Quantitative methods were used to review epidemiologic data relating consumption of alcoholic beverages to risk of colorectal cancer. The data (27 studies) supported the presence of a weak association. For consumption of two alcoholic beverages daily, on average the relative risk of colorectal cancer was 1.10 (95% confidence interval 1.05–1.14). Other findings were: (1) the association did not vary according to gender or site within the large bowel; (2) results from follow-up studies (relative risk 1.32, 95% confidence interval 1.16–1.51) suggested a stronger relationship than those from case-control studies (relative risk 1.07, 95% confidence interval 1.02–1.12); and (3) the evidence supporting beverage specificity was not conclusive, although the results were consistent with a stronger association with consumption of beer (relative risk 1.26, 95% confidence interval 1.13–1.41) than with consumption of wine (relative risk 1.11, 95% confidence interval 0.91–1.36) or liquor (relative risk 1.13, 95% confidence interval 0.99–1.29). Because the magnitude of the association between alcohol consumption and risk of colorectal cancer was small, the findings regarding a causal role of alcohol were inconclusive.
Similar content being viewed by others
References
International Agency for Research on Cancer. Alcohol Drinking, IARC Monographs on the evaluation of carcinogenic risks to humans Vol. 44. Lyon: World Health Organization 1988: 255.
Hill AB. The environment and disease: association or causation? Proc R Soc Med 1965; 58: 295–300.
Pollack ES, Nomura AM, Heilbrun LK, Stemmermann GN, Green SB. Prospective study of alcohol consumption and cancer. N Engl J Med 1984; 310: 617–21.
Kune S, Kune GA, Watson LF. Case-control study of alcoholic beverages as etiological factors: the Melbourne Colorectal Cancer Study. Nutr Cancer 1987; 9: 43–56.
Dean G, MacLennan R, McLoughlin H, Shelley E. Causes of death of blue-collar workers at a Dublin brewery, 1954–73. Br J Cancer 1979; 40: 581–9.
Freudenheim J, Graham S, Marshall J, Haughey B, Wilkinson G. Alcohol consumption and rectal cancer: a case-control study (Abstract). Am J Epidemiol 1988; 128: 890–1.
Kabat GC, Howson CP, Wynder EL. Beer consumption and rectal cancer. Int J Epidemiol 1986; 15: 494–501.
Bross I. Misclassification in 2×2 tables. Biometrics 1954; 10: 478–86.
Greenland S. Quantitative methods in the review of epidemiologic literature. Epidemiologic Reviews 1987; 9: 1–30.
Woolf B. On estimating the relation between blood group and disease. Ann Hum Gent 1955; 19: 251–3.
National Health Interview Survey 1983 Alcohol Supplement, data tape. Hyattsville, MD: National Center for Health Statistics, Division of Health Interview Statistics, 1985.
Klatsky AL, Armstrong MA, Friedman GD, Hiatt RA. The relations of alcoholic beverage use to colon and rectal cancer. Am J Epidemiol 1988; 128: 1007–15.
Draper NR, Smith H. Applied Regression Analysis. New York: John Wiley & Sons, 1981: 112.
Rothman K. Modern Epidemiology. Boston: Little, Brown, 1986: 343.
DerSimonian R, Laird N. Meta-analysis in clinical trials. Controlled Clin Trials 1986; 7: 177–88.
Jensen OM. Cancer morbidity and causes of death among Danish brewery workers. Int J Cancer 1979; 23: 454–63.
Schmidt W, Popham RE. The role of drinking and smoking in mortality from cancer and other causes in male alcoholics. Cancer 1981; 47: 1031–41.
Hakulinen T, Lehtimaki L, Lehtonen M, Teppo L. Cancer morbidity among two male cohorts with increased alcohol consumption in Finland. JNCI 1974; 52: 1711–14.
Sundby P. Alcoholism and Mortality Oslo: Universitets-forlaget, 1967.
Adelstein A, White G. Alcoholism and mortality. Popul Trends 1976; 6: 7–13.
Monson RR, Lyon JL. Proportional mortality among alcoholics. Cancer 1975; 36: 1077–79.
Robinette CD, Hrubec Z, Fraumeni JFJr. Chronic alcoholism and subsequent mortality in World War II veterans. Am J Epidemiol 1979; 109: 687–700.
Modan B, Barell V, Lubin F, Modan M, Greenberg RA, Graham S. Low-fiber intake as an etiologic factor in cancer of the colon. JNCI 1975; 55: 15–18.
Wu AH, Paganini-Hill A, Ross RK, Henderson BE. Alcohol, physical activity and other risk factors for colorectal cancer: a prospective study. Br J Cancer 1987; 55: 687–94.
Garland C, Shekelle RB, Barrett-Connor E, Criqui MH, Rossof AH, Paul O. Dietary vitamin D and calcium and risk of colorectal cancer: a 19-year prospective study in men. Lancet 1985; i: 307–9.
Hirayama T. A large scale cohort study on the relationship between diet and selected cancers of the digestive organs. In: Bruce WR, Correa P, Lipkin M, Tannenbaum SR, eds. Gastrointestinal Cancer: Endogenous Factors, Banbury Report No. 7. Cold Spring Harbor, NY: Cold Spring Harbor Laboratory, 1981: 409–26.
Potter JD, McMichael AJ. Diet and cancer of the colon and rectum: a case-control study. JNCI 1986; 76: 557–69.
Martinez I, Torres R, Frias Z, Colon JR, Fernandez N. Factors associated with adenocarcinomas of the large bowel in Puerto Rico. Adv Med Onc Res Educ 1982; 3: 45–52.
Graham S, Marshall J, Haughey B, et al. Dietary epidemiology of cancer of the colon in western New York. Am J Epidemiol 1988; 128: 490–503.
Tuyns AJ, Pequignot G, Gignoux M, Valla A. Cancers of the digestive tract, alcohol and tobacco. Int J Cancer 1982; 30: 9–11.
La Vecchia C, Negri E, Decarli A, et al. A case-control study of diet and colorectal cancer in northern Italy. Int J Cancer 1988; 41: 492–8.
Manousos O, Day NE, Trichopoulos D, Gerovassilis F, Tzonou A, Polychronopoulou A. Diet and colorectal cancer: a case-control study in Greece. Int J Cancer 1983; 32: 1–5.
Williams RR, Horm JW. Association of cancer sites with tobacco and alcohol consumption and socio-economic status of patients: interview study from the Third National Cancet Survey. JNCI 1977; 58: 525–47.
Macquart-Moulin G, Riboli E, Cornee J, Charnay B, Berthezene P, Day N. Case-control study on colorectal cancer and diet in Marseilles. Int J Cancer 1986; 38: 183–91.
Bristol JB, Emmett PM, Heaton KW, Williamson RC. Sugar, fat, and the risk of colorectal cancer. Br Med J 1985; 291: 1467–70.
Pickle LW, Greene MH, Ziegler RG, et al. Colorectal cancer in rural Nebraska. Cancer Res 1984; 44: 363–9.
Higginson J. Etiological factors in gastrointestinal cancer in man. JNCI 1966; 37: 527–45.
Tajima K, Tominaga S. Dietary habits and gastro-intestinal cancers: a comparative case-control study of stomach and large intestinal cancers in Nagoya, Japan. Jpn J Cancer Res 1985; 76: 705–16.
Bjelke E. Case-control study of cancer of the stomach, colon, and rectum. In: Oncology 1970: Proceedings of the Tenth International Congress. Chicago: Yearbook Medical Publ, 1971; 5: 320–34.
Dales LG, Friedman GD, Ury HK, Grossman S, Williams SR. A case-control study of relationships of diet and other traits to colorectal cancer in American blacks. Am J Epidemiol 1979; 109: 132–44.
Stocks P. Cancer incidence in North Wales and Liverpool region in relation to habits and environment. British Empire Cancer Campaign 35th Annual Report, Part II (Suppl), London: 1957: 51–6.
Wynder EL, Kajitani T, Ishikawa S, Dodo H, Takano A. Environmental factors of cancer of the colon and rectum. II. Japanese epidemiological data. Cancer 1969; 23: 1210–20.
Graham S, Dayal H, Swanson M, Mittelman A, Wilkinson G. Diet in the epidemiology of cancer of the colon and rectum. JNCI 1978; 61: 709–14.
Wynder EL, Shigematsu T. Environmental factors of cancer of the colon and rectum. Cancer 1967; 20: 1520–61.
Miller AB, Howe GR, Jain M, Craib KJ, Harrison L. Food items and food groups as risk factors in a case-control study of diet and colo-rectal cancer. Int J Cncer 1983; 32: 155–61.
Longnecker MP, Berlin JA, Orza MJ, Chalmers TCC. A meta-analysis of alcohol consumption in relation to risk of breast cancer. JAMA 1988; 260: 652–6.
Longnecker MP. Re: The evaluation of the data collection process for a multicenter, population-based case-control design (Letter). Am J Epidemiol 1989; 129: 1311.
US Department of Health and Human Services. Fifth Special Report of the US Congress on Alcohol and Health, DHHS Pub No (ADM) 84–1291. Washington, DC: Superintendent of Documents, USGPO, 1984: 4.
Willett WC, Stampfer MJ, Colditz GA, Rosner B, Hennekens CH, Speizer FE. Moderate alcohol consumption and the risk of breast cancer. N Engl J Med 1987; 316: 1174–80.
Pietinen P, Hartman AM, Haapa E, et al. Reproducibility and validity of dietary assessment instruments. I. A self-administered food use questionnaire with a portion size picture booklet. Am J Epidemiol 1988; 128: 655–66.
Longnecker MP. A case-control study of alcoholic beverage consumption in relation to risk of cancer of the right colon and rectum in men. Cancer Causes and Control 1990; 1: 5–14.
Longnecker MP, Clapp RW, Sheahan K. Associations between smoking status and stage at diagnosis of colorectal cancer, Massachusetts, 1982–1987. Cancer 1989; 64: 1372–4.
Additional information
Dr Longnecker is in the Department of Epidemiology, UCLA School of Public Health, 10833 Le Conte Avenue, Los Angeles, CA 90024. At the time of this work be was a Medical Foundation Research Fellow in the Department of Epidemiology, Harvard School of Public Health, supported by the Medical Foundation, Inc., Boston, MA. Mss Orza, Adams, and Dr Chalmers are with the Technology Assessment Group, Harvard School of Public Health. Dr Vioque is with the Department of Epidemiology, Harvard School of Public Health and is supported by a grant from the FIS 89/0827 (Spain). The research was supported by a grant from the International Life Sciences Institute. Address reprint requests to Dr Longnecker.
Rights and permissions
About this article
Cite this article
Longnecker, M.P., Orza, M.J., Adams, M.E. et al. A meta-analysis of alcoholic beverage consumption in relation to risk of colorectal cancer. Cancer Causes Control 1, 59–68 (1990). https://doi.org/10.1007/BF00053184
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00053184