Alcohol drinking and multiple myeloma risk--a systematic review and meta-analysis of the dose-risk relationship.
The role of alcohol intake in the risk for multiple myeloma (MM) is unclear, although some recent findings suggest an inverse relationship. To summarize the information on the topic, we carried out a systematic review and a dose-risk meta-analysis of published data. Through the literature search until August 2013, we identified 18 studies, eight case-control and 10 cohort studies, carried out in a total of 5694 MM patients. We derived pooled meta-analytic estimates using random-effects models, taking into account the correlation between estimates, and we carried out a dose-risk analysis using a class of nonlinear random-effects meta-regression models. The relative risk for alcohol drinkers versus non/occasional drinkers was 0.97 [95% confidence interval (CI), 0.85-1.10] overall, 0.96 (95% CI, 0.74-1.24) among case-control studies, and 1.00 (95% CI, 0.89-1.13) among cohort studies. Compared with nondrinkers, the pooled relative risks were 0.96 (95% CI, 0.81-1.13) for light (i.e. ≤ 1 drink/day) and 0.89 (95% CI, 0.74-1.07) for moderate-to-heavy (i.e. >1 drink/day) alcohol drinkers. The dose-risk analysis revealed a model-based MM risk reduction of about 15% at two to four drinks/day (i.e. 25-50 g of ethanol). The present meta-analysis of published data found no strong association between alcohol drinking and MM risk, although a modest favorable effect emerged for moderate-to-heavy alcohol drinkers.
aDepartment of Health Sciences, Centre of Biostatistics for Clinical Epidemiology bDepartment of Statistics and Quantitative Methods, University of Milan-Bicocca cDepartment of Clinical Sciences and Community Health, University of Milan dDepartment of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri eDivision of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy fDepartment of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden gThe Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, USA hInternational Prevention Research Institute, Lyon, France.
Matteo
M
Rota
Lorenzo
L
Porta
Claudio
C
Pelucchi
Eva
E
Negri
Vincenzo
V
Bagnardi
Rino
R
Bellocco
Giovanni
G
Corrao
Paolo
P
Boffetta
Carlo
C
La Vecchia
D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D000431:Ethanol / Q000008:administration & dosage*; D006801:Humans; D009101:Multiple Myeloma / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors
D000431:Ethanol