Alcohol intake and colorectal cancer: A comparison of approaches for including repeated measures of alcohol consumption

Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
Epidemiology (Impact Factor: 6.2). 04/2008; 19(2):258-64. DOI: 10.1097/EDE.0b013e31816339e0
Source: PubMed


In numerous studies, alcohol intake has been found to be positively associated with colorectal cancer risk. However, the majority of studies included only one exposure measurement, which may bias the results if long-term intake is relevant.
We compared different approaches for including repeated measures of alcohol intake among 47,432 US men enrolled in the Health Professionals Follow-up Study. Questionnaires including questions on alcohol intake had been completed in 1986, 1990, 1994, and 1998. The outcome was incident colorectal cancer during follow-up from 1986 to 2002.
During follow-up, 868 members of the cohort experienced colorectal cancer. Baseline, updated, and cumulative average alcohol intakes were positively associated with colorectal cancer, with only minor differences among the approaches. These results support moderately increased risk for intake >30 g/d and weaker increased risk for lower intake. The hazard ratio for baseline alcohol intake was 1.07 (95% confidence interval = 1.02-1.11) per 10 g/d increase, which was similar for updated and cumulative average alcohol intake. Consistent moderate and high alcohol intake showed increased risk, and the relative risk decreased slightly with longer latency time. Alcohol frequency was positively associated with cancer risk among men with alcohol intake above 15 g/d.
Alcohol intake was positively associated with colorectal cancer, with minor differences among analytic approaches (which may be attributable to low intraindividual variation during follow-up).

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    • "A recent meta analysis from the IARC of 34 case control and 7 cohort studies provides strong evidence for an association between alcohol consumption of more than 1 drink per day and the risk for colorectal cancer (Fedirko et al., 2011). Similar results were reported from the Netherlands (Bongaerts et al., 2008, 2010) and the US (Thygesen et al., 2008) but not from Great Britain (Park et al., 2009, 2010). "

    Full-text · Chapter · Feb 2012
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    • "All studies (I-squared = 76.4%, p = 0.000) Tavani, 1998 Barra, 1992 Choi, 1991 Murata, 1996 All cohort studies (I-squared = 0.0%, p = 0.468) Peters, 1989 Thygesen, 2008 Peters, 1992 Otani, 2003 Cohort studies Lim & Park, 2008 Akhter, 2007 Sharpe, 2002 Pedersen, 2003 Longnecker, 1990 Ferrari, 2007 Riboli, 1991 Wakai, 2005 Author, year Murata, 1999 Boutron, 1995 Ji, 2002 All case-control studies (I-squared = 83.4%, p = 0.0001) "
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