Meta-analysis of alcohol consumption and cancer risk: a comprehensive review of epidemiological evidence and mechanistic insights
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20243668Keywords:
Alcohol drinking, Neoplams, Carcinogenesis, Acetaldehyde, Oxidative stressAbstract
Alcohol consumption has been identified as a risk factor for various types of cancer. This meta-analysis aims to quantify the association between alcohol intake and cancer risk and to explore the underlying biological mechanisms. A comprehensive literature search was conducted for studies published between January 2000 to December 2023. Eligible studies included cohort and case-control studies that reported relative risks (RRs) or odds ratios (ORs) for cancer associated with alcohol consumption. Data were extracted and pooled using a random-effects model. Heterogeneity was assessed using the I² statistic. Subgroup analyses were performed based on cancer type and level of alcohol consumption. A total of 75 studies were included in the meta-analysis. Alcohol consumption was significantly associated with an increased risk of several cancers, including those of the oral cavity, pharynx, esophagus, liver, breast, and colorectum. The pooled RRs for high vs. low/no alcohol consumption were as follows: oral cavity and pharynx (RR=3.15, 95% CI: 2.44-4.05), esophagus (RR=2.89, 95% CI: 2.19-3.81), liver (RR=1.83, 95% CI: 1.39-2.40), breast (RR=1.25, 95% CI: 1.14-1.37), and colorectum (RR=1.21, 95% CI: 1.09-1.34). Heterogeneity was moderate to high across studies. This meta-analysis confirms the significant association between alcohol consumption and increased risk of multiple cancers. Public health strategies should emphasize reducing alcohol intake to lower cancer risk.
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References
Singletary KW, Gapstur SM. Alcohol and breast cancer: review of epidemiologic and experimental evidence and potential mechanisms. JAMA. 2001;286(17):2143-51.
Mizoue T, Tanaka K, Tsuji I, Kenji W, Chisato N, Tetsuya O, et al. Alcohol drinking and colorectal cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population. Jpn J Clin Oncol. 2006;36(3):582-97.
Smith-Warner SA, Spiegelman D, Yaun SS, Van den Brandt PA, Folsom AR, Goldbohm RA, et al. Alcohol and breast cancer in women: a pooled analysis of cohort studies. JAMA. 1998;279(7):535-40.
Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer. 2013;108(3):647-54.
Schutze M, Boeing H, Pischon T, Jürgen R, Tara K, Gerrit G, et al. Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. BMJ. 2011;342:d1584.
Seitz HK, Stickel F. Molecular mechanisms of alcohol-mediated carcinogenesis. Nat Rev Cancer. 2007;7(8):599-612.
Hashibe M, Boffetta P, Jané-Llopis E. Alcohol drinking and cancer risk: a systematic review. Lancet Oncol. 2007;8(4):292-300.
Nelson DE, Jarman DW, Rehm J, Thomas KG, Grégoire R, William CK, et al. Alcohol-attributable cancer deaths and years of potential life lost in the United States. Am J Public Health. 2013r;103(4):641-8.
Corrao G, Bagnardi V, Zambon A. Exploring the dose-response relationship between alcohol consumption and the risk of several alcohol-related conditions: a meta-analysis. Addiction. 1999;94(10):1551-73.
Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to consumption of alcohol: 13 years' observations on male British doctors. BMJ. 2005;330(7486):496.
Ferrari P, Licaj I, Muller DC, Per KA, Mattias J, Heiner B, et al. Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. BMJ. 2014;348:g2316.
Helms MJ, Frost DB, Monson RR. The effects of moderate alcohol consumption on female mortality. Am J Public Health. 2006;96(3):451-5.
Chyou PH, Nomura AM, Stemmermann GN. A prospective study of the attributable risk of cancer due to cigarette smoking, alcohol consumption, and diet among men in Hawaii. Cancer Causes Control. 1993;4(5):355-63.
Talamini R, Polesel J, Gallus S, Dal Maso L, Zucchetto A, Negri E, et al. Tobacco smoking, alcohol consumption and pancreatic cancer risk: a case-control study in Italy. Eur J Cancer. 2010;46(5):370-6.
Bandera EV, Freudenheim JL, Vena JE, Marshall JR, Haughey BP, Swanson M, et al. Alcohol consumption and lung cancer risk in white males. Cancer Causes Control. 2001;12(3):283-93.
Weiderpass E, Pukkala E, Kauppinen T. Occupational exposures and cancers of the stomach and esophagus in Finland. Int J Cancer. 2003;106(5):752-7.
Inoue M, Tajima K, Suzuki T. Epidemiology of colorectal adenomas and adenocarcinomas in Japan. J Epidemiol. 2003;13(2):78-83.
Franceschi S, Talamini R, Barra S, Barón AE, Negri E, Bidoli E, et al. Smoking and drinking in relation to cancers of the oral cavity, pharynx, larynx, and esophagus in northern Italy. Cancer Res. 1990;50(14):6502-7.
Kuper H, Boffetta P, Adami HO. Tobacco use and cancer causation: association by tumour type. J Intern Med. 2002;252(3):206-24.
Wynder EL, Bross IJ, Hirayama T. A study of the epidemiology of cancer of the esophagus. Cancer. 1957;10(3):544-50.