Alcohol and liver cancer: a systematic review and meta-analysis of prospective studies

医学 荟萃分析 相对风险 置信区间 队列研究 人口 肝癌 观察研究 系统回顾 前瞻性队列研究 癌症 流行病学 内科学 环境卫生 人口学 梅德林 社会学 法学 政治学
作者
Federica Turati,Carlotta Galeone,Matteo Rota,Claudio Pelucchi,Eva Negri,Vincenzo Bagnardi,Giovanni Corrao,Paolo Boffetta,Carlo La Vecchia
出处
期刊:Annals of Oncology [Elsevier BV]
卷期号:25 (8): 1526-1535 被引量:190
标识
DOI:10.1093/annonc/mdu020
摘要

Despite several studies support a positive association between heavy alcohol consumption and liver cancer risk, a consistent dose–risk relationship has not yet been established. We carried out a systematic review and a meta-analysis of the association between alcohol intake and liver cancer occurrence, following the Meta-analysis Of Observational Studies in Epidemiology guidelines. We searched for cohort and nested case–control studies on the general population published before April 2013, using PubMed and EMBASE. Summary meta-analytic relative risks (RRs) were estimated using random-effect models. We included 16 articles (19 cohorts) for a total of 4445 incident cases and 5550 deaths from liver cancer. Compared with non-drinking, the pooled RRs were 0.91 (95% confidence interval, CI, 0.81–1.02) for moderate drinking (<3 drinks per day) and 1.16 (95% CI, 1.01–1.34) for heavy drinking (≥3 drinks per day), with significant heterogeneity among studies. The dose–risk curve suggested a linear relationship with increasing alcohol intake in drinkers, with estimated excess risk of 46% for 50g of ethanol per day and 66% for 100g per day. This systematic review suggests a moderate detrimental role of consumption of 3 or more alcoholic drinks per day on liver cancer, and a lack of association with moderate drinking. Our results have to be taken with due caution on account of the possible limitations of the original studies included in the meta-analysis.
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