Home > The importance of exposure rate on odds ratios by cigarette smoking and alcohol consumption for esophageal adenocarcinoma and squamous cell carcinoma in the Barrett’s Esophagus and Esophageal Adenocarcinoma Consortium.

Lubin, Jay H and Cook, Michael B and Pandeya, Nirmala and Vaughan, Thomas and Abnet, Christian C and Giffen, Carol and Webb, Penelope M and Murray, Liam J and Casson, Alan G and Risch, Harvey A and Ye, Weimin and Kamanger, Farin and Bernstein, Leslie and Sharp, Linda and Nyren, Olof and Gammon, Marilie D and Corley, Douglas A and Wu, Anna H and Brown, Linda M and Chow, Wong-Ho and Ward, Mary H and Freeman, Neal D and Whiteman, David C (2012) The importance of exposure rate on odds ratios by cigarette smoking and alcohol consumption for esophageal adenocarcinoma and squamous cell carcinoma in the Barrett’s Esophagus and Esophageal Adenocarcinoma Consortium. Cancer Epidemiology , 36 , (3) , pp. 306-316.

Background: Cigarette smoking is associated with esophageal adenocarcinoma (EAC), esophagogastric junctional adenocarcinoma (EGJA) and esophageal squamous cell carcinoma (ESCC), and alcohol consumption with ESCC. However, no analyses have examined how delivery rate modifies the strength of odds ratio (OR) trends with total exposure, i.e., the impact on the OR for a fixed total exposure of high exposure rate for short duration compared with low exposure rate for long duration.

Methods: The authors pooled data from 12 case–control studies from the Barrett’s Esophagus and Esophageal Adenocarcinoma Consortium (BEACON), including 1242 (EAC), 1263 (EGJA) and 954 (ESCC) cases and 7053 controls, modeled joint ORs for cumulative exposure and exposure rate for cigarette smoking and alcohol consumption, and evaluated effect modification by sex, body mass index (BMI), age and self-reported acid reflux.

Results: For smoking, all sites exhibited inverse delivery rate effects, whereby ORs with pack-years increased, but trends weakened with increasing cigarettes/day. None of the examined factors modified associations, except for ESCC where younger ages at diagnosis enhanced smoking effects (P < 0.01). For EAC and EGJA, ORs with drink-years exhibited inverse associations in <5 drinks/day consumers and no association in heavier consumers. For ESCC, ORs with drink years increased, with trends strengthening with greater drinks/day. There was no significant effect modification, except for EAC and EGJA where acid reflux mitigated the inverse associations (P = 0.02). For ESCC, younger ages at diagnosis enhanced drinkingrelated ORs (P < 0.01).

Conclusions: Patterns of ORs by pack-years and drink-years, delivery rate effects and effect modifiers revealed common as well as distinct etiologic elements for these diseases.

 

Item Type:Article
Date:2012
Page Range:pp. 306-316
Publisher:Elsevier
Volume:36
Number:3
EndNote:View
Accession Number:HRB (Not in collection)
Subjects:A Substance use, abuse, and dependence > Prevalence > Substance use behaviour > Alcohol consumption
B Substances > Tobacco (cigarette smoking)
G Health and disease > State of health > Physical health
G Health and disease > Public health
G Health and disease > Pathologic process > Cancer
VA Geographic area > International aspects

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