Meta-analysis of 16 studies of the association of alcohol with colorectal cancer Link to DOI → Authors: McNabb, S. and Harrison, T. A. and Albanes, D. and Berndt, S. I. and Brenner, H. and Caan, B. J. and Campbell, P. T. and Cao, Y. and Chang-Claude, J. and Chan, A. and Chen, Z. and English, D. R. and Giles, G. G. and Giovannucci, E. L. and Goodman, P. J. and Hayes, R. B. and Hoffmeister, M. and Jacobs, E. J. and Joshi, A. D. and Larsson, S. C. and Le Marchand, L. and Li, L. and Lin, Y. and Männistö, S. and Milne, R. L. and Nan, H. and Newton, C. C. and Ogino, S. and Parfrey, P. S. and Petersen, P. S. and Potter, J. D. and Schoen, R. E. and Slattery, M. L. and Su, Y. R. and Tangen, C. M. and Tucker, T. C. and Weinstein, S. J. and White, E. and Wolk, A. and Woods, M. O. and Phipps, A. I. and Peters, U. Year: 2020 Journal: Int J Cancer Vol/Issue: Vol. 146, No. 3 Pages: 861-873 Study Characteristics Lifestyle Pillars Risky Substance Avoidance Study Design Meta-analysis/Sys Review Abstract Alcohol consumption is an established risk factor for colorectal cancer (CRC). However, while studies have consistently reported elevated risk of CRC among heavy drinkers, associations at moderate levels of alcohol consumption are less clear. We conducted a combined analysis of 16 studies of CRC to examine the shape of the alcohol-CRC association, investigate potential effect modifiers of the association, and examine differential effects of alcohol consumption by cancer anatomic site and stage. We collected information on alcohol consumption for 14,276 CRC cases and 15,802 controls from 5 case-control and 11 nested case-control studies of CRC. We compared adjusted logistic regression models with linear and restricted cubic splines to select a model that best fit the association between alcohol consumption and CRC. Study-specific results were pooled using fixed-effects meta-analysis. Compared to non-/occasional drinking (≤1 g/day), light/moderate drinking (up to 2 drinks/day) was associated with a decreased risk of CRC (odds ratio [OR]: 0.92, 95% confidence interval [CI]: 0.88-0.98, p = 0.005), heavy drinking (2-3 drinks/day) was not significantly associated with CRC risk (OR: 1.11, 95% CI: 0.99-1.24, p = 0.08) and very heavy drinking (more than 3 drinks/day) was associated with a significant increased risk (OR: 1.25, 95% CI: 1.11-1.40, p < 0.001). We observed no evidence of interactions with lifestyle risk factors or of differences by cancer site or stage. These results provide further evidence that there is a J-shaped association between alcohol consumption and CRC risk. This overall pattern was not significantly modified by other CRC risk factors and there was no effect heterogeneity by tumor site or stage.