title: Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis.
abstract: BACKGROUND
  Alcohol is a risk factor for cancer of the oral cavity, pharynx, oesophagus, colorectum, liver, larynx and female breast, whereas its impact on other cancers remains controversial.
  
  
  METHODS
  We investigated the effect of alcohol on 23 cancer types through a meta-analytic approach. We used dose-response meta-regression models and investigated potential sources of heterogeneity.
  
  
  RESULTS
  A total of 572 studies, including 486 538 cancer cases, were identified. Relative risks (RRs) for heavy drinkers compared with nondrinkers and occasional drinkers were 5.13 for oral and pharyngeal cancer, 4.95 for oesophageal squamous cell carcinoma, 1.44 for colorectal, 2.65 for laryngeal and 1.61 for breast cancer; for those neoplasms there was a clear dose-risk relationship. Heavy drinkers also had a significantly higher risk of cancer of the stomach (RR 1.21), liver (2.07), gallbladder (2.64), pancreas (1.19) and lung (1.15). There was indication of a positive association between alcohol consumption and risk of melanoma and prostate cancer. Alcohol consumption and risk of Hodgkin's and Non-Hodgkin's lymphomas were inversely associated.
  
  
  CONCLUSIONS
  Alcohol increases risk of cancer of oral cavity and pharynx, oesophagus, colorectum, liver, larynx and female breast. There is accumulating evidence that alcohol drinking is associated with some other cancers such as pancreas and prostate cancer and melanoma.
authors.affiliation: 1] Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy [2] Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Bagnardi
authors.affiliation: 1] Department of Health Sciences, Centre of Biostatistics for Clinical Epidemiology, University of Milan-Bicocca, Via Cadore 48, 20900 Monza, Italy [2] Department of Epidemiology, IRCCS Mario Negri Institute for Pharmacological Research, Via La Masa 19, 20156 Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rota
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Botteri
authors.affiliation: Neurology, Besta Neurological Institute, Via Celoria 11, 20133 Milan, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Tramacere
authors.affiliation: 1] The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029-6574, USA [2] Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Science, Kargar Shomali Ave, 14117-13135 Tehran, I.R. Iran [3] Surveillance and Health Services Research, American Cancer Society, 250 Williams Street, Atlanta, GA 30303, USA.
authors.forename: F
authors.initials: F
authors.lastname: Islami
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, 1518 Clifton Road, N.E., Atlanta, GA 30322, USA.
authors.forename: V
authors.initials: V
authors.lastname: Fedirko
authors.affiliation: Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Scotti
authors.affiliation: Nutritional Epidemiology Group, International Agency for Research on Cancer, 150 Cours Albert-Thomas, 69008 Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Jenab
authors.affiliation: 1] Department of Epidemiology, IRCCS Mario Negri Institute for Pharmacological Research, Via La Masa 19, 20156 Milan, Italy [2] Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale Tumori, Via Vanzetti, 5 - 20133 Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Turati
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Pasquali
authors.affiliation: Department of Epidemiology, IRCCS Mario Negri Institute for Pharmacological Research, Via La Masa 19, 20156 Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Pelucchi
authors.affiliation: Department of Epidemiology, IRCCS Mario Negri Institute for Pharmacological Research, Via La Masa 19, 20156 Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Galeone
authors.affiliation: 1] Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy [2] Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Box 281, Stockholm 171 77, Sweden.
authors.forename: R
authors.initials: R
authors.lastname: Bellocco
authors.affiliation: Department of Epidemiology, IRCCS Mario Negri Institute for Pharmacological Research, Via La Masa 19, 20156 Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Negri
authors.affiliation: Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Corrao
authors.affiliation: The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029-6574, USA.
authors.forename: P
authors.initials: P
authors.lastname: Boffetta
authors.affiliation: Department of Clinical Sciences and Community Health, University of Milan, Via Vanzetti, 5 - 20133 Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology*; D001943:Breast Neoplasms / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D004938:Esophageal Neoplasms / Q000453:epidemiology; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology; D009062:Mouth Neoplasms / Q000453:epidemiology; D009369:Neoplasms / Q000453:epidemiology*; D010610:Pharyngeal Neoplasms / Q000453:epidemiology; D011471:Prostatic Neoplasms / Q000453:epidemiology; D012307:Risk Factors