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Separate and Joint Effects of Alcohol and Smoking on the Risks of Cirrhosis and Gallbladder Disease in Middle-aged Women

Liu, Bette; Balkwill, Angela; Roddam, Andrew W; Brown, Anna; Beral, Valerie; Banks, Emily; Million Women Study, Collaborators

Description

The separate and joint effects of alcohol and smoking on incidences of liver cirrhosis and gallbladder disease were examined in a prospective study of 1,290,413 United Kingdom women (mean age, 56 years) recruited during 1996-2001. After a mean follow-up of 6.1 years (1996-2005), incidence rates of cirrhosis and gallbladder disease were 1.3 per 1,000 persons (n = 2,105) and 15 per 1,000 persons (n = 23,989), respectively, over 5 years. Cirrhosis risk increased with increasing alcohol...[Show more]

dc.contributor.authorLiu, Bette
dc.contributor.authorBalkwill, Angela
dc.contributor.authorRoddam, Andrew W
dc.contributor.authorBrown, Anna
dc.contributor.authorBeral, Valerie
dc.contributor.authorBanks, Emily
dc.contributor.authorMillion Women Study, Collaborators
dc.date.accessioned2015-12-08T22:25:41Z
dc.date.available2015-12-08T22:25:41Z
dc.identifier.issn0002-9262
dc.identifier.urihttp://hdl.handle.net/1885/33546
dc.description.abstractThe separate and joint effects of alcohol and smoking on incidences of liver cirrhosis and gallbladder disease were examined in a prospective study of 1,290,413 United Kingdom women (mean age, 56 years) recruited during 1996-2001. After a mean follow-up of 6.1 years (1996-2005), incidence rates of cirrhosis and gallbladder disease were 1.3 per 1,000 persons (n = 2,105) and 15 per 1,000 persons (n = 23,989), respectively, over 5 years. Cirrhosis risk increased with increasing alcohol consumption, while the risk of gallbladder disease decreased (Ptrend < 0.0001 for each). Comparing women who drank ≥15 units/week with those who drank 1-2 units/week, the relative risk was 4.32 (95% confidence interval (CI): 3.71, 5.03)) for cirrhosis and 0.59 (95% CI: 0.55, 0.64) for gallbladder disease. Increasing numbers of cigarettes smoked daily increased the risk of both conditions (Ptrend < 0.0001 for each). Comparing current smokers of ≥20 cigarettes/day with never smokers, the relative risk was 3.76 (95% CI: 3.25, 4.34) for cirrhosis and 1.29 (95% CI: 1.22, 1.37) for gallbladder disease. Effects of alcohol and smoking were more than multiplicative for cirrhosis (Pinteraction = 0.02) but not for gallbladder disease (Pinteraction = 0.4). Findings indicate that alcohol and smoking affect the risks of the 2 conditions in different ways. For cirrhosis, alcohol and smoking separately increase risk, and their joint effects are particularly hazardous. For gallbladder disease, alcohol reduces risk and smoking results in a small risk increase.
dc.publisherOxford University Press
dc.sourceAmerican Journal of Epidemiology
dc.subjectKeywords: alcohol; comparative study; disease incidence; health risk; smoking; womens health; adult; alcohol consumption; article; cigarette smoking; controlled study; female; follow up; gallbladder disease; human; incidence; liver cirrhosis; major clinical study; Alcohol drinking; Gallbladder diseases; Liver cirrhosis; Liver diseases, alcoholic; Prospective studies; Smoking
dc.titleSeparate and Joint Effects of Alcohol and Smoking on the Risks of Cirrhosis and Gallbladder Disease in Middle-aged Women
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume169
dc.date.issued2009
local.identifier.absfor111706 - Epidemiology
local.identifier.ariespublicationu4637548xPUB103
local.type.statusPublished Version
local.contributor.affiliationLiu, Bette, University of Oxford
local.contributor.affiliationBalkwill, Angela, University of Oxford
local.contributor.affiliationRoddam, Andrew W, University of Oxford
local.contributor.affiliationBrown, Anna, University of Oxford
local.contributor.affiliationBeral, Valerie, University of Oxford
local.contributor.affiliationBanks, Emily, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationMillion Women Study, Collaborators, NHS Breast Screening Centres
local.bibliographicCitation.issue2
local.bibliographicCitation.startpage153
local.bibliographicCitation.lastpage160
local.identifier.doi10.1093/aje/kwn280
dc.date.updated2016-02-24T11:15:54Z
local.identifier.scopusID2-s2.0-58449133378
local.identifier.thomsonID000262518200005
CollectionsANU Research Publications

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