Cigarette smoking and adenocarcinomas of the esophagus and esophagogastric junction: A pooled analysis From the International BEACON Consortium

Cook, Michael B., Kamangar, Farin, Whiteman, David C., Freedman, Neal D., Gammon, Marilie D., Bernstein, Leslie, Brown, Linda M., Risch, Harvey A., Ye, Weimin, Sharp, Linda, Pandeya, Nirmala, Webb, Penelope M., Wu, Anna H., Ward, Mary H., Giffen, Carol, Casson, Alan G., Abnet, Christian C., Murray, Liam J., Corley, Douglas A., Nyren, Olof, Vaughan, Thomas L. and Chow, Wong-Ho (2010) Cigarette smoking and adenocarcinomas of the esophagus and esophagogastric junction: A pooled analysis From the International BEACON Consortium. Journal of the National Cancer Institute, 102 17: 1344-1353. doi:10.1093/jnci/djq289


Author Cook, Michael B.
Kamangar, Farin
Whiteman, David C.
Freedman, Neal D.
Gammon, Marilie D.
Bernstein, Leslie
Brown, Linda M.
Risch, Harvey A.
Ye, Weimin
Sharp, Linda
Pandeya, Nirmala
Webb, Penelope M.
Wu, Anna H.
Ward, Mary H.
Giffen, Carol
Casson, Alan G.
Abnet, Christian C.
Murray, Liam J.
Corley, Douglas A.
Nyren, Olof
Vaughan, Thomas L.
Chow, Wong-Ho
Title Cigarette smoking and adenocarcinomas of the esophagus and esophagogastric junction: A pooled analysis From the International BEACON Consortium
Journal name Journal of the National Cancer Institute   Check publisher's open access policy
ISSN 0027-8874
Publication date 2010-09
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1093/jnci/djq289
Volume 102
Issue 17
Start page 1344
End page 1353
Total pages 10
Place of publication United Kingdom
Publisher Oxford University Press
Language eng
Formatted abstract
Background
Previous studies that showed an association between smoking and adenocarcinomas of the esophagus and esophagogastric junction were limited in their ability to assess differences by tumor site, sex, dose-response, and duration of cigarette smoking cessation.

Methods
We used primary data from 10 population-based case-control studies and two cohort studies from the Barrett's Esophagus and Esophageal Adenocarcinoma Consortium. Analyses were restricted to white non-Hispanic men and women. Patients were classified as having esophageal adenocarcinoma (n = 1540), esophagogastric junctional adenocarcinoma (n = 1450), or a combination of both (all adenocarcinoma; n = 2990). Control subjects (n = 9453) were population based. Associations between pack-years of cigarette smoking and risks of adenocarcinomas were assessed, as well as their potential modification by sex and duration of smoking cessation. Study-specific odds ratios (ORs) estimated using multivariable logistic regression models, adjusted for age, sex, body mass index, education, and gastroesophageal reflux, were pooled using a meta-analytic methodology to generate summary odds ratios. All statistical tests were two-sided.

Results
The summary odds ratios demonstrated strong associations between cigarette smoking and esophageal adenocarcinoma (OR = 1.96, 95% confidence interval [CI] = 1.64 to 2.34), esophagogastric junctional adenocarcinoma (OR = 2.18, 95% CI = 1.84 to 2.58), and all adenocarcinoma (OR = 2.08, 95% CI = 1.83 to 2.37). In addition, there was a strong dose-response association between pack-years of cigarette smoking and each outcome (P <. 001). Compared with current smokers, longer smoking cessation was associated with a decreased risk of all adenocarcinoma after adjusting for pack-years (<10 years of smoking cessation: OR = 0.82, 95% CI = 0.60 to 1.13; and ≥10 years of smoking cessation: OR = 0.71, 95% CI = 0.56 to 0.89). Sex-specific summary odds ratios were similar.

Conclusions
Cigarette smoking is associated with increased risks of adenocarcinomas of the esophagus and esophagogastric junction in white men and women; compared with current smoking, smoking cessation was associated with reduced risks.
Keyword Gastric Cardia Carcinomas
Modeling Total Exposure
Gastroesophageal-Reflux
United-States
Lung-Cancer
Risk-Factors
Barretts-Esophagus
Tobacco Use
Body-Mass
Alcohol
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: ERA 2012 Admin Only
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