Systematic Review with Meta-Analysis: Alcohol Consumption and Risk of Colorectal Serrated Polyp
Alcohol intake is closely related to colorectal cancer, which remains inconsistent with studies on the relation between alcohol consumption and risk of colorectal serrated polyp (SP) which was proven to have potential of developing into malignant serrated neoplasm.
A meta-analysis investigating the association between alcohol intake and colorectal SP with the dose–response of alcohol intake was conducted.
The literature search was performed on PubMed to identify pertinent articles presenting results for at least three categories of alcohol consumption dated up to October 2014. Summarized relative risks (RRs) with 95 % confidence intervals (CIs) were estimated using random or fixed effects models based on statistical heterogeneity.
A total of ten observational studies were identified in this meta-analysis. All drinkers were associated with 24 % increased risk of colorectal SP compared with non-/occasional drinkers. In particular, the light alcohol intake was not related to an increased risk of colorectal SP (RR 1.05, 95 % CI 0.93–1.18), whereas the RRs were 1.19 (95 % CI 1.02–1.40) for moderate alcohol intake and 1.60 (95 % CI 1.35–1.91) for heavy alcohol intake. The risks were consistent in further dose–response analysis. Meanwhile, subgroup analyses demonstrated that patients in America had more increased risk of SP with respect to those in Europe and Asia. In terms of subtype of colorectal SP, alcohol consumption had a greater influence on SSA than HP.
This is the first meta-analysis that demonstrated the relationship between moderate and heavy alcohol consumption and increasing risks of colorectal SP.
KeywordsColorectal serrated polyp Hyperplastic polyp Serrated adenoma Colorectal cancer Alcohol Meta-analysis
Sessile serrated adenoma
Traditional serrated adenoma
Conflict of interest
The authors have declared that no conflicts of interest exist.
- 10.Rex DK, Ahnen DJ, Baron JA, et al. Serrated lesions of the colorectum: review and recommendations from an expert panel. Am J Gastroenterol. 2012;107:1315–1329; quiz 1314, 1330.Google Scholar
- 18.Morimoto LM, Newcomb PA, Ulrich CM, et al. Risk factors for hyperplastic and adenomatous polyps: evidence for malignant potential? Cancer Epidemiol Biomark Prev. 2002;11:1012–1018.Google Scholar
- 28.Ulrich CM, Kampman E, Bigler J, et al. Lack of association between the C677T MTHFR polymorphism and colorectal hyperplastic polyps. Cancer Epidemiol Biomark Prev. 2000;9:427–433.Google Scholar
- 38.O’Brien MJ, Yang S, Mack C, et al. Comparison of microsatellite instability, CpG island methylation phenotype, BRAF and KRAS status in serrated polyps and traditional adenomas indicates separate pathways to distinct colorectal carcinoma end points. Am J Surg Pathol. 2006;30:1491–1501.PubMedCrossRefGoogle Scholar
- 40.Issa JP. The epigenetics of colorectal cancer. Ann N Y Acad Sci. 2000;910:140–153; discussion 153–155.Google Scholar
- 46.Acott AA, Theus SA, Marchant-Miros KE, et al. Association of tobacco and alcohol use with earlier development of colorectal cancer: Should we modify screening guidelines? Am J Surg. 2008;196:915–918; discussion 918–919.Google Scholar