Division of Epidemiology and Biostatistics, European Institute of Oncology, Via delle Oblate 2, 50139, Milan, Italy.
Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
Eur J Nutr. 2018 Oct;57(7):2323-2332. doi: 10.1007/s00394-018-1613-5. Epub 2018 Jan 11.
Several studies in recent years have investigated the relationship between alcohol intake and melanoma risk, with conflicting results. To help clarify this issue, we conducted a literature review and dose-response meta-analysis of studies published until June 30th, 2017, that examined the association between alcohol intake (overall and by beverage type) and melanoma risk.
We used random effect models with maximum likelihood estimation to calculate summary relative risk (SRR) and 95% confidence intervals (95%CI).
We included 20 independent studies (encompassing 10,555 melanoma cases and over 1.6 million non-cases/controls) published during 1986-2016, of which six had a prospective cohort study design. Adjustment for phenotypic characteristics and sunlight exposure was performed in 11 and nine studies, respectively. Alcohol intake was moderately associated with melanoma risk: the SRR were 1.29 (95% CI 1.14-1.45) for those in the highest vs. lowest category of current alcohol intake, and 1.96 (95% CI 1.02-3.76, I = 0%) for cumulative intake. In the dose-response analysis, the increase in risk associated with a 10 g increment in daily alcohol intake was 1.07 (95% CI 1.03-1.11). Risk estimates did not differ by gender, study design and adjustment for confounders; between-studies heterogeneity was acceptable, and there was no evidence of publication bias.
Our findings suggest that alcohol drinking may be moderately associated with increased melanoma risk, although residual confounding and bias cannot be ruled out. Further research is needed to confirm these findings, clarify the role of the different alcohol sources, and investigate the interaction with known melanoma risk factors.
近年来，有几项研究调查了饮酒与黑色素瘤风险之间的关系，结果相互矛盾。为了帮助澄清这一问题，我们对截至 2017 年 6 月 30 日发表的研究进行了文献回顾和剂量-反应荟萃分析，以检查饮酒（总体和按饮料类型）与黑色素瘤风险之间的关联。
我们使用随机效应模型和最大似然估计来计算汇总相对风险（SRR）和 95%置信区间（95%CI）。
我们纳入了 20 项独立研究（包括 10555 例黑色素瘤病例和超过 160 万例非病例/对照），这些研究发表于 1986 年至 2016 年期间，其中 6 项为前瞻性队列研究设计。有 11 项和 9 项研究分别对表型特征和阳光暴露进行了调整。饮酒与黑色素瘤风险中度相关：与当前饮酒量最低组相比，最高组的 SRR 为 1.29（95%CI 1.14-1.45），累积饮酒量的 SRR 为 1.96（95%CI 1.02-3.76，I=0%）。在剂量-反应分析中，与每天增加 10 克酒精摄入相关的风险增加了 1.07（95%CI 1.03-1.11）。风险估计值不因性别、研究设计和混杂因素的调整而不同；研究间异质性可接受，且无发表偏倚的证据。
我们的研究结果表明，饮酒可能与黑色素瘤风险增加中度相关，但不能排除残余混杂和偏倚。需要进一步的研究来证实这些发现，阐明不同酒精来源的作用，并研究与已知黑色素瘤风险因素的相互作用。
