Gapstur Susan M, Jacobs Eric J, Deka Anusila, McCullough Marjorie L, Patel Alpa V, Thun Michael J
Epidemiology Research Program, American Cancer Society, 250 Williams St NW, Atlanta, GA 30303-1002, USA.
Arch Intern Med. 2011 Mar 14;171(5):444-51. doi: 10.1001/archinternmed.2010.536.
An international panel of experts characterized the evidence linking alcoholic beverage consumption to pancreatic cancer as limited. Primary concerns include inconsistent results from underpowered studies, residual confounding by smoking, and the question of whether the association varies by type of alcoholic beverage.
The association of alcohol intake with pancreatic cancer mortality was examined using data from the Cancer Prevention Study II, a prospective study of US adults 30 years and older. Alcohol consumption was self-reported on a 4-page questionnaire in 1982. Based on follow-up through December 31, 2006, there were 6847 pancreatic cancer deaths among 1,030,467 participants. Multivariable-adjusted relative risks (RRs) and 95% confidence intervals (CIs) were computed using Cox proportional hazards regression analysis controlling for age, sex, race/ethnicity, education, marital status, body mass index, family history of pancreatic cancer, and personal history of gallstones, diabetes mellitus, or smoking.
The RRs (95% CIs) of pancreatic cancer mortality associated with current intake of less than 1, 1, 2, 3, and 4 or more drinks per day compared with nondrinkers were 1.06 (0.99-1.13), 0.99 (0.90-1.08), 1.06 (0.97-1.17), 1.25 (1.11-1.42), and 1.17 (1.06-1.29), respectively (P< .001 for trend). Consumption of 3 or more drinks per day was associated with pancreatic cancer mortality in never smokers (RR, 1.36; 95% CI, 1.13-1.62) and in ever smokers (RR, 1.16; 95% CI, 1.06-1.27). This association was observed for consumption of liquor (RR, 1.32; 95% CI, 1.10-1.57) but not beer (RR, 1.08; 95% CI, 0.90-1.30) or wine (RR, 1.09; 95% CI, 0.79-1.49).
These results strengthen the evidence that alcohol consumption, specifically liquor consumption of 3 or more drinks per day, increases pancreatic cancer mortality independent of smoking.
一个国际专家小组认为，将酒精饮料消费与胰腺癌联系起来的证据有限。主要担忧包括研究样本量不足导致结果不一致、吸烟造成的残余混杂因素，以及这种关联是否因酒精饮料类型而异的问题。
利用癌症预防研究II的数据，对酒精摄入量与胰腺癌死亡率之间的关联进行了研究。该研究是一项针对30岁及以上美国成年人的前瞻性研究。1982年，通过一份4页的问卷对酒精消费情况进行了自我报告。截至2006年12月31日的随访结果显示，1,030,467名参与者中有6847人死于胰腺癌。使用Cox比例风险回归分析计算多变量调整后的相对风险（RRs）和95%置信区间（CIs），并对年龄、性别、种族/民族、教育程度、婚姻状况、体重指数、胰腺癌家族史以及胆结石、糖尿病或吸烟个人史进行了控制。
与不饮酒者相比，目前每天饮酒少于1杯、1杯、2杯、3杯以及4杯或更多杯的胰腺癌死亡率RRs（95% CIs）分别为1.06（0.99 - 1.13）、0.99（0.90 - 1.08）、1.06（0.97 - 1.17）、1.25（1.11 - 1.42）和1.17（1.06 - 1.29）（趋势P <.001）。每天饮用3杯或更多杯酒与从不吸烟者（RR，1.36；95% CI，1.13 - 1.62）和曾经吸烟者（RR，1.16；95% CI，1.06 - 1.27）的胰腺癌死亡率相关。这种关联在饮用烈酒时观察到（RR，1.32；95% CI，1.10 - 1.57），但在饮用啤酒（RR，1.08；95% CI，0.90 - 1.30）或葡萄酒时未观察到（RR，1.09；95% CI，0.79 - 1.49）。
这些结果强化了以下证据，即酒精消费，特别是每天饮用3杯或更多杯烈酒，会增加胰腺癌死亡率，且与吸烟无关。
