Tobacco, alcohol and the risk of gastric cancer by sub-site and histologictype

Few studies have provided information on the role of smoking and alcohol in the carcinogenesis of gastric cancer by sub-site and histologic type. The relationship of snuff dipping with risk of gastric cancer has also been rar ely studied. In a population-based case-control study conducted in 5 counti es of Sweden from February 1989 to January 1995, a total of 90 cases of gas tric cardia cancer, 260 and 164 cases of distal gastric cancer of intestina l and diffuse types, respectively, and 1164 frequency-matched control subje cts were personally interviewed about life-time smoking, use of smokeless t obacco and use of alcohol 20 years ago. Current smokers had a higher risk t han never-smokers for all 3 kinds of gastric adenocarcinoma [odds ratio (OR ) 1.7, 95% confidence interval (CI) 1.0-3.1 for gastric cardia adenocarcino ma; OR 1.8, 95% CI 1.2-2.7 for distal gastric cancer of intestinal type; an d OR 2.2, 95% CI 1.4-3.5 for distal gastric cancer of diffuse type], and th e risk rose with increasing dose and duration of smoking among current smok ers. However, no elevated risk was observed for ex-smokers, Neither intake of alcoholic beverages nor snuff dipping was associated with an increased r isk of any type of cardia or gastric cancer. Our study did not support the hypothesis that the role of tobacco differs by sub-site and histologic sub- type of gastric cancer. (C) 1999 Wiley-Liss, Inc.