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BMC Cancer
Published in: BMC Cancer 1/2016

Open Access 01-12-2016 | Research article

Is alcohol consumption a risk factor for prostate cancer? A systematic review and meta–analysis

Authors: Jinhui Zhao, Tim Stockwell, Audra Roemer, Tanya Chikritzhs

Published in: BMC Cancer | Issue 1/2016

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Abstract

Background

Research on a possible causal association between alcohol consumption and risk of prostate cancer is inconclusive. Recent studies on associations between alcohol consumption and other health outcomes suggest these are influenced by drinker misclassification errors and other study quality characteristics. The influence of these factors on estimates of the relationship between alcohol consumption and prostate cancer has not been previously investigated.

Methods

PubMed and Web of Science searches were made for case–control and cohort studies of alcohol consumption and prostate cancer morbidity and mortality (ICD–10: C61) up to December 2014. Studies were coded for drinker misclassification errors, quality of alcohol measures, extent of control for confounding and other study characteristics. Mixed models were used to estimate relative risk (RR) of morbidity or mortality from prostate cancer due to alcohol consumption with study level controls for selection bias and confounding.

Results

A total of 340 studies were identified of which 27 satisfied inclusion criteria providing 126 estimates for different alcohol exposures. Adjusted RR estimates indicated a significantly increased risk of prostate cancer among low (RR = 1.08, P < 0.001), medium (RR = 1.07, P < 0.01), high (RR = 1.14, P < 0.001) and higher (RR = 1.18, P < 0.001) volume drinkers compared to abstainers. There was a significant dose–response relationship for current drinkers (Ptrend < 0.01). Studies free from misclassification errors produced the highest risk estimates for drinkers versus abstainers in adjusted models (RR = 1.22, P < 0.05).

Conclusion

Our study finds, for the first time, a significant dose–response relationship between level of alcohol intake and risk of prostate cancer starting with low volume consumption (>1.3, <24 g per day). This relationship is stronger in the relatively few studies free of former drinker misclassification error. Given the high prevalence of prostate cancer in the developed world, the public health implications of these findings are significant. Prostate cancer may need to be incorporated into future estimates of the burden of disease alongside other cancers (e.g. breast, oesophagus, colon, liver) and be integrated into public health strategies for reducing alcohol related disease.
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Literature
1.
Bostwick DG, Crawford DE, Higano CS, Roach III M. American Cancer Society’s complete guide to prostate cancer. Atlanta: American Cancer Society; 2004.
2.
Forman D, Ferlay J. The global and regional burden of cancer. In: Wild BWSaCP, editor. World Cancer Report 2014. Lyon: International Agency for Research on Cancer (IARC); 2014. p. 16–53.
3.
4.
Sesso HD, Paffenbarger RS, Lee IM. Alcohol consumption and risk of prostate cancer: The Harvard Alumni Health Study. Int J Epidemiol. 2001;30(4):749–55.CrossRefPubMed
5.
Watters JL, Park Y, Hollenbeck A, Schatzkin A, Albanes D. Alcoholic Beverages and Prostate Cancer in a Prospective US Cohort Study. Am J Epidemiol. 2010;172(7):773–80.CrossRefPubMedPubMedCentral
6.
Hayes RB, Brown LM, Schoenberg JB, Greenberg RS, Silverman DT, Schwartz AG, Swanson GM, Benichou J, Liff JM, Hoover RN, et al. Alcohol use and prostate cancer risk in US blacks and whites. Am J Epidemiol. 1996;143(7):692–7.CrossRefPubMed
7.
Dagnelie PC, Schuurman AG, Goldbohm RA, Van den Brandt PA. Diet, anthropometric measures and prostate cancer risk: a review of prospective cohort and intervention studies. BJU Int. 2004;93(8):1139–50.CrossRefPubMed
8.
Morton MS, Griffiths K, Blacklock N. The preventive role of diet in prostatic disease. Brit J Urol. 1996;77(4):481–93.CrossRefPubMed
9.
Hiatt RA, Armstrong MA, Klatsky AL, Sidney S. Alcohol-Consumption, Smoking, and Other Risk-Factors and Prostate-Cancer in a Large Health Plan Cohort in California (United-States). Cancer Cause Control. 1994;5(1):66–72.CrossRef
10.
Vandergulden JWJ, Verbeek ALM, Kolk JJ. Smoking and Drinking Habits in Relation to Prostate-Cancer. Brit J Urol. 1994;73(4):382–9.CrossRef
11.
Stemmermann GN, Nomura AMY, Chyou PH, Yoshizawa C. Prospective-Study of Alcohol Intake and Large-Bowel Cancer. Digest Dis Sci. 1990;35(11):1414–20.CrossRefPubMed
12.
Tavani A, Negri E, Franceschi S, Talamini R, Lavecchia C. Alcohol-Consumption and Risk of Prostate-Cancer. Nutr Cancer. 1994;21(1):25–31.CrossRef
13.
Longnecker MP. Alcohol-Consumption and Risk of Cancer in Humans - an Overview. Alcohol. 1995;12(2):87–96.CrossRefPubMed
14.
Stockwell T, Greer A, Fillmore K, Chikritzhs T, Zeisser C. Health Benefits of Moderate Alcohol Consumption How Good Is the Science? Brit Med J. 2012;344.
15.
Chikritzhs T, Fillmore K, Stockwell T. A healthy dose of scepticism: Four good reasons to think again about protective effects of alcohol on coronary heart disease. Drug Alcohol Rev. 2009;28(4):441–4.CrossRefPubMed
16.
Fillmore KM, Kerr WC, Stockwell T, Chikritzhs T, Bostrom A. Moderate alcohol use and reduced mortality risk: Systematic error in prospective studies. Addict Res Theory. 2006;14(2):101–32.CrossRef
17.
Fillmore KM, Stockwell T, Chikritzhs T, Bostrom A, Kerr W. Moderate alcohol use and reduced mortality risk: Systematic error in prospective studies and new hypotheses. Ann Epidemiol. 2007;17(5):S16–23.CrossRefPubMed
18.
Roizen R, Fillmore K, Chikritzhs T, Stockwell T. Light-to-moderate drinking and dementia risk: The former drinkers problem re-visited. Addict Res Theory. 2013;21(3):181–93.CrossRef
19.
Zeisser C, Stockwell TR, Chikritzhs T. Methodological Biases in Estimating the Relationship Between Alcohol Consumption and Breast Cancer: The Role of Drinker Misclassification Errors in Meta-Analytic Results. Alcohol Clin Exp Res. 2014;38(8):2297–306.CrossRefPubMedPubMedCentral
20.
Shaper AG, Wannamethee G, Walker M. Alcohol and mortality in British men: explaining the U-shaped curve. Lancet. 1988;2(8623):1267–73.CrossRefPubMed
21.
Fillmore KM, Chikritzhs T, Stockwell T, Bostrom A, Pascal R. Alcohol use and prostate cancer: A meta-analysis. Mol Nutr Food Res. 2009;53(2):240–55.CrossRef
22.
Dennis LK. Meta-analysis for combining relative risks of alcohol consumption and prostate cancer. Prostate. 2000;42(1):56–66.CrossRefPubMed
23.
Rota M, Scotti L, Turati F, Tramacere I, Islami F, Bellocco R, Negri E, Corrao G, Boffetta P, La Vecchia C, et al. Alcohol consumption and prostate cancer risk: a meta-analysis of the dose-risk relation. Eur J Cancer Prev. 2012;21(4):350–9.CrossRefPubMed
24.
Breslow RA, Weed DL. Review of epidemiologic studies of alcohol and prostate cancer: 1971-1996. Nutr Cancer. 1998;30(1):1–13.CrossRefPubMed
25.
26.
27.
Moher D, Liberati A, Tetzlaff J, Altman DG, Grp P. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Plos Med. 2009;6(7).
28.
Andersson SO, Baron J, Bergstrom R, Lindgren C, Wolk A, Adami HO. Lifestyle factors and prostate cancer risk: A case-control study in Sweden. Cancer Epidem Biomar. 1996;5(7):509–13.
29.
Baglietto L, Severi G, English DR, Hopper JL, Giles GG. Alcohol consumption and prostate cancer risk: Results from the Melbourne collaborative cohort study. Int J Cancer. 2006;119(6):1501–4.CrossRefPubMed
30.
Breslow RA, Wideroff L, Graubard BI, Erwin D, Reichman ME, Ziegler RG, Ballard-Barbash R. Alcohol and prostate cancer in the NHANES I epidemiologic follow-up study. Ann Epidemiol. 1999;9(4):254–61.CrossRefPubMed
31.
Chang ET, Hedelin M, Adami HO, Gronberg H, Balter KA. Alcohol drinking and risk of localized versus advanced and sporadic versus familial prostate cancer in Sweden. Cancer Cause Control. 2005;16(3):275–84.CrossRef
32.
Crispo A, Talamini R, Gallus S, Negri E, Gallo A, Bosetti C, La Vecchia C, Dal Maso L, Montella M. Alcohol and the risk of prostate cancer and benign prostatic hyperplasia. Urology. 2004;64(4):717–22.CrossRefPubMed
33.
DeStefani E, Fierro L, Barrios E, Ronco A. Tobacco, alcohol, diet and risk of prostate cancer. Tumori. 1995;81(5):315–20.
34.
Ellison LF. Tea and other beverage consumption and prostate cancer risk: a Canadian retrospective cohort study. Eur J Cancer Prev. 2000;9(2):125–30.CrossRefPubMed
35.
Jain MG, Hislop GT, Howe GR, Burch JD, Ghadirian P. Alcohol and other beverage use and prostate cancer risk among Canadian men. Int J Cancer. 1998;78(6):707–11.CrossRefPubMed
36.
Lumey LH, Pittman B, Wynder EL. Alcohol use and prostate cancer in US whites: No association in a confirmatory study. Prostate. 1998;36(4):250–5.CrossRefPubMed
37.
Nilsen TIL, Johnsen R, Vatten LJ. Socio-economic and lifestyle factors associated with the risk of prostate cancer. Brit J Cancer. 2000;82(7):1358–63.CrossRefPubMedCentral
38.
McGregor SE, Courneya KS, Kopciuk KA, Tosevski C, Friedenreich CM. Case-control study of lifetime alcohol intake and prostate cancer risk. Cancer Cause Control. 2013;24(3):451–61.CrossRef
39.
Pelucchi C, Galeone C, Talamini R, Negri E, Parpinel M, Franceschi S, Montella M, La Vecchia C. Dietary folate and risk of prostate cancer in Italy. Cancer Epidem Biomar. 2005;14(4):944–8.CrossRef
40.
Platz EA, Leitzmann MF, Rimm EB, Willett WC, Giovannucci E. Alcohol intake, drinking patterns, and risk of prostate cancer in a large prospective cohort study. Am J Epidemiol. 2004;159(5):444–53.CrossRefPubMed
41.
Putnam SD, Cerhan JR, Parker AS, Bianchi GD, Wallace RB, Cantor KP, Lynch CF. Lifestyle and anthropometric risk factors for prostate cancer in a cohort of Iowa men. Ann Epidemiol. 2000;10(6):361–9.CrossRefPubMed
42.
Rohrmann S, Linseisen J, Key TJ, Jensen MK, Overvad K, Johnsen NF, Tjonneland A, Kaaks R, Bergmann MM, Weikert C, et al. Alcohol consumption and the risk for prostate cancer in the European prospective investigation into cancer and nutrition. Cancer Epidem Biomar. 2008;17(5):1282–7.CrossRef
43.
Sawada N, Inoue M, Iwasaki M, Sasazuki S, Yamaji T, Shimazu T, Tsugane S. Alcohol and smoking and subsequent risk of prostate cancer in Japanese men: The Japan Public Health Center-based prospective study. Int J Cancer. 2014;134(4):971–8.CrossRefPubMed
44.
Schuurman AG, Goldbohm RA, van den Brandt PA. A prospective cohort study on consumption of alcoholic beverages in relation to prostate cancer incidence (The Netherlands). Cancer Cause Control. 1999;10(6):597–605.CrossRef
45.
Sutcliffe S, Giovannucci E, Leitzmann MF, Rimm EB, Stampfer MJ, Willett WC, Platz EA. A prospective cohort study of red wine consumption and risk of prostate cancer. Int J Cancer. 2007;120(7):1529–35.CrossRefPubMed
46.
Velicer CM, Kristal A, White E. Alcohol use and the risk of prostate cancer: Results from the VITAL cohort study. Nutr Cancer. 2006;56(1):50-56
47.
Weinstein SJ, Stolzenberg-Solomon R, Pietinen P, Taylor PR, Virtamo J, Albanes D. Dietary factors of one-carbon metabolism and prostate cancer risk. Am J Clin Nutr. 2006;84(4):929–35.PubMed
48.
Breslow RA, Chen CM, Graubard BI, Mukamal KJ. Prospective Study of Alcohol Consumption Quantity and Frequency and Cancer-Specific Mortality in the US Population. Am J Epidemiol. 2011;174(9):1044–53.CrossRefPubMedPubMedCentral
49.
Stockwell T, Chikritzhs T. Commentary: Another serious challenge to the hypothesis that moderate drinking is good for health? Int J Epidemiol. 2013;42(6):1792–4.CrossRefPubMed
50.
Tumer C. How much alcohol is in a ‘standard drink’? An analysis of 125 studies. Brit J Addict. 1990;85(9):6.
51.
52.
Roerecke M, Rehm J. The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta-analysis. Addiction. 2012;107(7):1246–60.CrossRefPubMedPubMedCentral
53.
National Health and Medical Research Council of Australia. Australian guidelines to reduce health risk from drinking alcohol. Canberra: Attorney-General’s Department; 2009.
54.
Stockwell T, Zhao JH, Macdonald S. Who under-reports their alcohol consumption in telephone surveys and by how much? An application of the 'yesterday method’ in a national Canadian substance use survey. Addiction. 2014;109(10):1657–66.CrossRefPubMed
55.
Ye Y, Bond J, Cherpitel CJ, Stockwell T, Macdonald S, Rehm J. Risk of Injury Due to Alcohol Evaluating Potential Bias Using the Case-Crossover Usual-Frequency Method. Epidemiology. 2013;24(2):240–3.CrossRefPubMed
56.
Woodward M. Epidemiology study design and data analysis. Boca Raton: Chapman & Hall/CRC; 2000.
57.
Zhang J, Yu KF. What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. Jama-J Am Med Assoc. 1998;280(19):1690–1.CrossRef
58.
59.
Cochran WG. The Combination of Estimates from Different Experiments. Biometrics. 1954;10(1):101–29.CrossRef
60.
Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.CrossRefPubMed
61.
Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Meta-regression. In: Borenstein M, Hedges LV, Higgins JPT, Rothstein HR, editors. Introduction to meta-analysis. West Sussex: John Wiley & Sons, Ltd; 2009. p. 127.CrossRef
62.
van Houwelingen HC, Arends LR, Stijnen T. Advanced methods in meta-analysis: multivariate approach and meta-regression. Stat Med. 2002;21(4):589–624.CrossRefPubMed
63.
Greenland S. Meta-analysis. In: Rothman KJ, Greenland S, editors. Modern epidemiology. Philadelphia: Lippincott Williams & Wilkins; 1998. p. 32.
64.
Greenland S, Rothman K. Introduction to stratified analysis. In: Rothman KJ, Greenland S, editors. Modern Epidemiology. Philadelphia: Lippincott Williams & Wilkins; 1998. p. 28.
65.
66.
Dales LG, Ury HK. Improper Use of Statistical Significance Testing in Studying Covariables. Int J Epidemiol. 1978;7(4):373–5.CrossRefPubMed
67.
68.
Pagano M, Gauvreau K. Principles of biostatistics. 2nd ed. Duxbury: Pacific Grove, CA; 2000.
69.
Institute SAS. SAS/STAT 9.3 user’s guide. Cary: SAS Institute Inc.; 2011.
70.
World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: A global perspective. Washington DC: AICR; 2007.
71.
English DR, Holman C, D’Arcy J, Australia Department of Community Services and Health National Drug Strategy. The quantification of drug caused morbidity and mortality in Australia/prepared for the Department of Human Services and Health for use in association with the National Drug Strategy. Canberra: Australia Government Publication Service; 1995.
72.
Lachenmeier DW, Przybylski MC, Rehm J. Comparative risk assessment of carcinogens in alcoholic beverages using the margin of exposure approach. Int J Cancer. 2012;131(6):E995–E1003.CrossRefPubMed
73.
IARC. IARC monographs on the evaluation of carcinogenic risks to humans: alcohol consumption and ethyl carbamate, vol. 96. Lyon: IARC; 2010.
74.
Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F, Bouvard V, Altieri A, Cogliano V, Monograph WIARC. Carcinogenicity of alcoholic beverages. Lancet Oncol. 2007;8(4):292–3.CrossRefPubMed
75.
Homann N, Stickel F, Konig IR, Jacobs A, Junghanns K, Benesova M, Schuppan D, Himsel S, Zuber-Jerger I, Hellerbrand C, et al. Alcohol dehydrogenase 1C*1 allele is a genetic marker for alcohol-associated cancer in heavy drinkers. Int J Cancer. 2006;118(8):1998–2002.CrossRefPubMed
76.
Austin PC, Steyerberg EW. The number of subjects per variable required in linear regression analyses. J Clin Epidemiol. 2015;68(6):627–36.CrossRefPubMed
77.
Liang WB, Chikritzhs T. The Association between Alcohol Exposure and Self-Reported Health Status: The Effect of Separating Former and Current Drinkers. Plos One. 2013;8(2).
Metadata
Title
Is alcohol consumption a risk factor for prostate cancer? A systematic review and meta–analysis
Authors
Jinhui Zhao
Tim Stockwell
Audra Roemer
Tanya Chikritzhs
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2016
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-016-2891-z

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