Abstract LB-398: Alcohol consumption and risk of lung cancer in the VITamins and Lifestyle Study

Abstract

Abstract Background: The effect of alcohol consumption on lung cancer risk has been controversial. We investigated the effects of different types of alcoholic beverage as well as total alcohol consumption on risk of lung cancer in the VITamins And Lifestyle (VITAL) Study. Methods: The VITAL study is a prospective cohort of 77,719 men and women aged 50-76 years who were residents of Washington State and completed the study questionnaire mailed between 2000-2002. Incident lung cancer cases (N= 812) were identified through the Washington Surveillance, Epidemiology and End Results cancer registry through December 2007. Data collection was accomplished at baseline using a self-administered, gender-specific questionnaire that covered diet, supplement use, health history and risk factors. Diet was assessed by a food frequency questionnaire that captures detailed information on alcoholic beverage use. Persons with any previous cancer (except non-melanoma skin cancer) or lung cancer diagnosed within 6 months post study baseline were excluded. As white account for 93% of the cohort, non-white race was excluded from the analysis to avoid residual confounding by race. Cox's regression was used to examine the effects of beer, red wine, white wine, liquor, and total alcoholic beverage intake on risk of overall lung cancer as well histologic subtypes. The effects of former drinking at age 30 and 45 on lung cancer risk were also assessed. Gender, education, household income, body mass index, history of COPD/emphysema, smoking duration, pack-years, pack-years squared (these three smoking variables constitute the smoking model with best model fit in VITAL), family history of lung cancer, physical activity, fat and fruit and vegetable intake were adjusted for in the multivariable analyses. Results: After applying the exclusion criteria, 60,556 subjects (533 lung cancer cases) remained eligible for the analyses. There was no clear association between lung cancer and moderate intake of beer, red wine, white wine or liquor up to ≥ 1 drink/day (average intake was 2 drinks/day in this category). Total alcoholic beverage intake of up to ≥4 drink/day was not associated with elevated overall lung cancer risk [Hazard ratio (HR) = 1.16, 95% confidence interval 0.75-1.78]. Heavy consumption (≥4 drink/day) of alcohol was, however, associated with a doubling of risk for squamous cell carcinoma [HR = 2.45 (1.12-5.37), p-value for linear trend=0.003], but not for adenocarcinoma [HR=1.32 (0.64-2.70)]. Total alcohol intake at age 30 was not associated with risk of overall lung cancer or any histologic subtype, while a significant linear dose-response was detected for total alcohol intake at age 45, primarily for squamous cell carcinoma [p-value for linear trend =0.02]. Conclusion: Heavy alcohol consumption in later adulthood (e.g., age 45 and greater), but not in early adulthood, may be associated with risk of lung squamous cell carcinoma. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr LB-398.