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

Sarah McNabb, Tabitha A. Harrison, Demetrius Albanes, Sonja I. Berndt, Hermann Brenner, Bette J. Caan, Peter T. Campbell, Yin Cao, Jenny Chang-Claude, Andrew Chan, Zhengyi Chen, Dallas R. English, Graham G. Giles, Edward L. Giovannucci, Phyllis J. Goodman, Richard B. Hayes, Michael Hoffmeister, Eric J. Jacobs, Amit D. Joshi, Susanna C. LarssonLoïc Le Marchand, Li Li, Yi Lin, Satu Männistö, Roger L. Milne, Hongmei Nan, Christina C. Newton, Shuji Ogino, Patrick S. Parfrey, Paneen S. Petersen, John D. Potter, Robert E. Schoen, Martha L. Slattery, Yu Ru Su, Catherine M. Tangen, Thomas C. Tucker, Stephanie J. Weinstein, Emily White, Alicja Wolk, Michael O. Woods, Amanda I. Phipps, Ulrike Peters

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish (US)
JournalInternational Journal of Cancer
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Meta-Analysis
Colorectal Neoplasms
Alcohols
Alcohol Drinking
Odds Ratio
Drinking
Confidence Intervals
Logistic Models
Neoplasms
Case-Control Studies
Life Style
Light

Keywords

  • alcohol
  • colon cancer
  • colorectal cancer
  • rectal cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

McNabb, S., Harrison, T. A., Albanes, D., Berndt, S. I., Brenner, H., Caan, B. J., ... Peters, U. (2019). Meta-analysis of 16 studies of the association of alcohol with colorectal cancer. International Journal of Cancer. https://doi.org/10.1002/ijc.32377

Meta-analysis of 16 studies of the association of alcohol with colorectal cancer. / McNabb, Sarah; Harrison, Tabitha A.; Albanes, Demetrius; Berndt, Sonja I.; Brenner, Hermann; Caan, Bette J.; Campbell, Peter T.; Cao, Yin; Chang-Claude, 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, Yu Ru; Tangen, Catherine M.; Tucker, Thomas C.; Weinstein, Stephanie J.; White, Emily; Wolk, Alicja; Woods, Michael O.; Phipps, Amanda I.; Peters, Ulrike.

In: International Journal of Cancer, 01.01.2019.

Research output: Contribution to journalArticle

McNabb, S, Harrison, TA, Albanes, D, Berndt, SI, Brenner, H, Caan, BJ, Campbell, PT, Cao, Y, Chang-Claude, J, Chan, A, Chen, Z, English, DR, Giles, GG, Giovannucci, EL, Goodman, PJ, Hayes, RB, Hoffmeister, M, Jacobs, EJ, Joshi, AD, Larsson, SC, Le Marchand, L, Li, L, Lin, Y, Männistö, S, Milne, RL, Nan, H, Newton, CC, Ogino, S, Parfrey, PS, Petersen, PS, Potter, JD, Schoen, RE, Slattery, ML, Su, YR, Tangen, CM, Tucker, TC, Weinstein, SJ, White, E, Wolk, A, Woods, MO, Phipps, AI & Peters, U 2019, 'Meta-analysis of 16 studies of the association of alcohol with colorectal cancer', International Journal of Cancer. https://doi.org/10.1002/ijc.32377
McNabb, Sarah ; Harrison, Tabitha A. ; Albanes, Demetrius ; Berndt, Sonja I. ; Brenner, Hermann ; Caan, Bette J. ; Campbell, Peter T. ; Cao, Yin ; Chang-Claude, 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, Yu Ru ; Tangen, Catherine M. ; Tucker, Thomas C. ; Weinstein, Stephanie J. ; White, Emily ; Wolk, Alicja ; Woods, Michael O. ; Phipps, Amanda I. ; Peters, Ulrike. / Meta-analysis of 16 studies of the association of alcohol with colorectal cancer. In: International Journal of Cancer. 2019.
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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.",
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author = "Sarah McNabb and Harrison, {Tabitha A.} and Demetrius Albanes and Berndt, {Sonja I.} and Hermann Brenner and Caan, {Bette J.} and Campbell, {Peter T.} and Yin Cao and Jenny Chang-Claude and Andrew Chan and Zhengyi Chen and English, {Dallas R.} and Giles, {Graham G.} and Giovannucci, {Edward L.} and Goodman, {Phyllis J.} and Hayes, {Richard B.} and Michael Hoffmeister and Jacobs, {Eric J.} and Joshi, {Amit D.} and Larsson, {Susanna C.} and {Le Marchand}, Lo{\"i}c and Li Li and Yi Lin and Satu M{\"a}nnist{\"o} and Milne, {Roger L.} and Hongmei Nan and Newton, {Christina C.} and Shuji Ogino and Parfrey, {Patrick S.} and Petersen, {Paneen S.} and Potter, {John D.} and Schoen, {Robert E.} and Slattery, {Martha L.} and Su, {Yu Ru} and Tangen, {Catherine M.} and Tucker, {Thomas C.} and Weinstein, {Stephanie J.} and Emily White and Alicja Wolk and Woods, {Michael O.} and Phipps, {Amanda I.} and Ulrike Peters",
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AU - Caan, Bette J.

AU - Campbell, Peter T.

AU - Cao, Yin

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AU - Chan, Andrew

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AU - Giles, Graham G.

AU - Giovannucci, Edward L.

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AU - Hayes, Richard B.

AU - Hoffmeister, Michael

AU - Jacobs, Eric J.

AU - Joshi, Amit D.

AU - Larsson, Susanna C.

AU - Le Marchand, Loïc

AU - Li, Li

AU - Lin, Yi

AU - Männistö, Satu

AU - Milne, Roger L.

AU - Nan, Hongmei

AU - Newton, Christina C.

AU - Ogino, Shuji

AU - Parfrey, Patrick S.

AU - Petersen, Paneen S.

AU - Potter, John D.

AU - Schoen, Robert E.

AU - Slattery, Martha L.

AU - Su, Yu Ru

AU - Tangen, Catherine M.

AU - Tucker, Thomas C.

AU - Weinstein, Stephanie J.

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AU - Woods, Michael O.

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AU - Peters, Ulrike

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KW - colorectal cancer

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