Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis.
Level 2 - randomized trial
Meta-analysis and systematic review of observational studies.
PubMed 25422909 · doi:10.1038/bjc.2014.579
What was done
A dose-response meta-analysis and meta-regression of 572 studies comprising 486,538 cancer cases was conducted to evaluate the relationship between alcohol consumption and risk across 23 site-specific cancer types, including an assessment of heterogeneity.
What was found
Heavy drinkers compared with nondrinkers and occasional drinkers had elevated relative risks (RRs) with clear dose-risk relationships for oral and pharyngeal cancer (RR 5.13), oesophageal squamous cell carcinoma (RR 4.95), laryngeal cancer (RR 2.65), female breast cancer (RR 1.61), and colorectal cancer (RR 1.44). Heavy drinking was also associated with increased risk of gallbladder (RR 2.64), liver (RR 2.07), stomach (RR 1.21), pancreas (RR 1.19), and lung (RR 1.15) cancers. Indications of positive associations were observed for melanoma and prostate cancer, whereas Hodgkin's and Non-Hodgkin's lymphomas showed inverse associations. Confidence intervals and exact numbers for melanoma, prostate cancer, and lymphomas were not reported in the abstract.
Why it matters
This paper synthesizes a massive body of epidemiological evidence to quantify site-specific cancer risks associated with heavy alcohol intake across 23 malignancies.
Limits
The findings derive from observational studies vulnerable to residual confounding (such as tobacco use) and exposure measurement error. The abstract does not define the gram-per-day thresholds for drinking categories or provide confidence intervals for the estimates.
Cited by
- supports Heavy alcohol drinking (more than three drinks per day) is associated with a 15% to 21% increase in relative risk for lung and stomach cancers, and over a 300% to 400% increase for esophageal, pharyngeal, and oral cancers.