Smoking, Alcohol, and Biliary Tract Cancer Risk: A Pooling Project of 26 Prospective Studies

Year: 2019

Type: article

Abstract: BACKGROUND: Tobacco and alcohol are well-established risk factors for numerous cancers, yet their relationship to biliary tract cancers remains unclear. METHODS: We pooled data from 26 prospective studies to evaluate associations of cigarette smoking and alcohol consumption with biliary tract cancer risk. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for associations with smoking and alcohol consumption were calculated. Random-effects meta-analysis produced summary estimates. All statistical tests were two-sided. RESULTS: Over a period of 38 369 156 person-years of follow-up, 1391 gallbladder, 758 intrahepatic bile duct, 1208 extrahepatic bile duct, and 623 ampulla of Vater cancer cases were identified. Ever, former, and current smoking were associated with increased extrahepatic bile duct and ampulla of Vater cancers risk (eg, current vs never smokers HR = 1.69, 95% CI = 1.34 to 2.13 and 2.22, 95% CI = 1.69 to 2.92, respectively), with dose-response effects for smoking pack-years, duration, and intensity (all Ptrend < .01). Current smoking and smoking intensity were also associated with intrahepatic bile duct cancer (eg, >40 cigarettes per day vs never smokers HR = 2.15, 95 % CI = 1.15 to 4.00; Ptrend = .001). No convincing association was observed between smoking and gallbladder cancer. Alcohol consumption was only associated with intrahepatic bile duct cancer, with increased risk for individuals consuming five or more vs zero drinks per day (HR = 2.35, 95%CI = 1.46 to 3.78; Ptrend = .04). There was evidence of statistical heterogeneity among several cancer sites, particularly between gallbladder cancer and the other biliary tract cancers. CONCLUSIONS: Smoking appears to increase the risk of developing all biliary tract cancers except gallbladder cancer. Alcohol may increase the risk of intrahepatic bile duct cancer. Findings highlight etiologic heterogeneity across the biliary tract.

Source: JNCI Journal of the National Cancer Institute

DOI: 10.1093/jnci/djz103

Authors: Emma E McGee, Sarah S Jackson, Jessica L Petrick, Alison L Van Dyke, Hans-Olov Adami, Demetrius Albanes, Gabriella Andreotti, Laura E Beane-Freeman, Amy Berrington de Gonzalez, Julie E Buring, Andrew T Chan, Yu Chen, Gary E Fraser, Neal D Freedman, Yu-Tang Gao, Susan M Gapstur, J Michael Gaziano, Graham G Giles, Eric J Grant, Francine Grodstein, Patricia Hartge, Mazda Jenab, Cari M Kitahara, Synnove F Knutsen, Woon-Puay Koh, Susanna C Larsson, I-Min Lee, Linda M Liao, Juhua Luo, Roger L Milne, Kristine R Monroe, Marian L Neuhouser, Katie M O’Brien, Ulrike Peters, Jenny N Poynter, Mark P Purdue, Kim Robien, Dale P Sandler, Norie Sawada, Catherine Schairer, Howard D Sesso, Tracey G Simon, Rashmi Sinha, Rachael Stolzenberg-Solomon, Shoichiro Tsugane, Renwei Wang, Elisabete Weiderpass, Stephanie J Weinstein, Emily White, Alicja Wolk, Jian-Min Yuan, Anne Zeleniuch-Jacquotte, Xuehong Zhang, Bin Zhu, Katherine A McGlynn, Peter T Campbell, Jill Koshiol

Language: English

Topic: Cholangiocarcinoma and Gallbladder Cancer Studies

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funders: U.S. Department of Energy, Wellcome Trust, Swedish Cancer Foundation, Cancer Research UK, National Institute for Health and Care Research, British Heart Foundation, National Institutes of Health, National Heart, Lung, and Blood Institute, National Cancer Institute, National Institute of Environmental Health Sciences

OpenAlex ID: W2945531675