Wine and other types of alcoholic beverages and the risk of esophageal cancer

Objective: To investigate the separate and combined effect of wine-drinking and other alcoholic beverages on esophageal cancer, in a high wine-consuming population. Design: Combined analysis of two hospital-based case-control studies. Setting: Major teaching and general hospitals in the greater Milan area and in the province of Pordenone, in northern Italy. Subjects: A total of 714 incident cases of esophageal cancer, and 3137 controls admitted to hospital for acute, non-neoplastic conditions, unrelated to alcohol consumption. Intervention: Trained interviews identified and questioned cases and controls using standardized structured questionnaires, including information on the average number of days per week each type of alcoholic beverages (wine, beer, spirits) was consumed, and the average number of drinks per day. Odds ratios (ORs) were calculated using unconditional multiple logistic regression equations. Results: With reference to total alcohol drinking, as compared to non- or moderate drinkers (< 3 drinks per day), the multivariate ORs were 1.98 for drinkers of 3-4 drinks per day, 4.22 for 5-7, 7.60 for 8-11, and 12.35 for <greater than or equal to> 12 drinks per day. Higher risks were observed for wine-only drinkers and the corresponding values were 1.70, 4.21, 8.76 and 17.90. After allowance for wine intake, no association was observed between beer and spirit drinking and esophageal cancer, in a population in which 80% of alcohol came from wine. Conclusion: The amount of ethanol determines the risk of esophageal cancer, and the most commonly used alcoholic beverage appear to be most strongly associated.