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Shin Ah Kim, Bo Youl Choi1, Kyu Sang Song2, Chan Hyuk Park3, 4, Chang Soo Eun3, 4, Dong Soo Han3, 4, Yong Sung Kim5, Hyun Ja Kim
Abstract
Background/Aims
Behavioral factors, such as smoking and heavy alcohol consumption, increase the risk of gastric cancer (GC), but their effects on survival are not clear. We examined associations between prediagnostic smoking and alcohol drinking behavior and GC death by long-term follow-up.
Methods
The participants were 508 GC patients enrolled at Chungnam University Hospital and Hanyang University Guri Hospital from 2001 to 2006. Information on clinicopathologic and behavioral risk factors was collected, and patient survival was prospectively followed until 2016 by medical chart review and telephone survey.
Results
During above 10 years follow-up period, overall death was 46.2% (n=226) and GC deaths was 38.2% (n=187) among the 489 GC patients included in the analysis. No significant association was found between smoking habits and overall or GC survival. However, after stratification by histological type, the hazard ratio (HR) of GC death for current smokers tended to be higher for the diffuse type (HR 1.61, 95% CI 0.57–4.59 for current vs. never) rather than for the intestinal type (HR 0.78, 95% CI 0.28–2.19 for current vs. never). Light alcohol consumption was found to be associated with a significantly lower risk of GC death (HR 0.52, 95% CI 0.36–0.75 for <20 g/day for women or <40 g/day for men vs. never and past), and the effects of alcohol drinking habits had similar effects on GC death for the intestinal and diffuse types.
Figures and Tables
Fig. 1
Gastric cancer specific survival curves of patients according to smoking and drinking behaviors. (A) Smoking status. (B) Pack-year. (C) Drinking status. (D) Alcohol consumption (g/day).
Table 1
Observed Overall and Gastric Cancer Specific Survivals in Gastric Cancer Patients with respect to General and Clinicopathological Characteristics
Values are presented as n (%).
GC, gastric cancer.
aThe final observation end-point was in 31 Dec 2016; bFamily history of GC included first and second-degree relatives; cIt was impossible to collect the tissue; dClassification by 8th edition of Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) staging system for gastric cancer.
Table 2
Observed Overall and Gastric Cancer Specific Survivals in Gastric Cancer Patients with respect to Smoking and Alcohol Drinking
Values are presented as n (%).
Numbers may not sum to total due to missing information.
GC, gastric cancer; WHO, World Health Organization.
aThe final observation end-point was in 31 Dec 2016; bThis daily alcohol consumption was annual average intake for 3 years ago; cThis category were divided according to WHO's recommendation (2004).
Table 3
Adjusted Hazard Ratios and 95% Confidence Intervals for Overall and Gastric Cancer Specific Death with Respect to Smoking and Alcohol Drinking Behaviors
Numbers may not sum to total due to missing information.
GC, gastric cancer; HR, hazard ratio; CI, confidence interval; NA, not applicable; WHO, World Health Organization.
aAdjusted for age (continuous), sex (women/men), registered hospital (Chungnam University/Hanyang University Guri), family history of gastric cancer (included first and second-degree relatives, no/yes), smoking and drinking status (never/past/current), Helicobacter pylori infection (negative/positive/not performed), surgery (no/yes), adjuvant chemotherapy (no/yes), stage (I/II/III/IV/unknown), and histological type (intestinal/diffuse and mixed/unknown); bThis daily alcohol consumption was annual average intake for 3 years ago; cThis category were divided according to WHO's recommendation (2004).
Table 4
Adjusted Hazard Ratios and 95% Confidence Intervals for Gastric Cancer Specific Death with Respect to Smoking and Alcohol Drinking Behaviors Stratified by Histological Type
Numbers may not sum to total due to missing information.
GC, gastric cancer; HR, hazard ratio; CI, confidence interval; NA, not applicable; WHO, World Health Organization.
aAdjusted for age (continuous), sex (women/men), registered hospital (Chungnam University/Hanyang University Guri), family history of gastric cancer (included first and second-degree relatives, no/yes), smoking and drinking status (never/past/current), Helicobacter pylori infection (negative/positive/not performed), surgery (no/yes), adjuvant chemotherapy (no/yes), and stage (I/II/III/IV/unknown); bThis daily alcohol consumption was annual average intake for 3 years ago; cThis category were divided according to WHO's recommendation (2004).
Notes
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