Baseline and lifetime alcohol consumption and risk of skin cancer in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC)

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DOI

  • Yahya Mahamat-Saleh, University Paris-Saclay, University Paris-Sud, Villejuif
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  • Marie Al-Rahmoun, University Paris-Saclay, University Paris-Sud, Villejuif
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  • Gianluca Severi, University Paris-Saclay, University Paris-Sud, Villejuif
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  • Reza Ghiasvand, University of Oslo, Norway; Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway; Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway. Electronic address: harald.breivik@medsin.uio.no.
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  • Marit B Veierod, University of Oslo, Norway; Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway; Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway. Electronic address: harald.breivik@medsin.uio.no.
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  • Saverio Caini, Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy.
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  • Domenico Palli, Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy.
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  • Edoardo Botteri, University of Oslo, Norway; Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway; Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway. Electronic address: harald.breivik@medsin.uio.no.
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  • Carlotta Sacerdote, Piedmont Reference Centre for Epidemiology and Cancer Prevention (CPO Piemonte), Turin
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  • Fulvio Ricceri, Epidemiology Unit
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  • Marko Lukic, Department of Pediatrics, University Hospital of North Norway, Tromsø, Norway ; Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
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  • Maria J Sánchez, Escuela Andaluza de Salud Pública (EASP), Granada
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  • Valeria Pala, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, 20133 Milano, Italy.
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  • Rosario Tumino, Hyblean Association for Epidemiological Research (AIRE -ONLUS)
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  • Paolo Chiodini, Dipartimento di Salute Mentale e Fisica e Medicina Preventiva
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  • Pilar Amiano, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
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  • Sandra Colorado-Yohar, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
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  • María-Dolores Chirlaque, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
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  • Eva Ardanaz, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
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  • Catalina Bonet, Catalan Institute of Oncology-ICO
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  • Verena Katzke, German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, 69120 Heidelberg, Germany. V.Katzke@Dkfz-Heidelberg.de.
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  • Rudolf Kaaks, German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, 69120 Heidelberg, Germany. V.Katzke@Dkfz-Heidelberg.de.
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  • Matthias B Schulze, German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany.
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  • Kim Overvad
  • Christina C Dahm
  • Christian S Antoniussen
  • Anne Tjønneland, Danish Cancer Society
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  • Cecilie Kyrø, National Institute for Public Health and the Environment (RIVM), Bilthoven
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  • Bas Bueno-de-Mesquita, National Institute for Public Health and the Environment (RIVM), Bilthoven
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  • Jonas Manjer, Department of Obstetrics and Gynecology, Skåne University Hospital Malmö, Lund University, Malmö, 20502, Sweden.
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  • Malin Jansson, Lund University, Malmö, Sweden; Umeå University, Umeå, Sweden.
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  • Anders Esberg, Lund University, Malmö, Sweden; Umeå University, Umeå, Sweden.
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  • Nagisa Mori, International Agency for Research on Cancer
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  • Pietro Ferrari, International Agency for Research on Cancer
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  • Elisabete Weiderpass, International Agency for Research on Cancer
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  • Marie-Christine Boutron-Ruault, University Paris-Saclay, University Paris-Sud, Villejuif
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  • Marina Kvaskoff, University Paris-Saclay, University Paris-Sud, Villejuif

Experimental evidence suggests that alcohol induces cutaneous carcinogenesis, yet epidemiological studies on the link between alcohol intake and skin cancer have been inconsistent. The European Prospective Investigation into Cancer and Nutrition (EPIC) is a prospective cohort initiated in 1992 in 10 European countries. Alcohol intake at baseline and average lifetime alcohol intake were assessed using validated country-specific dietary and lifestyle questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated in Cox models. A total of 14 037 skin cancer cases (melanoma: n = 2457; basal-cell carcinoma (BCC): n = 8711; squamous-cell carcinoma (SCC): n = 1928; unknown: n = 941) were identified among 450 112 participants (average follow-up: 15 years). Baseline alcohol intake was positively associated with SCC (>15 vs 0.1-4.9 g/day: HR = 1.44, 95% CI = 1.17-1.77; Ptrend = .001), BCC (HR = 1.12, 95% CI = 1.01-1.23; Ptrend = .04), and melanoma risks in men (HR = 1.17, 95% CI = 0.95-1.44; Ptrend = .17), while associations were more modest in women (SCC: HR = 1.09, 95% CI = 0.90-1.30; Ptrend = .13; BCC: HR = 1.08, 95% CI = 1.00-1.17, Ptrend = .03; melanoma: HR = 0.93, 95% CI = 0.80-1.08, Ptrend = .13). Associations were similar for lifetime alcohol intake, with an attenuated linear trend. Lifetime liquor/spirit intake was positively associated with melanoma (fourth vs first quartile: HR = 1.47, 95% CI = 1.08-1.99; Ptrend = .0009) and BCC risks in men (HR = 1.17, 95% CI = 1.04-1.31; Ptrend = .14). Baseline and lifetime intakes of wine were associated with BCC risk (HR = 1.25 in men; HR = 1.11-1.12; in women). No statistically significant associations were found between beverage types and SCC risk. Intake of beer was not associated with skin cancer risk. Our study suggests positive relationships between alcohol intake and skin cancer risk, which may have important implications for the primary prevention of skin cancer.

Original languageEnglish
JournalInternational Journal of Cancer
ISSN0020-7136
DOIs
Publication statusE-pub ahead of print - 19 Aug 2022

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© 2022 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

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