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British Journal of Cancer logoLink to British Journal of Cancer
. 2001 Nov;85(11):1700–1705. doi: 10.1054/bjoc.2001.2140

A meta-analysis of alcohol drinking and cancer risk

V Bagnardi 1, M Blangiardo 1, C La Vecchia 2,3, G Corrao 1
PMCID: PMC2363992  PMID: 11742491

Abstract

To evaluate the strength of the evidence provided by the epidemiological literature on the association between alcohol consumption and the risk of 18 neoplasms, we performed a search of the epidemiological literature from 1966 to 2000 using several bibliographic databases. Meta-regression models were fitted considering linear and non-linear effects of alcohol intake. The effects of characteristics of the studies, of selected covariates (tobacco) and of the gender of individuals included in the studies, were also investigated as putative sources of heterogeneity of the estimates. A total of 235 studies including over 117 000 cases were considered. Strong trends in risk were observed for cancers of the oral cavity and pharynx, oesophagus and larynx. Less strong direct relations were observed for cancers of the stomach, colon and rectum, liver, breast and ovary. For all these diseases, significant increased risks were found also for ethanol intake of 25 g per day. No significant nor consistent relation was observed for cancers of the pancreas, lung, prostate or bladder. Allowance for tobacco appreciably modified the relations with laryngeal, lung and bladder cancers, but not those with oral, oesophageal or colorectal cancers. This meta-analysis showed no evidence of a threshold effect for most alcohol-related neoplasms. The inference is limited by absence of distinction between lifelong abstainers and former drinkers in several studies, and the possible selective inclusion of relevant sites only in cohort studies. © 2001 Cancer Research Campaign http://www.bjcancer.com

Keywords: alcohol intake; neoplasms, humans; meta-analysis; risk

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Selected References

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  1. Aricó S., Corrao G., Torchio P., Galatola G., Tabone M., Valenti M., Di Orio F. A strong negative association between alcohol consumption and the risk of hepatocellular carcinoma in cirrhotic patients. A case-control study. Eur J Epidemiol. 1994 Jun;10(3):251–257. doi: 10.1007/BF01719346. [DOI] [PubMed] [Google Scholar]
  2. Barra S., Franceschi S., Negri E., Talamini R., La Vecchia C. Type of alcoholic beverage and cancer of the oral cavity, pharynx and oesophagus in an Italian area with high wine consumption. Int J Cancer. 1990 Dec 15;46(6):1017–1020. doi: 10.1002/ijc.2910460612. [DOI] [PubMed] [Google Scholar]
  3. Berlin J. A., Longnecker M. P., Greenland S. Meta-analysis of epidemiologic dose-response data. Epidemiology. 1993 May;4(3):218–228. doi: 10.1097/00001648-199305000-00005. [DOI] [PubMed] [Google Scholar]
  4. Bosetti C., Franceschi S., Levi F., Negri E., Talamini R., La Vecchia C. Smoking and drinking cessation and the risk of oesophageal cancer. Br J Cancer. 2000 Sep;83(5):689–691. doi: 10.1054/bjoc.2000.1274. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bosetti C., La Vecchia C., Negri E., Franceschi S. Wine and other types of alcoholic beverages and the risk of esophageal cancer. Eur J Clin Nutr. 2000 Dec;54(12):918–920. doi: 10.1038/sj.ejcn.1601113. [DOI] [PubMed] [Google Scholar]
  6. Corrao G., Bagnardi V., Zambon A., Arico S. Exploring the dose-response relationship between alcohol consumption and the risk of several alcohol-related conditions: a meta-analysis. Addiction. 1999 Oct;94(10):1551–1573. doi: 10.1046/j.1360-0443.1999.9410155111.x. [DOI] [PubMed] [Google Scholar]
  7. Corrao G., Rubbiati L., Bagnardi V., Zambon A., Poikolainen K. Alcohol and coronary heart disease: a meta-analysis. Addiction. 2000 Oct;95(10):1505–1523. doi: 10.1046/j.1360-0443.2000.951015056.x. [DOI] [PubMed] [Google Scholar]
  8. D'Avanzo B., La Vecchia C., Franceschi S., Gallotti L., Talamini R. Cigarette smoking and colorectal cancer: a study of 1,584 cases and 2,879 controls. Prev Med. 1995 Nov;24(6):571–579. doi: 10.1006/pmed.1995.1091. [DOI] [PubMed] [Google Scholar]
  9. Dennis L. K. Meta-analysis for combining relative risks of alcohol consumption and prostate cancer. Prostate. 2000 Jan;42(1):56–66. doi: 10.1002/(sici)1097-0045(20000101)42:1<56::aid-pros7>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  10. Dorgan J. F., Baer D. J., Albert P. S., Judd J. T., Brown E. D., Corle D. K., Campbell W. S., Hartman T. J., Tejpar A. A., Clevidence B. A. Serum hormones and the alcohol-breast cancer association in postmenopausal women. J Natl Cancer Inst. 2001 May 2;93(9):710–715. doi: 10.1093/jnci/93.9.710. [DOI] [PubMed] [Google Scholar]
  11. Fioretti F., Bosetti C., Tavani A., Franceschi S., La Vecchia C. Risk factors for oral and pharyngeal cancer in never smokers. Oral Oncol. 1999 Jul;35(4):375–378. doi: 10.1016/s1368-8375(98)00125-0. [DOI] [PubMed] [Google Scholar]
  12. Franceschi S., Levi F., Dal Maso L., Talamini R., Conti E., Negri E., La Vecchia C. Cessation of alcohol drinking and risk of cancer of the oral cavity and pharynx. Int J Cancer. 2000 Mar 15;85(6):787–790. doi: 10.1002/(sici)1097-0215(20000315)85:6<787::aid-ijc8>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  13. Franceschi S., Talamini R., Barra S., Barón A. E., Negri E., Bidoli E., Serraino D., La Vecchia C. Smoking and drinking in relation to cancers of the oral cavity, pharynx, larynx, and esophagus in northern Italy. Cancer Res. 1990 Oct 15;50(20):6502–6507. [PubMed] [Google Scholar]
  14. Giovannucci E. An updated review of the epidemiological evidence that cigarette smoking increases risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev. 2001 Jul;10(7):725–731. [PubMed] [Google Scholar]
  15. Greenland S., Longnecker M. P. Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol. 1992 Jun 1;135(11):1301–1309. doi: 10.1093/oxfordjournals.aje.a116237. [DOI] [PubMed] [Google Scholar]
  16. Grønbaek M., Becker U., Johansen D., Tønnesen H., Jensen G., Sørensen T. I. Population based cohort study of the association between alcohol intake and cancer of the upper digestive tract. BMJ. 1998 Sep 26;317(7162):844–847. doi: 10.1136/bmj.317.7162.844. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. La Vecchia C., Negri E., Cavalieri d'Oro L., Franceschi S. Liver cirrhosis and the risk of primary liver cancer. Eur J Cancer Prev. 1998 Aug;7(4):315–320. doi: 10.1097/00008469-199808000-00007. [DOI] [PubMed] [Google Scholar]
  18. Longnecker M. P. Alcohol consumption and risk of cancer in humans: an overview. Alcohol. 1995 Mar-Apr;12(2):87–96. doi: 10.1016/0741-8329(94)00088-3. [DOI] [PubMed] [Google Scholar]
  19. Longnecker M. P. Alcoholic beverage consumption in relation to risk of breast cancer: meta-analysis and review. Cancer Causes Control. 1994 Jan;5(1):73–82. doi: 10.1007/BF01830729. [DOI] [PubMed] [Google Scholar]
  20. Longnecker M. P., Enger S. M. Epidemiologic data on alcoholic beverage consumption and risk of cancer. Clin Chim Acta. 1996 Mar 15;246(1-2):121–141. doi: 10.1016/0009-8981(96)06232-8. [DOI] [PubMed] [Google Scholar]
  21. Longnecker M. P., Orza M. J., Adams M. E., Vioque J., Chalmers T. C. A meta-analysis of alcoholic beverage consumption in relation to risk of colorectal cancer. Cancer Causes Control. 1990 Jul;1(1):59–68. doi: 10.1007/BF00053184. [DOI] [PubMed] [Google Scholar]
  22. Negri E., La Vecchia C., Franceschi S., Decarli A., Bruzzi P. Attributable risks for oesophageal cancer in northern Italy. Eur J Cancer. 1992;28A(6-7):1167–1171. doi: 10.1016/0959-8049(92)90479-l. [DOI] [PubMed] [Google Scholar]
  23. Negri E., La Vecchia C., Franceschi S., Tavani A. Attributable risk for oral cancer in northern Italy. Cancer Epidemiol Biomarkers Prev. 1993 May-Jun;2(3):189–193. [PubMed] [Google Scholar]
  24. Royston P., Ambler G., Sauerbrei W. The use of fractional polynomials to model continuous risk variables in epidemiology. Int J Epidemiol. 1999 Oct;28(5):964–974. doi: 10.1093/ije/28.5.964. [DOI] [PubMed] [Google Scholar]
  25. Talamini R., La Vecchia C., Levi F., Conti E., Favero A., Franceschi S. Cancer of the oral cavity and pharynx in nonsmokers who drink alcohol and in nondrinkers who smoke tobacco. J Natl Cancer Inst. 1998 Dec 16;90(24):1901–1903. doi: 10.1093/jnci/90.24.1901. [DOI] [PubMed] [Google Scholar]
  26. Tavani A., Negri E., Franceschi S., Barbone F., La Vecchia C. Attributable risk for laryngeal cancer in northern Italy. Cancer Epidemiol Biomarkers Prev. 1994 Mar;3(2):121–125. [PubMed] [Google Scholar]
  27. Tuyns A. J., Péquignot G., Abbatucci J. S. Oesophageal cancer and alcohol consumption; importance of type of beverage. Int J Cancer. 1979 Apr 15;23(4):443–447. doi: 10.1002/ijc.2910230402. [DOI] [PubMed] [Google Scholar]
  28. Zeegers M. P., Tan F. E., Verhagen A. P., Weijenberg M. P., van den Brandt P. A. Elevated risk of cancer of the urinary tract for alcohol drinkers: a meta-analysis. Cancer Causes Control. 1999 Oct;10(5):445–451. doi: 10.1023/a:1008938520686. [DOI] [PubMed] [Google Scholar]

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