Li Xinyi, Hur Jinhee, Zhang Yin, Song Mingyang, Smith-Warner Stephanie A, Liang Liming, Mukamal Kenneth J, Rimm Eric B, Giovannucci Edward L
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.
J Natl Cancer Inst. 2025 May 1;117(5):971-979. doi: 10.1093/jnci/djae330.
Association between light to moderate alcohol consumption and colorectal cancer (CRC) incidence remains understudied, especially regarding drinking pattern, beverage type, and temporal aspects.
Hazard ratios (HRs) and 95% confidence intervals (CIs) for time to CRC diagnosis were estimated among 137 710 participants. Estimates based on remote (eg, >10 years before follow-up) and recent (eg, the preceding 10 years before follow-up) alcohol intake, using different cutoffs (eg, 8, 10, 12 years) and mutual adjustment, enabled separating independent effects and investigating time lag of alcohol-CRC association.
In total, 3599 CRC cases were documented over 3 decades. Light to moderate drinking was associated with an increased CRC risk only in men: HR (95% CI) for 5-14.9 and 15-29.9 vs 0 g/day of alcohol intake was 1.19 (1.01 to 1.41) and 1.38 (1.13 to 1.67). In women, that for 0.1-4.9 and 5-14.9 vs 0 g/day of alcohol was 1.07 (0.96 to 1.20) and 1.05 (0.91 to 1.20). Drinkers with both high drinking frequency and daily intake had the highest CRC risk, suggesting total alcohol intake was the critical factor. We estimated the time lag between alcohol consumption and CRC occurrence to be 8 to 12 years. Former drinkers did not experience a significant reduction in CRC risk even after 10 years of quitting or reducing consumption.
Based on 2 cohorts of health professionals, our findings suggest that the increased risk of CRC associated with alcohol intake is driven mainly by total quantity and remote intake. Former drinkers did not experience an immediate reduction in CRC risk after quitting or reducing consumption.
轻度至中度饮酒与结直肠癌(CRC)发病率之间的关联仍研究不足,尤其是在饮酒模式、饮料类型和时间因素方面。
在137710名参与者中估计了CRC诊断时间的风险比(HRs)和95%置信区间(CIs)。基于远期(如随访前>10年)和近期(如随访前10年)饮酒量,使用不同的阈值(如8、10、12年)并相互调整进行估计,能够分离出独立效应并研究酒精与CRC关联的时间滞后。
在30年期间共记录了3599例CRC病例。轻度至中度饮酒仅在男性中与CRC风险增加相关:与每日酒精摄入量0克相比,5 - 14.9克/天和15 - 29.9克/天的HR(95%CI)分别为1.19(1.01至1.41)和1.38(1.13至1.67)。在女性中,与每日酒精摄入量0克相比,0.1 - 4.9克/天和5 - 14.9克/天的HR分别为1.07(0.96至1.20)和1.05(0.91至1.20)。饮酒频率高且每日饮酒量多的人CRC风险最高,表明总酒精摄入量是关键因素。我们估计酒精摄入与CRC发生之间的时间滞后为8至12年。即使在戒酒或减少饮酒量10年后,既往饮酒者的CRC风险也没有显著降低。
基于两组健康专业人员的数据,我们的研究结果表明,与酒精摄入相关的CRC风险增加主要由总摄入量和远期摄入量驱动。既往饮酒者在戒酒或减少饮酒量后,CRC风险并未立即降低。