Smokeless tobacco associated with stomach cancer

The results of a study in the International Journal of Cancer confirm an association between smoking and cancers of the stomach and esophagus, and suggest that moist snuff, a popular form of smokeless tobacco in Scandinavia known as "snus," raises the risk of these cancers as well.

Dr. Kazem Zendehdel, of the Karolinska Institute, Stockholm, and colleagues examined the occurrence of esophageal and stomach cancers in a group of male Swedish construction workers who were followed for up to 33 years.

A total of 336,381 subjects provided information on tobacco smoking and snus use between 1971 and 1993. Follow-up through 2004 was accomplished through linkage to various nationwide registers.

Fifty-eight percent of the workers reported current or former smoking, and 28 percent reported snus use.

Tobacco smoking raised the risk of stomach and esophagus cancers by as much fivefold. Although snus use appeared to be safer, it still increased the risk of stomach cancer slightly and raised the odds of esophagus cancer by more than threefold.

Although there is still some uncertainty about the cause and strength of these associations, and if they can be extended to other populations, "we conclude that at present, Scandinavian snus cannot be considered to be without a (cancer) risk," Zendehdel and colleagues conclude.

SOURCE: International Journal of Cancer, March 2008.