A longitudinal evaluation of alcohol intake throughout adulthood and colorectal cancer risk

• Published in: European journal of epidemiology Vol. 37; no. 9; pp. 915 - 929
• Main Authors: Mayén, Ana-Lucia, Viallon, Vivian, Botteri, Edoardo, Proust-Lima, Cecile, Bagnardi, Vincenzo, Batista, Veronica, Cross, Amanda J., Laouali, Nasser, MacDonald, Conor J., Severi, Gianluca, Katzke, Verena, Bergmann, Manuela M., Schulze, Mattias B., Tjønneland, Anne, Eriksen, Anne Kirstine, Dahm, Christina C., Antoniussen, Christian S., Jakszyn, Paula, Sánchez, Maria-Jose, Amiano, Pilar, Colorado-Yohar, Sandra M., Ardanaz, Eva, Travis, Ruth, Palli, Domenico, Sabina, Sieri, Tumino, Rosario, Ricceri, Fulvio, Panico, Salvatore, Bueno-de-Mesquita, Bas, Derksen, Jeroen W. G., Sonestedt, Emily, Winkvist, Anna, Harlid, Sophia, Braaten, Tonje, Gram, Inger Torhild, Lukic, Marko, Jenab, Mazda, Riboli, Elio, Freisling, Heinz, Weiderpass, Elisabete, Gunter, Marc J., Ferrari, Pietro
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.09.2022; Springer Nature B.V; Springer Verlag
• Subjects: Adult; Alcohol change; Alcohol Drinking - adverse effects; Alcohol Drinking - epidemiology; Alcohol intake; Alcohol use; Alcohols; Assessments; Cancer; Cancer and Oncology; Cancer och onkologi; Cardiology; Clinical Medicine; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - etiology; Drinking behavior; Epidemiology; Female; Health risks; Health Sciences; Humans; Hälsovetenskap; Infectious Diseases; Klinisk medicin; Latent class analysis; Latent class mixed models; Life Sciences; Longitudinal exposure; Low alcohol; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Nutrition; Nutrition and Dietetics; Näringslära; Oncology; Prospective Studies; Public Health; Reduction; Risk analysis; Risk Factors; Santé publique et épidémiologie; Surveys and Questionnaires; Trajectory analysis; Trajectory profile analysis; Alcohol change; Alcohol intake; Longitudinal exposure; Latent class mixed models; Colorectal cancer; Trajectory profile analysis
• ISSN: 0393-2990; 1573-7284; 1573-7284
• DOI: 10.1007/s10654-022-00900-6

Background Alcohol intake is an established risk factor for colorectal cancer (CRC); however, there is limited knowledge on whether changing alcohol drinking habits during adulthood modifies CRC risk. Objective Leveraging longitudinal exposure assessments on alcohol intake at different ages, we examined the relationship between change in alcohol intake and subsequent CRC risk. Methods Within the European Prospective Investigation into Cancer and Nutrition, changes in alcohol intake comparing follow-up with baseline assessments were investigated in relation to CRC risk. The analysis included 191,180, participants and 1530 incident CRC cases, with exclusion of the first three years of follow-up to minimize reverse causation. Trajectory profiles of alcohol intake, assessed at ages 20, 30, 40, 50 years, at baseline and during follow-up, were estimated using latent class mixed models and related to CRC risk, including 407,605 participants and 5,008 incident CRC cases. Results Mean age at baseline was 50.2 years and the follow-up assessment occurred on average 7.1 years later. Compared to stable intake, a 12 g/day increase in alcohol intake during follow-up was positively associated with CRC risk (HR = 1.15, 95%CI 1.04, 1.25), while a 12 g/day reduction was inversely associated with CRC risk (HR = 0.86, 95%CI 0.78, 0.95). Trajectory analysis showed that compared to low alcohol intake, men who increased their alcohol intake from early- to mid- and late-adulthood by up to 30 g/day on average had significantly increased CRC risk (HR = 1.24; 95%CI 1.08, 1.42), while no associations were observed in women. Results were consistent by anatomical subsite. Conclusions Increasing alcohol intake during mid-to-late adulthood raised CRC risk, while reduction lowered risk.