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Answer 3
  1. Alcohol consumption. Although historically thought to predispose to gastric adenocarcinoma, multiple recent trials have not found alcohol to be an independent risk factor for the development of this disease.1-3 All of the other options have been associated with the development of gastric adenocarcinoma. Helicobacter pylori has been classified as a World Health Organization class I carcinogen due to its association with the development of gastric adenocarcinoma.

    1. Chow W, Swanson C, Lissowska J, et al. Risk of stomach cancer in relation to consumption of cigarettes, alcohol, tea and coffee in Warsaw, Poland. Int J Cancer 1999;81:871-6.

    2. Ye W, Elkstrom A, Hansson L, et al. Tobacco, alcohol and the risk of gastric cancer by sub-site and histologic type. Int J Cancer 1999;83:223-9.

    3. Lagergren J, Bergstrom R, Lindgren A, Nyren O. The role of tobacco, snuff and alcohol use in aetiology of cancer of the oesophagus and gastric cardia. Int J Cancer 2000;85:340-6.

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