Smoking, Alcohol, and Biliary Tract Cancer Risk: A Pooling Project of 26 Prospective Studies

Emma E. McGee; Sarah S. Jackson; Jessica L. Petrick; Alison L. Van Dyke; Hans Olov Adami; Demetrius Albanes; Gabriella Andreotti; Laura E. Beane-Freeman; Amy Berrington de Gonzalez; Julie E. Buring; Andrew T. Chan; Yu Chen; Gary E. Fraser; Neal D. Freedman; Yu Tang Gao; Susan M. Gapstur; J. Michael Gaziano; Graham G. Giles; Eric J. Grant; Francine Grodstein; Patricia Hartge; Mazda Jenab; Cari M. Kitahara; Synnove F. Knutsen; Woon Puay Koh; Susanna C. Larsson; I. Min Lee; Linda M. Liao; Juhua Luo; Roger L. Milne; Kristine R. Monroe; Marian L. Neuhouser; Katie M. O'Brien; Ulrike Peters; Jenny N. Poynter; Mark P. Purdue; Kim Robien; Dale P. Sandler; Norie Sawada; Catherine Schairer; Howard D. Sesso; Tracey G. Simon; Rashmi Sinha; Rachael Stolzenberg-Solomon; Shoichiro Tsugane; Renwei Wang; Elisabete Weiderpass; Stephanie J. Weinstein; Emily White; Alicja Wolk; Jian Min Yuan; Anne Zeleniuch-Jacquotte; Xuehong Zhang; Bin Zhu; Katherine A. McGlynn; Peter T. Campbell; Jill Koshiol

doi:10.1093/jnci/djz103

Smoking, Alcohol, and Biliary Tract Cancer Risk: A Pooling Project of 26 Prospective Studies

Emma E. McGee, Sarah S. Jackson, Jessica L. Petrick, Alison L. Van Dyke, Hans Olov Adami, Demetrius Albanes, Gabriella Andreotti, Laura E. Beane-Freeman, Amy Berrington de Gonzalez, Julie E. Buring, Andrew T. Chan, Yu Chen, Gary E. Fraser, Neal D. Freedman, Yu Tang Gao, Susan M. Gapstur, J. Michael Gaziano, Graham G. Giles, Eric J. Grant, Francine GrodsteinPatricia Hartge, Mazda Jenab, Cari M. Kitahara, Synnove F. Knutsen, Woon Puay Koh, Susanna C. Larsson, I. Min Lee, Linda M. Liao, Juhua Luo, Roger L. Milne, Kristine R. Monroe, Marian L. Neuhouser, Katie M. O'Brien, Ulrike Peters, Jenny N. Poynter, Mark P. Purdue, Kim Robien, Dale P. Sandler, Norie Sawada, Catherine Schairer, Howard D. Sesso, Tracey G. Simon, Rashmi Sinha, Rachael Stolzenberg-Solomon, Shoichiro Tsugane, Renwei Wang, Elisabete Weiderpass, Stephanie J. Weinstein, Emily White, Alicja Wolk, Jian Min Yuan, Anne Zeleniuch-Jacquotte, Xuehong Zhang, Bin Zhu, Katherine A. McGlynn, Peter T. Campbell, Jill Koshiol

Pediatrics - Pediatric Epidemiology

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Abstract

BACKGROUND: Tobacco and alcohol are well-established risk factors for numerous cancers, yet their relationship to biliary tract cancers remains unclear. METHODS: We pooled data from 26 prospective studies to evaluate associations of cigarette smoking and alcohol consumption with biliary tract cancer risk. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for associations with smoking and alcohol consumption were calculated. Random-effects meta-analysis produced summary estimates. All statistical tests were two-sided. RESULTS: Over a period of 38 369 156 person-years of follow-up, 1391 gallbladder, 758 intrahepatic bile duct, 1208 extrahepatic bile duct, and 623 ampulla of Vater cancer cases were identified. Ever, former, and current smoking were associated with increased extrahepatic bile duct and ampulla of Vater cancers risk (eg, current vs never smokers HR = 1.69, 95% CI = 1.34 to 2.13 and 2.22, 95% CI = 1.69 to 2.92, respectively), with dose-response effects for smoking pack-years, duration, and intensity (all Ptrend < .01). Current smoking and smoking intensity were also associated with intrahepatic bile duct cancer (eg, >40 cigarettes per day vs never smokers HR = 2.15, 95 % CI = 1.15 to 4.00; Ptrend = .001). No convincing association was observed between smoking and gallbladder cancer. Alcohol consumption was only associated with intrahepatic bile duct cancer, with increased risk for individuals consuming five or more vs zero drinks per day (HR = 2.35, 95%CI = 1.46 to 3.78; Ptrend = .04). There was evidence of statistical heterogeneity among several cancer sites, particularly between gallbladder cancer and the other biliary tract cancers. CONCLUSIONS: Smoking appears to increase the risk of developing all biliary tract cancers except gallbladder cancer. Alcohol may increase the risk of intrahepatic bile duct cancer. Findings highlight etiologic heterogeneity across the biliary tract.

Original language	English (US)
Pages (from-to)	1263-1278
Number of pages	16
Journal	Journal of the National Cancer Institute
Volume	111
Issue number	12
DOIs	https://doi.org/10.1093/jnci/djz103
State	Published - Dec 1 2019

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Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Review

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10.1093/jnci/djz103

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910180

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McGee, E. E., Jackson, S. S., Petrick, J. L., Van Dyke, A. L., Adami, H. O., Albanes, D., Andreotti, G., Beane-Freeman, L. E., Berrington de Gonzalez, A., Buring, J. E., Chan, A. T., Chen, Y., Fraser, G. E., Freedman, N. D., Gao, Y. T., Gapstur, S. M., Gaziano, J. M., Giles, G. G., Grant, E. J., ... Koshiol, J. (2019). Smoking, Alcohol, and Biliary Tract Cancer Risk: A Pooling Project of 26 Prospective Studies. Journal of the National Cancer Institute, 111(12), 1263-1278. https://doi.org/10.1093/jnci/djz103

McGee, EE, Jackson, SS, Petrick, JL, Van Dyke, AL, Adami, HO, Albanes, D, Andreotti, G, Beane-Freeman, LE, Berrington de Gonzalez, A, Buring, JE, Chan, AT, Chen, Y, Fraser, GE, Freedman, ND, Gao, YT, Gapstur, SM, Gaziano, JM, Giles, GG, Grant, EJ, Grodstein, F, Hartge, P, Jenab, M, Kitahara, CM, Knutsen, SF, Koh, WP, Larsson, SC, Lee, IM, Liao, LM, Luo, J, Milne, RL, Monroe, KR, Neuhouser, ML, O'Brien, KM, Peters, U, Poynter, JN, Purdue, MP, Robien, K, Sandler, DP, Sawada, N, Schairer, C, Sesso, HD, Simon, TG, Sinha, R, Stolzenberg-Solomon, R, Tsugane, S, Wang, R, Weiderpass, E, Weinstein, SJ, White, E, Wolk, A, Yuan, JM, Zeleniuch-Jacquotte, A, Zhang, X, Zhu, B, McGlynn, KA, Campbell, PT & Koshiol, J 2019, 'Smoking, Alcohol, and Biliary Tract Cancer Risk: A Pooling Project of 26 Prospective Studies', Journal of the National Cancer Institute, vol. 111, no. 12, pp. 1263-1278. https://doi.org/10.1093/jnci/djz103

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title = "Smoking, Alcohol, and Biliary Tract Cancer Risk: A Pooling Project of 26 Prospective Studies",

abstract = "BACKGROUND: Tobacco and alcohol are well-established risk factors for numerous cancers, yet their relationship to biliary tract cancers remains unclear. METHODS: We pooled data from 26 prospective studies to evaluate associations of cigarette smoking and alcohol consumption with biliary tract cancer risk. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for associations with smoking and alcohol consumption were calculated. Random-effects meta-analysis produced summary estimates. All statistical tests were two-sided. RESULTS: Over a period of 38 369 156 person-years of follow-up, 1391 gallbladder, 758 intrahepatic bile duct, 1208 extrahepatic bile duct, and 623 ampulla of Vater cancer cases were identified. Ever, former, and current smoking were associated with increased extrahepatic bile duct and ampulla of Vater cancers risk (eg, current vs never smokers HR = 1.69, 95% CI = 1.34 to 2.13 and 2.22, 95% CI = 1.69 to 2.92, respectively), with dose-response effects for smoking pack-years, duration, and intensity (all Ptrend < .01). Current smoking and smoking intensity were also associated with intrahepatic bile duct cancer (eg, >40 cigarettes per day vs never smokers HR = 2.15, 95 % CI = 1.15 to 4.00; Ptrend = .001). No convincing association was observed between smoking and gallbladder cancer. Alcohol consumption was only associated with intrahepatic bile duct cancer, with increased risk for individuals consuming five or more vs zero drinks per day (HR = 2.35, 95%CI = 1.46 to 3.78; Ptrend = .04). There was evidence of statistical heterogeneity among several cancer sites, particularly between gallbladder cancer and the other biliary tract cancers. CONCLUSIONS: Smoking appears to increase the risk of developing all biliary tract cancers except gallbladder cancer. Alcohol may increase the risk of intrahepatic bile duct cancer. Findings highlight etiologic heterogeneity across the biliary tract.",

author = "McGee, {Emma E.} and Jackson, {Sarah S.} and Petrick, {Jessica L.} and {Van Dyke}, {Alison L.} and Adami, {Hans Olov} and Demetrius Albanes and Gabriella Andreotti and Beane-Freeman, {Laura E.} and {Berrington de Gonzalez}, Amy and Buring, {Julie E.} and Chan, {Andrew T.} and Yu Chen and Fraser, {Gary E.} and Freedman, {Neal D.} and Gao, {Yu Tang} and Gapstur, {Susan M.} and Gaziano, {J. Michael} and Giles, {Graham G.} and Grant, {Eric J.} and Francine Grodstein and Patricia Hartge and Mazda Jenab and Kitahara, {Cari M.} and Knutsen, {Synnove F.} and Koh, {Woon Puay} and Larsson, {Susanna C.} and Lee, {I. Min} and Liao, {Linda M.} and Juhua Luo and Milne, {Roger L.} and Monroe, {Kristine R.} and Neuhouser, {Marian L.} and O'Brien, {Katie M.} and Ulrike Peters and Poynter, {Jenny N.} and Purdue, {Mark P.} and Kim Robien and Sandler, {Dale P.} and Norie Sawada and Catherine Schairer and Sesso, {Howard D.} and Simon, {Tracey G.} and Rashmi Sinha and Rachael Stolzenberg-Solomon and Shoichiro Tsugane and Renwei Wang and Elisabete Weiderpass and Weinstein, {Stephanie J.} and Emily White and Alicja Wolk and Yuan, {Jian Min} and Anne Zeleniuch-Jacquotte and Xuehong Zhang and Bin Zhu and McGlynn, {Katherine A.} and Campbell, {Peter T.} and Jill Koshiol",

year = "2019",

month = dec,

day = "1",

doi = "10.1093/jnci/djz103",

language = "English (US)",

volume = "111",

pages = "1263--1278",

journal = "Journal of the National Cancer Institute",

issn = "0027-8874",

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TY - JOUR

T1 - Smoking, Alcohol, and Biliary Tract Cancer Risk

T2 - A Pooling Project of 26 Prospective Studies

AU - McGee, Emma E.

AU - Jackson, Sarah S.

AU - Petrick, Jessica L.

AU - Van Dyke, Alison L.

AU - Adami, Hans Olov

AU - Albanes, Demetrius

AU - Andreotti, Gabriella

AU - Beane-Freeman, Laura E.

AU - Berrington de Gonzalez, Amy

AU - Buring, Julie E.

AU - Chan, Andrew T.

AU - Chen, Yu

AU - Fraser, Gary E.

AU - Freedman, Neal D.

AU - Gao, Yu Tang

AU - Gapstur, Susan M.

AU - Gaziano, J. Michael

AU - Giles, Graham G.

AU - Grant, Eric J.

AU - Grodstein, Francine

AU - Hartge, Patricia

AU - Jenab, Mazda

AU - Kitahara, Cari M.

AU - Knutsen, Synnove F.

AU - Koh, Woon Puay

AU - Larsson, Susanna C.

AU - Lee, I. Min

AU - Liao, Linda M.

AU - Luo, Juhua

AU - Milne, Roger L.

AU - Monroe, Kristine R.

AU - Neuhouser, Marian L.

AU - O'Brien, Katie M.

AU - Peters, Ulrike

AU - Poynter, Jenny N.

AU - Purdue, Mark P.

AU - Robien, Kim

AU - Sandler, Dale P.

AU - Sawada, Norie

AU - Schairer, Catherine

AU - Sesso, Howard D.

AU - Simon, Tracey G.

AU - Sinha, Rashmi

AU - Stolzenberg-Solomon, Rachael

AU - Tsugane, Shoichiro

AU - Wang, Renwei

AU - Weiderpass, Elisabete

AU - Weinstein, Stephanie J.

AU - White, Emily

AU - Wolk, Alicja

AU - Yuan, Jian Min

AU - Zeleniuch-Jacquotte, Anne

AU - Zhang, Xuehong

AU - Zhu, Bin

AU - McGlynn, Katherine A.

AU - Campbell, Peter T.

AU - Koshiol, Jill

PY - 2019/12/1

Y1 - 2019/12/1

N2 - BACKGROUND: Tobacco and alcohol are well-established risk factors for numerous cancers, yet their relationship to biliary tract cancers remains unclear. METHODS: We pooled data from 26 prospective studies to evaluate associations of cigarette smoking and alcohol consumption with biliary tract cancer risk. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for associations with smoking and alcohol consumption were calculated. Random-effects meta-analysis produced summary estimates. All statistical tests were two-sided. RESULTS: Over a period of 38 369 156 person-years of follow-up, 1391 gallbladder, 758 intrahepatic bile duct, 1208 extrahepatic bile duct, and 623 ampulla of Vater cancer cases were identified. Ever, former, and current smoking were associated with increased extrahepatic bile duct and ampulla of Vater cancers risk (eg, current vs never smokers HR = 1.69, 95% CI = 1.34 to 2.13 and 2.22, 95% CI = 1.69 to 2.92, respectively), with dose-response effects for smoking pack-years, duration, and intensity (all Ptrend < .01). Current smoking and smoking intensity were also associated with intrahepatic bile duct cancer (eg, >40 cigarettes per day vs never smokers HR = 2.15, 95 % CI = 1.15 to 4.00; Ptrend = .001). No convincing association was observed between smoking and gallbladder cancer. Alcohol consumption was only associated with intrahepatic bile duct cancer, with increased risk for individuals consuming five or more vs zero drinks per day (HR = 2.35, 95%CI = 1.46 to 3.78; Ptrend = .04). There was evidence of statistical heterogeneity among several cancer sites, particularly between gallbladder cancer and the other biliary tract cancers. CONCLUSIONS: Smoking appears to increase the risk of developing all biliary tract cancers except gallbladder cancer. Alcohol may increase the risk of intrahepatic bile duct cancer. Findings highlight etiologic heterogeneity across the biliary tract.

AB - BACKGROUND: Tobacco and alcohol are well-established risk factors for numerous cancers, yet their relationship to biliary tract cancers remains unclear. METHODS: We pooled data from 26 prospective studies to evaluate associations of cigarette smoking and alcohol consumption with biliary tract cancer risk. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for associations with smoking and alcohol consumption were calculated. Random-effects meta-analysis produced summary estimates. All statistical tests were two-sided. RESULTS: Over a period of 38 369 156 person-years of follow-up, 1391 gallbladder, 758 intrahepatic bile duct, 1208 extrahepatic bile duct, and 623 ampulla of Vater cancer cases were identified. Ever, former, and current smoking were associated with increased extrahepatic bile duct and ampulla of Vater cancers risk (eg, current vs never smokers HR = 1.69, 95% CI = 1.34 to 2.13 and 2.22, 95% CI = 1.69 to 2.92, respectively), with dose-response effects for smoking pack-years, duration, and intensity (all Ptrend < .01). Current smoking and smoking intensity were also associated with intrahepatic bile duct cancer (eg, >40 cigarettes per day vs never smokers HR = 2.15, 95 % CI = 1.15 to 4.00; Ptrend = .001). No convincing association was observed between smoking and gallbladder cancer. Alcohol consumption was only associated with intrahepatic bile duct cancer, with increased risk for individuals consuming five or more vs zero drinks per day (HR = 2.35, 95%CI = 1.46 to 3.78; Ptrend = .04). There was evidence of statistical heterogeneity among several cancer sites, particularly between gallbladder cancer and the other biliary tract cancers. CONCLUSIONS: Smoking appears to increase the risk of developing all biliary tract cancers except gallbladder cancer. Alcohol may increase the risk of intrahepatic bile duct cancer. Findings highlight etiologic heterogeneity across the biliary tract.

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U2 - 10.1093/jnci/djz103

DO - 10.1093/jnci/djz103

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SN - 0027-8874

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JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

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ER -

Smoking, Alcohol, and Biliary Tract Cancer Risk: A Pooling Project of 26 Prospective Studies

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