Alcohol intake and colorectal cancer: A pooled analysis of 8 cohort studies
Alcohol intake and colorectal cancer: A pooled analysis of 8 cohort studies
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DOI：
10.7326/0003-4819-140-8-200404200-00007
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发表时间：
2004-04-20
影响因子：
39.2
通讯作者：
Hunter, DJ
中科院分区：
文献类型：
--
作者：
Cho, EY;Smith-Warner, SA;Hunter, DJ
背景：流行病学研究普遍报道了饮酒与结直肠癌风险之间的正相关关系。然而，与特定酒精饮料或大肠不同解剖部位相关的研究结果一直不一致。目的：检查总酒精摄入量和特定饮料摄入量与结直肠癌发病率的关系，并评估其他潜在危险因素是否会改变这种联系。设计：对来自5个国家的8项队列研究的主要数据进行汇集分析。地点：北美和欧洲。参与者：489 979名女性和男性，除基线上的非黑色素瘤皮肤癌外，没有癌症病史。测量：每个研究在基线时通过有效的食物频率问卷评估酒精摄入量。结果：在整个研究中，在最长6至16年的随访期间，共记录了4687例结直肠癌病例。在分类分析中，结直肠癌风险的增加仅限于每天饮酒30克或更多(大约等于或等于每天2杯)的人，4%的女性和13%的男性报告了这一消费水平。与不饮酒者相比，饮酒量为30~45g/d者的合并多变量相对危险度为1.16(95%CI，0.99~1.36)，饮酒量为45g/d或以上者的合并多变量相对危险度为1.41(CI，1.16~1.72)。没有观察到研究或性别的显著异质性。这种关联在近端结肠癌、远端结肠癌和直肠癌中很明显。限制：这项研究只包括基线时酒精消耗量的一项测量，不能调查终生酒精消耗量、年轻时的酒精消耗量或随访期间酒精消耗量的变化。它也不能检查饮酒模式或饮酒持续时间。结论：单一的酒精摄入量测定与结直肠癌发病率的适度相对上升相关，主要是在酒精摄入量最高的水平。
Background: Epidemiologic studies have generally reported positive associations between alcohol consumption and risk for colorectal cancer. However, findings related to specific alcoholic beverages or different anatomic sites in the large bowel have been inconsistent.Objective: To examine the relationship of total alcohol intake and intake from specific beverages to the incidence of colorectal cancer and to evaluate whether other potential risk factors modify the association.Design: Pooled analysis of primary data from 8 cohort studies in 5 countries.Setting: North America and Europe.Participants: 489 979 women and men with no history of cancer other than nonmelanoma skin cancer at baseline.Measurements: Alcohol intake was assessed in each study at baseline by using a validated food-frequency questionnaire.Results: During a maximum of 6 to 16 years of follow-up across the studies, 4687 cases of colorectal cancer were documented. In categorical analyses, increased risk for colorectal cancer was limited to persons with an alcohol intake of 30 g/d or greater (approximately greater than or equal to2 drinks/d), a consumption level reported by 4% of women and 13% of men. Compared with nondrinkers, the pooled multivariate relative risks were 1.16 (95% Cl, 0.99 to 1.36) for persons who consumed 30 to less than 45 g/d and 1.41 (Cl, 1.16 to 1.72) for those who consumed 45 g/d or greater. No significant heterogeneity by study or sex was observed. The association was evident for cancer of the proximal colon, distal colon, and rectum. No clear difference in relative risks was found among specific alcoholic beverages.Limitations: The study included only one measure of alcohol consumption at baseline and could not investigate lifetime alcohol consumption, alcohol consumption at younger ages, or changes in alcohol consumption during follow-up. It also could not examine drinking patterns or duration of alcohol use.Conclusions: A single determination of alcohol intake correlated with a modest relative elevation in colorectal cancer rate, mainly at the highest levels of alcohol intake.