Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Feb 5, 2026
Date Accepted: Apr 30, 2026
Age-Specific Associations Between Alcohol Consumption and Esophageal Cancer Risk: Evidence from the China Kadoorie Biobank
ABSTRACT
Background:
China accounted for over 40% of new global cases and deaths from esophageal cancer.
Objective:
This study aims to investigate the age-specific associations between alcohol consumption and the risk of esophageal cancer to inform more precise screening strategies.
Methods:
Data were obtained from the China Kadoorie Biobank (CKB), a large-scale, nationwide prospective cohort study. The final analysis included 489,664 adult participants enrolled between 2004 and 2008, aged 30-79 years at baseline. Age-specific incidence rates per 100,000 person-years of esophageal cancer were calculated. Cox proportional hazards models were used to assess the associations between alcohol consumption and the risk of esophageal cancer, stratified by age groups.
Results:
Esophageal cancer incidence rates increased markedly with age, notably rising from 10.9 to 42.7 per 100,000 person-years between the 30-49 and 50-54 age groups. All levels of alcohol consumption were significantly associated with an increased risk of esophageal cancer, for example, adjusted hazard ratio (aHR) for weekly drinkers was 2.64 (95% CI: 2.34-2.98). Stratified analyses indicated a significant association between weekly drinking and the risk of esophageal cancer across all age groups except ages 75-79, respectively, and markedly strong effect observed in younger individuals. For example, among participants aged 30 - 49 years, weekly drinkers had an aHR of 4.06 (95% CI: 2.73-6.02). Furthermore, among weekly drinkers, initiation of drinking between ages 15-24 was associated with an elevated risk compared to initiation at ages 45 or older.
Conclusions:
These results provide crucial evidence to support the refinement of risk-stratified, age-targeted screening strategies, advocating for targeted prevention efforts aimed at young heavy drinkers in China.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.