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Alcohol drinking and colorectal cancer risk: an overall and dose-response meta-analysis of published studies.

Abstract

BACKGROUND

The International Agency for Research on Cancer (IARC) concluded that alcohol consumption is related to colorectal cancer (CRC). However, several issues remain unresolved, including quantification of the association for light (≤1 drink/day) and moderate (2-3 drinks/day) alcohol drinking, investigation of the dose-response relationship, and potential heterogeneity of effects by sex, colorectal site, and geographical region.

METHODS

Twenty-seven cohort and 34 case-control studies presenting results for at least three categories of alcohol intake were identified from a PubMed search of articles published before May 2010. The summary relative risks (RRs) were estimated by the random effects model. Second-order fractional polynomials and random effects meta-regression models were used for modeling the dose-risk relation.

RESULTS

The RRs were 1.21 [95% confidence interval (CI) 1.13-1.28] for moderate and 1.52 (95% CI 1.27-1.81) for heavy (≥4 drinks/day) alcohol drinking. The RR for moderate drinkers, compared with non-/occasional drinkers, was stronger for men (RR = 1.24, 95% CI 1.13-1.37) than for women (RR = 1.08, 95% CI 1.03-1.13; P(heterogeneity) = 0.02). For heavy drinkers, the association was stronger in Asian studies (RR = 1.81, 95% CI 1.33-2.46; P(heterogeneity) = 0.04). The dose-risk analysis estimated RRs of 1.07 (95% CI 1.04-1.10), 1.38 (95% CI 1.28-1.50), and 1.82 (95% CI 1.41-2.35) for 10, 50, and 100 g/day of alcohol, respectively.

CONCLUSIONS

This meta-analysis provides strong evidence for an association between alcohol drinking of >1 drink/day and colorectal cancer risk.

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  • Authors+Show Affiliations

    ,

    International Agency for Research on Cancer, Lyon, France. fedirkov@fellows.iarc.fr

    , , , , , , , , , ,

    Source

    MeSH

    Alcohol Drinking
    Case-Control Studies
    Cohort Studies
    Colorectal Neoplasms
    Dose-Response Relationship, Drug
    Female
    Humans
    Male
    Risk
    Sex Factors

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    21307158

    Citation

    Fedirko, V, et al. "Alcohol Drinking and Colorectal Cancer Risk: an Overall and Dose-response Meta-analysis of Published Studies." Annals of Oncology : Official Journal of the European Society for Medical Oncology, vol. 22, no. 9, 2011, pp. 1958-72.
    Fedirko V, Tramacere I, Bagnardi V, et al. Alcohol drinking and colorectal cancer risk: an overall and dose-response meta-analysis of published studies. Ann Oncol. 2011;22(9):1958-72.
    Fedirko, V., Tramacere, I., Bagnardi, V., Rota, M., Scotti, L., Islami, F., ... Jenab, M. (2011). Alcohol drinking and colorectal cancer risk: an overall and dose-response meta-analysis of published studies. Annals of Oncology : Official Journal of the European Society for Medical Oncology, 22(9), pp. 1958-72. doi:10.1093/annonc/mdq653.
    Fedirko V, et al. Alcohol Drinking and Colorectal Cancer Risk: an Overall and Dose-response Meta-analysis of Published Studies. Ann Oncol. 2011;22(9):1958-72. PubMed PMID: 21307158.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Alcohol drinking and colorectal cancer risk: an overall and dose-response meta-analysis of published studies. AU - Fedirko,V, AU - Tramacere,I, AU - Bagnardi,V, AU - Rota,M, AU - Scotti,L, AU - Islami,F, AU - Negri,E, AU - Straif,K, AU - Romieu,I, AU - La Vecchia,C, AU - Boffetta,P, AU - Jenab,M, Y1 - 2011/02/09/ PY - 2011/2/11/entrez PY - 2011/2/11/pubmed PY - 2011/12/13/medline SP - 1958 EP - 72 JF - Annals of oncology : official journal of the European Society for Medical Oncology JO - Ann. Oncol. VL - 22 IS - 9 N2 - BACKGROUND: The International Agency for Research on Cancer (IARC) concluded that alcohol consumption is related to colorectal cancer (CRC). However, several issues remain unresolved, including quantification of the association for light (≤1 drink/day) and moderate (2-3 drinks/day) alcohol drinking, investigation of the dose-response relationship, and potential heterogeneity of effects by sex, colorectal site, and geographical region. METHODS: Twenty-seven cohort and 34 case-control studies presenting results for at least three categories of alcohol intake were identified from a PubMed search of articles published before May 2010. The summary relative risks (RRs) were estimated by the random effects model. Second-order fractional polynomials and random effects meta-regression models were used for modeling the dose-risk relation. RESULTS: The RRs were 1.21 [95% confidence interval (CI) 1.13-1.28] for moderate and 1.52 (95% CI 1.27-1.81) for heavy (≥4 drinks/day) alcohol drinking. The RR for moderate drinkers, compared with non-/occasional drinkers, was stronger for men (RR = 1.24, 95% CI 1.13-1.37) than for women (RR = 1.08, 95% CI 1.03-1.13; P(heterogeneity) = 0.02). For heavy drinkers, the association was stronger in Asian studies (RR = 1.81, 95% CI 1.33-2.46; P(heterogeneity) = 0.04). The dose-risk analysis estimated RRs of 1.07 (95% CI 1.04-1.10), 1.38 (95% CI 1.28-1.50), and 1.82 (95% CI 1.41-2.35) for 10, 50, and 100 g/day of alcohol, respectively. CONCLUSIONS: This meta-analysis provides strong evidence for an association between alcohol drinking of >1 drink/day and colorectal cancer risk. SN - 1569-8041 UR - https://www.unboundmedicine.com/medline/citation/21307158/Alcohol_drinking_and_colorectal_cancer_risk:_an_overall_and_dose_response_meta_analysis_of_published_studies_ L2 - https://academic.oup.com/annonc/article-lookup/doi/10.1093/annonc/mdq653 DB - PRIME DP - Unbound Medicine ER -