Alcohol Intake and Colorectal Cancer

A Pooled Analysis of 8 Cohort Studies

Eunyoung Cho, Stephanie A. Smith-Warner, John Ritz, Piet A. Van Den Brandt, Graham A. Colditz, Aaron R. Folsom, Jo L. Freudenheim, Edward Giovannucci, R. Alexandra Goldbohm, Saxon Graham, Lars Holmberg, Dong Hyun Kim, Nea Malila, Anthony B. Miller, Pirjo Pietinen, Thomas E. Rohan, Thomas A. Sellers, Frank E. Speizer, Walter C. Willett, Alicja Wolk & 1 others David J. Hunter

Research output: Contribution to journalArticle

345 Citations (Scopus)

Abstract

Background: Epidemiologic studies have generally reported positive associations between alcohol consumption and risk for colorectal cancer. However, findings related to specific alcoholic beverages or different anatomic sites in the large bowel have been inconsistent. Objective: To examine the relationship of total alcohol intake and intake from specific beverages to the incidence of colorectal cancer and to evaluate whether other potential risk factors modify the association. Design: Pooled analysis of primary data from 8 cohort studies in 5 countries. Setting: North America and Europe. Participants: 489 979 women and men with no history of cancer other than nonmelanoma skin cancer at baseline. Measurements: Alcohol intake was assessed in each study at baseline by using a validated food-frequency questionnaire. Results: During a maximum of 6 to 16 years of follow-up across the studies, 4687 cases of colorectal cancer were documented. In categorical analyses, increased risk for colorectal cancer was limited to persons with an alcohol intake of 30 g/d or greater (approximately ≥2 drinks/d), a consumption level reported by 4% of women and 13% of men. Compared with nondrinkers, the pooled multivariate relative risks were 1.16 (95% CI, 0.99 to 1.36) for persons who consumed 30 to less than 45 g/d and 1.41 (CI, 1.16 to 1.72) for those who consumed 45 g/d or greater. No significant heterogeneity by study or sex was observed. The association was evident for cancer of the proximal colon, distal colon, and rectum. No clear difference in relative risks was found among specific alcoholic beverages. Limitations: The study included only one measure of alcohol consumption at baseline and could not investigate lifetime alcohol consumption, alcohol consumption at younger ages, or changes in alcohol consumption during follow-up. It also could not examine drinking patterns or duration of alcohol use. Conclusions: A single determination of alcohol intake correlated with a modest relative elevation in colorectal cancer rate, mainly at the highest levels of alcohol intake.

Original languageEnglish (US)
JournalAnnals of Internal Medicine
Volume140
Issue number8
StatePublished - Apr 20 2004
Externally publishedYes

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Colorectal Neoplasms
Cohort Studies
Alcohol Drinking
Alcohols
Alcoholic Beverages
Beverages
Skin Neoplasms
North America
Rectum
Colonic Neoplasms
Drinking
Epidemiologic Studies
Colon
Food
Incidence
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Cho, E., Smith-Warner, S. A., Ritz, J., Van Den Brandt, P. A., Colditz, G. A., Folsom, A. R., ... Hunter, D. J. (2004). Alcohol Intake and Colorectal Cancer: A Pooled Analysis of 8 Cohort Studies. Annals of Internal Medicine, 140(8).

Alcohol Intake and Colorectal Cancer : A Pooled Analysis of 8 Cohort Studies. / Cho, Eunyoung; Smith-Warner, Stephanie A.; Ritz, John; Van Den Brandt, Piet A.; Colditz, Graham A.; Folsom, Aaron R.; Freudenheim, Jo L.; Giovannucci, Edward; Goldbohm, R. Alexandra; Graham, Saxon; Holmberg, Lars; Kim, Dong Hyun; Malila, Nea; Miller, Anthony B.; Pietinen, Pirjo; Rohan, Thomas E.; Sellers, Thomas A.; Speizer, Frank E.; Willett, Walter C.; Wolk, Alicja; Hunter, David J.

In: Annals of Internal Medicine, Vol. 140, No. 8, 20.04.2004.

Research output: Contribution to journalArticle

Cho, E, Smith-Warner, SA, Ritz, J, Van Den Brandt, PA, Colditz, GA, Folsom, AR, Freudenheim, JL, Giovannucci, E, Goldbohm, RA, Graham, S, Holmberg, L, Kim, DH, Malila, N, Miller, AB, Pietinen, P, Rohan, TE, Sellers, TA, Speizer, FE, Willett, WC, Wolk, A & Hunter, DJ 2004, 'Alcohol Intake and Colorectal Cancer: A Pooled Analysis of 8 Cohort Studies', Annals of Internal Medicine, vol. 140, no. 8.
Cho E, Smith-Warner SA, Ritz J, Van Den Brandt PA, Colditz GA, Folsom AR et al. Alcohol Intake and Colorectal Cancer: A Pooled Analysis of 8 Cohort Studies. Annals of Internal Medicine. 2004 Apr 20;140(8).
Cho, Eunyoung ; Smith-Warner, Stephanie A. ; Ritz, John ; Van Den Brandt, Piet A. ; Colditz, Graham A. ; Folsom, Aaron R. ; Freudenheim, Jo L. ; Giovannucci, Edward ; Goldbohm, R. Alexandra ; Graham, Saxon ; Holmberg, Lars ; Kim, Dong Hyun ; Malila, Nea ; Miller, Anthony B. ; Pietinen, Pirjo ; Rohan, Thomas E. ; Sellers, Thomas A. ; Speizer, Frank E. ; Willett, Walter C. ; Wolk, Alicja ; Hunter, David J. / Alcohol Intake and Colorectal Cancer : A Pooled Analysis of 8 Cohort Studies. In: Annals of Internal Medicine. 2004 ; Vol. 140, No. 8.
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title = "Alcohol Intake and Colorectal Cancer: A Pooled Analysis of 8 Cohort Studies",
abstract = "Background: Epidemiologic studies have generally reported positive associations between alcohol consumption and risk for colorectal cancer. However, findings related to specific alcoholic beverages or different anatomic sites in the large bowel have been inconsistent. Objective: To examine the relationship of total alcohol intake and intake from specific beverages to the incidence of colorectal cancer and to evaluate whether other potential risk factors modify the association. Design: Pooled analysis of primary data from 8 cohort studies in 5 countries. Setting: North America and Europe. Participants: 489 979 women and men with no history of cancer other than nonmelanoma skin cancer at baseline. Measurements: Alcohol intake was assessed in each study at baseline by using a validated food-frequency questionnaire. Results: During a maximum of 6 to 16 years of follow-up across the studies, 4687 cases of colorectal cancer were documented. In categorical analyses, increased risk for colorectal cancer was limited to persons with an alcohol intake of 30 g/d or greater (approximately ≥2 drinks/d), a consumption level reported by 4{\%} of women and 13{\%} of men. Compared with nondrinkers, the pooled multivariate relative risks were 1.16 (95{\%} CI, 0.99 to 1.36) for persons who consumed 30 to less than 45 g/d and 1.41 (CI, 1.16 to 1.72) for those who consumed 45 g/d or greater. No significant heterogeneity by study or sex was observed. The association was evident for cancer of the proximal colon, distal colon, and rectum. No clear difference in relative risks was found among specific alcoholic beverages. Limitations: The study included only one measure of alcohol consumption at baseline and could not investigate lifetime alcohol consumption, alcohol consumption at younger ages, or changes in alcohol consumption during follow-up. It also could not examine drinking patterns or duration of alcohol use. Conclusions: A single determination of alcohol intake correlated with a modest relative elevation in colorectal cancer rate, mainly at the highest levels of alcohol intake.",
author = "Eunyoung Cho and Smith-Warner, {Stephanie A.} and John Ritz and {Van Den Brandt}, {Piet A.} and Colditz, {Graham A.} and Folsom, {Aaron R.} and Freudenheim, {Jo L.} and Edward Giovannucci and Goldbohm, {R. Alexandra} and Saxon Graham and Lars Holmberg and Kim, {Dong Hyun} and Nea Malila and Miller, {Anthony B.} and Pirjo Pietinen and Rohan, {Thomas E.} and Sellers, {Thomas A.} and Speizer, {Frank E.} and Willett, {Walter C.} and Alicja Wolk and Hunter, {David J.}",
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T1 - Alcohol Intake and Colorectal Cancer

T2 - A Pooled Analysis of 8 Cohort Studies

AU - Cho, Eunyoung

AU - Smith-Warner, Stephanie A.

AU - Ritz, John

AU - Van Den Brandt, Piet A.

AU - Colditz, Graham A.

AU - Folsom, Aaron R.

AU - Freudenheim, Jo L.

AU - Giovannucci, Edward

AU - Goldbohm, R. Alexandra

AU - Graham, Saxon

AU - Holmberg, Lars

AU - Kim, Dong Hyun

AU - Malila, Nea

AU - Miller, Anthony B.

AU - Pietinen, Pirjo

AU - Rohan, Thomas E.

AU - Sellers, Thomas A.

AU - Speizer, Frank E.

AU - Willett, Walter C.

AU - Wolk, Alicja

AU - Hunter, David J.

PY - 2004/4/20

Y1 - 2004/4/20

N2 - Background: Epidemiologic studies have generally reported positive associations between alcohol consumption and risk for colorectal cancer. However, findings related to specific alcoholic beverages or different anatomic sites in the large bowel have been inconsistent. Objective: To examine the relationship of total alcohol intake and intake from specific beverages to the incidence of colorectal cancer and to evaluate whether other potential risk factors modify the association. Design: Pooled analysis of primary data from 8 cohort studies in 5 countries. Setting: North America and Europe. Participants: 489 979 women and men with no history of cancer other than nonmelanoma skin cancer at baseline. Measurements: Alcohol intake was assessed in each study at baseline by using a validated food-frequency questionnaire. Results: During a maximum of 6 to 16 years of follow-up across the studies, 4687 cases of colorectal cancer were documented. In categorical analyses, increased risk for colorectal cancer was limited to persons with an alcohol intake of 30 g/d or greater (approximately ≥2 drinks/d), a consumption level reported by 4% of women and 13% of men. Compared with nondrinkers, the pooled multivariate relative risks were 1.16 (95% CI, 0.99 to 1.36) for persons who consumed 30 to less than 45 g/d and 1.41 (CI, 1.16 to 1.72) for those who consumed 45 g/d or greater. No significant heterogeneity by study or sex was observed. The association was evident for cancer of the proximal colon, distal colon, and rectum. No clear difference in relative risks was found among specific alcoholic beverages. Limitations: The study included only one measure of alcohol consumption at baseline and could not investigate lifetime alcohol consumption, alcohol consumption at younger ages, or changes in alcohol consumption during follow-up. It also could not examine drinking patterns or duration of alcohol use. Conclusions: A single determination of alcohol intake correlated with a modest relative elevation in colorectal cancer rate, mainly at the highest levels of alcohol intake.

AB - Background: Epidemiologic studies have generally reported positive associations between alcohol consumption and risk for colorectal cancer. However, findings related to specific alcoholic beverages or different anatomic sites in the large bowel have been inconsistent. Objective: To examine the relationship of total alcohol intake and intake from specific beverages to the incidence of colorectal cancer and to evaluate whether other potential risk factors modify the association. Design: Pooled analysis of primary data from 8 cohort studies in 5 countries. Setting: North America and Europe. Participants: 489 979 women and men with no history of cancer other than nonmelanoma skin cancer at baseline. Measurements: Alcohol intake was assessed in each study at baseline by using a validated food-frequency questionnaire. Results: During a maximum of 6 to 16 years of follow-up across the studies, 4687 cases of colorectal cancer were documented. In categorical analyses, increased risk for colorectal cancer was limited to persons with an alcohol intake of 30 g/d or greater (approximately ≥2 drinks/d), a consumption level reported by 4% of women and 13% of men. Compared with nondrinkers, the pooled multivariate relative risks were 1.16 (95% CI, 0.99 to 1.36) for persons who consumed 30 to less than 45 g/d and 1.41 (CI, 1.16 to 1.72) for those who consumed 45 g/d or greater. No significant heterogeneity by study or sex was observed. The association was evident for cancer of the proximal colon, distal colon, and rectum. No clear difference in relative risks was found among specific alcoholic beverages. Limitations: The study included only one measure of alcohol consumption at baseline and could not investigate lifetime alcohol consumption, alcohol consumption at younger ages, or changes in alcohol consumption during follow-up. It also could not examine drinking patterns or duration of alcohol use. Conclusions: A single determination of alcohol intake correlated with a modest relative elevation in colorectal cancer rate, mainly at the highest levels of alcohol intake.

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