Klatsky A L, Armstrong M A, Friedman G D, Hiatt R A
Department of Medicine, Kaiser Permanente Medical Center, Oakland, CA 94611.
Am J Epidemiol. 1988 Nov;128(5):1007-15. doi: 10.1093/oxfordjournals.aje.a115045.
The authors prospectively studied the incidence of cancers of the colon and rectum in 106,203 men and women, both white and black, who supplied data at northern California Kaiser Permanente facilities about use of alcoholic beverages in 1978-1984. Analysis controlling for age, sex, race, body mass index, coffee use, total serum cholesterol, and education showed a positive association of alcohol use to both types of cancer, which was stronger for rectal cancer (trend test, p = 0.03) than for colon cancer (trend test, p = 0.11). When persons with a daily intake of three or more drinks were compared with abstainers, relative risk for rectal cancer was 3.17 (95% confidence interval (CI): 1.05-9.57) and relative risk for colon cancer was 1.71 (95% CI: 0.92-3.19). Women with a daily intake of three or more drinks had a relative risk for colon cancer of 2.56 (95% CI: 1.03-6.40) compared with 1.16 (95% CI: 0.46-2.90) for men. Among drinkers, preference for wine, beer, or hard liquor had no significant independent relation to either type of cancer; those who preferred beer were at slightly greater risk of rectal cancer, but those who preferred wine were more likely to develop colon cancer. These data suggest that total alcohol use, but no one specific beverage type, is associated with increased risk of rectal cancer.
作者对106,203名男性和女性（包括白人和黑人）进行了前瞻性研究，这些人于1978年至1984年期间在北加利福尼亚凯撒医疗集团提供了有关酒精饮料使用情况的数据。在对年龄、性别、种族、体重指数、咖啡饮用情况、总血清胆固醇和教育程度进行控制分析后发现，饮酒与这两种癌症均呈正相关，其中直肠癌的相关性（趋势检验，p = 0.03）比结肠癌（趋势检验，p = 0.11）更强。将每日饮酒三杯或更多杯的人与不饮酒者进行比较时，直肠癌的相对风险为3.17（95%置信区间（CI）：1.05 - 9.57），结肠癌的相对风险为1.71（95% CI：0.92 - 3.19）。每日饮酒三杯或更多杯的女性患结肠癌的相对风险为2.56（95% CI：1.03 - 6.40），而男性为1.16（95% CI：0.46 - 2.90）。在饮酒者中，对葡萄酒、啤酒或烈性酒的偏好与这两种癌症均无显著独立关联；偏好啤酒的人患直肠癌的风险略高，但偏好葡萄酒的人更易患结肠癌。这些数据表明，总体饮酒量而非某一种特定饮料类型与直肠癌风险增加有关。
