Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study.
Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study.
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DOI：
10.1136/bmj.d1584
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发表时间：
2011-04-07
期刊：
影响因子：
--
通讯作者：
Bergmann MM
中科院分区：
文献类型：
--
作者：
Schütze M;Boeing H;Pischon T;Rehm J;Kehoe T;Gmel G;Olsen A;Tjønneland AM;Dahm CC;Overvad K;Clavel-Chapelon F;Boutron-Ruault MC;Trichopoulou A;Benetou V;Zylis D;Kaaks R;Rohrmann S;Palli D;Berrino F;Tumino R;Vineis P;Rodríguez L;Agudo A;Sánchez MJ;Dorronsoro M;Chirlaque MD;Barricarte A;Peeters PH;van Gils CH;Khaw KT;Wareham N;Allen NE;Key TJ;Boffetta P;Slimani N;Jenab M;Romaguera D;Wark PA;Riboli E;Bergmann MM
目的 根据队列研究的直接相对风险估计，计算八个欧洲国家当前和以前饮酒造成的癌症负担。设计 将前瞻性队列研究与基于代表性人群的酒精暴露数据相结合。设置 八个国家（法国、意大利、西班牙、英国、荷兰、希腊、德国、丹麦）参与欧洲癌症与营养前瞻性调查 (EPIC) 研究。参与者男性109 118人，女性254 870人，主要年龄在37-70岁。主要结果衡量危险率比率，表示 EPIC 参与者之前和当前饮酒的癌症发病率的相对风险。危险率与饮酒的代表性信息相结合，按国家和性别计算因果相关癌症的酒精归因分数。饮酒量高于建议上限（酒精含量约为 24 克的男性每天喝两杯，酒精含量约为 12 克的女性每天喝一杯）的部分酒精归因分数以及估计的年度酒精归因癌症病例总数。结果 如果我们假设因果关系，在男性和女性中，在选定的欧洲国家中，10%（95% 置信区间 7 至 13%）和 3%（1 至 5%）的总癌症发病率可归因于以前和当前的饮酒情况。对于选定的癌症，男性和女性上呼吸消化道的发病率分别为 44%（31 至 56%）和 25%（5 至 46%），肝癌为 33%（11 至 54%）和 18%（-3 至 38%），结直肠癌为 17%（10 至 25%）和 4%（-1 至 10%），以及 5.0% （2%至8%）女性乳腺癌。 2008年，大部分酒精归因与饮酒量高于建议上限有关：178 578例酒精相关癌症病例中，男性有33 037例；女性397 043例酒精相关癌症病例中，有17 470例。结论 在西欧，很大一部分癌症病例可归因于饮酒，尤其是饮酒量高于建议上限。这些数据支持当前减少或戒酒以降低癌症发病率的政治努力。
Objective To compute the burden of cancer attributable to current and former alcohol consumption in eight European countries based on direct relative risk estimates from a cohort study. Design Combination of prospective cohort study with representative population based data on alcohol exposure. Setting Eight countries (France, Italy, Spain, United Kingdom, the Netherlands, Greece, Germany, Denmark) participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Participants 109 118 men and 254 870 women, mainly aged 37-70. Main outcome measures Hazard rate ratios expressing the relative risk of cancer incidence for former and current alcohol consumption among EPIC participants. Hazard rate ratios combined with representative information on alcohol consumption to calculate alcohol attributable fractions of causally related cancers by country and sex. Partial alcohol attributable fractions for consumption higher than the recommended upper limit (two drinks a day for men with about 24 g alcohol, one for women with about 12 g alcohol) and the estimated total annual number of cases of alcohol attributable cancer. Results If we assume causality, among men and women, 10% (95% confidence interval 7 to 13%) and 3% (1 to 5%) of the incidence of total cancer was attributable to former and current alcohol consumption in the selected European countries. For selected cancers the figures were 44% (31 to 56%) and 25% (5 to 46%) for upper aerodigestive tract, 33% (11 to 54%) and 18% (−3 to 38%) for liver, 17% (10 to 25%) and 4% (−1 to 10%) for colorectal cancer for men and women, respectively, and 5.0% (2 to 8%) for female breast cancer. A substantial part of the alcohol attributable fraction in 2008 was associated with alcohol consumption higher than the recommended upper limit: 33 037 of 178 578 alcohol related cancer cases in men and 17 470 of 397 043 alcohol related cases in women. Conclusions In western Europe, an important proportion of cases of cancer can be attributable to alcohol consumption, especially consumption higher than the recommended upper limits. These data support current political efforts to reduce or to abstain from alcohol consumption to reduce the incidence of cancer.
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50.5
作者：
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通讯作者：
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