Alcohol consumption and increased risk of colon cancer: Evidence from NHANES I Epidemiologic Follow-up Study

Several mechanisms have been proposed for the relationship between increased alcohol consumption and colonic carcinogenesis However, the findings from epidemiological studies are not consistent. Although the majority of cohort studies have observed positive association between colon cancer risk and alcohol consumption, the effects seen were generally weak. Findings from case-control studies depend on the study design. NHANES I Epidemiologic Follow-up Study consists of a non-institutional national probability-sampled population of 10,267 subjects with alcohol information at the baseline with 20 years of follow-up resulting in 211 cases of colon cancer. Cox proportional hazard models were used to estimate the relationship between the risk of colon cancer morbidity and the alcohol consumption information at the baseline. The results suggest that there is a significant increase of colon cancer risk for alcohol drinkers. The relative risks were 1.53 (95%CI=1.11, 2.10) and 1.58 (95%CI= 1.10, 2.27) for models unadjusted and adjusted for possible confounders, respectively, when comparing drinkers to non-drinkers. The adjustments include age, gender, race, education level, baseline aspirin use, and smoking status. Tertile distributions of alcohol amounts consumed as compared to non-drinkers resulted in adjusted relative risks of 1.41 (95%CI=0.90, 2.19), 1.59 (95%CI=1.04, 2.44), and 1.76 (95%CI=1.14, 2.72) for the tertiles with a significant dose-response relationship (p =0.04). The results of this study suggest that increased alcohol consumption is significantly associated with elevated risk of colon cancer.