Alcohol consumption and risk of glioblastoma; evidence from the Melbourne collaborative cohort study

Abstract

Despite the brain being highly susceptible to the action of alcohol and, therefore, potentially susceptible to its carcinogenic effects, it is not clear whether alcohol consumption is associated with risk of glioblastoma. We analyzed data from 39,766 participants of the Melbourne Collaborative Cohort Study recruited in 1990-1994 and followed to the end of 2008 for an average of 15 years. Incidence of glioblastoma of the brain was ascertained via linkage to the Victorian and other State cancer registries in Australia. During a structured face-to-face interview at baseline we elicited each participant's history of alcoholic beverage consumption during the current decade at baseline. We used Cox regression models with age as the time metric, adjusted for country of birth, sex, total energy intake, educational attainment and coffee consumption to estimate hazard ratios (HR) and corresponding 95% confidence intervals (CI). A total of 67 glioblastomas was diagnosed in the cohort during follow-up. The HRs associated with each additional 10 grams per day of alcohol intake was 1.16 (95% CI, 1.05 to 1.29; p for linear trend 5 0.007). Compared to lifetime abstainer, the HR for glioblastoma associated with alcohol consumption were 1.07 (0.55 to 2.10) for 1 to 19 g/day, 1.79 (0.81 to 3.95) for 20 to 39 g/day, 3.07 (1.26 to 7.47) for 40 to 59 g/day and 2.54 (0.92 to 7.00) for 60 or more g/day. Alcohol consumption at baseline was associated with the risk of glioblastoma in a dose-response relationship.Glioblastoma is the most common and most aggressive histological subtype of cranial glioma with a 5-year survival of less than 5%.1 The causes of glioblastoma are poorly understood, the only established environmental factor being ionizing radiation. 2,3Using the Melbourne Collaborative Cohort Study (MCCS) 4 we initially investigated the potential associations of well-known risk factors for cancer including body mass index (BMI), smoking, level of education, and alcohol consumption with the risk of glioblastoma. In this article, we present results for alcohol consumption.Alcohol is neurotoxic and several studies, particularly of alcoholics, have described the short and long-term effects of excessive alcohol consumption on brain function and pathology. 5 The mechanisms responsible for these effects are complex and still partly unknown. The effects on the brain of low or moderate alcohol consumption are less clear and more controversial but some studies suggest that low to moderate alcohol consumption might alter brain function and decrease brain health.6 Alcohol is also an established carcinogen and epidemiologic studies have shown that it is associated with increased risk of several types of cancer including breast cancer and cancers of the upper and lower aero-digestive tract.7 Despite the brain clearly being susceptible to the action of alcohol and potentially susceptible to its carcinogenic effects, few epidemiological studies have tested the association between alcohol consumption and risk of glioma. Those that have, have repo...

Risk factors for gliomas. An extensive review

“…In the Melbourne Collaborative Cohort study, alcohol was associated with the risk for developing Brought to you by | Oakland University Authenticated Download Date | 7/3/15 7:15 PM Risk factors for gliomas. An extensive review gliomas in a dose-response relation (81). But an older study from some of the members of the same team did not reveal any link between alcohol usage and gliomas (82).…”

Immune phenotypes predict survival in patients with glioblastoma multiforme

“…In addition to age, a number of stress factors, including chemical exposure, and demographical aspects influence the incidence of tumor manifestation [7]. At least one study demonstrated an increased risk for glioblastoma by alcohol consumption [8]. When compared with other malignancies, modulation of immune suppressor effector cells appears to be of major importance [9], and individual tumor patients may require an individual treatment regimen against immune suppressive elements.…”

Carotenoid intakes and risk of breast cancer defined by estrogen receptor and progesterone receptor status: a pooled analysis of 18 prospective cohort studies

“…Mortality registries were also used in some studies to ascertain additional cases (19,20,22,25,26,29,33,35). Follow-up rates exceeded 90% for 16 of 18 current studies (14,(37)(38)(39)(40)(41)(42) included in this analysis and is 80% for all studies (37)(38)(39)(40)(41)(42)(43)(44). We used the receptor status data from each study to define breast cancer subtypes by ER/PR status.…”