Abstract
Chronic alcohol use is a risk factor for non-cardia gastric adenocarcinoma. However, it is less well understood whether alcohol use is a risk factor for premalignant mucosal changes, namely gastric intestinal metaplasia. We examined the association between various parameters of alcohol use and risk of gastric intestinal metaplasia. We used data from 2084 participants (including 403 with gastric intestinal metaplasia) recruited between February 2008-August 2013 into a cross-sectional study at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas. All participants underwent a study upper endoscopy with systematic gastric mapping biopsies. Cases had intestinal metaplasia on any non-cardia gastric biopsy. Participants self-reported lifetime history of alcohol consumption, along with other lifestyle risk factors, through a study survey. We calculated odds ratios (OR) and 95% confidence intervals (95% CI) for categories of average alcohol consumption using multivariable logistic regression, and restricted cubic spline regression to explore the potential shape of a dose-response relationship. Compared to lifelong non-drinkers, individuals who consumed on average ≥28 drinks per week had no elevated risk for gastric intestinal metaplasia (adjusted OR, 1.27; 95% CI, 0.74-2.19). Based on a spline regression curve and its 95% CI, there was also no demonstrable association between cumulative lifetime alcohol consumption and risk of gastric intestinal metaplasia. Similarly, we found no association between beverage type (beer, wine, liquor/spirits) and risk for gastric intestinal metaplasia. Neither amount of alcohol consumed nor specific beverage type was associated with risk of gastric intestinal metaplasia.
Highlights
Gastric adenocarcinoma is among the leading causes of cancer-related deaths worldwide [1]
Compared to lifelong non-drinkers, individuals who consumed on average 28 drinks per week had no elevated risk for gastric intestinal metaplasia
Neither amount of alcohol consumed nor specific beverage type was associated with risk of gastric intestinal metaplasia
Summary
Gastric adenocarcinoma (gastric cancer) is among the leading causes of cancer-related deaths worldwide [1]. Chronic Helicobacter pylori infection has long been established to cause inflammation of the gastric mucosa and subsequently, the development of gastric intestinal metaplasia [4,5,6]. In populations with high incidence of gastric cancer, there have been multiple studies that investigate environmental risk factors synergistic to H. pylori infections in regard to the development of gastric intestinal metaplasia [6, 7]. There are few studies that look primarily at these modifiable factors independent of H. pylori infection, and even fewer in western populations, where H. pylori infection rates are lower, that focus on lifestyle risk factors, such as alcohol use, and their effects on gastric intestinal metaplasia and gastric cancer independent of or synergistically with H. pylori infection. Chronic alcohol use is a risk factor for non-cardia gastric adenocarcinoma. We examined the association between various parameters of alcohol use and risk of gastric intestinal metaplasia
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