title: Does alcohol consumption modify the risk of endometrial cancer? A dose-response meta-analysis of prospective studies.
abstract: BACKGROUND
  Epidemiological studies have provided controversial evidence of an association between alcohol intake and endometrial cancer (EC) risk. The World Cancer Research Fund/American Institute for Cancer Research classifies alcohol as having a "limited-no conclusion" grade of evidence in the Endometrial Cancer 2013 Report (the latest version).
  
  
  OBJECTIVE
  The purpose of this meta-analysis is to systematically analyze the effect of alcohol intake on EC risk.
  
  
  METHODS
  We conducted a dose-response meta-analysis of prospective cohort studies identified from the PubMed, Embase, Cochrane Library and China Biological Medicine databases. Categorical and dose-response meta-analyses were conducted to estimate the effects of alcohol on EC risk.
  
  
  RESULTS
  A total of 10 studies involving 9766 cases and 1,612,798 participants were included in this meta-analysis. Overall, the relative risk(RR) for alcohol intake on EC was 1.04 (95% CI 0.88-1.22). The RRs for alcohol intake from wine, beer, and liquor were 1.10 (95% CI 0.80-1.51), 0.94 (95% CI 0.72-1.22), and 1.04 (95% CI 0.86-1.27), respectively). When alcohol consumption was stratified by drinking level, the RRs for moderate and heavy alcohol intake were 0.95 (95% CI 0.89-1.01) and 1.00 (95% CI 0.88-1.13), respectively. In the subgroup analyses, this association was not modified by other lifestyle factors or the characteristics of the study design and population. No significant associations were detected in the dose-response meta-analyses.
  
  
  CONCLUSIONS
  Alcohol intake is not associated with EC regardless of the beverage choice and alcohol consumption level. More studies are warranted in other populations, such as Asians and Africans.
authors.affiliation: Department of Science and Education, The First People's Hospital of Changde City, Changde, 415003, Hunan, China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Hepatobiliary Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Guo
authors.affiliation: Department of Oncology, The First People's Hospital of Changde City, Changde, 415003, Hunan, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Science and Education, Jiangxi Provincial Cancer Hospital, 519 Beijing East Road, Nanchang, 330029, Jiangxi, China. xdchensci@163.com.
authors.forename: Xiao-Dan
authors.initials: XD
authors.lastname: Chen
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D016889:Endometrial Neoplasms / Q000209:etiology*; D005260:Female; D006801:Humans; D008019:Life Style; D011446:Prospective Studies; D012306:Risk
keywords: Alcohol; Dose–response; Endometrial cancer; Meta-analysis; Systematic review