Prediagnostic alcohol consumption and colorectal cancer survival: The Colon Cancer Family Registry.
Prediagnostic alcohol consumption and colorectal cancer survival: The Colon Cancer Family Registry.
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DOI：
10.1002/cncr.30446
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发表时间：
2017-05-15
期刊：
影响因子：
6.2
通讯作者：
Newcomb PA
中科院分区：
文献类型：
--
作者：
Phipps AI;Robinson JR;Campbell PT;Win AK;Figueiredo JC;Lindor NM;Newcomb PA
尽管先前的研究已注意到，与不饮酒者相比，中度至重度饮酒者患结直肠癌（CRC）的风险增加，但饮酒与CRC患者生存率之间的关系仍不明确。
1997年至2007年间确诊的浸润性CRC病例是通过结肠癌家族登记处四个研究地点的以人群为基础的癌症登记系统确定的。研究参与者在基线时完成了一份关于诊断前行为的危险因素调查问卷，包括葡萄酒、啤酒和烈性酒的饮用情况。对4966例CRC病例进行了前瞻性生存随访。利用考克斯回归分析，我们就总体生存率和疾病特异性生存率，将不饮酒者与在CRC确诊前平均每天饮用≥1份酒精饮品的个体进行了比较。还按饮品类型进行了单独分析，并根据患者和肿瘤特征进行了分层分析。所有模型都根据确诊年龄、性别、研究地点、确诊年份、吸烟史、体重指数和教育程度进行了调整。
诊断前饮用啤酒和烈性酒与CRC生存率无关；然而，较高的葡萄酒饮用量总体上与较好的预后有一定关联[疾病特异性风险比（HR）=0.70，95%置信区间（CI）：0.48 - 1.03；总体HR = 0.70，95% CI：0.53 - 0.94]。在分层分析中也发现了类似的模式。
这些研究结果表明，诊断前饮用葡萄酒与CRC确诊后的较好生存率有一定关联。
Although previous studies have noted an increased risk of colorectal cancer (CRC) among moderate to heavy alcohol consumers relative to non-drinkers, the relationship between alcohol consumption and CRC survival remains unclear. Cases of incident invasive CRC diagnosed between 1997-2007 were identified via population-based cancer registries at four study sites in the Colon Cancer Family Registry. Study participants completed a risk factor questionnaire on pre-diagnostic behaviors, including wine, beer, and liquor consumption, at baseline. Prospective follow-up for survival was conducted for 4966 CRC cases. Using Cox regression, we compared non-drinkers to individuals who consumed, on average, ≥1 serving/day of alcohol in the years preceding CRC diagnosis with respect to overall and disease-specific survival. Separate analyses by beverage type, and stratified by patient and tumor attributes, were also performed. All models were adjusted for age at diagnosis, sex, study site, year of diagnosis, smoking history, body mass index, and education. Pre-diagnostic beer and liquor consumption were not associated with CRC survival; however, higher levels of wine consumption were modestly associated with better prognosis overall [hazard ratio (HR)CRC-specific=0.70, 95% confidence interval (CI): 0.48-1.03 and HRoverall=0.70, 95% CI: 0.53-0.94). Similar patterns were noted in stratified analyses. These findings suggest that pre-diagnostic wine consumption is modestly associated with more favorable survival after CRC.