Jiao Li, Silverman Debra T, Schairer Catherine, Thiébaut Anne C M, Hollenbeck Albert R, Leitzmann Michael F, Schatzkin Arthur, Stolzenberg-Solomon Rachael Z
Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20852, USA.
Am J Epidemiol. 2009 May 1;169(9):1043-51. doi: 10.1093/aje/kwp034. Epub 2009 Mar 18.
The epidemiologic evidence for the role of alcohol use in pancreatic cancer development is equivocal. The authors prospectively examined the relation between alcohol use and risk of pancreatic cancer among 470,681 participants who were aged 50-71 years in 1995-1996 in the US National Institutes of Health-AARP Diet and Health Study. The authors identified 1,149 eligible exocrine pancreatic cancer cases through December 2003. Multivariate Cox proportional hazards regression models were used to calculate relative risks and 95% confidence intervals with the referent group being light drinkers (<1 drink/day). The relative risks of developing pancreatic cancer were 1.45 (95% confidence interval (CI): 1.17, 1.80; P(trend) = 0.002) for heavy total alcohol use (>or=3 drinks/day, approximately 40 g of alcohol/day) and 1.62 (95% CI: 1.24, 2.10; P(trend) = 0.001) for heavy liquor use, compared with the respective referent group. The increased risk with heavy total alcohol use was seen in never smokers (relative risk = 1.35, 95% CI: 0.79, 2.30) and participants who quit smoking 10 or more years ago before baseline (relative risk = 1.41, 95% CI: 1.01, 2.00). These findings suggest a moderately increased pancreatic cancer risk with heavy alcohol use, particularly liquor; however, residual confounding by cigarette smoking cannot be completely excluded.
饮酒在胰腺癌发生过程中所起作用的流行病学证据并不明确。作者在美国国立卫生研究院-美国退休人员协会饮食与健康研究中,对1995 - 1996年年龄在50 - 71岁的470,681名参与者进行了前瞻性研究,以探讨饮酒与胰腺癌风险之间的关系。截至2003年12月,作者共识别出1149例符合条件的外分泌性胰腺癌病例。采用多变量Cox比例风险回归模型计算相对风险及95%置信区间,参照组为轻度饮酒者(<1杯/天)。与各自的参照组相比,重度总酒精摄入量(≥3杯/天,约40克酒精/天)者患胰腺癌的相对风险为1.45(95%置信区间(CI):1.17, 1.80;P趋势 = 0.002),重度饮用烈性酒者患胰腺癌的相对风险为1.62(95% CI:1.24, 2.10;P趋势 = 0.001)。在从不吸烟者(相对风险 = 1.35, 95% CI:0.79, 2.30)以及在基线前10年或更久前戒烟的参与者中(相对风险 = 1.41, 95% CI:1.01, 2.00),均观察到重度总酒精摄入量会增加患癌风险。这些发现表明,大量饮酒,尤其是饮用烈性酒,会使患胰腺癌的风险适度增加;然而,吸烟造成的残余混杂因素尚不能被完全排除。