title: Impact of alcohol drinking on gastric cancer development according to Helicobacter pylori infection status.
abstract: BACKGROUND
  Helicobacter pylori are major carcinogen of gastric cancer, but the associations among gastric cancer, H. pylori infection status, and alcohol consumption are not fully described. This study aimed to clarify how H. pylori infection status affects the association between alcohol consumption and gastric cancer risk.
  
  
  METHODS
  We selected 949 case-cohort participants from the 18,863 Korean Multi-center Cancer Cohort (KMCC) populations. Gastric cancer incidence inside and outside of the subcohort were 12 and 254 cases, respectively. Seropositivities for CagA, VacA, and H. pylori infection were determined by performing immunoblot assays. Weighted Cox regression models were used to calculate hazard ratios and 95% confidence intervals (CIs).
  
  
  RESULTS
  Relative to non-drinking, heavy drinking (⩾7 times a week), and binge drinking (⩾55 g alcohol intake per occasion) showed a 3.48-fold (95% CI, 1.13-10.73) and 3.27-fold (95% CI, 1.01-10.56) higher risk in subjects not previously infected by H. pylori. There was no significant association between drinking pattern and gastric cancer risk in H. pylori IgG seropositive subjects. An increased risk for gastric cancer in heavy- and binge-drinking subjects were also present in subjects not infected by CagA- or VacA-secreting H. pylori.
  
  
  CONCLUSIONS
  Heavy and binge alcohol consumption is an important risk factor related to an increasing incidence of gastric cancer in a population not infected by H. pylori.
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.|Cancer Research Institute, Seoul National University, Seoul, Korea.
authors.forename: Seung-Hyun
authors.initials: SH
authors.lastname: Ma
authors.affiliation: Department of Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Woohyun
authors.initials: W
authors.lastname: Jung
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.|Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.|Cancer Registry of Norway, Oslo, Norway.|Department of Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jieun
authors.initials: J
authors.lastname: Jang
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.|Cancer Research Institute, Seoul National University, Seoul, Korea.|Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Yunji
authors.initials: Y
authors.lastname: Hwang
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Chunghyun
authors.initials: C
authors.lastname: Ahn
authors.affiliation: Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea.
authors.forename: Kwang-Pil
authors.initials: KP
authors.lastname: Ko
authors.affiliation: Department of Preventive Medicine, Konkuk University, Chungju, Korea.
authors.forename: Soung-Hoon
authors.initials: SH
authors.lastname: Chang
authors.affiliation: Non-communicable Disease and Health Promotion, Western Pacific Regional Office, World Health Organization, Manila, Philippines.
authors.forename: Hai-Rim
authors.initials: HR
authors.lastname: Shin
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Keun-Young
authors.initials: KY
authors.lastname: Yoo
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.|Cancer Research Institute, Seoul National University, Seoul, Korea.|Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sue K
authors.initials: SK
authors.lastname: Park
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D016481:Helicobacter Infections / Q000209:etiology / Q000382:microbiology* / Q000473:pathology*; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D015994:Incidence; D007723:Korea; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D013270:Stomach / Q000382:microbiology / Q000473:pathology; D013274:Stomach Neoplasms / Q000209:etiology / Q000382:microbiology* / Q000473:pathology*