International Agency for Research On Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France.
Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway, Department of Research, Cancer Registry of Norway, Oslo, Norway.
Eur J Epidemiol. 2022 Sep;37(9):915-929. doi: 10.1007/s10654-022-00900-6. Epub 2022 Sep 5.
Alcohol intake is an established risk factor for colorectal cancer (CRC); however, there is limited knowledge on whether changing alcohol drinking habits during adulthood modifies CRC risk.
Leveraging longitudinal exposure assessments on alcohol intake at different ages, we examined the relationship between change in alcohol intake and subsequent CRC risk.
Within the European Prospective Investigation into Cancer and Nutrition, changes in alcohol intake comparing follow-up with baseline assessments were investigated in relation to CRC risk. The analysis included 191,180, participants and 1530 incident CRC cases, with exclusion of the first three years of follow-up to minimize reverse causation. Trajectory profiles of alcohol intake, assessed at ages 20, 30, 40, 50 years, at baseline and during follow-up, were estimated using latent class mixed models and related to CRC risk, including 407,605 participants and 5,008 incident CRC cases.
Mean age at baseline was 50.2 years and the follow-up assessment occurred on average 7.1 years later. Compared to stable intake, a 12 g/day increase in alcohol intake during follow-up was positively associated with CRC risk (HR = 1.15, 95%CI 1.04, 1.25), while a 12 g/day reduction was inversely associated with CRC risk (HR = 0.86, 95%CI 0.78, 0.95). Trajectory analysis showed that compared to low alcohol intake, men who increased their alcohol intake from early- to mid- and late-adulthood by up to 30 g/day on average had significantly increased CRC risk (HR = 1.24; 95%CI 1.08, 1.42), while no associations were observed in women. Results were consistent by anatomical subsite.
Increasing alcohol intake during mid-to-late adulthood raised CRC risk, while reduction lowered risk.
饮酒是结直肠癌（CRC）的既定危险因素；然而，对于成年后改变饮酒习惯是否会改变 CRC 风险，我们知之甚少。
利用不同年龄段饮酒的纵向暴露评估，我们研究了饮酒量变化与随后 CRC 风险之间的关系。
在欧洲癌症前瞻性调查和营养研究中，我们研究了与基线评估相比，随访期间饮酒量的变化与 CRC 风险的关系。该分析包括 191180 名参与者和 1530 例 CRC 病例，排除了前三年的随访期，以最大程度地减少反向因果关系。使用潜在类别混合模型评估基线和随访期间在 20、30、40 和 50 岁时的饮酒量轨迹，包括 407605 名参与者和 5008 例 CRC 病例，并将其与 CRC 风险相关联。
基线时的平均年龄为 50.2 岁，平均随访时间为 7.1 年。与稳定饮酒相比，随访期间增加 12g/d 的饮酒量与 CRC 风险呈正相关（HR=1.15，95%CI 1.04，1.25），而减少 12g/d 的饮酒量与 CRC 风险呈负相关（HR=0.86，95%CI 0.78，0.95）。轨迹分析显示，与低饮酒量相比，男性从成年早期到中期和晚期平均增加 30g/d 的饮酒量，CRC 风险显著增加（HR=1.24；95%CI 1.08，1.42），而女性则没有观察到关联。按解剖部位亚组分析结果一致。
中年至老年期饮酒量增加会增加 CRC 风险，而减少饮酒量则会降低风险。
