Mizoue Tetsuya, Inoue Manami, Wakai Kenji, Nagata Chisato, Shimazu Taichi, Tsuji Ichiro, Otani Tetsuya, Tanaka Keitaro, Matsuo Keitaro, Tamakoshi Akiko, Sasazuki Shizuka, Tsugane Shoichiro
Department of Epidemiology and International Health, Research Institute, International Medical Center of Japan, Tokyo, Japan.
Am J Epidemiol. 2008 Jun 15;167(12):1397-406. doi: 10.1093/aje/kwn073. Epub 2008 Apr 11.
Colorectal cancer is an alcohol-related malignancy; however, the association appears to be stronger among Asian populations with a relatively high prevalence of the slow-metabolizing aldehyde dehydrogenase variant. To examine the association between alcohol consumption and colorectal cancer in Japanese, the authors analyzed original data from five cohort studies that measured alcohol intake using validated questionnaires at baseline. Hazard ratios were calculated in the individual studies, with adjustment for a common set of variables, and then combined using a random-effects model. During 2,231,010 person-years of follow-up (ranging variously from 1988 to 2004), 2,802 colorectal cancer cases were identified. In men, multivariate-adjusted pooled hazard ratios for alcohol intakes of 23-45.9 g/day, 46-68.9 g/day, 69-91.9 g/day, and > or =92 g/day, compared with nondrinking, were 1.42 (95% confidence interval (CI): 1.21, 1.66), 1.95 (95% CI: 1.53, 2.49), 2.15 (95% CI: 1.74, 2.64), and 2.96 (95% CI: 2.27, 3.86), respectively (p for trend < 0.001). The association was evident for both the colon and the rectum. A significant positive association was also observed in women. One fourth of colorectal cancer cases in men were attributable to an alcohol intake of > or =23 g/day. An alcohol-colorectal cancer association seems to be more apparent in Japanese than in Western populations. Whether this difference can be ascribed to genetic or environmental factors needs to be clarified.
结直肠癌是一种与酒精相关的恶性肿瘤；然而，在具有相对较高的慢代谢乙醛脱氢酶变体患病率的亚洲人群中，这种关联似乎更强。为了研究日本人群中饮酒与结直肠癌之间的关联，作者分析了五项队列研究的原始数据，这些研究在基线时使用经过验证的问卷测量饮酒量。在各个研究中计算风险比，并对一组共同变量进行调整，然后使用随机效应模型进行合并。在2231010人年的随访期间（时间跨度从1988年到2004年不等），共确定了2802例结直肠癌病例。在男性中，与不饮酒者相比，每日饮酒量为23 - 45.9克、46 - 68.9克、69 - 91.9克以及≥92克时，多变量调整后的合并风险比分别为1.42（95%置信区间（CI）：1.21, 1.66）、1.95（95% CI：1.53, 2.49）、2.15（95% CI：1.74, 2.64）和2.96（95% CI：2.27, 3.86）（趋势p值<0.001）。这种关联在结肠癌和直肠癌中均很明显。在女性中也观察到显著的正相关。男性中四分之一的结直肠癌病例可归因于每日饮酒量≥23克。饮酒与结直肠癌之间的关联在日本人中似乎比在西方人群中更明显。这种差异是否可归因于遗传或环境因素尚需阐明。
