Weikert Cornelia, Dietrich Thomas, Boeing Heiner, Bergmann Manuela M, Boutron-Ruault Marie Christine, Clavel-Chapelon Francoise, Allen Naomi, Key Tim, Lund Eiliv, Olsen Anja, Tjønneland Anne, Overvad Kim, Rohrmann Sabine, Linseisen Jakob, Pischon Tobias, Trichopoulou Antonia, Weinehall Lars, Johansson Ingegerd, Sánchez Maria-José, Agudo Antonio, Barricarte Aurelio, Amiano Pilar, Chirlaque Maria-Dolores, Quirós J Ramón, Wirfalt Elisabet, Peeters Petra H, Bueno-de-Mesquita H Bas, Vrieling Alina, Pala Valeria, Palli Domenico, Vineis Paolo, Tumino Rosario, Panico Salvatore, Bingham Sheila, Khaw Kay-Tee, Norat Teresa, Jenab Mazda, Ferrari Pietro, Slimani Nadia, Riboli Elio
German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
Int J Cancer. 2009 Jul 15;125(2):406-12. doi: 10.1002/ijc.24393.
Recent alcohol consumption is an established risk factor for squamous cell carcinoma (SCC) of the upper aero-digestive tract. In contrast, the role of lifetime exposure to alcohol with regard to risk of SCC is not well established. Historical data on alcohol use are available in 271,253 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). During 2,330,381 person years, 392 incident SCC cases (279 men and 113 women) were identified. Cox regression was applied to model sex-specific associations between lifetime alcohol intake and SCC risk adjusting for potential confounders including smoking. Compared to men who drank 0.1-6.0 g/day alcohol at lifetime, the relative risks (RR) for developing SCC were significantly increased for men who drank 30.1-60.0 g/day (RR 1.65, 95% confidence interval:1.00-2.71), 60.1-96.0 g/day (RR 2.20, 95%CI 1.23-3.95), and >96.0 g/day, (RR 4.63, 95% CI 2.52-8.48), and for former drinkers (RR 4.14, 95%CI 2.38-7.19). These risk estimates did not considerably change when baseline alcohol intake was analyzed. Compared to women who drank 0.1-6.0 g/day alcohol intake at lifetime, the RR were significantly increased for women who drank >30 g/d (RR 6.05, 95%CI 2.98-12.3). Applying similar categories, the relative risk for baseline alcohol intake was 3.26 (95%CI 1.82-5.87). We observed a stronger association between alcohol intake at lifetime and risk of SCC in women compared to men (p for interaction = 0.045). The strong dose-response relation for lifetime alcohol use underscores that alcohol is an important risk factor of SCC of the upper aero-digestive tract throughout life.
近期饮酒是上呼吸消化道鳞状细胞癌(SCC)的一个既定风险因素。相比之下,终生饮酒暴露对SCC风险的作用尚未明确。欧洲癌症与营养前瞻性调查(EPIC)的271,253名参与者有饮酒的历史数据。在2,330,381人年期间,共识别出392例SCC新发病例(279名男性和113名女性)。应用Cox回归模型来模拟终生酒精摄入量与SCC风险之间的性别特异性关联,并对包括吸烟在内的潜在混杂因素进行调整。与终生每天饮酒0.1 - 6.0克的男性相比,每天饮酒30.1 - 60.0克(相对风险[RR] 1.65,95%置信区间:1.00 - 2.71)、60.1 - 96.0克(RR 2.20,95%CI 1.23 - 3.95)以及>96.0克(RR 4.63,95%CI 2.52 - 8.48)的男性发生SCC的相对风险显著增加,既往饮酒者也是如此(RR 4.14,95%CI 2.38 - 7.19)。分析基线酒精摄入量时,这些风险估计值没有太大变化。与终生每天饮酒摄入量为0.1 - 6.0克的女性相比,每天饮酒>30克的女性RR显著增加(RR 6.05,95%CI 2.98 - 12.3)。采用类似分类,基线酒精摄入量的相对风险为3.26(95%CI 1.82 - 5.87)。我们观察到,与男性相比,女性终生酒精摄入量与SCC风险之间的关联更强(交互作用p = 0.045)。终生饮酒的强剂量反应关系强调,酒精是上呼吸消化道SCC贯穿一生的重要风险因素。