Alcohol intake and risk of stomach cancer: a pooled analysis of 20 cohorts

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ID: 322279
2026
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Abstract
BACKGROUND: Stomach cancer presents complex etiologic heterogeneity. Ethanol in alcoholic beverages and its metabolite acetaldehyde are carcinogens causally linked to several cancers, but their role in gastric carcinogenesis has not been established. We analyzed harmonized, individual-level prospective data to examine associations between alcohol intake and risk of stomach cancer and its subtypes. METHODS: 2,009,951 participants in 20 cohorts (mean follow-up=9-29 years) within the Pooling Project of Prospective Studies of Diet and Cancer (n = 8,357 incident invasive gastric adenocarcinomas) were included. We used Cox regression to assess associations between alcohol intake and risk of stomach cancer overall and by anatomical and histological subtype and population subgroup, adjusting for confounders. RESULTS: Evidence for an association between alcohol intake and overall stomach cancer risk was weak (hazard ratio, HR, for ≥30 v 0.1-<5 g/day: 1.06 [95% confidence interval, CI, 0.96 to 1.16], P between-studies heterogeneity=0.43). Positive associations with stomach cancer risk were observed in never smokers (HR, for ≥30 v 0.1-<5 g/day: 1.20 [95% CI, 1.02 to 1.42]; P interaction=0.02) and for Asian studies (HR, 1.21 [95% CI, 1.02 to 1.42]; P interaction=0.01). Modest increased risks were observed for non-cardia cancers such as those of the fundus, body and greater curvature, but not distally located non-cardia cancers. HRs did not differ materially between diffuse- and intestinal-type cancers (P heterogeneity>0.05). CONCLUSION: There was little evidence of an overall association between alcohol intake and stomach cancer risk, although modest positive associations were observed among never smokers and in Asian cohorts.
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Authors Harindra Jayasekara, Molin Wang, Yang Peng, Sarah Krull Abe, Christian Abnet, Hui Cai, Andrew T Chan, Mridul Datta, A Heather Eliassen, Yu-Tang Gao, E. Giovannucci, Mayo Hirabayashi, Tao Hou, Wen-Yi Huang, Ugonna Ihenacho, Manami Inoue, Koh Wp, Susanna C Larsson, Linda M. Liao, Erikka Loftfield, Marjorie L. McCullough, Anthony B. Miller, L Mucci, Gwen Murphy, J T Park, Song‐Yi Park, Anna Prizment, Kim Robien, Thomas E Rohan, Norie Sawada, Marissa Shams‐White, Xie Shu, Rashmi Sinha, Mingyang Song, Stampfer Mj, Yangbo Sun, Anne Tjønneland, Um Cm, Piet A. van den Brandt, R Wang, Jean Wactawski Wende, Emily White, Lynne Wilkens, Alicja Wolk, Jian-Min Yuan, Robin Room, Andrew Haydon, Robert J MacInnis, M Constanza Camargo, Giles GG, Milne RL, Pietro Ferrari, Stephanie A. Smith‐Warner
Journal jnci cancer spectrum
Year 2026
DOI
10.1093/jncics/pkag073
URL
https://doi.org/10.1093/jncics/pkag073
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