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Tobacco, alcohol use and risk of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: The Liver Cancer Pooling Project.

About this Publication
Title
Tobacco, alcohol use and risk of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: The Liver Cancer Pooling Project.
Pubmed ID
29520041 (View this publication on the PubMed website)
Digital Object Identifier
Publication
Br J Cancer. 2018 Apr; Volume 118 (Issue 7): Pages 1005-1012
Authors
Petrick JL, Campbell PT, Koshiol J, Thistle JE, Andreotti G, Beane-Freeman LE, Buring JE, Chan AT, Chong DQ, Doody MM, Gapstur SM, Gaziano JM, Giovannucci E, Graubard BI, Lee IM, Liao LM, Linet MS, Palmer JR, Poynter JN, Purdue MP, ...show more Robien K, Rosenberg L, Schairer C, Sesso HD, Sinha R, Stampfer MJ, Stefanick M, Wactawski-Wende J, Zhang X, Zeleniuch-Jacquotte A, Freedman ND, McGlynn KA
Affiliations
  • Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. jessica.petrick@nih.gov.
  • Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA.
  • Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
  • Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
  • Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
  • Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
  • Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Slone Epidemiology Center at Boston University, Boston, MA, USA.
  • Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
  • Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
...show more
  • Department of Medicine and Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA, USA.
  • Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA.
  • Department of Population Health, New York University School of Medicine, New York, NY, USA.
Abstract

BACKGROUND: While tobacco and alcohol are established risk factors for hepatocellular carcinoma (HCC), the most common type of primary liver cancer, it is unknown whether they also increase the risk of intrahepatic cholangiocarcinoma (ICC). Thus, we examined the association between tobacco and alcohol use by primary liver cancer type.

METHODS: The Liver Cancer Pooling Project is a consortium of 14 US-based prospective cohort studies that includes data from 1,518,741 individuals (HCC n = 1423, ICC n = 410). Multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (CI) were estimated using proportional hazards regression.

RESULTS: Current smokers at baseline had an increased risk of HCC (hazard ratio (HR) = 1.86, 95% confidence interval (CI): 1.57-2.20) and ICC (HR = 1.47, 95% CI: 1.07-2.02). Among individuals who quit smoking >30 years ago, HCC risk was almost equivalent to never smokers (HR = 1.09, 95% CI: 0.74-1.61). Compared to non-drinkers, heavy alcohol consumption was associated with an 87% increased HCC risk (HR≥7 drinks/day = 1.87, 95% CI: 1.41-2.47) and a 68% increased ICC risk (HR≥5 drinks/day = 1.68, 95% CI: 0.99-2.86). However, light-to-moderate alcohol consumption of <3 drinks/day appeared to be inversely associated with HCC risk (HR>0-<0.5 drinks/day = 0.77, 95% CI: 0.67-0.89; HR>0.5-<1 drinks/day = 0.57, 95% CI: 0.44-0.73; HR1-<3 drinks/day = 0.71, 95% CI: 0.58-0.87), but not ICC.

CONCLUSIONS: These findings suggest that, in this relatively healthy population, smoking cessation and light-to-moderate drinking may reduce the risk of HCC.

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