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Alcohol consumption is causally linked to several cancers but the evidence for stomach cancer is inconclusive. In our study, the association between long-term alcohol intake and risk of stomach cancer and its subtypes was evaluated. We performed a pooled analysis of data collected at baseline from 491,714 participants in the European Prospective Investigation into Cancer and Nutrition and the Melbourne Collaborative Cohort Study. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated for incident stomach cancer in relation to lifetime alcohol intake and group-based life course intake trajectories, adjusted for potential confounders including Helicobacter pylori infection. 1,225 incident stomach cancers (78% non-cardia) were diagnosed over 7,094,637 person-years; 984 in 382,957 study participants with lifetime alcohol intake data (5,455,507 person-years). Although lifetime alcohol intake was not associated with overall stomach cancer risk, we observed a weak positive association with non-cardia cancer (HR=1.03, 95% CI: 1.00-1.06 per 10 g/day increment), with a HR of 1.50 (95% CI: 1.08-2.09) for ≥60 g/day compared with 0.1-4.9 g/day. A weak inverse association with cardia cancer (HR=0.93, 95% CI: 0.87-1.00) was also observed. HRs of 1.48 (95% CI: 1.10-1.99) for non-cardia and 0.51 (95% CI: 0.26-1.03) for cardia cancer were observed for a life course trajectory characterized by heavy decreasing intake compared with light stable intake (phomogeneity =0.02). These associations did not differ appreciably by smoking or Helicobacter pylori infection status. Limiting alcohol use during lifetime, particularly avoiding heavy use during early adulthood, might help prevent non-cardia stomach cancer. Heterogeneous associations observed for cardia and non-cardia cancers may indicate etiologic differences.

Original publication




Journal article


Int J Cancer

Publication Date



EPIC, Lifetime alcohol intake, MCCS, cardia cancer, non-cardia cancer, stomach cancer