Introduction: The number of colorectal related deaths is estimated to be approximately 608000 worldwide, accounting for 8% of all cancer deaths and making Colorectal cancers the fourth most common cause of death due to cancer. In India, the annual incidence rates for colon cancer and rectal cancer are 4.4 and 4.1 per lakh respectively. As we know alcohol drinking may be associated with incidence of colorectal cancer. On the basis of a systematic review of epidemiological evidence, we evaluated this association among the Indian population. Although numerous studies reported a positive association between alcohol drinking and colorectal cancer risk, it remains unclear whether alcohol drinking is causally related to carcinogenesis of the colorectum. A report from the World Cancer Research Fund and American Institute for Cancer Research concluded that alcohol drinking ‘probably’ increases colorectal cancer risk, whereas a recent report of a Joint World Health Organization (WHO)/Food and Agriculture Organization (FAO) Expert Consultation did not include colorectal cancer in the list of alcohol-related malignancies.
Methods: Original data were obtained from searches of MEDLINE using PubMed, Indian Council of Medical Research, and other sites and places, complemented with manual searches. The evaluation of associations was based on the strength of evidence and the magnitude of association, together with biological plausibility as previously evaluated by the International Agency for Research on Cancer.
Results: We identified 4 cohort studies and 10 case–control studies. A moderate or strong positive association was observed between alcohol drinking and colon cancer risk in all large-scale cohort studies, with some showing a dose–response relation, and among several case–control studies. The risk of colon or colorectal cancer was increased even among moderate drinkers consuming <45 g of alcohol per day, levels at which no material increase in the risk was observed in a pooled analysis of Western studies. A positive association with rectal cancer was also reported, but it was less consistent, and the magnitude of the association was generally weaker compared with colon cancer.
Conclusion: We conclude that alcohol drinking probably increases the risk of colorectal cancer among the Indian population. More specifically, the association for the colon is probable, whereas that for the rectum is possible