酒精和大腸直腸癌風險有關聯


  【24drs.com】根據一篇新發表的統合分析結果,飲酒與大腸直腸癌風險有強烈關聯,且和飲酒量有關。
  
  法國里昂國際癌症研究中心的Veronika Fedirko博士等人在9月的腫瘤學誌(Annals of Oncology)中發表研究結果。
  
  根據研究者指出,許多研究認為飲酒和大腸直腸癌風險有關,不過,有關輕度和/或適度飲酒之關聯的精準量化、以及確認可能的閾值之間依舊有待確定;此外,需要更多有關性別、大腸直腸部位、地理區域等可能的異質性資訊。
  
  這篇研究包括了發表於2010年5月前的27個世代研究與34個案例控制研究,研究結果至少有三類飲酒類型。
  
  適度飲酒和大腸直腸癌風險增加21%有關(相對風險[RR]為1.21;95%信心區間[CI]為1.13 - 1.28),重度飲酒(≧4杯/天)和風險增加52%有關(RR,1.52;95% CI,1.27 - 1.81)。
  
  與未曾飲酒者或偶爾飲酒者相比,適度飲酒男性的風險(RR,1.24;95% CI,1.13 - 1.37)高於飲酒量差不多的女性(RR,1.08;95% CI,1.03 - 1.13)。
  
  此外,亞洲的重度飲酒者風險比其他種族更嚴重;研究人員指出,這是因為亞洲人的乙醛脫氫酶緩慢代謝變種的盛行率頗高。
  
  整體而言,攝取量與風險的分析發現,每天攝取10 g的酒精則大腸直腸癌風險顯著增加7%,這包括了輕度飲酒在內。根據研究者指出,1杯相當於12 g的乙醇。
  
  Fedirko博士等人結論指出,這篇大型統合分析的結果有重要的公衛意義,讓更多飲酒的女性和男性知道,特別是已開發國家,這與大腸直腸癌高盛行率有關。
  
  研究人員並未提出可以解釋飲酒與大腸直腸癌風險的可能機轉。此外,研究作者指出,他們並未檢視葉酸值、抽菸或其他可能的可調整因素等不同變項下,酒精和大腸直腸癌風險的關聯,因為很少研究探討這些關聯。

Alcohol Linked to Colorectal Cancer Risk

By Emma Hitt, PhD
Medscape Medical News

September 18, 2011 — Alcohol consumption appears to be strongly and dose-dependently linked to colorectal cancer risk, according to the findings of a new meta-analysis.

Veronika Fedirko, PhD, with the International Agency for Research on Cancer, in Lyon, France, and colleagues reported their findings in the September issue of the Annals of Oncology.

According to the researchers, several studies have suggested a link between alcohol consumption and colorectal cancer risk. However, "precise quantification of the association for light and/or moderate alcohol consumption and the identification of a possible threshold of effect remain to be determined." In addition, further information is needed on the "potential heterogeneity of effects by sex, colorectal site, and geographical region."

The current study included 27 cohort and 34 case-control studies published before May 2010 that reported results for at least 3 categories of alcohol intake.

Moderate alcohol consumption was associated with a 21% increase in colorectal cancer (relative risk [RR], 1.21; 95% confidence interval [CI], 1.13 - 1.28), whereas heavy drinking (? 4 drinks/day) was associated with a 52% increased risk (RR, 1.52; 95% CI, 1.27 - 1.81).

Compared with nondrinkers and occasional drinkers, men who drank moderate amounts of alcohol (RR, 1.24; 95% CI, 1.13 - 1.37) were more at risk than women who drank similar amounts (RR, 1.08; 95% CI, 1.03 - 1.13).

In addition, Asians were more at risk if they were heavy drinkers than were other ethnicities. The researchers state that this finding may be due in part to a high prevalence of the slow-metabolizing variant of aldehyde dehydrogenase enzyme, present among Asians.

Overall, the dose-risk analysis found a statistically significant 7% increased risk for colorectal cancer for 10 g per day of alcohol intake, which includes light alcohol consumers. According to the researchers, 1 drink is equivalent to 12 g of ethanol.

"The results from this large meta-analysis have important public health implications, given the large number of women and, especially, men consuming alcohol and the high incidence of colorectal cancer worldwide and in developed countries in particular," Dr. Fedirko and colleagues conclude.

No potential explanation was given by the researchers for a mechanism that could explain the association between alcohol consumption and colorectal cancer. In addition, the study authors note that they did not examine whether the "association of alcohol with colorectal cancer risk varied by folate status, smoking, or other potential modifying factors because very few studies investigated these associations."

This study was supported by the International Agency for Research on Cancer, the Italian Association for Research on Cancer, and the Italian Foundation for Cancer Research. The study authors have disclosed no relevant financial relationships.

    
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