Alcohol intake trajectories during the life course and risk of alcohol-related cancer: a prospective cohort study
Menée en Australie à partir de données portant sur 22 756 femmes et 15 701 hommes âgés entre 40 et 69 ans, cette étude de cohorte prospective analyse l'association entre l'évolution de la consommation d'alcool tout au long de la vie et le risque de cancer lié à l'alcool (durées de suivi : 485 525 personnes-années chez les femmes et 303 218 personnes-années chez les hommes)
We examined associations between sex-specific alcohol intake trajectories and alcohol-related cancer risk using data from 22,756 women and 15,701 men aged 40-69 years at baseline in the Melbourne Collaborative Cohort Study. Alcohol intake for 10-year periods from age 20 until the decade encompassing recruitment, calculated using recalled beverage-specific frequency and quantity, was used to estimate group-based sex-specific intake trajectories. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated for primary invasive alcohol-related cancer (upper aerodigestive tract, breast, liver and colorectum). Three distinct alcohol intake trajectories for women (lifetime abstention, stable light, increasing moderate) and six for men (lifetime abstention, stable light, stable moderate, increasing heavy, early decreasing heavy, late decreasing heavy) were identified. 2,303 incident alcohol-related cancers were diagnosed during 485,525 person-years in women and 789 during 303,218 person-years in men. For men, compared with lifetime abstention, heavy intake (mean≥60 g/day) at age 20-39 followed by either an early (from age 40-49) (early decreasing heavy; HR=1.75, 95% CI: 1.25-2.44) or late decrease (from age 60-69) (late decreasing heavy; HR=1.94, 95% CI: 1.28-2.93), and moderate intake (mean<60 g/day) at age 20-39 increasing to heavy intake in middle-age (increasing heavy; HR=1.45, 95% CI: 1.06-1.97) were associated with increased risk of alcohol-related cancer. For women, compared with lifetime abstention, increasing intake from age 20 (increasing moderate) was associated with increased alcohol-related cancer risk (HR=1.25, 95% CI: 1.06-1.48). Similar associations were observed for colorectal (men) and breast cancer. Heavy drinking during early adulthood might increase cancer risk later in life.