title: Alcohol consumption and colorectal cancer in a Mediterranean population: a case-control study.
abstract: BACKGROUND
  Alcohol is considered to be a cocarcinogen or a tumor promoter, and various studies have shown a linear dose-dependent association between alcohol consumption and colorectal cancer. However, a few studies suggest that moderate alcohol consumption may have a protective effect, similar to that in cardiovascular disease.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the relationship of colorectal cancer to quantity and type of alcohol consumed.
  
  
  METHODS
  This was case-control study.
  
  
  METHODS
  The study was conducted in the area of Attica, Greece.
  
  
  METHODS
  A total of 250 consecutive patients with a first diagnosis of colorectal cancer were matched for age group and sex with 250 controls recruited from the community. The mean age was 63 (SD, 12) years for the patient group (147 men, 59%; 103 women, 41%) and 55 (SD, 13) years for the control group (112 men; 44.8%; 138 women, 55.2%).
  
  
  METHODS
  Questionnaires were administered by trained interviewers to assess sociodemographic, clinical, and lifestyle characteristics, in addition to dietary habits and quantity and type of alcoholic beverages usually consumed during the preceding year. Adherence to the Mediterranean diet was evaluated with the MedDietScore (theoretical range, 0-55).
  
  
  RESULTS
  With intake of less than 12 g of alcohol per day as the reference, moderate alcohol intake (12-35 g/day) was associated with a significantly decreased likelihood of colorectal cancer in men (OR, 0.35; 95% CI, 0.16-0.74) and in women (OR, 0.40; 95% CI, 0.18-0.91). High alcohol intake (more than 48 g/day) was associated with an increased likelihood, which was significant in men (OR, 3.45; 95% CI, 1.35-8.83) but not in women (OR, 3.40; 95% CI, 0.50-22.92). Drinking red wine was associated with reduced odds of colorectal cancer, significant in men (OR, 0.47; 95% CI, 0.23-0.96) but not in women (OR, 0.54; 95% CI, 0.23-1.30). None of the associations between other beverage types and colorectal cancer were significant. Adherence to the Mediterranean diet was independently associated with lower odds of colorectal cancer overall (p < 0.001), in men (OR, 0.90; 95% CI, 0.83-0.97), and in women (OR, 0.87; 95% CI, 0.80-0.94).
  
  
  CONCLUSIONS
  The major limitations of this study included the inability of a case-control design to determine causation and the potential for recall bias.
  
  
  CONCLUSIONS
  The association between quantity of alcohol consumed and the presence of colorectal cancer followed a J-shaped curve. While demonstrating the detrimental effect of consuming large amounts of alcohol, the results of this study suggest that moderate alcohol consumption exerts a protective effect on colorectal cancer in both men and women, possibly related to the effects of red wine.
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors.forename: Niki
authors.initials: N
authors.lastname: Kontou
authors.forename: Theodora
authors.initials: T
authors.lastname: Psaltopoulou
authors.forename: Nick
authors.initials: N
authors.lastname: Soupos
authors.forename: Evangelos
authors.initials: E
authors.lastname: Polychronopoulos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Xinopoulos
authors.forename: Athena
authors.initials: A
authors.lastname: Linos
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Panagiotakos
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires