Jayasekara Harindra, MacInnis Robert J, Room Robin, English Dallas R
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria 3010, Australia Population Health, Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria 3010, Australia Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, Victoria 3004, Australia.
Alcohol Alcohol. 2016 May;51(3):315-30. doi: 10.1093/alcalc/agv110. Epub 2015 Sep 22.
Cancers of female breast, upper aero-digestive tract (UADT) (oral cavity, pharynx, larynx, oesophagus) and colorectum are causally related to alcohol consumption. Although alcohol consumption is likely to vary during life, the few studies that have explicitly measured lifetime consumption or intake over time have not been summarised. We therefore conducted a systematic review and meta-analysis.
Studies were identified by searching the Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and Scopus databases through January 2015 using broad search criteria. Studies reporting relative risks (RR) for quantitatively defined categories of alcohol consumption over time for breast, UADT or colorectal cancer were eligible. A two-stage random-effects meta-analysis was used to estimate a dose-response relationship between alcohol intake and each cancer site. RRs were also calculated for the highest relative to the lowest intake category.
Sixteen articles for breast, 16 for UADT and 7 for colorectal cancer met the eligibility criteria. We observed a weak non-linear dose-response relationship for breast cancer and positive linear dose-response relationships for UADT and colorectal cancer. The pooled RRs were 1.28 (95% confidence interval, CI: 1.07, 1.52) for breast, 2.83 (95% CI: 1.73, 4.62) for UADT, 4.84 (95% CI: 2.51, 9.32) for oral cavity and pharynx, 2.25 (95% CI: 1.49, 3.42) for larynx, 6.71 (95% CI: 4.21, 10.70) for oesophageal and 1.49 (95% CI: 1.27, 1.74) for colorectal cancer.
Our findings confirm dose-dependent associations between long-term alcohol intake and breast, UADT and colorectal cancer.
女性乳腺癌、上消化道(UADT)(口腔、咽、喉、食管)癌和结直肠癌与饮酒存在因果关系。尽管一生中饮酒量可能会有所变化,但少数明确测量终生饮酒量或随时间摄入量的研究尚未进行总结。因此,我们进行了一项系统综述和荟萃分析。
通过使用广泛的检索标准,检索截至2015年1月的Medline、CINAHL(护理学与健康相关文献累积索引)和Scopus数据库来识别研究。报告随时间对乳腺癌、UADT或结直肠癌按定量定义的饮酒类别相对风险(RR)的研究符合条件。采用两阶段随机效应荟萃分析来估计酒精摄入量与每个癌症部位之间的剂量反应关系。还计算了最高摄入量类别相对于最低摄入量类别的RR。
16篇关于乳腺癌的文章、16篇关于UADT的文章和7篇关于结直肠癌的文章符合纳入标准。我们观察到乳腺癌存在微弱的非线性剂量反应关系,UADT和结直肠癌存在正线性剂量反应关系。汇总的RR值乳腺癌为1.28(95%置信区间,CI:1.07,1.52),UADT为2.83(95%CI:1.73,4.62),口腔和咽为4.84(95%CI:2.51,9.32),喉为2.25(95%CI:1.49,3.42),食管为6.71(95%CI:4.21,10.70),结直肠癌为1.49(95%CI:1.27,1.74)。
我们的研究结果证实了长期酒精摄入与乳腺癌、UADT和结直肠癌之间存在剂量依赖性关联。