Korean J Gastroenterol.  2019 Mar;73(3):141-151. 10.4166/kjg.2019.73.3.141.

Prediagnostic Smoking and Alcohol Drinking and Gastric Cancer Survival: A Korean Prospective Cohort Study

• Kim SA
• Choi BY
• Song KS
• Park CH
• Eun CS
• Han DS
• Kim YS
• Kim HJ

• KMID: 2442080
• DOI: http://doi.org/10.4166/kjg.2019.73.3.141

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.
CONCLUSIONS
These results suggest smoking and alcohol drinking behaviors before a diagnosis of GC are weakly associated with GC survival. Nevertheless, the effect of smoking behavior on prognosis appears to depend on the histological type of GC.

Keyword

Stomach neoplasms; Survival; Smoking; Drinking; Prospective studies

MeSH Terms

Alcohol Drinking*
Chungcheongnam-do
Cohort Studies*
Diagnosis
Drinking
Female
Follow-Up Studies
Humans
Male
Prognosis
Prospective Studies*
Risk Factors
Smoke*
Smoking*
Stomach Neoplasms*
Telephone
Smoke

Figure

• 

  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).

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