▌ 导语
据大通福克斯美国会诊中心（CMAA）了解：2017年，美国临床肿瘤学会（ASCO）公布数据指出，在众多肿瘤中，酒精是一个已知的风险因素！最新相关资讯信息，大通福克斯美国会诊中心（CMAA）将持续为您报道。
对572项研究进行了荟萃分析发现，相比控制饮酒或不喝酒的人来说，大量饮酒的人会增加口咽癌、食管癌、结肠癌、喉癌、乳腺癌的患病风险。
此外研究还指出，酒精摄取对胃癌、肝癌、胆囊癌、前列腺癌、肺癌、黑色素癌和胰腺癌的风险有关。
其他的研究显示，癌症患者如果饮酒会大大增加癌症的死亡率。
饮酒与癌症风险之间的关系的结果基于流行病学的研究。美国临床肿瘤学会（ASCO）指出，剂量反应关系是其中的关键。
饮酒增加风险的癌症
▪ 乳腺癌
对26项对照组试验和队列试验进行荟萃分析显示，21,149名乳腺癌患者以剂量依赖型的方式进行酒精摄取，会增加乳腺癌的风险。
大量饮酒和少量饮酒的总体相对风险为1.36 (95% CI, 1.20-1.54; P < .001)。研究表明，每1克的酒精摄取会增加0.59%的乳腺癌风险。
但是在患者诊断出乳腺癌后，饮酒并不会增加乳腺癌复发或对总体生存率产生影响。只有每日饮酒量超过20克才会增加乳腺癌的死亡率。
▪ 结直肠癌
对30个结直肠腺瘤研究的荟萃分析表明，每日摄取25克的酒精会增加27%的腺瘤风险(RR, 1.27; 95% CI, 1.17-1.37).另一项荟萃分析表明每日饮酒50克或100克会增加腺瘤的患病风险。这项结果与前一个荟萃分析的基本相同。
另一项研究结果表明，啤酒也会显著提升结直肠癌的患病风险(CRC; summary RR, 1.20; 95% CI, 1.06-1.37)，特别是每天喝至少两瓶啤酒的人更是如此。(summary RR, 1.37; 95% CI, 1.26-1.4).大量饮用啤酒会增加男性结直肠癌的风险，而在女性身上尚未发现。
▪ 食管癌
4项研究的合并数据显示，每日饮酒的人会增加食管鳞癌的风险(odds ratio, 2.34; 95% CI, 1.22-3.45)。饮酒和吸烟会发挥相互协同作用，共同对食管癌产生影响，研究预测，吸烟和饮酒会增加3.28%食管鳞癌的风险(95% CI, 2.11-508)。
研究同时指出，患者在未诊断前饮酒会增加食管鳞癌的死亡率。
▪ 胰腺癌
大量饮酒能够显著增加胰腺癌的患病风险(RR, 1.15; 95% CI, 1.06-1.25),特别对于那些嗜酒者来说更是如此(RR, 1.43; 95% CI, 1.17-1.74)。
另一项荟萃分析发现，虽然大量饮酒会增加胰腺癌的患病风险，但是人们完全可以通过减少酒精摄取来降低这种风险因素。
▪ 其他肿瘤
流行病学的多个荟萃分析表明，饮酒，特别是大量的饮酒，会增加胃癌、头颈部鳞癌、肝癌、上呼吸道癌和黑色素瘤的患病风险。母亲在怀孕期间饮酒与儿童急性髓性白血病有关。
尽管这项研究并没有发现饮酒和前列腺癌之间存在相关性，但是近期的多个研究表明，相比戒酒或不喝酒的人士，饮酒与前列腺癌存在剂量依赖型的相关性，也就是说，饮酒的剂量与前列腺癌患病的风险成正比。
饮酒与癌症具有明显的相关性，大量饮酒(P < .001)与前列腺癌的相对关系为1.18。此外在前列腺癌的发病率和死亡率方面也存在相似的结果。
无影响的癌症
荟萃分析发现，以下饮酒与以下癌症无明显相关性：膀胱癌、脑瘤、肝外胆管癌、子宫内膜癌、肺癌、卵巢癌、子宫肌瘤、神经胶质瘤、白血病。
▪ 保护效应
多个荟萃分析指出饮酒会对一些类型的癌症，特别是一些血液恶性肿瘤和肾细胞癌产生保护效应。
▪ 霍奇金淋巴瘤
对10个研究项目的荟萃分析显示，酒精摄取会降低霍奇金淋巴瘤的患病风险(RR, 0.70; 95% CI, 0.60-0.81)，其中二者的关系为剂量依赖型关系，少量饮酒的相对相关性为0.71(RR, 0.71; 95% CI, 0.57-0.89)，中等到大量饮酒的相对相关性为0.73(RR, 0.73; 95% CI, 0.60-0.87)
▪ 多发性骨髓瘤
尽管一项荟萃分析显示饮酒会增加多发性骨髓瘤的患病风险，但另一项分析表明，曾经有饮酒史的人会减低多发性骨髓瘤的风险(RR, 0.88; 95% CI, 0.79-0.99)。
对于女性来说，其相对相关性为0.79 (RR, 0.79; 95% CI, 0.69-0.89)，酒类中红酒的相对相关性为0.77 RR, 0.77; 95% CI, 0.67-0.89)
▪ 肾细胞癌
三个荟萃分析指出，酒精摄取能够降低肾细胞癌。男性和女性每日摄入5克对肾细胞癌的降低率分别为5%和9%。
▪ 甲状腺癌
五份对1003名甲状腺癌患者的合并数据显示，每周超过七次饮酒会降低甲状腺癌的发病率(hazard ratio, 0.72; 95% CI, 0.58-0.90)，尤其能够降低甲状腺乳头状瘤的发病率。
研究总结
不同种类的酒对不同类型的癌症影响有所不同。但是，研究并没有说明酒精摄取对癌症有预防作用。
参考文献
1. LoConte NK, Brewster AM, Kaur JS, Merrill JK, Alberg AJ. Alcohol and cancer: a statement of the American Society ofClinical Oncology. J Clin Oncol. 2018;36(1):83-93. doi: 10.1200/JCO.2017.76.1155
2. Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-responsemeta-analysis. Br J Cancer. 2015;112:580-93.
3. Schwedhelm C, Boeing H, Hoffmann G, Aleksandrova K, Schwingshackl L. Effect of diet on mortality and cancerrecurrence among cancer survivors: a systematic review and meta-analysis of cohort studies. Nutr Rev. 2016;74:737-48.
4. Jin M, Cai S, Guo J, et al. Alcohol drinking and all cancer mortality: a meta-analysis. Ann Oncol. 2013;24:807-16.
5. Chen JY, Zhu HC, Guo Q, et al. Dose-dependent associations between wine drinking and breast cancer risk - metaanalysisfindings. Asian Pac J Cancer Prev. 2016;17:1221-33.
6. Gou YJ, Xie DX, Yang KH, et al. Alcohol consumption and breast cancer survival: a meta-analysis of cohort studies.Asian Pac J Cancer Prev. 2013;14:4785-90.
7. Ali AM, Schmidt MK, Bolla MK, et al. Alcohol consumption and survival after a breast cancer diagnosis: a literaturebasedmeta-analysis and collaborative analysis of data for 29, 239 cases. Cancer Epidemiol Biomarkers Prev.
8. Ben Q, Wang L, Liu J, Qian A, Wang Q, Yuan Y. Alcohol drinking and the risk of colorectal adenoma: a dose-responsemeta-analysis. Eur J Cancer Prev. 2015;24:286-95.
9. Zhu JZ, Wang YM, Zhou QY, Zhu KF, Yu CH, Li YM. Systematic review with meta-analysis: alcohol consumption andthe risk of colorectal adenoma. Aliment Pharmacol Ther. 2014;40:325-37.
10. Zhang C, Zhong M. Consumption of beer and colorectal cancer incidence: a meta-analysis of observational studies.Cancer Causes Control. 2015;26:549-60.
11. Cai S, Li Y, Ding Y, Chen K, Jin M. Alcohol drinking and the risk of colorectal cancer death: a meta-analysis. Eur JCancer Prev. 2014;23:532-9.
12. Liu X, Wang X, Lin S, Yuan J, Yu IT. Dietary patterns and oesophageal squamous cell carcinoma: a systematic reviewand meta-analysis. Br J Cancer. 2014;110:2785-95.
13. Prabhu A, Obi KO, Rubenstein JH. The synergistic effect of alcohol and tobacco consumption on the risk of esophagealsquamous cell carcinoma: a meta-analysis. Am J Gastroenterol. 2014;109:822-7.
14. Fahey PP, Mallitt KA, Astell-Burt T, Stone G, Whiteman DC. Impact of pre-diagnosis behavior on risk of death fromesophageal cancer: a systematic review and meta-analysis. Cancer Causes Control. 2015;26:1365-73.
15. Wang YT, Gou YW, Jin WW, Xiao M, Fang HY. Association between alcohol intake and the risk of pancreatic cancer: adose-response meta- analysis of cohort studies. BMC Cancer. 2016;16:212-22.
16. Lu PY, Shu L, Shen SS, Chen XJ, Zhang XY. Dietary patterns and pancreatic cancer risk: a meta-analysis. Nutrients.2017;9:38-56.
17. Ma K, Baloch Z, He TT, Xia X. Alcohol consumption and gastric cancer risk: a meta-analysis. Med Sci Monit.2017;23:238-46.
18. Lubin JH, Purdue M, Kelsey K, t al. Total exposure and exposure rate effects for alcohol and smoking and risk of headand neck cancer: a pooled analysis of case-controlled studies. Am J Epidemiol. 2009;170:937-47.
19. Chuang SC, Lee YC, Wu GJ, Straif K, Hashibe M. Alcohol consumption and liver cancer risk: a meta-analysis. CancerCauses Control. 2015;26:1205-31.
20. Li Y, Mao Y, Zhang Y, et al. Alcohol drinking and upper aerodigestive tract cancer mortality: a systematic review andmeta-analysis. Oral Onc. 2014;50:269-75.
21. Rota M, Pasquali E, Bellocco R, et al. Alcohol drinking and cutaneous melanoma risk: a systematic review and dose-riskmeta-analysis. Br J Dermatol. 2014;170:1021-8.
22. Latino-Martel P, Chan DS, Druesne-Pecollo N, Barrandon E, Hercberg S, Norat T. Maternal alcohol consumption duringpregnancy risk of childhood leukemia: systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev.2010;19:1238-61.
23. Zhao J, Stockwell T, Roemer A, Chikritzhs T. Is alcohol consumption a risk factor for prostate cancer? A systematicreview and meta-analysis. BMC Cancer. 2016;16:845-58.
24. Pelucchi C, Galeone C, Tramacere I, et al. Alcohol drinking and bladder cancer risk: a meta-analysis. Ann Oncol.2012;23:1586-93.
25. Galeone C, Malerba S, Rota M, et al. A meta-analysis of alcohol consumption and the risk of brain tumors. Ann Oncol.2013;24:514-23.
26. Ye XH, Huai JP, Ding J, Chen YP, Sun XC. Smoking, alcohol consumption, and the risk of extrahepaticcholangiocarcinoma: a meta-analysis. World J Gastroenterol. 2013;19:8780-8.
27. Zhou Q, Guo P, Li H, Chen XD. Does alcohol consumption modify the risk of endometrial cancer? A dose-responsemeta-analysis of prospective studies. Arch Gynecol Obstet. 2017;295:467-79.
28. Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and lung cancer risk in never smokers: a meta-analysis. AnnOncol. 2011;22:2631-9.
29. Yan-Hong H, Jing L, Hong L, Shan-Shan H, Yan L, Ju L. Association between alcohol consumption and the risk ofovarian cancer: a meta- analysis of prospective observational studies. BMC Public Health. 2015;15;223-35.
30. Chiaffarino F, Cipriani S, Ricci E, et al. Alcohol consumption and risk of uterine myoma: a systematic review and metaanalysis. PLoS ONE. 2017;12:e0188355.
31. Qi ZY, Shao C, Yang C, Wang Z, Hui GZ. Alcohol consumption and risk of glioma: a metal-analysis of 19 observationalstudies. Nutrients. 2014;6:504-16.
32. Rota M, Porta L, Pelucchi C, et al. Alcohol drinking and risk of leukemia - a systematic review and meta-analysis of thedose-risk relation. Cancer Epidemiol. 2014;38:339-45.
33. Tramacere I, Pelucchi C, Bonifazi M, et al. A meta-analysis on alcohol drinking and the risk of Hodgkin lymphoma. EurJ Cancer Prev. 2012;21:268-73.
34. Sergentanis TN, Zagouri F, Tsilimidos G, et al. Risk factors for multiple myeloma: a systematic review of meta-analyses.Clin Lymphoma Myeloma Lek. 2015;15:563-77.
35. Psaltopoulou T, Sergentanis TN, Sergentanis IN, Karadimitris A, Terpos E, Dimopoulos MA. Alcohol intake, alcoholicbeverage type and multiple myeloma risk: a meta-analysis of 26 observational studies. Leuk Lymphoma. 2015;56:1484-501.
36. Rota M, Porta L, Pelucchi C, et al. Alcohol drinking and multiple myeloma risk-- a systematic review and meta-analysisof the dose-risk relationship. Eur J Cancer Prev. 2014;23:113-21.
37. Song DY, Song S, Song Y, Lee JE. Alcohol intake and renal cell cancer risk: a meta-analysis. Br J Cancer.
2012;106:1881-90.
38. Bellocco R, Pasquali E, Rota M, et al. Alcohol drinking and risk of renal cell carcinoma: results of a meta-analysis. AnnOncol. 2012;23:2235-44.
39. Xu X, Zhu Y, Zheng X, Xie L. Does beer, wine, or liquor consumption correlate with the risk of renal cell carcinoma? Adose-response meta-analysis of prospective cohort studies. Oncotarget. 2015;6:13347-58.
据大通福克斯美国会诊中心（CMAA）了解：2017年，美国临床肿瘤学会（ASCO）公布数据指出，在众多肿瘤中，酒精是一个已知的风险因素！最新相关资讯信息，大通福克斯美国会诊中心（CMAA）将持续为您报道。
对572项研究进行了荟萃分析发现，相比控制饮酒或不喝酒的人来说，大量饮酒的人会增加口咽癌、食管癌、结肠癌、喉癌、乳腺癌的患病风险。
此外研究还指出，酒精摄取对胃癌、肝癌、胆囊癌、前列腺癌、肺癌、黑色素癌和胰腺癌的风险有关。
其他的研究显示，癌症患者如果饮酒会大大增加癌症的死亡率。
饮酒与癌症风险之间的关系的结果基于流行病学的研究。美国临床肿瘤学会（ASCO）指出，剂量反应关系是其中的关键。
饮酒增加风险的癌症
▪ 乳腺癌
对26项对照组试验和队列试验进行荟萃分析显示，21,149名乳腺癌患者以剂量依赖型的方式进行酒精摄取，会增加乳腺癌的风险。
大量饮酒和少量饮酒的总体相对风险为1.36 (95% CI, 1.20-1.54; P < .001)。研究表明，每1克的酒精摄取会增加0.59%的乳腺癌风险。
但是在患者诊断出乳腺癌后，饮酒并不会增加乳腺癌复发或对总体生存率产生影响。只有每日饮酒量超过20克才会增加乳腺癌的死亡率。
▪ 结直肠癌
对30个结直肠腺瘤研究的荟萃分析表明，每日摄取25克的酒精会增加27%的腺瘤风险(RR, 1.27; 95% CI, 1.17-1.37).另一项荟萃分析表明每日饮酒50克或100克会增加腺瘤的患病风险。这项结果与前一个荟萃分析的基本相同。
另一项研究结果表明，啤酒也会显著提升结直肠癌的患病风险(CRC; summary RR, 1.20; 95% CI, 1.06-1.37)，特别是每天喝至少两瓶啤酒的人更是如此。(summary RR, 1.37; 95% CI, 1.26-1.4).大量饮用啤酒会增加男性结直肠癌的风险，而在女性身上尚未发现。
▪ 食管癌
4项研究的合并数据显示，每日饮酒的人会增加食管鳞癌的风险(odds ratio, 2.34; 95% CI, 1.22-3.45)。饮酒和吸烟会发挥相互协同作用，共同对食管癌产生影响，研究预测，吸烟和饮酒会增加3.28%食管鳞癌的风险(95% CI, 2.11-508)。
研究同时指出，患者在未诊断前饮酒会增加食管鳞癌的死亡率。
▪ 胰腺癌
大量饮酒能够显著增加胰腺癌的患病风险(RR, 1.15; 95% CI, 1.06-1.25),特别对于那些嗜酒者来说更是如此(RR, 1.43; 95% CI, 1.17-1.74)。
另一项荟萃分析发现，虽然大量饮酒会增加胰腺癌的患病风险，但是人们完全可以通过减少酒精摄取来降低这种风险因素。
▪ 其他肿瘤
流行病学的多个荟萃分析表明，饮酒，特别是大量的饮酒，会增加胃癌、头颈部鳞癌、肝癌、上呼吸道癌和黑色素瘤的患病风险。母亲在怀孕期间饮酒与儿童急性髓性白血病有关。
尽管这项研究并没有发现饮酒和前列腺癌之间存在相关性，但是近期的多个研究表明，相比戒酒或不喝酒的人士，饮酒与前列腺癌存在剂量依赖型的相关性，也就是说，饮酒的剂量与前列腺癌患病的风险成正比。
饮酒与癌症具有明显的相关性，大量饮酒(P < .001)与前列腺癌的相对关系为1.18。此外在前列腺癌的发病率和死亡率方面也存在相似的结果。
无影响的癌症
荟萃分析发现，以下饮酒与以下癌症无明显相关性：膀胱癌、脑瘤、肝外胆管癌、子宫内膜癌、肺癌、卵巢癌、子宫肌瘤、神经胶质瘤、白血病。
▪ 保护效应
多个荟萃分析指出饮酒会对一些类型的癌症，特别是一些血液恶性肿瘤和肾细胞癌产生保护效应。
▪ 霍奇金淋巴瘤
对10个研究项目的荟萃分析显示，酒精摄取会降低霍奇金淋巴瘤的患病风险(RR, 0.70; 95% CI, 0.60-0.81)，其中二者的关系为剂量依赖型关系，少量饮酒的相对相关性为0.71(RR, 0.71; 95% CI, 0.57-0.89)，中等到大量饮酒的相对相关性为0.73(RR, 0.73; 95% CI, 0.60-0.87)
▪ 多发性骨髓瘤
尽管一项荟萃分析显示饮酒会增加多发性骨髓瘤的患病风险，但另一项分析表明，曾经有饮酒史的人会减低多发性骨髓瘤的风险(RR, 0.88; 95% CI, 0.79-0.99)。
对于女性来说，其相对相关性为0.79 (RR, 0.79; 95% CI, 0.69-0.89)，酒类中红酒的相对相关性为0.77 RR, 0.77; 95% CI, 0.67-0.89)
▪ 肾细胞癌
三个荟萃分析指出，酒精摄取能够降低肾细胞癌。男性和女性每日摄入5克对肾细胞癌的降低率分别为5%和9%。
▪ 甲状腺癌
五份对1003名甲状腺癌患者的合并数据显示，每周超过七次饮酒会降低甲状腺癌的发病率(hazard ratio, 0.72; 95% CI, 0.58-0.90)，尤其能够降低甲状腺乳头状瘤的发病率。
研究总结
不同种类的酒对不同类型的癌症影响有所不同。但是，研究并没有说明酒精摄取对癌症有预防作用。
参考文献
1. LoConte NK, Brewster AM, Kaur JS, Merrill JK, Alberg AJ. Alcohol and cancer: a statement of the American Society ofClinical Oncology. J Clin Oncol. 2018;36(1):83-93. doi: 10.1200/JCO.2017.76.1155
2. Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-responsemeta-analysis. Br J Cancer. 2015;112:580-93.
3. Schwedhelm C, Boeing H, Hoffmann G, Aleksandrova K, Schwingshackl L. Effect of diet on mortality and cancerrecurrence among cancer survivors: a systematic review and meta-analysis of cohort studies. Nutr Rev. 2016;74:737-48.
4. Jin M, Cai S, Guo J, et al. Alcohol drinking and all cancer mortality: a meta-analysis. Ann Oncol. 2013;24:807-16.
5. Chen JY, Zhu HC, Guo Q, et al. Dose-dependent associations between wine drinking and breast cancer risk - metaanalysisfindings. Asian Pac J Cancer Prev. 2016;17:1221-33.
6. Gou YJ, Xie DX, Yang KH, et al. Alcohol consumption and breast cancer survival: a meta-analysis of cohort studies.Asian Pac J Cancer Prev. 2013;14:4785-90.
7. Ali AM, Schmidt MK, Bolla MK, et al. Alcohol consumption and survival after a breast cancer diagnosis: a literaturebasedmeta-analysis and collaborative analysis of data for 29, 239 cases. Cancer Epidemiol Biomarkers Prev.
8. Ben Q, Wang L, Liu J, Qian A, Wang Q, Yuan Y. Alcohol drinking and the risk of colorectal adenoma: a dose-responsemeta-analysis. Eur J Cancer Prev. 2015;24:286-95.
9. Zhu JZ, Wang YM, Zhou QY, Zhu KF, Yu CH, Li YM. Systematic review with meta-analysis: alcohol consumption andthe risk of colorectal adenoma. Aliment Pharmacol Ther. 2014;40:325-37.
10. Zhang C, Zhong M. Consumption of beer and colorectal cancer incidence: a meta-analysis of observational studies.Cancer Causes Control. 2015;26:549-60.
11. Cai S, Li Y, Ding Y, Chen K, Jin M. Alcohol drinking and the risk of colorectal cancer death: a meta-analysis. Eur JCancer Prev. 2014;23:532-9.
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大通福克斯美国会诊中心（CMAA）是一家专注于为中国患者提供美国高端精准医疗咨询和服务的专业机构。自成立至今，已经为许许多多的中国患者提供了这样的服务，不仅让他们体会到了高端的，专业的服务，而且接受了精准的，个体化的治疗。最重要的是，通过中心提供的服务，很多病人获得了满意的，甚至是超越他们期望的治疗效果。
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