Alcohol intake and risk of stomach cancer: a pooled analysis of 20 cohorts

BACKGROUND: Stomach cancer presents complex etiologic heterogeneity. Ethanol in alcoholic beverages and its metabolite acetaldehyde are carcinogens causally linked to several cancers, but their role in gastric carcinogenesis has not been established. We analyzed harmonized, individual-level prospective data to examine associations between alcohol intake and risk of stomach cancer and its subtypes. METHODS: 2,009,951 participants in 20 cohorts (mean follow-up=9-29 years) within the Pooling Project of Prospective Studies of Diet and Cancer (n = 8,357 incident invasive gastric adenocarcinomas) were included. We used Cox regression to assess associations between alcohol intake and risk of stomach cancer overall and by anatomical and histological subtype and population subgroup, adjusting for confounders. RESULTS: Evidence for an association between alcohol intake and overall stomach cancer risk was weak (hazard ratio, HR, for ≥30 v 0.1-<5 g/day: 1.06 [95% confidence interval, CI, 0.96 to 1.16], P between-studies heterogeneity=0.43). Positive associations with stomach cancer risk were observed in never smokers (HR, for ≥30 v 0.1-<5 g/day: 1.20 [95% CI, 1.02 to 1.42]; P interaction=0.02) and for Asian studies (HR, 1.21 [95% CI, 1.02 to 1.42]; P interaction=0.01). Modest increased risks were observed for non-cardia cancers such as those of the fundus, body and greater curvature, but not distally located non-cardia cancers. HRs did not differ materially between diffuse- and intestinal-type cancers (P heterogeneity>0.05). CONCLUSION: There was little evidence of an overall association between alcohol intake and stomach cancer risk, although modest positive associations were observed among never smokers and in Asian cohorts.

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Journal
JNCI Cancer Spectrum
Published
2026-07-24
DOI
https://doi.org/10.1093/jncics/pkag073
Primary Topic
Alcohol Consumption and Health Effects
Type
article
Field-Weighted Citation Impact
0.00
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article

Alcohol intake and risk of stomach cancer: a pooled analysis of 20 cohorts

Stephanie A. Smith‐Warner, Piet A. van den Brandt, Robin Room, Yang Peng et al.
JNCI Cancer Spectrum
Alcohol Consumption and Health Effects
article

Alcohol intake and risk of stomach cancer: a pooled analysis of 20 cohorts

Stephanie A. Smith‐Warner, Piet A. van den Brandt, Robin Room, Yang Peng, Marjorie L. McCullough, L Mucci, Yangbo Sun, Linda M. Liao, Xie Shu, Mayo Hirabayashi, Erikka Loftfield, Harindra Jayasekara, Sarah Krull Abe, J T Park, Anthony B. Miller, Stampfer Mj, Um Cm, Kim Robien, R Wang, Gwen Murphy, Marissa Shams‐White, Song‐Yi Park, E. Giovannucci, Koh Wp, Mridul Datta, Andrew Haydon, Emily White, Christian Abnet, Milne RL, Giles GG, Lynne Wilkens, Anna Prizment, Andrew T Chan, Anne Tjønneland, Yu-Tang Gao, Molin Wang, Ugonna Ihenacho, Rashmi Sinha, Jean Wactawski Wende, Tao Hou, Pietro Ferrari, Mingyang Song, Manami Inoue, Robert J MacInnis, Hui Cai, Susanna C Larsson, Norie Sawada, Thomas E Rohan, Jian-Min Yuan, M Constanza Camargo, Alicja Wolk, Wen-Yi Huang, A Heather Eliassen
article en

Abstract

BACKGROUND: Stomach cancer presents complex etiologic heterogeneity. Ethanol in alcoholic beverages and its metabolite acetaldehyde are carcinogens causally linked to several cancers, but their role in gastric carcinogenesis has not been established. We analyzed harmonized, individual-level prospective data to examine associations between alcohol intake and risk of stomach cancer and its subtypes. METHODS: 2,009,951 participants in 20 cohorts (mean follow-up=9-29 years) within the Pooling Project of Prospective Studies of Diet and Cancer (n = 8,357 incident invasive gastric adenocarcinomas) were included. We used Cox regression to assess associations between alcohol intake and risk of stomach cancer overall and by anatomical and histological subtype and population subgroup, adjusting for confounders. RESULTS: Evidence for an association between alcohol intake and overall stomach cancer risk was weak (hazard ratio, HR, for ≥30 v 0.1-<5 g/day: 1.06 [95% confidence interval, CI, 0.96 to 1.16], P between-studies heterogeneity=0.43). Positive associations with stomach cancer risk were observed in never smokers (HR, for ≥30 v 0.1-<5 g/day: 1.20 [95% CI, 1.02 to 1.42]; P interaction=0.02) and for Asian studies (HR, 1.21 [95% CI, 1.02 to 1.42]; P interaction=0.01). Modest increased risks were observed for non-cardia cancers such as those of the fundus, body and greater curvature, but not distally located non-cardia cancers. HRs did not differ materially between diffuse- and intestinal-type cancers (P heterogeneity>0.05). CONCLUSION: There was little evidence of an overall association between alcohol intake and stomach cancer risk, although modest positive associations were observed among never smokers and in Asian cohorts.

JNCI Cancer Spectrum
University of Southern California (US), Brigham and Women's Hospital (US), American Cancer Society (US), Albert Einstein College of Medicine (US), Queensland Health (AU), Milken Institute (US), Cape Town HVTN Immunology Laboratory / Hutchinson Centre Research Institute of South Africa (ZA), Harvard University (US), Hawaii Pacific University (US), University of Tennessee Health Science Center (US), Queensland University of Technology (AU), Stockholm University (SE), The University of Queensland (AU), The University of Melbourne (AU), National University of Singapore (SG), Iowa State University (US), Toronto Public Health (CA), Cancer Council Victoria (AU), La Trobe University (AU), Vanderbilt University (US), The Alfred Hospital (AU), Karolinska Institutet (SE), Maastricht University (NL), Massachusetts General Hospital (US), National Cancer Center (US), Fred Hutch Cancer Center (US), Cancer Center of Hawaii (US), Shanghai Cancer Institute (CN), Monash Health (AU), Prevention Group (US), Public Health Ontario (CA), UPMC Hillman Cancer Center (US), University of Minnesota Medical Center (US), National Cancer Institute (US), Danish Cancer Society (DK), National University Health System (SG), Department of Health and Human Services (US), Centre international de recherche sur le cancer (FR), Imperial College London (GB), National Cancer Research Institute (GB), Monash University (AU), University at Buffalo, State University of New York (US)
Good health and well-being
Openalex Percentile: Top 9%
Alcohol Consumption and Health Effects
DOIOpen Access PDFOpenAlex
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