Background Alcohol consumption, metabolic factors and oxidative stress have consistently been linked to cancer development. Gamma-glutamyltransferase (GGT) is a biomarker for adverse alcohol consumption and oxidative stress. It is highly related to metabolic factors such as hyperglycaemia, dislipidaemia and obesity. We therefore hypothesise that GGT is associated with cancer incidence at different sites.

Methods First visit measurements in 94 628 adult women and 80 224 men screened for metabolic risk factors as part of the Vorarlberg Health Monitoring & Promotion Programme (VHM&PP). During a median follow-up of 13 years, a total of 5136 incident cancers were diagnosed in men and 4665 in women. Sex-specific Cox proportional hazards models, adjusted for age, body-mass index and smoking were performed to estimate HRs and 95% CI per quintiles of GGT.

Results In males, there were associations (highest vs lowest quintiles) of GGT with liver cancer (HR=16.50, 4.00–68.19), cancers of the lip, oral cavity, pharynx and larynx (HR=3.80, 2.33–6.20), oesophageal cancer (HR=2.39, 1.01–5.72), pancreatic cancer (HR=2.13, 1.01–4.56), lung cancer (HR=2.04, 1.55–2.70), bladder cancer (HR=1.76, 1.11–2.77), kidney cancer (HR=1.61, 0.92–2.82, p for trend=0.009) and colorectal cancer (HR=1.36, 1.01–1.83). In females, the association was most pronounced in cervical cancer (HR=3.77, 1.94–7.32), followed by lung cancer (HR=1.63, 1.02–2.60), endometrial cancer (HR=1.42, 0.98–2.05, p for trend=0.013) and breast cancer (HR=1.19, 1.02–1.39).

Conclusions GGT is a highly promising marker for risk stratification in cancer prevention.