Table 2.
Alcohol Intake and Colorectal Cancer Risk in the Multiethnic Cohort Study, Hawaii and California, 1993–2013
| Subgroup | No. of Cases | Alcohol Intake, g/day | Per 10-g Increment | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0 | 0.1–4.9 | 5.0–14.9 | 15.0–29.9 | ≥30.0 | P for Trend | |||||||||
| HR | 95% CI | HR | 95% CI | HR | 95% CI | HR | 95% CI | HR | 95% CI | HR | 95% CI | |||
| All | ||||||||||||||
| Model 1a | 4,923 | 1.00 | Referent | 0.99 | 0.92, 1.07 | 0.93 | 0.84, 1.03 | 1.11 | 1.00, 1.24 | 1.37 | 1.24, 1.50 | <0.001 | 1.03 | 1.02, 1.04 |
| Model 2a,b | 4,327 | 1.00 | Referent | 0.96 | 0.89, 1.04 | 0.93 | 0.83, 1.03 | 1.13 | 1.01, 1.27 | 1.36 | 1.23, 1.50 | <0.001 | 1.03 | 1.02, 1.04 |
| Model 3b,c | 4,327 | 1.00 | Referent | 0.99 | 0.91, 1.07 | 0.94 | 0.84, 1.05 | 1.12 | 1.00, 1.26 | 1.24 | 1.11, 1.37 | <0.001 | 1.02 | 1.01, 1.03 |
| Sex | ||||||||||||||
| Male | 2,304 | 1.00 | Referent | 1.06 | 0.94, 1.18 | 0.96 | 0.84, 1.10 | 1.16 | 1.01, 1.34 | 1.28 | 1.12, 1.45 | <0.001 | 1.02 | 1.01, 1.03 |
| Female | 2,023 | 1.00 | Referent | 0.93 | 0.83, 1.04 | 0.93 | 0.77, 1.12 | 1.06 | 0.85, 1.32 | 1.15 | 0.92, 1.43 | 0.16 | 1.01 | 0.98, 1.04 |
| P for heterogeneity | 0.74 | |||||||||||||
| Age at cohort entry, years | ||||||||||||||
| 45–54 | 830 | 1.00 | Referent | 0.99 | 0.82, 1.18 | 1.00 | 0.80, 1.25 | 0.81 | 0.61, 1.08 | 1.36 | 1.08, 1.71 | 0.02 | 1.02 | 1.00, 1.04 |
| 55–64 | 1,405 | 1.00 | Referent | 0.99 | 0.86, 1.14 | 0.97 | 0.80, 1.16 | 1.22 | 1.01, 1.49 | 1.17 | 0.97, 1.41 | 0.05 | 1.02 | 1.00, 1.03 |
| 65–75 | 2,092 | 1.00 | Referent | 1.00 | 0.89, 1.12 | 0.89 | 0.76, 1.05 | 1.21 | 1.03, 1.44 | 1.23 | 1.05, 1.44 | 0.002 | 1.02 | 1.00, 1.03 |
| P for heterogeneity | 0.29 | |||||||||||||
| Race/ethnicity | ||||||||||||||
| Black | 800 | 1.00 | Referent | 1.06 | 0.89, 1.26 | 0.85 | 0.65, 1.11 | 1.01 | 0.74, 1.37 | 1.03 | 0.77, 1.38 | 0.95 | 0.99 | 0.97, 1.02 |
| Native Hawaiian | 276 | 1.00 | Referent | 1.29 | 0.94, 1.76 | 1.08 | 0.72, 1.64 | 1.04 | 0.63, 1.70 | 1.64 | 1.12, 2.40 | 0.03 | 1.02 | 0.99, 1.06 |
| Japanese American | 1,554 | 1.00 | Referent | 1.06 | 0.92, 1.21 | 1.02 | 0.84, 1.24 | 1.15 | 0.94, 1.42 | 1.38 | 1.14, 1.68 | 0.001 | 1.04 | 1.02, 1.06 |
| Latino | 808 | 1.00 | Referent | 0.90 | 0.76, 1.08 | 0.91 | 0.72, 1.16 | 1.29 | 0.99, 1.68 | 1.20 | 0.93, 1.55 | 0.03 | 1.01 | 0.98, 1.03 |
| White | 889 | 1.00 | Referent | 0.83 | 0.69, 1.00 | 0.90 | 0.72, 1.12 | 1.06 | 0.85, 1.32 | 1.11 | 0.90, 1.35 | 0.06 | 1.02 | 1.00, 1.04 |
| P for heterogeneity | 0.07 | |||||||||||||
| Family history of colorectal cancer | ||||||||||||||
| No | 3,854 | 1.00 | Referent | 0.97 | 0.89, 1.06 | 0.97 | 0.87, 1.08 | 1.13 | 1.00, 1.28 | 1.25 | 1.12, 1.40 | <0.001 | 1.02 | 1.00, 1.03 |
| Yes | 473 | 1.00 | Referent | 1.13 | 0.90, 1.43 | 0.69 | 0.47, 1.00 | 1.04 | 0.72, 1.50 | 1.06 | 0.75, 1.50 | 0.81 | 1.03 | 0.99, 1.06 |
| P for heterogeneity | 0.23 | |||||||||||||
| Body mass indexd | ||||||||||||||
| <25.0 | 1,711 | 1.00 | Referent | 0.98 | 0.86, 1.12 | 0.99 | 0.83, 1.17 | 1.15 | 0.96, 1.39 | 1.38 | 1.17, 1.63 | <0.001 | 1.03 | 1.02, 1.05 |
| 25.0–29.9 | 1,700 | 1.00 | Referent | 0.96 | 0.85, 1.09 | 0.91 | 0.77, 1.07 | 1.09 | 0.91, 1.30 | 1.10 | 0.93, 1.31 | 0.14 | 1.00 | 0.98, 1.02 |
| ≥30.0 | 916 | 1.00 | Referent | 1.07 | 0.90, 1.26 | 0.92 | 0.71, 1.18 | 1.13 | 0.85, 1.51 | 1.26 | 0.98, 1.62 | 0.07 | 1.01 | 0.99, 1.04 |
| P for heterogeneity | 0.10 | |||||||||||||
| Physical activity, hours/daye | ||||||||||||||
| 0 | 2,114 | 1.00 | Referent | 0.99 | 0.88, 1.11 | 0.91 | 0.77, 1.07 | 1.04 | 0.86, 1.26 | 1.14 | 0.97, 1.35 | 0.12 | 1.01 | 0.99, 1.03 |
| 0.1–0.2 | 965 | 1.00 | Referent | 0.99 | 0.84, 1.17 | 0.90 | 0.72, 1.13 | 1.20 | 0.94, 1.52 | 1.38 | 1.10, 1.72 | 0.002 | 1.03 | 1.00, 1.05 |
| ≥0.3 | 1,248 | 1.00 | Referent | 1.00 | 0.86, 1.17 | 1.02 | 0.85, 1.23 | 1.20 | 0.99, 1.46 | 1.29 | 1.08, 1.55 | 0.002 | 1.02 | 1.00, 1.04 |
| P for heterogeneity | 0.72 | |||||||||||||
| Smoking status | ||||||||||||||
| Never | 1,723 | 1.00 | Referent | 0.95 | 0.84, 1.08 | 0.93 | 0.76, 1.12 | 1.01 | 0.80, 1.29 | 1.35 | 1.07, 1.69 | 0.01 | 1.02 | 0.99, 1.05 |
| Former | 1,897 | 1.00 | Referent | 0.99 | 0.88, 1.12 | 0.91 | 0.78, 1.06 | 1.17 | 1.00, 1.36 | 1.14 | 0.98, 1.33 | 0.03 | 1.02 | 1.00, 1.03 |
| Current | 707 | 1.00 | Referent | 1.08 | 0.88, 1.33 | 1.03 | 0.80, 1.33 | 1.12 | 0.85, 1.46 | 1.35 | 1.08, 1.68 | 0.009 | 1.02 | 1.00, 1.04 |
| P for heterogeneity | 0.46 | |||||||||||||
| NSAID use | ||||||||||||||
| Never | 2,215 | 1.00 | Referent | 0.97 | 0.87, 1.09 | 1.02 | 0.87, 1.18 | 1.15 | 0.97, 1.35 | 1.35 | 1.16, 1.56 | <0.001 | 1.03 | 1.01, 1.04 |
| Ever | 2,112 | 1.00 | Referent | 1.00 | 0.90, 1.12 | 0.87 | 0.74, 1.01 | 1.10 | 0.93, 1.29 | 1.12 | 0.96, 1.31 | 0.11 | 1.00 | 0.99, 1.02 |
| P for heterogeneity | 0.02 | |||||||||||||
| MHT use among women | ||||||||||||||
| Never | 1,119 | 1.00 | Referent | 0.90 | 0.77, 1.05 | 0.90 | 0.69, 1.17 | 0.92 | 0.67, 1.28 | 1.09 | 0.79, 1.49 | 0.67 | 1.02 | 0.98, 1.06 |
| Ever | 904 | 1.00 | Referent | 0.95 | 0.81, 1.13 | 0.95 | 0.73, 1.24 | 1.21 | 0.89, 1.64 | 1.23 | 0.90, 1.68 | 0.10 | 1.01 | 0.96, 1.05 |
| P for heterogeneity | 0.56 | |||||||||||||
| Dietary fiber, g/1,000 kcal | ||||||||||||||
| <9.6 | 1,600 | 1.00 | Referent | 1.05 | 0.91, 1.22 | 0.94 | 0.78, 1.12 | 1.22 | 1.02, 1.45 | 1.46 | 1.26, 1.68 | <0.001 | 1.02 | 1.01, 1.04 |
| 9.6–13.2 | 1,430 | 1.00 | Referent | 0.94 | 0.82, 1.08 | 0.92 | 0.77, 1.10 | 0.99 | 0.80, 1.21 | 0.97 | 0.78, 1.22 | 0.92 | 1.00 | 0.96, 1.03 |
| ≥13.3 | 1,297 | 1.00 | Referent | 0.99 | 0.86, 1.14 | 1.02 | 0.83, 1.24 | 1.29 | 1.01, 1.65 | 1.20 | 0.88, 1.65 | 0.09 | 1.06 | 1.01, 1.11 |
| P for heterogeneity | 0.006 | |||||||||||||
| Total folate intake, μg DFEsf | ||||||||||||||
| <350 | 1,520 | 1.00 | Referent | 1.01 | 0.88, 1.16 | 0.93 | 0.77, 1.13 | 1.22 | 1.01, 1.49 | 1.43 | 1.19, 1.71 | <0.001 | 1.03 | 1.01, 1.06 |
| 350–769 | 1,449 | 1.00 | Referent | 0.95 | 0.83, 1.10 | 0.85 | 0.70, 1.03 | 1.07 | 0.88, 1.31 | 1.21 | 1.01, 1.45 | 0.02 | 1.01 | 1.00, 1.03 |
| ≥770 | 1,358 | 1.00 | Referent | 1.00 | 0.87, 1.15 | 1.04 | 0.87, 1.25 | 1.07 | 0.87, 1.32 | 1.08 | 0.89, 1.32 | 0.41 | 1.01 | 1.00, 1.03 |
| P for heterogeneity | 0.03 | |||||||||||||
| Alcohol typeg | ||||||||||||||
| Beer | 639 | 1.00 | Referent | 1.12 | 0.98, 1.28 | 1.06 | 0.87, 1.29 | 1.22 | 0.99, 1.51 | 1.47 | 1.23, 1.76 | <0.001 | 1.04 | 1.02, 1.05 |
| Wine | 344 | 1.00 | Referent | 0.96 | 0.84, 1.09 | 0.94 | 0.68, 1.31 | 1.22 | 0.85, 1.76 | 1.83 | 1.18, 2.83 | 0.02 | 1.08 | 1.01, 1.14 |
| Liquor | 156 | 1.00 | Referent | 1.02 | 0.81, 1.28 | 1.14 | 0.76, 1.71 | 1.40 | 0.90, 2.15 | 1.11 | 0.79, 1.57 | 0.20 | 1.02 | 0.98, 1.06 |
| Anatomical subsite | ||||||||||||||
| Right colon | 2,042 | 1.00 | Referent | 0.94 | 0.84, 1.06 | 0.93 | 0.79, 1.08 | 1.05 | 0.89, 1.26 | 1.06 | 0.90, 1.25 | 0.32 | 1.01 | 0.99, 1.03 |
| Left colon | 1,215 | 1.00 | Referent | 1.13 | 0.98, 1.32 | 1.03 | 0.84, 1.26 | 1.15 | 0.92, 1.43 | 1.35 | 1.11, 1.65 | 0.008 | 1.02 | 1.00, 1.04 |
| Rectum | 988 | 1.00 | Referent | 0.96 | 0.81, 1.14 | 0.88 | 0.70, 1.10 | 1.23 | 0.98, 1.55 | 1.42 | 1.16, 1.75 | <0.001 | 1.02 | 1.00, 1.04 |
| P for heterogeneity | <0.001 | |||||||||||||
Abbreviation: CI, confidence interval; DFE, dietary folate equivalent; HR, hazard ratio; MHT, menopausal hormone therapy; NSAID, nonsteroidal antiinflammatory drug.
a Adjusted for age at cohort entry, sex, and race/ethnicity.
b Excluding participants with missing data on any of the covariates.
c Additionally adjusted for family history of colorectal cancer, history of colorectal polyps, body mass index, pack-years of cigarette smoking, multivitamin use, NSAID use, physical activity, MHT use, and daily intakes of total energy (excluding energy from alcohol), red meat, dietary fiber, calcium, folate, and vitamin D. All subgroup analyses were based on Model 3, excluding covariates corresponding to stratification variables.
d Weight (kg)/height(m)2.
e Hours spent in vigorous work or sports per day.
f From foods and supplements.
g Among exclusive drinkers who drank only one type of alcohol. Nondrinkers of any types of alcohol were the reference group.