American Journal of Epidemiology Advance Access published online on September 20, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj326
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1 Division of Clinical Epidemiology, German Cancer Research Centre, Heidelberg, Germany
* To whom correspondence should be addressed. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), the authors examined the association of ethanol intake at recruitment (1,119 cases) and mean lifelong ethanol intake (887 cases) with lung cancer. Information on baseline and past alcohol consumption, lifetime tobacco smoking, diet, and the anthropometric characteristics of 478,590 participants was collected between 1992 and 2000. Cox proportional hazards regression was used to calculate multivariate-adjusted hazard ratios and 95% confidence intervals. Overall, neither ethanol intake at recruitment nor mean lifelong ethanol intake was significantly associated with lung cancer. However, moderate intake (5-14.9 g/day) at recruitment (hazard ratio (HR) = 0.76, 95% confidence interval (CI): 0.63, 0.90) and moderate mean lifelong intake (HR = 0.80, 95% CI: 0.66, 0.97) were associated with a lower lung cancer risk in comparison with low consumption (0.1-4.9 g/day). Compared with low intake, a high (
Received January 4, 2006
Accepted April 28, 2006
ORIGINAL CONTRIBUTIONS
Ethanol Intake and Risk of Lung Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)
Sabine Rohrmann 1 *, Jakob Linseisen 1, Hendriek C. Boshuizen 2, John Whittaker 3, Antonio Agudo 4, Paolo Vineis 5, Paolo Boffetta 6, Majken K. Jensen 7, Anja Olsen 8, Kim Overvad 7, Anne Tjønneland 8, Marie-Christine Boutron-Ruault 9, Françoise Clavel-Chapelon 9, Manuela M. Bergmann 10, Heiner Boeing 10, Naomi Allen 11, Tim Key 11, Sheila Bingham 12, Kay-Tee Khaw 12, Georgia Kyriazi 13, Stavroula Soukara 13, Antonia Trichopoulou 13, Salvatore Panico 14, Domenico Palli 15, Sabina Sieri 16, Rosario Tumino 17, Petra H. M. Peeters 18, H. Bas Bueno-de-Mesquita 19, Frederike L. Büchner 19, Inger Torhild Gram 20, Eiliv Lund 20, Eva Ardanaz 21, María-Dolores Chirlaque 22, Miren Dorronsoro 23, Maria-José Sánchez Pérez 24, Jose R. Quirós 25, Göran Berglund 26, Lars Janzon 26, Torgny Rasmuson 27, Lars Weinehall 28, Pietro Ferrari 6, Mazda Jenab 6, Teresa Norat 6, and Elio Riboli 29
2 Centre for Information Technology and Methodology, National Institute of Public Health and the Environment, Bilthoven, the Netherlands
3 Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
4 Department of Epidemiology, Catalan Institute of Oncology, Barcelona, Spain
5 Environmental Epidemiology, Imperial College London, London, United Kingdom
6 Unit of Nutrition, International Agency for Research on Cancer, Lyon, France
7 Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aarhus, Denmark
8 Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
9 Institute Gustave Roussy, E3N-EPIC Group, INSERM, Villejuif, France
10 Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
11 Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, United Kingdom
12 Strangeways Research Laboratory, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
13 Department of Hygiene and Epidemiology, University of Athens Medical School, Athens, Greece
14 Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy
15 Molecular and Nutritional Epidemiology Unit, CSPO-Scientific Institute of Tuscany, Florence, Italy
16 Epidemiology Unit, Italian National Cancer Institute, Milan, Italy
17 Cancer Registry, Azienda Ospedaliera "Civile MP Arezzo," Ragusa, Italy
18 Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands
19 Centre for Nutrition and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
20 Institute of Community Medicine, University of Tromsø, Tromsø, Norway
21 Public Health Institute of Navarra, Pamplona, Spain
22 Epidemiology Department, Murcia Health Council, Murcia, Spain
23 Public Health Division of Gipuzkoa, San Sebastian, Spain
24 The Andalusian School of Public Health, Granada, Spain
25 Public Health and Health Planning Directorate, Asturias, Spain
26 Department of Clinical Sciences Malmö, University of Lund, Lund, Sweden
27 Oncology, Department of Radiation Sciences, Umeå University, Umeå, Sweden
28 Epidemiology and Public Health Sciences, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
29 Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
Sabine Rohrmann, E-mail: s.rohrmann{at}dkfz.de
Abstract 
60 g/day) mean lifelong ethanol intake tended to be related to a higher risk of lung cancer (HR = 1.29, 95% CI: 0.93, 1.74), but high intake at recruitment was not. Although there was no overall association between ethanol intake and risk of lung cancer, the authors cannot rule out a lower risk for moderate consumption and a possibly increased risk for high lifelong consumption.
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