Meta-analysis of 16 studies of the association of alcohol with colorectal cancer.

Int J Cancer
Authors
Keywords
Abstract

Alcohol consumption is an established risk factor for colorectal cancer (CRC). However, while studies have consistently reported elevated risk of CRC among heavy drinkers, associations at moderate levels of alcohol consumption are less clear. We conducted a combined analysis of 16 studies of CRC to examine the shape of the alcohol-CRC association, investigate potential effect modifiers of the association, and examine differential effects of alcohol consumption by cancer anatomic site and stage. We collected information on alcohol consumption for 14,276 CRC cases and 15,802 controls from 5 case-control and 11 nested case-control studies of CRC. We compared adjusted logistic regression models with linear and restricted cubic splines to select a model that best fit the association between alcohol consumption and CRC. Study-specific results were pooled using fixed-effects meta-analysis. Compared to non-/occasional drinking (≤1 g/day), light/moderate drinking (up to 2 drinks/day) was associated with a decreased risk of CRC (odds ratio [OR]: 0.92, 95% confidence interval [CI]: 0.88-0.98, p = 0.005), heavy drinking (2-3 drinks/day) was not significantly associated with CRC risk (OR: 1.11, 95% CI: 0.99-1.24, p = 0.08) and very heavy drinking (more than 3 drinks/day) was associated with a significant increased risk (OR: 1.25, 95% CI: 1.11-1.40, p 0.001). We observed no evidence of interactions with lifestyle risk factors or of differences by cancer site or stage. These results provide further evidence that there is a J-shaped association between alcohol consumption and CRC risk. This overall pattern was not significantly modified by other CRC risk factors and there was no effect heterogeneity by tumor site or stage.

Year of Publication
2020
Journal
Int J Cancer
Volume
146
Issue
3
Pages
861-873
Date Published
2020 02 01
ISSN
1097-0215
DOI
10.1002/ijc.32377
PubMed ID
31037736
PubMed Central ID
PMC6819207
Links
Grant list
P50 CA127003 / NH / NIH HHS / United States
R01 CA60987 / NH / NIH HHS / United States
RFA # CA-09-002 U19 CA148107 / CA / NCI NIH HHS / United States
K07 CA190673 / NH / NIH HHS / United States
HHSN268201100002I / HL / NHLBI NIH HHS / United States
R01 CA059045 / CA / NCI NIH HHS / United States
P01 CA087969 / NH / NIH HHS / United States
HHSN268201100004I / HL / NHLBI NIH HHS / United States
R35 CA197735 / CA / NCI NIH HHS / United States
HHSN271201100004C / HL / NHLBI NIH HHS / United States
5UM1CA182883 / CA / NCI NIH HHS / United States
CRT 43821 / CIHR / Canada
R35 CA197735 / NH / NIH HHS / United States
U10 CA037429 / CA / NCI NIH HHS / United States
U01 CA182883 / CA / NCI NIH HHS / United States
P01 CA087969 / CA / NCI NIH HHS / United States
K05 CA154337 / CA / NCI NIH HHS / United States
P01 CA055075 / NH / NIH HHS / United States
R01 CA206279 / CA / NCI NIH HHS / United States
P01 CA055075 / CA / NCI NIH HHS / United States
UM1 CA186107 / NH / NIH HHS / United States
UG1 CA189974 / CA / NCI NIH HHS / United States
R01 CA151993 / CA / NCI NIH HHS / United States
HHSN268201100046C / HL / NHLBI NIH HHS / United States
U01 CA167552 / CA / NCI NIH HHS / United States
R01 CA048998 / CA / NCI NIH HHS / United States
U01 CA137088 / CA / NCI NIH HHS / United States
HHSN268201100003C / WH / WHI NIH HHS / United States
U01 CA164930 / CA / NCI NIH HHS / United States
R01 CA48998 / NH / NIH HHS / United States
R01 CA137178 / CA / NCI NIH HHS / United States
U01 CA167552 / NH / NIH HHS / United States
HHSN268201100003C / HL / NHLBI NIH HHS / United States
HHSN271201100004C / AG / NIA NIH HHS / United States
R01CA136726 / CA / NCI NIH HHS / United States
R01 CA201407 / CA / NCI NIH HHS / United States
HHSN268201100001C / HL / NHLBI NIH HHS / United States
UM1 CA186107 / CA / NCI NIH HHS / United States
R01 CA151993 / NH / NIH HHS / United States
HHSN268201100002C / WH / WHI NIH HHS / United States
HHSN268201100004C / HL / NHLBI NIH HHS / United States
U10CA37429 / CA / NCI NIH HHS / United States
UM1 CA167552 / NH / NIH HHS / United States
R01 CA060987 / CA / NCI NIH HHS / United States
R01 CA136726 / CA / NCI NIH HHS / United States
R01 CA137178 / NH / NIH HHS / United States
UM1 CA167552 / CA / NCI NIH HHS / United States
HHSN261201500005C / CA / NCI NIH HHS / United States
U01 CA074783 / CA / NCI NIH HHS / United States
R01 CA120582 / CA / NCI NIH HHS / United States
HHSN268201100001I / HL / NHLBI NIH HHS / United States
HHSN268201100002C / HL / NHLBI NIH HHS / United States
P50 CA127003 / CA / NCI NIH HHS / United States
UM1 CA182883 / CA / NCI NIH HHS / United States
U01 CA164973 / NH / NIH HHS / United States
K07 CA190673 / CA / NCI NIH HHS / United States
U01 CA74783 / NH / NIH HHS / United States
U01 CA164973 / CA / NCI NIH HHS / United States
HHSN268201100001C / WH / WHI NIH HHS / United States
HHSN268201100004C / WH / WHI NIH HHS / United States
U19 CA148107 / CA / NCI NIH HHS / United States