Prediagnostic alcohol consumption and colorectal cancer survival: The Colon Cancer Family Registry

Abstract

Background Although previous studies have noted an increased risk of colorectal cancer (CRC) among moderate to heavy alcohol consumers relative to non-drinkers, the relationship between alcohol consumption and CRC survival remains unclear. Methods Cases of incident invasive CRC diagnosed between 1997-2007 were identified via population-based cancer registries at four study sites in the Colon Cancer Family Registry. Study participants completed a risk factor questionnaire on pre-diagnostic behaviors, including wine, beer, and liquor consumption, at baseline. Prospective follow-up for survival was conducted for 4966 CRC cases. Using Cox regression, we compared non-drinkers to individuals who consumed, on average, ≥1 serving/day of alcohol in the years preceding CRC diagnosis with respect to overall and disease-specific survival. Separate analyses by beverage type, and stratified by patient and tumor attributes, were also performed. All models were adjusted for age at diagnosis, sex, study site, year of diagnosis, smoking history, body mass index, and education. Results Pre-diagnostic beer and liquor consumption were not associated with CRC survival; however, higher levels of wine consumption were modestly associated with better prognosis overall [hazard ratio (HR)CRC-specific=0.70, 95% confidence interval (CI): 0.48-1.03 and HRoverall=0.70, 95% CI: 0.53-0.94). Similar patterns were noted in stratified analyses. Conclusions These findings suggest that pre-diagnostic wine consumption is modestly associated with more favorable survival after CRC.

Smoking and survival of colorectal cancer patients: Population-based study from Germany

“…Similarly, smokers with ≥20 pack years showed reduced survival when compared with never smokers. Although we reported separate results for former and current smokers while former studies combined these categories for pack years assessments, our results are in accordance with previous studies …”

“…reported associations to be stronger in men and colon cancer cases and Phipps et al . reported associations to be restricted to colon cancer cases in one study and to men in a second study …”

Association between smoking at diagnosis and cause‐specific survival in patients with rectal cancer: Results from a population‐based analysis of 10,794 cases

“…10,13 Two studies suggested that the effect of smoking on mortality/survival was stronger in older patients, 11,15 and 3 studies suggested that it was limited to, or stronger in, men 13,15,16 ; however, most of these analyses included all colorectal cancers. 11 Finally, despite evidence that smoking can adversely affect post-resection outcomes (see, for example, Walter et al, 9 Nickelsen et al, 17 and Richards et al 18 ) and perhaps also chemoradiation response, 19 no studies appear to have considered whether treatment modifies associations between smoking and survival. Moreover, only 1 study identified subjects using a populationbased registry, but this study focused primarily on younger patients.…”

Risk Factors for Colorectal Cancer in Thailand

“…For instance , no relationship between smoking and CRC was found in a US Prospective cohort study of white males (Hsing et al, 1998), Nor did previous studies in Japan (Nisa et al, 2010) or Holland (Tiemersma et al, 2002), or indeed, earlier colorectal case-control studies in Thailand (Promthet et al, 2010;Poomphakwaen et al, 2014). However, several colorectal cancer studies have shown a relationship between smoking and CRC development (Botteri et al, 2008;Phipps et al, 2011;Leufkens, et al, 2011;Gong et al, 2012;Zhivotovskiy et al, 2012;Peng et al, 2013;Stegeman et al, 2013).…”