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The association of alcohol and tobacco with age at diagnosis among subjects with pancreatic cancer

The present meta-analysis was based on data from more than four million subjects in prospective cohort studies, among whom 11,846 incident cases of pancreatic cancer were diagnosed. With the lowest intake group (non-drinkers or occasional drinkers) as the referent group, the authors defined “light” consumption as up to 12 grams/day (essentially one typical drink); 12-24 g/day as “moderate”; and ≥24 g/day as “heavy” drinking. The key results of the study were that, overall, neither light drinkers (RR = 0.97) nor moderate drinkers (RR = 0.98) showed an increase in risk of pancreatic cancer, while subjects classified as heavy drinkers had a slight increase (RR= 1.15, 95% CI 1.06 – 1.25). The increase in risk was due to heavy drinkers of liquor, as there was no significant increase in risk even for heavy drinkers of beer (RR = 1.08, CI 0.90 – 1.30) or wine (RR = 1.09, CI 0.79 -1.49).

Forum members considered this to be an excellent paper on the association between alcohol consumption and pancreatic cancer. The authors used appropriate methods and limited subjects to those in prospective cohort studies, which would tend to limit bias. The paper shows that the significant increase in risk occurred only among men, with no significant effect of alcohol being found among women. Among the weaknesses of the study were that there was a mixture of lifetime abstainers and ex-drinkers included in the referent group, and the same cut-points for category of alcohol intake was used for both men and women, whereas drinking guidelines are generally lower for women than for men. Further, data on the pattern of drinking (regular versus binge) were not available.

To summarize, this study showed no significant association with cancer risk for any level of consumption of beer or wine, which could relate to their lower concentration of alcohol per volume of the beverage, to non-alcoholic substances (such as polyphenols, present in wine and beer), or even to different drinking practices among subjects consuming different beverages. Thus, Forum members agree with the conclusions of the authors that heavy alcohol consumption, especially of liquor, increases the risk of pancreatic cancer, but the intake of beer or wine may not be associated with an increased risk.

Reference: Wang Y-T, Gou Y-W, Jin WW, Xiao M, Fang H-Y. Association between alcohol intake and the risk of pancreatic cancer: a dose–response meta-analysis of cohort studies. BMC Cancer 2016;16:212. DOI 10.1186/s12885-016-2241-1

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