Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Impact of Smoking and Alcohol Consumption on Early-Onset Gastric Cancer Development in Young Koreans: A Population-Based Study

  • Seung Joo Kang (Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital) ;
  • Cheol Min Shin (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kyungdo Han (Department of Statistics and Actuarial Science, Soongsil University) ;
  • Jin Hyung Jung (Department of Medical Statistics, College of Medicine, The Catholic University of Korea) ;
  • Eun Hyo Jin (Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital) ;
  • Joo Hyun Lim (Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital) ;
  • Yoon Jin Choi (Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Hyuk Yoon (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Young Soo Park (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Nayoung Kim (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Dong Ho Lee (Department of Internal Medicine, Seoul National University Bundang Hospital)
  • Received : 2023.08.28
  • Accepted : 2023.10.28
  • Published : 2024.04.01
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Abstract

Purpose: 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. Materials and Methods: 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. Results: 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 (Pinteraction=0.002). Conclusion: 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.

Keywords

Acknowledgement

This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HI18C1140).

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