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British Journal of Cancer (2015) 112, 580593 | doi: 10.1038/bjc.2014.579
Keywords: alcohol; meta-analysis; doseresponse; epidemiology
V Bagnardi*,1,2, M Rota3,4, E Botteri2, I Tramacere5, F Islami6,7,8, V Fedirko9, L Scotti1, M Jenab10, F Turati4,11, E Pasquali2, C Pelucchi4, C Galeone4, R Bellocco1,12, E Negri4, G Corrao1, P Boffetta6 and C La Vecchia13
1Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy; 2Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy;
3Department of Health Sciences, Centre of Biostatistics for Clinical Epidemiology, University of Milan-Bicocca, Via Cadore 48, 20900 Monza, Italy; 4Department of Epidemiology, IRCCS Mario Negri Institute for Pharmacological Research, Via La Masa 19, 20156 Milan, Italy; 5Neurology, Besta Neurological Institute, Via Celoria 11, 20133 Milan, Italy; 6The 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; 7Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Science, Kargar Shomali Ave, 14117-13135 Tehran, I.R. Iran; 8Surveillance and Health Services Research, American Cancer Society, 250 Williams Street, Atlanta, GA 30303, USA; 9Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, 1518 Clifton Road, N.E., Atlanta, GA 30322, USA; 10Nutritional Epidemiology Group, International Agency for Research on Cancer, 150 Cours Albert-Thomas, 69008 Lyon, France; 11Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale Tumori, Via Vanzetti, 5 - 20133 Milan, Italy; 12Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Box 281, Stockholm 171 77, Sweden and 13Department of Clinical Sciences and Community Health, University of Milan, Via Vanzetti, 5 - 20133 Milan, Italy
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 doseresponse 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...