THE INFLUENCE OF CIGARETTE-SMOKING, ALCOHOL, AND GREEN TEA CONSUMPTION ON THE RISK OF CARCINOMA OF THE CARDIA AND DISTAL STOMACH IN SHANGHAI, CHINA

BACKGROUND. The divergent incidence patterns of gastric cardia and dis tal stomach cancer may suggest different etiologies. This study examin ed the role of cigarette smoking, alcohol drinking, and green tea cons umption as risk factors for carcinoma by anatomic subsite of stomach. METHODS. Newly-diagnosed stomach carcinoma patients (n = 1124) and fre quency-matched population controls (n = 1451) were interviewed in pers on. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models. RESULTS. Excess risks ass ociated with cigarette smoking and alcohol consumption were observed l argely among men. The adjusted ORs for all stomach cancer combined wer e 1.35 (CI: 1.06-1.71) for current smokers, and 1.26 (CI: 0.86-1.84) f or ex-smokers. For rumors of the distal stomach, statistically signifi cant positive dose-response trends were found for the number of cigare ttes smoked per day, the duration and pack-years of smoking, and inver se trends for years of stopped smoking. For tumors of the gastric card ia, however, a monotonic association was found only for the number of cigarettes smoked per day (P = 0.06). Alcohol consumption was not rela ted to the risk of cardia cancer, while a moderate excess risk of dist al stomach cancer (OR: 1.55; CI: 1.07-2.26) was observed among heavy a lcohol drinkers. Green tea drinking was inversely associated with risk of stomach cancer arising from either subsite, with ORs of 0.77 (CI: 0.52-1.13) among female heavy drinkers, and 0.76 (CI: 0.55-1.27) among male heavy drinkers. CONCLUSIONS. Our findings provide further eviden ce that cigarette smoking and, possibly, alcohol consumption increase the risk of stomach carcinoma, notably of the distal segment. An inver se association with green tea drinking was also observed. (C) 1996 Ame rican Cancer Society.