Alcohol drinking and cutaneous melanoma risk: a systematic review and dose-risk meta-analysis.
Level 4 - case-series / case-control
Systematic review and meta-analysis of predominantly case-control studies (14 case-control, 2 cohort).
PubMed 24495200 · doi:10.1111/bjd.12856
What was done
A systematic review and dose-risk meta-analysis evaluated the association between alcohol consumption and cutaneous melanoma (CM) risk. Nonlinear random-effects meta-regression models were applied to data pooled from 16 observational studies (14 case-control and 2 cohort studies) including a total of 6,251 CM cases.
What was found
Any alcohol intake compared with no or occasional drinking was associated with an increased risk of CM (pooled relative risk [RR] 1.20, 95% CI 1.06–1.37). Subgroup findings showed similar estimates in case-control (RR 1.20, 95% CI 1.01–1.44) and cohort studies (RR 1.26, 95% CI 1.19–1.35). Light drinking (≤ 1 drink per day) yielded an RR of 1.10 (95% CI 0.96–1.26), whereas moderate-to-heavy drinking had an RR of 1.18 (95% CI 1.01–1.40). In 10 studies adjusting for sun exposure, the pooled RR was 1.15 (95% CI 0.94–1.41), compared with 1.27 (95% CI 1.20–1.35) across 6 unadjusted studies. No publication bias was detected.
Why it matters
This review provides quantitative evidence of a modest positive association between alcohol intake and cutaneous melanoma. However, the attenuation and loss of statistical significance after controlling for sun exposure suggests residual confounding may drive much of the observed effect.
Limits
The included literature is dominated by retrospective case-control designs (14 of 16 studies), introducing substantial recall and selection biases. Inadequate or absent adjustment for UV radiation/sun exposure across several studies leaves residual confounding unexcluded, and the abstract does not report specific beverage types or lifetime exposure patterns.
Cited by
- contradicts Consuming fewer than 7 drinks per week increases the relative risk for breast cancer by ~4%, colorectal cancer by ~9%, oral and pharyngeal cancer by 13% to 17%, and esophageal cancer and malignant melanoma by 26% to 44%.