Alcohol and lung cancer risk among never smokers: A pooled analysis from the international lung cancer consortium and the SYNERGY study

Gordon Fehringer, Darren R. Brenner, Zuo Feng Zhang, Yuan Chin Amy Lee, Keitaro Matsuo, Hidemi Ito, Qing Lan, Paolo Vineis, Mattias Johansson, Kim Overvad, Elio Riboli, Antonia Trichopoulou, Carlotta Sacerdote, Isabelle Stucker, Paolo Boffetta, Paul Brennan, David C. Christiani, Yun Chul Hong, Maria Teresa Landi, Hal MorgensternAnn G. Schwartz, Angela S. Wenzlaff, Gad Rennert, John R. McLaughlin, Curtis C. Harris, Susan Olivo-Marston, Irene Orlow, Bernard J. Park, Marjorie Zauderer, Juan M. Barros Dios, Alberto Ruano Raviña, Jack Siemiatycki, Anita Koushik, Philip Lazarus, Ana Fernández-Somoano, Adonina Tardon, Loic Le Marchand, Hermann Brenner, Kai Uwe Saum, Eric J. Duell, Angeline S. Andrew, Neonila Szeszenia-Dabrowska, Jolanta Lissowska, David Zaridze, Peter Rudnai, Eleonora Fabianova, Dana Mates, Lenka Foretova, Vladimir Janout, Vladimir Bencko, Ivana Holcatova, Angela Cecilia Pesatori, Dario Consonni, Ann Olsson, Kurt Straif, Rayjean J. Hung

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


It is not clear whether alcohol consumption is associated with lung cancer risk. The relationship is likely confounded by smoking, complicating the interpretation of previous studies. We examined the association of alcohol consumption and lung cancer risk in a large pooled international sample, minimizing potential confounding of tobacco consumption by restricting analyses to never smokers. Our study included 22 case-control and cohort studies with a total of 2548 never-smoking lung cancer patients and 9362 never-smoking controls from North America, Europe and Asia within the International Lung Cancer Consortium (ILCCO) and SYNERGY Consortium. Alcohol consumption was categorized into amounts consumed (grams per day) and also modelled as a continuous variable using restricted cubic splines for potential non-linearity. Analyses by histologic sub-type were included. Associations by type of alcohol consumed (wine, beer and liquor) were also investigated. Alcohol consumption was inversely associated with lung cancer risk with evidence most strongly supporting lower risk for light and moderate drinkers relative to non-drinkers (>0–4.9 g per day: OR = 0.80, 95% CI = 0.70–0.90; 5–9.9 g per day: OR = 0.82, 95% CI = 0.69–0.99; 10–19.9 g per day: OR = 0.79, 95% CI = 0.65–0.96). Inverse associations were found for consumption of wine and liquor, but not beer. The results indicate that alcohol consumption is inversely associated with lung cancer risk, particularly among subjects with low to moderate consumption levels, and among wine and liquor drinkers, but not beer drinkers. Although our results should have no relevant bias from the confounding effect of smoking we cannot preclude that confounding by other factors contributed to the observed associations. Confounding in relation to the non-drinker reference category may be of particular importance.

Original languageEnglish
Pages (from-to)1976-1984
Number of pages9
JournalInternational Journal of Cancer
Issue number9
StatePublished - 1 May 2017


  • alcohol
  • beer
  • liquor
  • lung cancer
  • wine


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