Chen Liwei, Gallicchio Lisa, Boyd-Lindsley Kristina, Tao Xuguang Grant, Robinson Karen A, Lam Tram Kim, Herman James G, Caulfield Laura E, Guallar Eliseo, Alberg Anthony J
Center for Human Nutrition, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Nutr Cancer. 2009;61(1):1-15. doi: 10.1080/01635580802372633.
The evidence concerning the influence of alcohol drinking on the risk of nasopharyngeal carcinoma (NPC) has yielded intriguing findings but has lacked a clear-cut interpretation due to inconsistencies. To unify this body of evidence, we performed a systematic review. With funding and using a protocol developed by the World Cancer Research Fund (WCRF), 15 bibliographic databases were searched for epidemiological studies that reported a measure of association between alcoholic beverage consumption and NPC. Pooled odds ratios (ORs) for highest-vs.-lowest categories of total alcohol intake was obtained by using an inverse-variance weighted random-effects model. A dose-response trend was examined in models using generalized least square estimation. The search identified 14 case-control studies from 5 countries. For total alcohol intake, the pooled ORs in a comparison of the highest to the lowest category was 1.33 (95% CI: = 1.09-1.62) in 11 studies. Data from 6 studies indicated a J-shape dose-response trend, with NPC risk decreasing with up to 15 drinks/wk and increasing with higher intake. Fewer data were available to assess the associations between NPC and intake of beer, wine, and spirits. The potential J-shaped dose-response trend suggests a reduced risk of NPC related to the light alcohol drinking, an observation that warrants further study. Considered in total, the quantitative summaries of the case-control evidence suggest that heavy alcohol consumption is associated with an increased risk of NPC.
关于饮酒对鼻咽癌(NPC)风险影响的证据得出了有趣的结果,但由于存在不一致性,缺乏明确的解释。为了整合这一证据体系,我们进行了一项系统综述。在获得资金支持并采用世界癌症研究基金会(WCRF)制定的方案后,我们在15个文献数据库中搜索了关于酒精饮料消费与鼻咽癌之间关联测量的流行病学研究。通过使用逆方差加权随机效应模型,得出了总酒精摄入量最高组与最低组的合并比值比(OR)。在使用广义最小二乘估计的模型中检验了剂量反应趋势。搜索共识别出来自5个国家的14项病例对照研究。对于总酒精摄入量,在11项研究中,最高组与最低组比较的合并OR为1.33(95%CI:1.09 - 1.62)。6项研究的数据显示出J形剂量反应趋势,即每周饮酒量达15杯时鼻咽癌风险降低,饮酒量更高时风险增加。可用于评估鼻咽癌与啤酒、葡萄酒和烈酒摄入量之间关联的数据较少。潜在的J形剂量反应趋势表明,轻度饮酒与鼻咽癌风险降低有关,这一观察结果值得进一步研究。总体而言,病例对照证据的定量总结表明,大量饮酒与鼻咽癌风险增加有关。