Background: There are controversies on the role of alcohol in lung cancer but no studies have examined the role of alcohol consumption patterns. We examined the association between binge drinking and lung cancer.

Methods: Prospective population based study of 2267 middle aged men from Finland without a history of lung cancer at baseline.

Results: There were 65 cases of lung cancer during an average follow-up of 16.7 years. The relative risk (RR) of lung cancer for binge drinkers was 1.89 (95% CI 1.10-3.20) after adjusting for age, examination year, family history of cancer, smoking, socio-economic status (SES), leisure-time physical activity and body mass index (BMI). No increased risk was observed among non-smoking binge drinkers, RR 1.48 (95% CI 0.89-2.47). Binge drinking smokers had increased risks of lung cancer in all categories of daily smoking compared with non-binge drinking smokers. The RR were 2.70 (95% CI 1.61-4.53), 2.35 (95% CI 1.38-3.96) and 2.24 (95% CI 1.29-3.80) for those who smoked 1-19, 20-29 and > or =30/day, respectively.

Conclusion: Binge drinking is not associated with an increased risk of lung cancer among non-smokers but among smokers, it is associated with an increased risk irrespective of the number of cigarettes smoked daily. Even though the number of lung cancer cases among non-smokers was relatively small, the fact that the increased risk was limited to only smokers means that residual confounding by smoking may play a role. Larger studies are needed to clarify this association.