Norwegian Institute of Public Health, Centre for Fertility and Health, Pb 222 Skøyen, 0213 Oslo, Norway.
Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Pb 1171 Blinderen, 0318 Oslo, Norway.
Alcohol Alcohol. 2021 Oct 29;56(6):718-725. doi: 10.1093/alcalc/agab007.
Alcohol consumption has been linked to colorectal cancer (CRC) and also to the high-density lipoprotein cholesterol level (HDL-C). HDL-C has been associated with the incidence of CRC. The aim of this study was to investigate the association between self-reported alcohol consumption, HDL-C and incidence of CRC, separately for the two sites.
Altogether, 250,010 participants in Norwegian surveys have been followed-up for an average of 18 years with respect to a first-time outcome of colon or rectal cancer. During follow-up, 3023 and 1439 colon and rectal cancers were registered.
For men, the HR per 1 drink per day was 1.05 with 95% confidence interval (0.98-1.12) for colon and 1.08 (1.02-1.15) for rectal cancer. The corresponding figures for women were 1.03 (0.97-1.10) and 1.05 (1.00-1.10). There was a positive association between alcohol consumption and HDL-C. HDL-C was inversely associated with colon cancer in men (0.74 (0.62-0.89) per 1 mmol/l) and positively associated with rectal cancer, although not statistically significant (1.15 (0.92-1.44). A robust regression that assigned weights to each observation and exclusion of weights ≤ 0.1 increased the HRs per 1 drink per day and decreased the HR per 1 mmol/l for colon cancer. The associations with rectal cancer remained unchanged.
Our results support a positive association between alcohol consumption and colon and rectal cancer, most pronounced for rectal cancer. Considering the positive relation between alcohol consumption and HDL-C, the inverse association between HDL-C and colon cancer in men remains unsettled.
饮酒与结直肠癌（CRC）以及高密度脂蛋白胆固醇水平（HDL-C）有关。HDL-C 与 CRC 的发病率有关。本研究的目的是分别研究结直肠癌和直肠癌患者中，报告的饮酒量、HDL-C 与 CRC 发病率之间的关系。
在挪威的调查中，共有 250010 名参与者，平均随访时间为 18 年，观察首次结直肠癌或直肠癌的发生。随访期间，登记了 3023 例结肠癌和 1439 例直肠癌。
对于男性，每天每增加 1 份酒的 HR 为 1.05（95%CI：0.98-1.12），结肠癌为 1.08（1.02-1.15），直肠癌为 1.03（0.97-1.10），1.05（1.00-1.10）。女性的饮酒量与 HDL-C 呈正相关。HDL-C 与男性结肠癌呈负相关（每增加 1mmol/L 为 0.74（0.62-0.89）），与直肠癌呈正相关，但无统计学意义（1.15（0.92-1.44））。稳健回归给每个观察值分配权重并排除权重≤0.1，增加了每天每增加 1 份酒的 HR，并降低了结肠癌的 HR 每增加 1mmol/L。直肠癌的相关性保持不变。
我们的研究结果支持饮酒与结直肠癌和直肠癌之间存在正相关关系，直肠癌的相关性最明显。考虑到饮酒与 HDL-C 之间的正相关关系，男性 HDL-C 与结肠癌之间的负相关关系仍未得到解决。
