Kang Seung Joo, Shin Cheol Min, Han Kyungdo, Jung Jin Hyung, Jin Eun Hyo, Lim Joo Hyun, Choi Yoon Jin, Yoon Hyuk, Park Young Soo, Kim Nayoung, Lee Dong Ho
Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
J Gastric Cancer. 2024 Apr;24(2):145-158. doi: 10.5230/jgc.2024.24.e2.
Although smoking and alcohol consumption are known risk factors for gastric cancer (GC), studies assessing their effects on early-onset GC are limited. In this nationwide, population-based, prospective cohort study, we assessed the effects of smoking and alcohol consumption on early-onset GC in patients aged <50 years.
We analyzed data of patients aged 20-39 years who underwent cancer and general health screening in the Korean National Health Screening Program between 2009 and 2012. We calculated the adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for GC incidence until December 2020.
We enrolled 6,793,699 individuals (men:women=4,077,292:2,716,407) in this cohort. The mean duration of follow-up was 9.4 years. During follow-up, 9,893 cases of GC (men:women=6,304:3,589) were reported. Compared with the aHRs (95% CI) of never-smokers, those of former and current-smokers were 1.121 (1.044-1.205) and 1.282 (1.212-1.355), respectively. Compared with the aHRs (95% CI) of non-consumers, those of low-moderate- and high-risk alcohol consumers were 1.095 (1.046-1.146) and 1.212 (1.113-1.321), respectively. GC risk was the highest in current-smokers and high-risk alcohol consumers (1.447 [1.297-1.615]). Interestingly, alcohol consumption and smoking additively increased the GC risk in men but not in women (P=0.002).
Smoking and alcohol consumption are significant risk factors for early-onset GC in young Koreans. Further studies are needed to investigate sex-based impact of alcohol consumption and smoking on GC incidence in young individuals.
尽管吸烟和饮酒是已知的胃癌（GC）风险因素，但评估它们对早发性胃癌影响的研究有限。在这项全国性的、基于人群的前瞻性队列研究中，我们评估了吸烟和饮酒对年龄<50岁患者早发性胃癌的影响。
我们分析了2009年至2012年期间在韩国国家健康筛查计划中接受癌症和一般健康筛查的20-39岁患者的数据。我们计算了截至2020年12月胃癌发病率的调整后风险比（aHR）和95%置信区间（CI）。
我们在该队列中纳入了6,793,699名个体（男性：女性=4,077,292：2,716,407）。平均随访时间为9.4年。随访期间，报告了9,893例胃癌病例（男性：女性=6,304：3,589）。与从不吸烟者的aHR（95%CI）相比，既往吸烟者和当前吸烟者的aHR分别为1.121（1.044-1.205）和1.282（1.212-1.355）。与不饮酒者的aHR（95%CI）相比，低中度和高风险饮酒者的aHR分别为1.095（1.046-1.146）和1.212（1.113-1.321）。当前吸烟者和高风险饮酒者的胃癌风险最高（1.447[1.297-1.615]）。有趣的是，饮酒和吸烟在男性中增加胃癌风险具有相加作用，但在女性中并非如此（P=0.002）。
吸烟和饮酒是韩国年轻人早发性胃癌的重要风险因素。需要进一步研究以调查饮酒和吸烟对年轻个体胃癌发病率的性别差异影响。
