohol intake increase > 14 drinks/week was associated with significantly elevated risk (hazard ratio = 2.5; 95% confidence interval, 1.1-5.3), while suggestively decreased risk was observed for persons lowering alcohol intake > 7 drinks/week (0.5; 0.1-2.5). The trend test was highly significant (p < 0.0001).
  
  
  CONCLUSIONS
  These findings support public health messages of not increasing alcohol intake and lowering consumption among people with high alcohol intake.
authors.affiliation: Centre for Alcohol Research, National Institute of Public Health, Copenhagen, Denmark. lct@niph.dk
authors.forename: Lau C
authors.initials: LC
authors.lastname: Thygesen
authors.forename: Niels
authors.initials: N
authors.lastname: Keiding
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
authors.forename: Morten
authors.initials: M
authors.lastname: Grønbaek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000639:trends; D015992:Body Mass Index; D002277:Carcinoma / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D041742:Upper Gastrointestinal Tract / Q000187:drug effects / Q000473:pathology