Japanese Journal of Clinical Oncology Advance Access originally published online on July 26, 2006
Japanese Journal of Clinical Oncology 2006 36(9):582-597; doi:10.1093/jjco/hyl069
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© 2006 Foundation for Promotion of Cancer Research
Alcohol Drinking and Colorectal Cancer Risk: an Evaluation Based on a Systematic Review of Epidemiologic Evidence among the Japanese Population
1 Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 2 Department of Preventive Medicine, Saga Medical School, Faculty of Medicine, Saga University, Saga, 3 Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, 4 Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, 5 Department of Epidemiology & Preventive Medicine, Gifu University School of Medicine, Gifu and 6 Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
For reprints and all correspondence: Tetsuya Mizoue, MD, Department of Epidemiology, Research Institute, International Medical Center of Japan, 1-21-1 Toyama, Shijuku-ku, Tokyo 162-8555, Japan. E-mail: mizoue{at}ri.imcj.go.jp
* Members of the Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan: S.T. (Principal Investigator), M.I. Shizuka Sasazuki, Motoki Iwasaki, T.O. (National Cancer Center, Tokyo); I.T. (since 2004), Yoshitaka Tsubono (in 2003), Taichi Shimazu (Tohoku University, Sendai); K.W. (Aichi Cancer Center, Nagoya); C.N. (Gifu University, Gifu); T.M. (Kyushu University, Fukuoka); and K.T. (Saga University, Saga).
Received April 4, 2006; accepted May 26, 2006
Background: It remains unclear whether alcohol drinking is causally associated with colorectal cancer. On the basis of a systematic review of epidemiological evidence, we evaluated this association among the Japanese population, who may be more susceptible to alcohol-related diseases than Western populations.
Methods: Original data were obtained from searches of MEDLINE using PubMed, 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 5 cohort studies and 13 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 <46 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 Japanese population. More specifically, the association for the colon is probable, whereas that for the rectum is possible.
Key Words: systematic review • epidemiology • alcohol drinking • colorectal cancer • Japanese
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