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Japanese Journal of Clinical Oncology 2008 38(1):8-25; doi:10.1093/jjco/hym152
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© The Authors (2008). Published by Oxford University Press. All rights reserved

Alcohol Drinking and Gastric Cancer Risk: An Evaluation Based on a Systematic Review of Epidemiologic Evidence among the Japanese Population

Taichi Shimazu1,2,, Ichiro Tsuji1, Manami Inoue2, Kenji Wakai3, Chisato Nagata4, Tetsuya Mizoue5, Keitaro Tanaka6, Shoichiro Tsugane for the Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan2

1 Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
2 Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
3 Department of Preventive Medicine/Biostatistics and Medical Decision Making, Nagoya University Graduate School of Medicine, Nagoya, Japan
4 Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
5 Department of Epidemiology and International Health, Research Institute, International Medical Center of Japan, Tokyo, Japan
6 Department of Preventive Medicine, Saga Medical School, Faculty of Medicine, Saga University, Saga, Japan

For reprints and all correspondence: Taichi Shimazu, Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. E-mail: tshimazu{at}gan2.res.ncc.go.jp

Received August 6, 2007; accepted October 17, 2007

Background: We reviewed epidemiologic studies on the association between alcohol drinking and gastric cancer among the Japanese population. This report is one of a series of articles by our research group, which is evaluating the existing evidence concerning the association between health-related lifestyles and cancer.

Methods: Original data were collected by searches of MEDLINE using PubMed, or searches of the Ichushi database, complemented with manual searches. Evaluation of associations was based on the strength of evidence and the magnitude of association, together with biological plausibility as evaluated previously by the International Agency for Research on Cancer.

Results: Of the 11 cohort studies evaluated, nine showed no association between alcohol drinking and gastric cancer, and one study showed a strong positive association among men. All of 11 case–control studies found no association between alcohol drinking and gastric cancer. By anatomical subsites of gastric cancer, only three studies have evaluated the association between alcohol drinking and gastric cancer, and one cohort study found a positive association for cardia and upper-third gastric cancer in men. Few studies conducted among the Japanese population have made a detailed assessment of alcohol drinking, possible important confounding factors such as smoking and diet and anatomical subsites of gastric cancer.

Conclusion: We conclude that epidemiologic evidence for an association between alcohol drinking and gastric cancer risk remains insufficient due to the methodological quality of studies that have been conducted among the Japanese population.

Key Words: systematic review • epidemiology • alcohol drinking • gastric cancer • Japanese


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