Prospective study of alcohol consumption and the risk of colorectal cancer before and after folic acid fortification in the United States

Hongmei Nan, Jung Eun Lee, Eric B. Rimm, Charles S. Fuchs, Edward L. Giovannucci, Eunyoung Cho

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: To evaluate the influence of alcohol consumption on the risk of colorectal cancer according to folic acid fortification period in the United States. Methods: We evaluated the association between alcohol consumption and colorectal cancer by fortification period (before 1998 vs. after 1998) in 2 prospective cohort studies, the Nurses' Health Study (NHS) of women and the Health Professionals Follow-up Study (HPFS) of men, in which 2793 cases of invasive colorectal cancer were documented. Results: Alcohol consumption was associated with an increased risk of colorectal cancer. Among nonusers of multivitamins and/or folic acid supplements, the pooled multivariate relative risk for ≥30g/d drinkers versus nondrinkers was 1.36 (95% confidence interval [95% CI], 1.09-1.70; P for trend, 0.02). The effect of alcohol consumption was slightly stronger in the prefolic acid fortification period (1980 NHS/1986 HPFS-1998) than in the postfortification period (1998-2008); the pooled multivariate relative risks for ≥30g/d drinkers versus nondrinkers were 1.31 (95% CI, 1.00-1.71; P for trend, 0.10) in the prefortification period and 1.07 (95% CI, 0.69-1.65; P for trend, 0.67) in the postfortification period. Conclusions: Folic acid fortification may attenuate the adverse effect of high alcohol consumption on the risk of colorectal cancer.

Original languageEnglish (US)
Pages (from-to)558-563
Number of pages6
JournalAnnals of Epidemiology
Volume23
Issue number9
DOIs
StatePublished - Sep 1 2013
Externally publishedYes

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Folic Acid
Alcohol Drinking
Colorectal Neoplasms
Prospective Studies
Confidence Intervals
Health
Nurses
Women's Health
Cohort Studies
Acids

Keywords

  • Alcohol consumption
  • Colorectal cancer
  • Folic acid fortification

ASJC Scopus subject areas

  • Epidemiology

Cite this

Prospective study of alcohol consumption and the risk of colorectal cancer before and after folic acid fortification in the United States. / Nan, Hongmei; Lee, Jung Eun; Rimm, Eric B.; Fuchs, Charles S.; Giovannucci, Edward L.; Cho, Eunyoung.

In: Annals of Epidemiology, Vol. 23, No. 9, 01.09.2013, p. 558-563.

Research output: Contribution to journalArticle

Nan, Hongmei ; Lee, Jung Eun ; Rimm, Eric B. ; Fuchs, Charles S. ; Giovannucci, Edward L. ; Cho, Eunyoung. / Prospective study of alcohol consumption and the risk of colorectal cancer before and after folic acid fortification in the United States. In: Annals of Epidemiology. 2013 ; Vol. 23, No. 9. pp. 558-563.
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N2 - Purpose: To evaluate the influence of alcohol consumption on the risk of colorectal cancer according to folic acid fortification period in the United States. Methods: We evaluated the association between alcohol consumption and colorectal cancer by fortification period (before 1998 vs. after 1998) in 2 prospective cohort studies, the Nurses' Health Study (NHS) of women and the Health Professionals Follow-up Study (HPFS) of men, in which 2793 cases of invasive colorectal cancer were documented. Results: Alcohol consumption was associated with an increased risk of colorectal cancer. Among nonusers of multivitamins and/or folic acid supplements, the pooled multivariate relative risk for ≥30g/d drinkers versus nondrinkers was 1.36 (95% confidence interval [95% CI], 1.09-1.70; P for trend, 0.02). The effect of alcohol consumption was slightly stronger in the prefolic acid fortification period (1980 NHS/1986 HPFS-1998) than in the postfortification period (1998-2008); the pooled multivariate relative risks for ≥30g/d drinkers versus nondrinkers were 1.31 (95% CI, 1.00-1.71; P for trend, 0.10) in the prefortification period and 1.07 (95% CI, 0.69-1.65; P for trend, 0.67) in the postfortification period. Conclusions: Folic acid fortification may attenuate the adverse effect of high alcohol consumption on the risk of colorectal cancer.

AB - Purpose: To evaluate the influence of alcohol consumption on the risk of colorectal cancer according to folic acid fortification period in the United States. Methods: We evaluated the association between alcohol consumption and colorectal cancer by fortification period (before 1998 vs. after 1998) in 2 prospective cohort studies, the Nurses' Health Study (NHS) of women and the Health Professionals Follow-up Study (HPFS) of men, in which 2793 cases of invasive colorectal cancer were documented. Results: Alcohol consumption was associated with an increased risk of colorectal cancer. Among nonusers of multivitamins and/or folic acid supplements, the pooled multivariate relative risk for ≥30g/d drinkers versus nondrinkers was 1.36 (95% confidence interval [95% CI], 1.09-1.70; P for trend, 0.02). The effect of alcohol consumption was slightly stronger in the prefolic acid fortification period (1980 NHS/1986 HPFS-1998) than in the postfortification period (1998-2008); the pooled multivariate relative risks for ≥30g/d drinkers versus nondrinkers were 1.31 (95% CI, 1.00-1.71; P for trend, 0.10) in the prefortification period and 1.07 (95% CI, 0.69-1.65; P for trend, 0.67) in the postfortification period. Conclusions: Folic acid fortification may attenuate the adverse effect of high alcohol consumption on the risk of colorectal cancer.

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