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Alcohol consumption, type of alcoholic beverage and risk of colorectal cancer at specific subsites

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Author: Bongaerts, B.W.C. · Brandt, P.A. van den · Goldbohm, R.A. · Goeij, A.F.P.M. de · Weijenberg, M.P.
Type:article
Date:2008
Institution: TNO Kwaliteit van Leven
Source:International Journal of Cancer, 10, 123, 2411-2417
Identifier: 241124
doi: doi:10.1002/ijc.23774
Keywords: Health · Alcohol · Alcoholic beverages · Cohort study · Colorectal cancer · The Netherlands · alcohol · adult · aged · alcohol abstinence · alcohol consumption · alcoholic beverage · article · ascending colon · cancer localization · cancer risk · colon cancer · colorectal cancer · controlled study · descending colon · diet · disease association · female · follow up · human · male · Netherlands · priority journal · rectum cancer · sex difference · cohort analysis · colorectal tumor · drinking behavior · middle aged · proportional hazards model · questionnaire · risk factor · Aged · Alcohol Drinking · Alcoholic Beverages · Cohort Studies · Colorectal Neoplasms · Female · Humans · Male · Middle Aged · Netherlands · Proportional Hazards Models · Questionnaires · Risk Factors · Healthy for Life · Healthy Living

Abstract

Within the Netherlands Cohort Study on diet and cancer, we 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. 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 non-drinkers of the specific beverage and after adjustment for total alcohol intake. No evidence was found for sex-specific effects of alcohol and alcoholic beverages. In conclusion, our 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. © 2008 Wiley-Liss, Inc.