title: The Association Between Alcohol Consumption and Lung Carcinoma by Histological Subtype.
abstract: Alcohol is a carcinogen suspected of increasing lung cancer risk. Therefore, we prospectively evaluated the relationship between alcohol consumption and lung carcinoma in 492,902 persons from the National Institutes of Health-AARP Diet and Health Study. We used Cox models to calculate hazard ratios and 95% confidence intervals, adjusting for tobacco smoking and other potential confounders. Between 1995/1996 and December 31, 2006, there were 10,227 incident cases of lung carcinoma, classified as adenocarcinoma (n = 4,036), squamous cell carcinoma (n = 1,998), small cell carcinoma (n = 1,524), undifferentiated carcinoma (n = 559), and other (n = 2,110). Compared with nondrinking, alcohol consumption was associated with a modest nonlinear reduction in total lung carcinoma risk at lower levels of consumption (for 0.5-<1 drink/day, HR = 0.89, 95% confidence interval: 0.82, 0.96) but a modest increase in risk in the highest category (for ≥7 drinks/day, HR = 1.11, 95% confidence interval: 1.00, 1.24). Regarding histological type, alcohol was associated with a nonlinear reduction in squamous cell carcinoma that became attenuated as consumption increased and a modest increase in adenocarcinoma among heavier drinkers. Cubic spline models confirmed these findings. Our data suggest that the relationship between alcohol consumption and lung carcinoma differs by histological subtype.
authors.forename: Jose Ramon
authors.initials: JR
authors.lastname: Troche
authors.forename: Susan T
authors.initials: ST
authors.lastname: Mayne
authors.forename: Neal D
authors.initials: ND
authors.lastname: Freedman
authors.forename: Fatma M
authors.initials: FM
authors.lastname: Shebl
authors.forename: Christian C
authors.initials: CC
authors.lastname: Abnet
mesh_terms: D000230:Adenocarcinoma / Q000139:chemically induced / Q000453:epidemiology; D000077192:Adenocarcinoma of Lung; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D020751:Alcohol-Induced Disorders / Q000150:complications*; D002277:Carcinoma / Q000139:chemically induced* / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D055752:Small Cell Lung Carcinoma / Q000139:chemically induced / Q000453:epidemiology; D012907:Smoking; D014481:United States / Q000453:epidemiology
keywords: alcohol consumption; cohort studies; lung cancer