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Korean J Gastroenterol  <  Volume 73(3); 2019 <  Articles

Korean J Gastroenterol 2019; 73(3): 141-151  https://doi.org/10.4166/kjg.2019.73.3.141
Prediagnostic Smoking and Alcohol Drinking and Gastric Cancer Survival: A Korean Prospective Cohort Study
Shin Ah Kim, Bo Youl Choi1, Kyu Sang Song2, Chan Hyuk Park3,4, Chang Soo Eun3,4, Dong Soo Han3,4, Yong Sung Kim5 and Hyun Ja Kim
Department of Food and Nutrition, Gangneung-Wonju National University College of Life Science, Gangneung; Department of Preventive Medicine, Hanyang University College of Medicine1, Seoul; Department of Pathology, Chungnam National University College of Medicine2, Daejeon; Department of Internal Medicine, Hanyang University College of Medicine3, Seoul; Division of Gastroenterology, Department of Internal Medicine, Hanyang University Guri Hospital4, Guri; Genome Editing Research Center, Korea Research Institute of Bioscience and Biotechnology5, Daejeon, Korea
Correspondence to: Hyun Ja Kim, Department of Food and Nutrition, Gangneung-Wonju National University College of Life Science, 7 Jukheon-gil, Gangneung 25457, Korea. Tel: +82-33-640-2967, Fax: +82-33-640-2330, E-mail: wisekim@gwnu.ac.kr, ORCID: https://orcid.org/0000-0002-0965-9704
Received: October 23, 2018; Revised: December 20, 2018; Accepted: January 2, 2019; Published online: March 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: Behavioral factors, such as smoking and heavy alcohol consumption, increase the risk of gastric cancer (GC), but their effects on survival are not clear. We examined associations between prediagnostic smoking and alcohol drinking behavior and GC death by long-term follow-up.
Methods: The participants were 508 GC patients enrolled at Chungnam University Hospital and Hanyang University Guri Hospital from 2001 to 2006. Information on clinicopathologic and behavioral risk factors was collected, and patient survival was prospectively followed until 2016 by medical chart review and telephone survey.
Results: During above 10 years follow-up period, overall death was 46.2% (n=226) and GC deaths was 38.2% (n=187) among the 489 GC patients included in the analysis. No significant association was found between smoking habits and overall or GC survival. However, after stratification by histological type, the hazard ratio (HR) of GC death for current smokers tended to be higher for the diffuse type (HR 1.61, 95% CI 0.57-4.59 for current vs. never) rather than for the intestinal type (HR 0.78, 95% CI 0.28-2.19 for current vs. never). Light alcohol consumption was found to be associated with a significantly lower risk of GC death (HR 0.52, 95% CI 0.36-0.75 for <20 g/day for women or <40 g/day for men vs. never and past), and the effects of alcohol drinking habits had similar effects on GC death for the intestinal and diffuse types.
Conclusions: These results suggest smoking and alcohol drinking behaviors before a diagnosis of GC are weakly associated with GC survival. Nevertheless, the effect of smoking behavior on prognosis appears to depend on the histological type of GC.
Keywords: Stomach neoplasms; Survival; Smoking; Drinking; Prospective studies


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