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American Journal of Epidemiology Advance Access published online on November 22, 2009
American Journal of Epidemiology, doi:10.1093/aje/kwp332
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American Journal of Epidemiology © The Author 2009. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Original Contribution

Alcohol Consumption and Lung Cancer Risk in the Environment and Genetics in Lung Cancer Etiology (EAGLE) Study

Vincenzo Bagnardi, Giorgia Randi, Jay Lubin, Dario Consonni, Tram Kim Lam, Amy F. Subar, Alisa M. Goldstein, Sholom Wacholder, Andrew W. Bergen, Margaret A. Tucker, Adriano Decarli, Neil E. Caporaso, Pier Alberto Bertazzi and Maria Teresa Landi*

* Correspondence to Dr. Maria Teresa Landi, Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd., EPS 7114, Bethesda, MD 20892-7236 (e-mail: landim{at}mail.nih.gov).

Received for publication May 8, 2009. Accepted for publication September 17, 2009.

The authors investigated the relation between alcohol consumption and lung cancer risk in the Environment and Genetics in Lung Cancer Etiology (EAGLE) Study, a population-based case-control study. Between 2002 and 2005, 2,100 patients with primary lung cancer were recruited from 13 hospitals within the Lombardy region of Italy and were frequency-matched on sex, area of residence, and age to 2,120 randomly selected controls. Alcohol consumption during adulthood was assessed in 1,855 cases and 2,065 controls. Data on lifetime tobacco smoking, diet, education, and anthropometric measures were collected. Adjusted odds ratios and 95% confidence intervals for categories of mean daily ethanol intake were calculated using unconditional logistic regression. Overall, both nondrinkers (odds ratio = 1.42, 95% confidence interval: 1.03, 2.01) and very heavy drinkers (≥60 g/day; odds ratio = 1.44, 95% confidence interval: 1.01, 2.07) were at significantly greater risk than very light drinkers (0.1–4.9 g/day). The alcohol effect was modified by smoking behavior, with no excess risk being observed in never smokers. In summary, heavy alcohol consumption was a risk factor for lung cancer among smokers in this study. Although residual confounding by tobacco smoking cannot be ruled out, this finding may reflect interplay between alcohol and smoking, emphasizing the need for preventive measures.

alcohol drinking; case-control studies; ethanol; lung neoplasms; risk factors; smoking

Abbreviations: CI, confidence interval; EAGLE, Environment and Genetics in Lung Cancer Etiology


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