title: Interaction between alcohol drinking and obesity in relation to colorectal cancer risk: a case-control study in Newfoundland and Labrador, Canada.
abstract: BACKGROUND
  While substantive epidemiological literature suggests that alcohol drinking and obesity are potential risk factors of colorectal cancer (CRC), the possible interaction between the two has not been adequately explored. We used a case-control study to examine if alcohol drinking is associated with an increased risk of CRC and if such risk differs in people with and without obesity.
  
  
  METHODS
  Newly diagnosed CRC cases were identified between 1999 and 2003 in Newfoundland and Labrador (NL). Cases were frequency-matched by age and sex with controls selected using random digit dialing. Cases (702) and controls (717) completed self-administered questionnaires assessing health and lifestyle variables. Estimates of alcohol intake included types of beverage, years of drinking, and average number of alcohol drinks per day. Odds ratios were estimated to investigate the associations of alcohol independently and when stratified by obesity status on the risk of CRC.
  
  
  RESULTS
  Among obese participants (BMI ≥ 30), alcohol was associated with higher risk of CRC (OR: 2.2; 95% CI: 1.2-4.0) relative to the non-alcohol category. Among obese individuals, 3 or more different types of drinks were associated with a 3.4-fold higher risk of CRC relative to non-drinkers. The risk of CRC also increased with drinking years and drinks daily among obese participants. However, no increased risk was observed in people without obesity.
  
  
  CONCLUSIONS
  The effect of alcohol of drinking on CRC seems to be modified by obesity.
authors.affiliation: Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St, John's, NL, A1B 3V6, Canada.
authors.forename: Jinhui
authors.initials: J
authors.lastname: Zhao
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhu
authors.forename: Peizhong Peter
authors.initials: PP
authors.lastname: Wang
authors.forename: Roy
authors.initials: R
authors.lastname: West
authors.forename: Sharon
authors.initials: S
authors.lastname: Buehler
authors.forename: Zhuoyu
authors.initials: Z
authors.lastname: Sun
authors.forename: Josh
authors.initials: J
authors.lastname: Squires
authors.forename: Barbara
authors.initials: B
authors.lastname: Roebothan
authors.forename: John R
authors.initials: JR
authors.lastname: McLaughlin
authors.forename: Peter T
authors.initials: PT
authors.lastname: Campbell
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Parfrey
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009523:Newfoundland and Labrador / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D012042:Registries; D018570:Risk Assessment; D055815:Young Adult