Ana-Lucia Mayén1, Vivian Viallon1, Edoardo Botteri2, Cecile Proust-Lima3, Vincenzo Bagnardi4, Veronica Batista1, Amanda J Cross5, Nasser Laouali6, Conor J MacDonald6, Gianluca Severi6,7, Verena Katzke8, Manuela M Bergmann9, Mattias B Schulze10,11, Anne Tjønneland12, Anne Kirstine Eriksen12, Christina C Dahm13, Christian S Antoniussen13, Paula Jakszyn14,15, Maria-Jose Sánchez16,17,18,19, Pilar Amiano18,20,21,22, Sandra M Colorado-Yohar18,23,24, Eva Ardanaz18,25,26, Ruth Travis27, Domenico Palli28, Sieri Sabina29, Rosario Tumino30, Fulvio Ricceri31, Salvatore Panico32, Bas Bueno-de-Mesquita33, Jeroen W G Derksen34, Emily Sonestedt35, Anna Winkvist36, Sophia Harlid37, Tonje Braaten38, Inger Torhild Gram38, Marko Lukic38, Mazda Jenab1, Elio Riboli5, Heinz Freisling1, Elisabete Weiderpass1, Marc J Gunter1, Pietro Ferrari39. 1. International Agency for Research On Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France. 2. Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway, Department of Research, Cancer Registry of Norway, Oslo, Norway. 3. Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, U1219, 33000, Bordeaux, France. 4. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy. 5. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. 6. Université Paris-Saclay, UVSQ, Gustave Roussy, CESP U1018 Inserm, "Exposome and Heredity" Group, Villejuif, France. 7. Department of Statistics, Computer Science, Applications "G. Parenti" (DISIA), University of Florence, Florence, Italy. 8. Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. 9. German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany. 10. Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany. 11. Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany. 12. Danish Cancer Society Research Center, Diet, Genes and Environment, Copenhagen, Denmark. 13. Department of Public Health, Aarhus University, Aarhus, Denmark. 14. Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. 15. Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain. 16. Escuela Andaluza de Salud Pública (EASP), 18011, Granada, Spain. 17. Instituto de Investigación Biosanitaria Ibs.GRANADA, 18012, Granada, Spain. 18. Centro de Investigación Biomédica en Red de Epidemiología Y Salud Pública (CIBERESP), 28029, Madrid, Spain. 19. Department of Preventive Medicine and Public Health, University of Granada, 18071, Granada, Spain. 20. Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain. 21. Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain. 22. Instituto de Salud Carlos III, Madrid, Spain. 23. Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. 24. Research Group On Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia. 25. Navarra Public Health Institute, Pamplona, Spain. 26. IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. 27. Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Oxford, OX3 7LF, UK. 28. Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy. 29. Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy. 30. Hyblean Association for Epidemiological Research AIRE-ONLUS Ragusa, Milan, Italy. 31. Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, Orbassano, TO, Italy. 32. Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Naples, Italy. 33. Former Senior Scientist, Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, The Netherlands. 34. Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. 35. Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, 21428, Malmö, Sweden. 36. Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, 901 85, Umeå, Sweden. 37. Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden. 38. Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway. 39. International Agency for Research On Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France. ferrarip@iarc.fr.
Abstract
BACKGROUND: 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. OBJECTIVE: Leveraging longitudinal exposure assessments on alcohol intake at different ages, we examined the relationship between change in alcohol intake and subsequent CRC risk. METHODS: 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. RESULTS: 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. CONCLUSIONS: Increasing alcohol intake during mid-to-late adulthood raised CRC risk, while reduction lowered risk.
BACKGROUND: 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. OBJECTIVE: Leveraging longitudinal exposure assessments on alcohol intake at different ages, we examined the relationship between change in alcohol intake and subsequent CRC risk. METHODS: 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. RESULTS: 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. CONCLUSIONS: Increasing alcohol intake during mid-to-late adulthood raised CRC risk, while reduction lowered risk.
Authors: Melina Arnold; Heinz Freisling; Rachael Stolzenberg-Solomon; Frank Kee; Mark George O'Doherty; José Manuel Ordóñez-Mena; Tom Wilsgaard; Anne Maria May; Hendrik Bas Bueno-de-Mesquita; Anne Tjønneland; Philippos Orfanos; Antonia Trichopoulou; Paolo Boffetta; Freddie Bray; Mazda Jenab; Isabelle Soerjomataram Journal: Eur J Epidemiol Date: 2016-06-14 Impact factor: 8.082
Authors: Meng Wang; Yanqing Yi; Barbara Roebothan; Jennifer Colbourne; Victor Maddalena; Peizhong Peter Wang; Guang Sun Journal: J Environ Public Health Date: 2016-01-27