IDDF2023-ABS-0254 Alcohol consumption without meals and risk of gastrointestinal cancers

Background

The incidence of multiple gastrointestinal (GI) cancers is increasing in younger adults. Alcohol consumption is a causal risk factor for multiple GI cancers. While the dosage of alcohol is recognized to affect this risk, the pattern or time of drinking maybe also important. For example, skipping meals prior to drinking is gaining popularity among younger adults, a pattern shown to be associated with excess liver cirrhosis independent of total alcohol intake. Additionally, experimental data suggest an interaction between mealtime and alcohol on colorectal cancer formation. There is an unmet need to identify factors that may modulate the effect of alcohol on the risk of GI cancers, especially those of earlier onset.

Methods

We prospectively examined the associations of alcohol consumption with meals (yes, it varies, no) with the risk of GI cancers among 347,591 current drinkers in the UK Biobank (2006-2021). Cox models were used to estimate relative risks (RRs) and 95% confidence intervals (CIs). We also examined the associations by the age of diagnosis (earlier-onset [<55] vs. later-onset [≥55]).

Results

During 3,636,677 person-years of follow-up, 6,813 incident GI cancers occurred. After multivariable adjustment including total alcohol intake, current drinkers consuming alcohol without meals, compared to those drinking with meals, had a 9% increased risk of GI cancer (RR=1.09, 95%CI 1.02-1.16), driven by gastric (RR=1.57, 1.22-2.02), liver (RR=1.43, 1.08-1.89), and rectal cancer (RR=1.16, 1.01-1.34). We also observed stronger associations of alcohol consumption without meals for earlier-onset GI cancers (GI cancer RR=1.30, 1.01-1.68; gastric/liver/rectal cancer RR=1.49, 1.00-2.21) compared with cancers of later-onset (GI cancer RR=1.07, 1.01-1.15; gastric/liver/rectal cancer RR=1.25, 1.11-1.41). The joint analyses for alcohol consumption with/without meals and total alcohol intake with risk of gastric/liver/rectal cancer are shown in IDDF2023-ABS-0254 Figure 1. The joint analyses for alcohol consumption with without meals and total alcohol intake with risk of gastric liver rectal cancer.

Conclusions

Among current drinkers, alcohol consumption without meals was associated with higher risks of overall GI cancer and several GI cancer subtypes (liver, gastric, and rectal cancer), with stronger associations for cases of earlier onset.