title: Alcohol consumption and survival of colorectal cancer patients: a population-based study from Germany.
abstract: Studies on the association between alcohol consumption and colorectal cancer (CRC) prognosis have yielded inconsistent results.
  
  
  
  The associations of lifetime and 1-y prediagnostic alcohol consumption with relevant prognostic outcomes were evaluated in a large population-based cohort of CRC patients.
  
  
  
  In 2003-2010, 3121 patients diagnosed with CRC were interviewed on sociodemographic and lifestyle factors, medication, and comorbidities. Cancer recurrence, vital status, and cause of death were documented for a median follow-up time of 4.8 y. With the use of Cox proportional hazard regression, associations between lifetime and recent alcohol consumption and overall, CRC-specific, recurrence-free, and disease-free survival were analyzed.
  
  
  
  In this patient cohort with a median age of 69 y at diagnosis, lifetime abstainers showed poorer overall [adjusted HR (aHR): 1.25; 95% CI: 1.03, 1.52] and CRC-specific (aHR: 1.37; 95% CI: 1.10, 1.70) survival than lifetime light drinkers (women: >0-12 g/d; men: >0-24 g/d). Lifetime heavy drinkers showed poorer overall (aHR: 1.37; 95% CI: 1.06, 1.78) and disease-free (aHR: 1.38; 95% CI: 1.09, 1.74) survival. Alcohol abstaining in the year before diagnosis was associated with poorer overall (aHR: 1.42; 95% CI: 1.20, 1.68), CRC-specific (aHR: 1.38; 95% CI: 1.13, 1.68), and disease-free (aHR: 1.23; 95% CI: 1.05, 1.44) survival. Lifetime abstainers with nonmetastatic disease showed poorer CRC-specific (aHR: 1.48; 95% CI: 1.10, 2.00) and recurrence-free (aHR: 1.32; 95% CI: 1.02, 1.70) survival. Wine abstaining but not beer or liquor abstaining was associated with poorer survival. Associations between alcohol consumption and prognosis varied according to presence of diabetes and age.
  
  
  
  Prediagnostic alcohol abstaining and heavy drinking were associated with poorer survival after a CRC diagnosis than light drinking. The protective effects of light consumption might be restricted to wine, and associations might differ according to age and presence of diabetes mellitus.
authors.affiliation: Division of Clinical Epidemiology and Aging Research, v.walter@dkfz.de.
authors.forename: Viola
authors.identifier: 0000-0001-6780-8846
authors.initials: V
authors.lastname: Walter
authors.affiliation: Division of Clinical Epidemiology and Aging Research.
authors.forename: Lina
authors.initials: L
authors.lastname: Jansen
authors.affiliation: Departments of General, Visceral and Transplantation Surgery and.
authors.forename: Alexis
authors.initials: A
authors.lastname: Ulrich
authors.affiliation: Unit of Molecular Tumor Pathology, Pathology, Institute of Pathology, University Hospital, Heidelberg, Germany; and.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Roth
authors.affiliation: Institute of Pathology, Charité University Medicine, Berlin, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Bläker
authors.affiliation: Division of Cancer Epidemiology, and.
authors.forename: Jenny
authors.initials: J
authors.lastname: Chang-Claude
authors.affiliation: Division of Clinical Epidemiology and Aging Research.
authors.forename: Michael
authors.initials: M
authors.lastname: Hoffmeister
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany; Division of Preventive Oncology, National Center for Tumor Diseases, Heidelberg, Germany;
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064829:Alcohol Abstinence; D000428:Alcohol Drinking / Q000009:adverse effects*; D000434:Alcoholic Beverages; D001515:Beer; D015179:Colorectal Neoplasms / Q000401:mortality*; D018572:Disease-Free Survival; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D015996:Survival Rate; D014920:Wine
keywords: alcohol consumption; colorectal neoplasms; prognosis; recurrence; survival