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Meta‐analysis of 16 studies of the association of alcohol with colorectal cancer
Author(s) -
McNabb Sarah,
Harrison Tabitha A.,
Albanes Demetrius,
Berndt Sonja I.,
Brenner Hermann,
Caan Bette J.,
Campbell Peter T.,
Cao Yin,
ChangClaude Jenny,
Chan Andrew,
Chen Zhengyi,
English Dallas R.,
Giles Graham G.,
Giovannucci Edward L.,
Goodman Phyllis J.,
Hayes Richard B.,
Hoffmeister Michael,
Jacobs Eric J.,
Joshi Amit D.,
Larsson Susanna C.,
Le Marchand Loïc,
Li Li,
Lin Yi,
Männistö Satu,
Milne Roger L.,
Nan Hongmei,
Newton Christina C.,
Ogino Shuji,
Parfrey Patrick S.,
Petersen Paneen S.,
Potter John D.,
Schoen Robert E.,
Slattery Martha L.,
Su YuRu,
Tangen Catherine M.,
Tucker Thomas C.,
Weinstein Stephanie J.,
White Emily,
Wolk Alicja,
Woods Michael O.,
Phipps Amanda I.,
Peters Ulrike
Publication year - 2019
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.32377
Subject(s) - medicine , odds ratio , colorectal cancer , confidence interval , case control study , logistic regression , alcohol , alcohol consumption , risk factor , meta analysis , environmental health , demography , cancer , oncology , biology , sociology , biochemistry
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.