[1]Icahn School of Medicine at Mount Sinai,New York,United States
[2]Fred Hutchinson Cancer Research Center, Public Health Sciences Division,Seattle,United States
[3]Taipei Medical University, College of Medical Science and Technology,Taipei,Taiwan
[4]National Cancer Institute, Division of Cancer Epidemiology and Genetics,Bethesda,United States
[5]University of Tokyo,Tokyo,Japan
[6]Medical Center of Fudan University, Department of Epidemiology,Shanghai,China
[7]National University Health System, Saw Swee Hock School of Public Health,Singapore City,Singapore
[8]Vanderbilt Ingram Cancer Center, Department of Medicine,Nashville,United States
[9]Radiation Effects Research Foundation Hiroshima,,Japan
[10]Tohoku University School of Medicine,Sendai,Japan
[11]Miyagi Cancer Research Institute,Natori,Japan
[12]Fu Jen Catholic University, Department of Public Health,Hsinchuang,Taiwan
[13]Seoul National University College of Medicine, Department of Preventive Medicine,Seoul,South Korea
[14]University of Pittsburgh Cancer Institute, Division of Cancer Control and Population Sciences,Pittsburgh,United States
[15]National Cancer Center, Gyeonggi, Division of Cancer Epidemiology and Prevention,Goyang,South Korea
[16]National Cancer Center Tokyo, Center for Public Health Sciences,Tokyo,Japan
[17]Renji Hospital, Department of Epidemiology,Shanghai,China
[18]Tohoku University, Tohoku Medical Megabank Organization,Sendai,Japan
[19]Tohoku University School of Medicine, Department of Public Health and Forensic Medicine,Sendai,Japan
[20]Genomics Research Center, Academia Sinica,Nankang,Taiwan
[21]Seoul National University College of Medicine,Seoul,South Korea
[22]University of Chicago, Department of Public Health Sciences,Chicago,United States
[23]Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Department of Cancer Epidemiology,Beijing,China
[24]s University, Department of Food and Nutrition,Seoul,South Korea
[25]University of Wisconsin Madison, Carbone Cancer Center,Madison,United States
[26]University of Texas M. D. Anderson Cancer Center, Department of Biostatistics,Houston,United States
[27]Fred Hutchinson Cancer Research Center, Division of Public Health Sciences,Seattle,United States
Background: The evidence for a role of tobacco smoking, alcohol drinking, and body mass index (BMI) in the etiology of small intestine cancer is based mainly on case-control studies from Europe and United States. Subjects and methods: We harmonized the data across 12 cohort studies from mainland China, Japan, Korea, Singapore, and Taiwan, comprising over 500 000 subjects followed for an average of 10.6 years. We calculated hazard ratios (HRs) for BMI and (only among men) tobacco smoking and alcohol drinking. Results: A total of 134 incident cases were observed (49 adenocarcinoma, 11 carcinoid, 46 other histologic types, and 28 of unknown histology). There was a statistically non-significant trend toward increased HR in subjects with high BMI [HR for BMI >27.5 kg/m. 2, compared with 22.6-25.0, 1.50; 95% confidence interval (CI) 0.76-2.96]. No association was suggested for tobacco smoking; men drinking >400 g of ethanol per week had an HR of 1.57 (95% CI 0.66-3.70), compared with abstainers. Conclusions: Our study supports the hypothesis that elevated BMI may be a risk factor for small intestine cancer. An etiologic role of alcohol drinking was suggested. Our results reinforce the existing evidence that the epidemiology of small intestine cancer resembles that of colorectal cancer. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.