Abstract 1273: Association between smoking, alcohol, and salty food intake and risk of stomach cancer by topographic location and histological type in Seoul Male Cohort
Authors: Shin Myung-Hee , Hwang Seon-Mi , Choi Min-Gew , Kim Duk-Hwan , Bae Jong-Myon , Lee Moo-Song , Kim Dong-Hyun , Li Zhong-Min , Ahn Yoon-Ok 
Published: May 2015

Abstract
Incidence of stomach cancer has been declining in South Korea, but it still remains as the highest among men in the country. Cancers of upper and lower parts of stomach, and diffuse and intestinal type of stomach are thought to have different risk factors. Smoking, alcohol, and salty food intake are consistently associated with the risk of stomach cancer, but possible differential associations by topographic location and histological type are not well established. We evaluated the associations between smoking, alcohol, and salty food intake and the risk of cancers in upper (cardia and fundus), middle (body), and lower parts (antrum) of stomach, and of diffuse and intestinal type of stomach cancer in a prospective cohort study in Korea. Seoul Male Cohort was established in 1993. Members were recruited from the male beneficiaries of the Korean Health Insurance Company, who were aged 40-59 and living in Seoul. A lifestyle questionnaire survey was conducted through mailing. Dietary intake was measured using a quantitative food frequency questionnaire with 88 food items. Cancer occurrence was identified through data linkage to the Korean Central Cancer Registry and Korean Death Records. A total of 14,533 members were followed up until December 31, 2008, and 362 incident stomach cancer cases were identified. Multivariable hazard ratios (aHR) and 95% confidence intervals (95% CI) were calculated using Cox's regression model. None of the smoking, alcohol, and salty food intake was associated with risk of upper stomach cancer. Smoking had strongest association with risk of mid stomach cancer. Men who smoked currently and who stopped smoking for less than 4 years had 2.57 and 3.28 times higher risk of mid stomach cancer than never smokers (95% CI = 1.26-5.26, 1.36-7.96, respectively, ptrend=0.0036). Ex-smokers who stopped smoking for 4 or more years had no increase in risk of mid stomach cancer. Alcohol also had strongest association with risk of mid stomach cancer. The aHR of mid stomach cancer for those who had alcohol more than 45g/day compared to non-drinkers was 2.13 (95% CI = 0.94-4.82, ptrend=0.0353). Salty food and sodium intake had strongest association with risk of lower stomach cancer (Highest vs. lowest quartile, aHR=1.53 (95%CI = 0.93-2.52, ptrend=0.0670) for salty food, aHR=2.25 (95%CI = 1.18- 4.31, ptrend=0.0442) for sodium). Current smoking was strongly associated with both diffuse (aHR=2.44) and intestinal type of stomach cancer (aHR=1.87). Ex-smoking, alcohol, and salty food intake had significant positive association with intestinal type of stomach cancer, but not with diffuse type. In conclusion, smoking, alcohol, and salty food intake were mostly associated with risk of mid and lower stomach cancer and intestinal type of stomach cancer.
Citation Format: Myung-Hee Shin, Seon-Mi Hwang, Min-Gew Choi, Duk-Hwan Kim, Jong-Myon Bae, Moo-Song Lee, Dong-Hyun Kim, Zhong-Min Li, Yoon-Ok Ahn. Association between smoking, alcohol, and salty food intake and risk of stomach cancer by topographic location and histological type in Seoul Male Cohort. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1273. doi:10.1158/1538-7445.AM2014-1273