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THE RENAUD SOCIETY MEMBER BULLETIN BOARD
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| Subject: RE: Journal Watch: Alcohol & Health |
Author: R. Curtis Ellison, MD
Date: 11/23/2008 7:30 am MST
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Review of Recent Publication November 22, 2008
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Article: Bongaerts BWC, van den Brandt PA, Goldbohm RA, de Goeij AFPM, Weijenberg MP. Alcohol consumption, type of alcoholic beverage and risk of colorectal cancer at specific subsites. Int J Cancer 2008;123:2411–2417.
Summary: The authors state that within the Netherlands Cohort Study on diet and cancer, they investigated associations between total alcohol consumption, specific alcoholic beverage consumption and risk of colorectal cancer (CRC) according to anatomical subsite. Hazard Ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models. Analyses were performed on 2,323 CRC cases, available after 13.3 years of follow up.
Results indicated that, compared to abstaining, alcohol consumption of ≥30.0 g/day (~ 3 alcoholic drinks) was positively associated with the risk of CRC (HR: 1.32, 95% CI: 1.06–1.65). Analyses restricted to subjects who reported to have consumed equal amounts of alcohol 5 years before baseline compared to baseline, showed elevated risk estimates for consumers of ≥30.0 g of total alcohol per day as well (HR: 1.53, 95% CI: 1.16–2.01). Suggestive of a subsite-specific effect, cancer risk seemed to increase from proximal colon through rectum; HR: 1.29, 95% CI: 0.85–1.96 for proximal colon cancer, HR: 1.41, 95% CI: 0.94–2.11 for distal colon cancer, HR: 2.07, 95% CI: 1.03–4.18 for rectosigmoid cancer and HR: 1.69, 95% CI: 1.08–2.64 for rectal cancer. No associations were observed between consumption of alcoholic beverages and CRC risk when compared with the nondrinkers of the specific beverage and after adjustment for total alcohol intake. No evidence was found for sex-specific effects of alcohol and alcoholic beverages. The authors conclude that their data showed a positive association between alcohol consumption and risk of CRC, which seemed to be mainly explained by the alcoholic content of alcoholic beverages, rather than other constituents. Also, cancer risk may vary according to anatomical subsite.
Comments: While many studies have suggested a slight increase in the risk of colorectal cancer to be associated with heavier alcohol intake, few studies are large enough to evaluate the dose-response effect or test for beverage-specific effects. This large prospective study identified 1,573 cases of colorectal cancer. The key findings were a slight increase in risk for consumers of 30 or more grams/day of alcohol, about 2 1/2 typical US drinks, but no effect of smaller amounts. When adjusting for total alcohol intake, there were no differences from the type of beverage consumed: beer, wine, or spirits. There was a tendency for the increase in risk to be greater for rectosigmoid and rectal cancers than for those in the proximal colon.
The association with cancer occurring over an average follow up of 13 years was calculated from baseline alcohol intake, as no subsequent information on drinking was obtained from these subjects. Further, no information was available on the pattern of drinking (regular or binge) or on other potential risk factors such as folate intake, which in many studies mediates the effect of alcohol on cancer. Still, this study has confirmed a number of earlier studies showing that heavier drinking may increase the risk of colorectal cancer.
Lay Summary: This large prospective study in the Netherlands followed up a large number of subjects and identified more than 1,500 who developed colorectal cancer. Consistent with some previous epidemiologic studies, their analyses show that consumers of more than about 2 1/2 drinks per day at baseline were at about 30% or more increased risk of cancer than were abstainers. Subjects consuming less than this amount had no increase in risk.
R. Curtis Ellison, MD Yuqing Zhang, MD, DSc Institute on Lifestyle & Health Boston University School of Medicine
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R. Curtis Ellison, MD |
11/23/2008 7:29 am MST |
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RE: Journal Watch: Alcohol & Health |
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R. Curtis Ellison, MD |
11/23/2008 7:30 am MST |
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R. Curtis Ellison, MD |
11/23/2008 7:32 am MST |
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R. Curtis Ellison, MD |
12/12/2008 4:07 pm MST |
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R. Curtis Ellison, MD |
1/11/2009 7:27 am MST |
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R. Curtis Ellison, MD |
1/11/2009 7:13 am MST |
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