Alcohol intake and mortality among survivors of colorectal cancer: The Cancer Prevention Study II Nutrition Cohort

Yang, Baiyu; Gapstur, Susan M.; Newton, Christina C.; Jacobs, Eric J.; Campbell, Peter T.

doi:10.1002/cncr.30556

Cited by 18 publications

(27 citation statements)

References 24 publications

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“…Although data on binge alcohol consumption and CRC risk is limited, mechanistically, this is possible, as binge drinking has been shown to increase CYP2E1 and HIF-1α levels in human samples [ 19 ]. In addition to CRC risk, one German study reported on an increased CRC mortality from heavy drinking (>50 g/day for men, >25 g/day for women, HR = 1.37, 95% CI, 1.06–1.78, p = 0.015) [ 20 ], though these findings were not replicated by another recent large study [ 21 ]. Nonetheless, a meta-analysis supported an association between heavy alcohol drinking (≥50 g/day of ethanol) and CRC mortality [ 14 ].…”

Section: The Epidemiology Of Alcohol and Colon Carcinogenesismentioning

confidence: 99%

Colorectal Cancer and Alcohol Consumption—Populations to Molecules

Rossi

Anwar

Usman

et al. 2018

Cancers

149

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Colorectal cancer (CRC) is a major cause of morbidity and mortality, being the third most common cancer diagnosed in both men and women in the world. Several environmental and habitual factors have been associated with the CRC risk. Alcohol intake, a common and rising habit of modern society, is one of the major risk factors for development of CRC. Here, we will summarize the evidence linking alcohol with colon carcinogenesis and possible underlying mechanisms. Some epidemiologic studies suggest that even moderate drinking increases the CRC risk. Metabolism of alcohol involves ethanol conversion to its metabolites that could exert carcinogenic effects in the colon. Production of ethanol metabolites can be affected by the colon microbiota, another recently recognized mediating factor to colon carcinogenesis. The generation of acetaldehyde and alcohol’s other metabolites leads to activation of cancer promoting cascades, such as DNA-adduct formation, oxidative stress and lipid peroxidation, epigenetic alterations, epithelial barrier dysfunction, and immune modulatory effects. Not only does alcohol induce its toxic effect through carcinogenic metabolites, but alcoholics themselves are predisposed to a poor diet, low in folate and fiber, and circadian disruption, which could further augment alcohol-induced colon carcinogenesis.

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Section: The Epidemiology Of Alcohol and Colon Carcinogenesismentioning

confidence: 99%

Colorectal Cancer and Alcohol Consumption—Populations to Molecules

Rossi

Anwar

Usman

et al. 2018

Cancers

149

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“…No major differences in survival in heavier drinkers were observed when compared to non/never drinkers (n=6 studies, HR 0.92, 95% CI 0.84-1.01). However, a J-shape association was noted in some studies, with heavier drinkers having poorer survival when compared to light drinkers [8,39,46], though this was not reflected in other studies as the excess risk compared to never drinkers was similar in heavy drinkers and light drinkers [9,10,13,15,38,47]. More studies comparing heavier drinkers to light drinkers are needed to assess whether alcohol reduction interventions would benefit colorectal cancer patients who drink heavily.…”

Section: Alcohol and Colorectal Cancer Survivalmentioning

confidence: 98%

“…We identified 15 studies assessing the association between alcohol intakes and survival in colorectal cancer patients [8][9][10]13,15,[38][39][40][41][42][43][44][45][46][47] from around the world (Supplementary table 1). Many of the studies identified did not adequately separate light, moderate and heavy drinkers [41][42][43]45].…”

Section: Alcohol and Colorectal Cancer Survivalmentioning

confidence: 99%

“…Nickelsen et al [22] found that 30-day mortality following surgery for colorectal cancer was better amongst light-moderate drinkers than non-drinkers. Long-term survival may also be improved, as pooled analyses suggested light or light-moderate drinkers had better overall survival (n=7 studies [9,10,13,15,38,46,47], HR 0.85, 95% CI: 0.77 to 0.94, Table 1) and colorectal cancer specific survival (n=5 studies [13,15,38,46,47], HR 0.82, 95% CI: 0.67-1.00, Figure 2) than non-or never drinkers. The results seem robust to differences in assessment timing, as no major differences were apparent between studies using pre-diagnostic measures and post-diagnostic measures.…”

Section: Alcohol and Colorectal Cancer Survivalmentioning

confidence: 99%

“…The results seem robust to differences in assessment timing, as no major differences were apparent between studies using pre-diagnostic measures and post-diagnostic measures. However, reverse causality is hard to rule out as the results for colorectal cancer specific survival from two studies using lifetime never drinkers as comparison are less consistent [46,47] and may warrant additional study. Therefore, it appears that colorectal cancer patients who consume light amounts of alcohol have better survival profiles than nondrinkers.…”

Section: Alcohol and Colorectal Cancer Survivalmentioning

confidence: 99%

See 2 more Smart Citations

Do smoking and alcohol behaviours influence GI cancer survival?

McMenamin

McCain

Kunzmann

2017

Best Practice & Research Clinical Gastroenterology

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Little is known about the role of alcohol and smoking in GI cancer survival compared to GI cancer development. We systematically reviewed the evidence for a role of smoking and alcohol in prognosis among GI cancer patients and inform whether smoking or alcohol cessation interventions or guidelines for GI cancer patients are likely to improve prognosis. A total of 84 relevant studies were identified. Continued smokers, particularly heavy smokers, had worse prognosis than never smokers in most GI cancers. However, more evidence is needed to establish the likely impact of smoking cessation interventions amongst GI cancer patients. Heavy alcohol drinkers had worse prognosis in oesophageal squamous cell carcinoma and hepatocellular carcinoma patients. Light alcohol consumption was not associated with worse prognosis from any GI cancer, though further studies are needed. UK guidelines for the general population recommending under 14 units (∼7 drinks) per week may be sufficient for GI cancer patients, until further evidence is available.

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Post‐diagnosis dietary factors, supplement use and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis

Chan,

Cariolou,

Markozannes

et al. 2024

Intl Journal of Cancer

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The role of diet in colorectal cancer prognosis is not well understood and specific lifestyle recommendations are lacking. We searched for randomised controlled trials (RCTs) and longitudinal observational studies on post‐diagnosis dietary factors, supplement use and colorectal cancer survival outcomes in PubMed and Embase from inception until 28th February 2022. Random‐effects dose–response meta‐analyses were conducted when at least three studies had sufficient information. The evidence was interpreted and graded by the CUP Global independent Expert Committee on Cancer Survivorship and Expert Panel. Five RCTs and 35 observational studies were included (30,242 cases, over 8700 all‐cause and 2100 colorectal cancer deaths, 3700 progression, recurrence, or disease‐free events). Meta‐analyses, including 3–10 observational studies each, were conducted for: whole grains, nuts/peanuts, red and processed meat, dairy products, sugary drinks, artificially sweetened beverages, coffee, alcohol, dietary glycaemic load/index, insulin load/index, marine omega‐3 polyunsaturated fatty acids, supplemental calcium, circulating 25‐hydroxyvitamin D (25[OH]D) and all‐cause mortality; for alcohol, supplemental calcium, circulating 25(OH)D and colorectal cancer‐specific mortality; and for circulating 25(OH)D and recurrence/disease‐free survival. The overall evidence was graded as ‘limited’. The inverse associations between healthy dietary and/or lifestyle patterns (including diets that comprised plant‐based foods), whole grains, total, caffeinated, or decaffeinated coffee and all‐cause mortality and the positive associations between unhealthy dietary patterns, sugary drinks and all‐cause mortality provided ‘limited—suggestive’ evidence. All other exposure‐outcome associations provided ‘limited—no conclusion’ evidence. Additional, well‐conducted cohort studies and carefully designed RCTs are needed to develop specific lifestyle recommendations for colorectal cancer survivors.

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Alcohol intake and mortality among survivors of colorectal cancer: The Cancer Prevention Study II Nutrition Cohort

Cited by 18 publications

References 24 publications

Colorectal Cancer and Alcohol Consumption—Populations to Molecules

Colorectal Cancer and Alcohol Consumption—Populations to Molecules

Do smoking and alcohol behaviours influence GI cancer survival?

Post‐diagnosis dietary factors, supplement use and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis

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