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000300131 1001_ $$00000-0002-0442-3284$$aAglago, Elom K$$b0
000300131 245__ $$aAlcohol and smoking habits in association with hepatocellular carcinoma risk.
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000300131 520__ $$aWe assessed hepatocellular carcinoma (HCC) risk associated with smoking and alcohol consumption and their interactions, using both questionnaire data and objective serum biomarkers. Information on smoking and alcohol consumption was collected at baseline from 450,112 participants of the EPIC cohort, among whom 255 developed HCC after a median follow-up of 14 years. In a nested case-control subset of 108 HCC cases and 108 matched controls, known biomarkers of smoking (cotinine, nicotine) and habitual alcohol consumption (2-hydroxy-3-methylbutyric acid) were annotated from untargeted metabolomics features. Multivariable-adjusted hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were computed, and multiplicative and additive interaction parameters were calculated. Compared to never smokers, current smokers had a higher HCC risk (HR = 2.46, 95% CI = 1.77-3.43) dose-dependently with the number of cigarettes smoked per day (Ptrend <.001). Compared to light drinkers, HCC risk was higher in former (HR = 3.20, 95% CI = 1.70-6.03), periodically heavy (HR = 1.98, 95% CI = 1.11-3.54), and always heavy (HR = 5.51, 95% CI = 2.39-12.7) drinkers. Higher HCC risk was also observed in the highest versus the lowest tertiles of cotinine (OR = 4.88, 95% CI = 1.52-15.70), nicotine (OR = 5.80, 95% CI = 1.33-25.30) and 2-hydroxy-3-methylbutyric acid (OR = 5.89, 95% CI = 1.33-26.12). Questionnaire-assessed smoking and alcohol exposures did not demonstrate an HCC risk interaction at the multiplicative (MI = 0.88, 95% CI = 0.40-1.96) or additive (RERI = 0.71, 95% CI = -10.1 to 23.6; attributable proportion = 0.17, 95% CI = -0.52 to 1.16; synergy index = 1.27, 95% CI = 0.98-1.66) scales. Similar analyses with cotinine, nicotine, and 2-hydroxy-3-methylbutyric acid also did not show interactions between smoking and alcohol consumption on HCC risk. Smoking and alcohol consumption are strong independent risk factors for HCC and do not appear to synergistically impact its risk, but larger studies are needed.
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000300131 650_7 $$2Other$$abiological markers
000300131 650_7 $$2Other$$aethanol
000300131 650_7 $$2Other$$ainteraction
000300131 650_7 $$2Other$$aliver cancer
000300131 650_7 $$2Other$$atobacco
000300131 7001_ $$aRamos, Ines$$b1
000300131 7001_ $$00000-0001-9437-3040$$aKeski-Rahkonen, Pekka$$b2
000300131 7001_ $$aChatziioannou, Chrysovalantou$$b3
000300131 7001_ $$aFreisling, Heinz$$b4
000300131 7001_ $$00000-0002-7805-9913$$aFedirko, Veronika$$b5
000300131 7001_ $$aGunter, Marc J$$b6
000300131 7001_ $$aDahm, Christina C$$b7
000300131 7001_ $$aLangmann, Fie$$b8
000300131 7001_ $$aBondonno, Nicola$$b9
000300131 7001_ $$aTjønneland, Anne$$b10
000300131 7001_ $$00000-0001-7157-419X$$aSeveri, Gianluca$$b11
000300131 7001_ $$00000-0002-2943-6786$$aTruong, Therese$$b12
000300131 7001_ $$0P:(DE-He78)fb68a9386399d72d84f7f34cfc6048b4$$aKatzke, Verena$$b13$$udkfz
000300131 7001_ $$0P:(DE-He78)4b2dc91c9d1ac33a1c0e0777d0c1697a$$aKaaks, Rudolf$$b14$$udkfz
000300131 7001_ $$aBergmann, Manuela$$b15
000300131 7001_ $$aSchulze, Matthias B$$b16
000300131 7001_ $$00000-0002-5758-9069$$aMasala, Giovanna$$b17
000300131 7001_ $$00000-0001-5438-970X$$aPala, Valeria$$b18
000300131 7001_ $$ade Magistris, Maria Santucci$$b19
000300131 7001_ $$00000-0002-6031-1009$$aDi Girolamo, Chiara$$b20
000300131 7001_ $$00000-0002-3608-9743$$aLukic, Marko$$b21
000300131 7001_ $$00000-0002-0031-4152$$aGram, Inger Torhild$$b22
000300131 7001_ $$aBonet, Catalina$$b23
000300131 7001_ $$aSánchez, Maria-Jose$$b24
000300131 7001_ $$aChirlaque, María-Dolores$$b25
000300131 7001_ $$aAmiano, Pilar$$b26
000300131 7001_ $$aGuevara, Marcela$$b27
000300131 7001_ $$aVermeulen, Roel$$b28
000300131 7001_ $$00000-0002-3158-5289$$aManjer, Jonas$$b29
000300131 7001_ $$aEriksson, Linda$$b30
000300131 7001_ $$aKey, Tim J$$b31
000300131 7001_ $$aMayen, Ana-Lucia$$b32
000300131 7001_ $$aDossus, Laure$$b33
000300131 7001_ $$aWeiderpass, Elisabete$$b34
000300131 7001_ $$00000-0001-6517-1300$$aHeath, Alicia K$$b35
000300131 7001_ $$aFerrari, Pietro$$b36
000300131 7001_ $$00000-0002-0573-1852$$aJenab, Mazda$$b37
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