Drinking pattern and time lag of alcohol consumption with colorectal cancer risk in US men and women

Xinyi Li, Jinhee Hur, Yin Zhang, Mingyang Song, Stephanie A Smith-Warner, Liming Liang, Kenneth J Mukamal, Eric B Rimm, Edward L Giovannucci
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Abstract

Background Association between light to moderate alcohol consumption and colorectal cancer (CRC) incidence remains understudied, especially regarding drinking pattern, beverage type and temporal aspects. Methods Hazard ratios (HRs) and 95% confidence intervals (CIs) for time to CRC diagnosis were estimated among 137,710 participants. Estimates based on remote (eg, >10 years before follow-up) and recent (eg, the preceding 10 years before follow-up) alcohol intake, using different cutoffs (eg, 8, 10, 12 years, etc) and mutual adjustment, enabled separating independent effects and investigating time lag of alcohol-CRC association. Results 3,599 CRC cases were documented over three decades. Light to moderate drinking was associated with an increased CRC risk only in men: HR (95% CI) for 5-14.9 and 15-29.9 vs 0 g/day of alcohol intake was 1.19 (1.01, 1.41) and 1.38 (1.13, 1.67). In women, that for 0.1-4.9 and 5-14.9 vs 0 g/day of alcohol was 1.07 (0.96, 1.20) and 1.05 (0.91, 1.20). Drinkers with both high drinking frequency and daily intake had the highest CRC risk, suggesting total alcohol intake was the critical factor. We estimated the time lag between alcohol consumption and CRC occurrence to be 8 to 12 years. Former drinkers did not experience a significant reduction in CRC risk even after 10 years of quitting or reducing consumption. Conclusions Based on two cohorts of health professionals, our findings suggest that the increased risk of CRC associated with alcohol intake is mainly driven by total quantity and remote intake. Former drinkers did not experience an immediate reduction in CRC risk after quitting or reducing consumption.
美国男性和女性的饮酒模式和饮酒时间与结直肠癌风险的关系
背景 轻度至中度饮酒与结直肠癌(CRC)发病率之间的关系仍未得到充分研究,特别是在饮酒模式、饮料类型和时间方面。方法 在 137,710 名参与者中估算了 CRC 诊断时间的危险比 (HRs) 和 95% 置信区间 (CIs)。根据远期(例如,随访前 10 年)和近期(例如,随访前 10 年)酒精摄入量进行估算,采用不同的临界值(例如,8 年、10 年、12 年等)并进行相互调整,从而区分独立效应并研究酒精与癌症关系的时滞。结果 三十年来共记录了 3599 例癌症病例。轻度至中度饮酒仅与男性的 CRC 风险增加有关:酒精摄入量为 5-14.9 克和 15-29.9 克 vs 0 克/天的 HR(95% CI)分别为 1.19(1.01,1.41)和 1.38(1.13,1.67)。在女性中,酒精摄入量为 0.1-4.9 克和 5-14.9 克与每天 0 克的对比分别为 1.07 (0.96, 1.20) 和 1.05 (0.91, 1.20)。饮酒频率和每日摄入量都很高的饮酒者患 CRC 的风险最高,这表明酒精总摄入量是关键因素。我们估计饮酒与 CRC 发生之间的时间差为 8 到 12 年。曾经饮酒的人即使在戒酒或减少饮酒 10 年后,其患 CRC 的风险也没有显著降低。结论 基于两组健康专业人员的研究,我们的发现表明,酒精摄入量导致的 CRC 风险增加主要是由总量和远程摄入量引起的。曾经饮酒的人在戒酒或减少饮酒后,患 CRC 的风险并没有立即降低。
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