The Association Between Alcohol Consumption and Lung Carcinoma by Histological Subtype

Am J Epidemiol. 2016 Jan 15;183(2):110-21. doi: 10.1093/aje/kwv170. Epub 2015 Dec 15.

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.

Keywords: alcohol consumption; cohort studies; lung cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adenocarcinoma / chemically induced
  • Adenocarcinoma / epidemiology
  • Adenocarcinoma of Lung
  • Aged
  • Alcohol Drinking / adverse effects*
  • Alcohol-Induced Disorders / complications*
  • Carcinoma / chemically induced*
  • Carcinoma / epidemiology
  • Carcinoma, Squamous Cell / chemically induced
  • Carcinoma, Squamous Cell / epidemiology
  • Female
  • Humans
  • Incidence
  • Lung Neoplasms / chemically induced*
  • Lung Neoplasms / epidemiology
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Small Cell Lung Carcinoma / chemically induced
  • Small Cell Lung Carcinoma / epidemiology
  • Smoking
  • United States / epidemiology