Excessive alcohol consumption favours high risk polyp or colorectal cancer occurrence among patients with adenomas: a case control study.
OBJECTIVE
Excessive alcohol consumption is a risk factor for developing colorectal adenomas. This study aimed to investigate the influence of excessive alcohol consumption on the occurrence of high risk polyps (adenoma > or = 10 mm, villous component, high grade dysplasia) or colorectal cancer among patients with at least one colonic adenoma.


METHODS
Three groups of patients with at least one colorectal adenoma were included in a case control study: 401 heavy drinkers (group HD, mean daily alcohol intake 117 (SD 4) g/day for a mean duration of 22 (SD 0.6) years), aged 57 (0.5) years (78% men); 152 patients suffering from irritable bowel syndrome (IBS), aged 61 (0.9) years (57% male); and 108 patients with a family history (FH) of colorectal adenoma or cancer, aged 55 (1) years (64% male). Exclusion criteria were: anaemia, haematochezia, personal history of colorectal adenoma or cancer, and for groups HD and IBS a family history of colorectal adenoma and/or cancer. Relative risks were estimated by the odds ratio (OR) using a logistic regression model and were expressed with 95% confidence interval (CI).


RESULTS
After age and sex adjustment, the likelihood of having an adenoma > or = 10 mm was higher in group HD than in the IBS group (OR 1.8, 95% CI (1.2-2.7)) and the likelihood of having high risk adenomas or cancer was higher in group HD compared with the IBS group (OR 1.6, 95% CI (1.2-2.1)) and the FH group although this was not significant (OR 1.6, 95% CI (0.97-2.6) (p=0.081); 90% CI (1.03-2.4)). After age and sex adjustment, the likelihood of having an adenoma with high grade dysplasia or cancer was higher in group HD than in the IBS group (OR 1.7, 95% CI (1.02-2.8)) or group FH, although this was not significant (OR 3.7, 95% CI (0.98-15) (p=0.076); 90% CI (1.10-12.47)).


CONCLUSIONS
In patients with at least one colorectal adenoma, excessive alcohol consumption increases the likelihood of developing high risk adenomas or colorectal cancer.
Bardou
M
M
Hepatogastroenterology Unit, Antoine Béclére Hospital, 157, rue de la Porte de Trivaux F-92141 Clamart Cedex, France. Marc.Bardou@u-bourgogne.fr
Montembault
S
S
Giraud
V
V
Balian
A
A
Borotto
E
E
Houdayer
C
C
Capron
F
F
Chaput
J-C
JC
Naveau
S
S
D000236:Adenoma / Q000209:etiology*; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications*; D016022:Case-Control Studies; D003111:Colonic Polyps / Q000209:etiology*; D015179:Colorectal Neoplasms / Q000209:etiology*; D005260:Female; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013223:Statistics as Topic