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Alcohol drinking and the risk of colorectal cancer death: a meta-analysis

Cai, Shaofang; Li, Yingjun; Ding, Ye; Chen, Kun; Jin, Mingjuan

European Journal of Cancer Prevention: November 2014 - Volume 23 - Issue 6 - p 532–539
doi: 10.1097/CEJ.0000000000000076
Research Papers: Gastrointestinal Cancer

A causal link between alcohol consumption and colorectal cancer (CRC) was established only recently by the International Agency for Research on Cancer. However, the quantitative association between alcohol drinking and CRC mortality is still an open question. We performed a systemic review and meta-analysis on epidemiological studies to quantify the risk for CRC mortality at different levels of alcohol consumption. A literature search was carried out in PubMed and Web of Science to identify all relevant studies published from January 1966 to June 2013. The pooled relative risk (RR) and the corresponding 95% confidence interval (CI) were estimated by categorical meta-analysis. A dose–risk relation was also analyzed. Nine cohort studies exploring the association between CRC mortality and alcohol drinking were identified. Compared with non/occasional drinkers, the pooled RR was 1.03 (95% CI, 0.93–1.15) for any, 0.97 (95% CI, 0.86–1.10) for light (≤12.5 g/day of ethanol), 1.04 (95% CI, 0.94–1.16) for moderate (12.6–49.9 g/day of ethanol), and 1.21 (1.01–1.46) for heavy drinkers (≥50 g/day of ethanol). For heavy drinkers, the pooled estimate was apparently higher for men (RR=1.28; 95% CI, 1.13–1.46) than for women (RR=0.79; 95% CI, 0.40–1.54; Pheterogeneity=0.007). The dose–response analysis showed a J-shaped relationship between alcohol consumption and CRC mortality. The present meta-analysis provides the evidence for an association between heavy alcohol drinking (≥50 g/day of ethanol) and CRC mortality.

Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, People’s Republic of China

All supplementary digital content is available directly from the corresponding author.

Correspondence to Mingjuan Jin, MD, PhD, Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, 866 Yuhangtang Road, Hangzhou 310058, People’s Republic of China Tel: +86 0571 88208193; fax: +86 0571 88208194; e-mail:

Received September 7, 2013

Accepted June 30, 2014

© 2014 Lippincott Williams & Wilkins, Inc.