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Updated: Jun 19, 2026

Development of Compendium for Esophageal Squamous Cell Carcinoma
Published on: April 12, 2024
Alcohol consumption, cigarette smoking and risk of subtypes of oesophageal and gastric cancer: a prospective cohort
J Steevens1, L J Schouten, R A Goldbohm
1GROW-School for Oncology and Developmental Biology, Department of Epidemiology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. Jessie.Steevens@epid.unimaas.nl
Alcohol consumption increases the risk of oesophageal squamous cell carcinoma (OSCC). Cigarette smoking is linked to all four upper gastrointestinal cancers studied, including OSCC, OAC, GCA, and GNCA.
Area of Science:
- Gastroenterology and Oncology
- Epidemiology of Cancer
- Risk Factor Analysis
Background:
- Previous studies suggested differential associations of alcohol and smoking with upper gastrointestinal cancers.
- Retrospective study designs limited definitive conclusions on these associations.
Purpose of the Study:
- To prospectively investigate the associations between alcohol consumption, cigarette smoking, and the risk of four upper gastrointestinal cancers.
- To examine potential interactions between alcohol and smoking for these cancer types.
Main Methods:
- A prospective cohort study of 120,852 participants in the Netherlands.
- Baseline questionnaire data on lifestyle factors collected in 1986.
- Analysis of 107 OSCC, 145 OAC, 164 GCA, and 491 GNCA cases over 16.3 years using Cox models and case-cohort approach.
Main Results:
- Alcohol consumption was significantly associated with an increased risk of oesophageal squamous cell carcinoma (OSCC) (RR=4.61).
- No significant association was found between alcohol and oesophageal adenocarcinoma (OAC), gastric cardia adenocarcinoma (GCA), or gastric non-cardia adenocarcinoma (GNCA).
- Current cigarette smoking was associated with increased risk for all four cancers (GCA RR=1.60, OSCC RR=2.63).
- Smoking frequency, duration, and pack-years were independently linked to all four cancer risks.
- A synergistic effect was observed between heavy alcohol consumption (>15 g/day) and smoking for OSCC risk (RR=8.05).
Conclusions:
- Alcohol consumption is a risk factor specifically for oesophageal squamous cell carcinoma (OSCC).
- Cigarette smoking is a significant risk factor for all four studied upper gastrointestinal cancers.
- Combined alcohol and smoking habits pose a substantially elevated risk for OSCC.
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