title: Inverse relationship between moderate alcohol intake and rectal cancer: analysis of the North Carolina Colon Cancer Study.
abstract: BACKGROUND
  The relationship between alcohol intake and rectal cancer is uncertain.
  
  
  OBJECTIVE
  We sought to evaluate whether alcohol consumption is associated with distal colorectal cancer and rectal cancer specifically.
  
  
  METHODS
  Data on alcohol intake were examined from the North Carolina Colon Cancer Study, a population-based case-control study of distal colorectal cancer.
  
  
  METHODS
  This study encompassed 33 counties in the central and eastern part of North Carolina.
  
  
  METHODS
  Cases had adenocarcinoma of the rectum, rectosigmoid, and sigmoid colon. Controls were frequency-matched on age, race, and sex.
  
  
  METHODS
  Demographic and dietary intake data were collected with use of a validated questionnaire.
  
  
  METHODS
  Logistic regression was used to estimate odds ratios for the relationship between alcohol consumption and distal colorectal cancer.
  
  
  RESULTS
  Included in the study were 1033 cases and 1011 controls. The odds ratio for rectal cancer comparing any vs no alcohol intake was 0.73 (95% CI 0.60, 0.90), adjusted for age, sex, race, smoking status, obesity, education, red meat intake, use of nonsteroidal anti-inflammatory medications, and family history of colorectal cancer. The odds ratio for moderate alcohol (≤14 g/day) was 0.66 (95% CI 0.53, 0.82), whereas the odds ratio for heavy alcohol (>14 g/day) was 0.93 (95% CI 0.70, 1.23). Moderate beer and wine intakes were also inversely associated with distal colorectal cancer: odds ratios 0.76 (95% CI 0.60, 0.96) and 0.69 (95% CI 0.56, 0.86).
  
  
  CONCLUSIONS
  This was a retrospective, observational study. Residual confounding is possible.
  
  
  CONCLUSIONS
  In this study, moderate alcohol intake (especially wine) was inversely associated with distal colorectal cancer.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA. seth_crockett@med.unc.edu
authors.forename: Seth D
authors.initials: SD
authors.lastname: Crockett
authors.forename: Millie D
authors.initials: MD
authors.lastname: Long
authors.forename: Evan S
authors.initials: ES
authors.lastname: Dellon
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Martin
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Galanko
authors.forename: Robert S
authors.initials: RS
authors.lastname: Sandler
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D011379:Prognosis; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D011795:Surveys and Questionnaires