Br J Cancer. 2014 Nov 25. doi: 10.1038/bjc.2014.579. [Epub ahead of print]

Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis.

Bagnardi V1, Rota M2, Botteri E3, Tramacere I4, Islami F5, Fedirko V6, Scotti L7, Jenab M8, Turati F9, Pasquali E3, Pelucchi C10, Galeone C10, Bellocco R11,Negri E10, Corrao G7, Boffetta P12, La Vecchia C13.

Author information

• 11] Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy [2] Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
• 21] Department of Health Sciences, Centre of Biostatistics for Clinical Epidemiology, University of Milan-Bicocca, Via Cadore 48, 20900 Monza, Italy [2] Department of Epidemiology, IRCCS Mario Negri Institute for Pharmacological Research, Via La Masa 19, 20156 Milan, Italy.
• 3Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
• 4Neurology, Besta Neurological Institute, Via Celoria 11, 20133 Milan, Italy.
• 51] The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029-6574, USA [2] Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Science, Kargar Shomali Ave, 14117-13135 Tehran, I.R. Iran [3] Surveillance and Health Services Research, American Cancer Society, 250 Williams Street, Atlanta, GA 30303, USA.
• 6Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, 1518 Clifton Road, N.E., Atlanta, GA 30322, USA.
• 7Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy.
• 8Nutritional Epidemiology Group, International Agency for Research on Cancer, 150 Cours Albert-Thomas, 69008 Lyon, France.
• 91] Department of Epidemiology, IRCCS Mario Negri Institute for Pharmacological Research, Via La Masa 19, 20156 Milan, Italy [2] Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale Tumori, Via Vanzetti, 5 - 20133 Milan, Italy.
• 10Department of Epidemiology, IRCCS Mario Negri Institute for Pharmacological Research, Via La Masa 19, 20156 Milan, Italy.
• 111] Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy [2] Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Box 281, Stockholm 171 77, Sweden.
• 12The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029-6574, USA.
• 13Department of Clinical Sciences and Community Health, University of Milan, Via Vanzetti, 5 - 20133 Milan, Italy.

Abstract

Background:Alcohol is a risk factor for cancer of the oral cavity, pharynx, oesophagus, colorectum, liver, larynx and female breast, whereas its impact on other cancers remains controversial.Methods:We investigated the effect of alcohol on 23 cancer types through a meta-analytic approach. We used dose-response meta-regression models and investigated potential sources of heterogeneity.Results:A total of 572 studies, including 486 538 cancer cases, were identified. Relative risks (RRs) for heavy drinkers compared with nondrinkers and occasional drinkers were 5.13 for oral and pharyngeal cancer, 4.95 for oesophageal squamous cell carcinoma, 1.44 for colorectal, 2.65 for laryngeal and 1.61 for breast cancer; for thoseneoplasms there was a clear dose-risk relationship. Heavy drinkers also had a significantly higher risk of cancer of the stomach (RR 1.21), liver (2.07), gallbladder (2.64), pancreas (1.19) and lung (1.15). There was indication of a positive association between alcohol consumption and risk of melanoma and prostate cancer. Alcohol consumption and risk of Hodgkin's and Non-Hodgkin's lymphomas were inversely associated.Conclusions:Alcohol increases risk of cancer of oral cavity and pharynx, oesophagus, colorectum, liver, larynx and female breast. There is accumulating evidence that alcohol drinking is associated with some other cancers such as pancreas and prostate cancer and melanoma.