Abstract
The alcohol intake of a cohort of Japanese men in Hawaii is directly and significantly related to the risk of developing rectal cancer, whether assessed on the basis of amount consumed or as a percent of total calories. Wine and whiskey are directly related to rectal cancer, but beer is the only alcoholic beverage that displays a statistically significant dose-response (P=0.008) Colon cancer risk also is related directly to alcohol intake, but the association is statistically significant only when measured as a percent of energy intake. This suggests that alcohol might displace cancer inhibitors from the diet. Calcium, vitamin C, and dietary fiber are inversely related to colon cancer risk in this cohort, and each of these micronutrients displays statistically significant negative correlation with alcohol intake. A possible positive association between alcohol and lung cancer was ruled out after adjusting for cigarette smoking. Cancers of the prostate and stomach were unrelated to alcohol intake, but the risk of acquiring cancer at all other sites combined was strongly related to alcohol intake.
Similar content being viewed by others
References
Pollack ES, Nomura AMY, Heilbrun LK, Stemmermann GN, Green SB: Prospective study of alcohol consumption and cancer. N Engl J Med 110:617–621, 1984
Stemmermann GN, Heilbrun LK, Nomura AMY: Association of diet and other factors with adenomatous polyps of the large bowel: A prospective autopsy study. Am J Clin Nutr 47:312–317, 1988
Kikendall JN, Bowen P, Burgess MB, Magnetti C, Woodward J, Langenberg P: Cigarettes and alcohol as independent risk factors for colonic adenomas. Gastroenterology 97:660–664, 1989
Ziegler R: Alcohol-nutrient interactions in cancer etiology. Cancer 58:1942–1948, 1986
Cox DR: Regression models and life tables (with discussion). J R Stat Soc (Ser B) 34:187–220, 1972
Harrell F: The PHGLM Procedure.In SUGI Supplemental Library User's Guide. Cary, North Carolina, SAS Institute, Inc., 1983, pp 267–294
Freund RJ, Littell RC: Statistical Analysis System (SAS) for Linear Models. Cary, North Carolina, SAS Institute Inc., 1981
SAS User's Guide: Statistics (The GLM Procedure). Version 5 edition. Cary, North Carolina, SAS Institute Inc., 1985
Breslow NE, Enstrom JE: Geographic correlations between cancer mortality rates and alcohol-tobacco consumption in the United States. J Natl Cancer Inst 53:631–639, 1974
Potter JD, McMichael AJ, Hartshorne JM: Alcohol and beer consumption in relation to cancers of the bowel and lung: An extended correlation study. J Chron Dis 35:833–842, 1982
Dean G, MacLennan R, McLaughlin H, Shelley E: Causes of death of blue-collar workers at a Dublin brewery, 1954–73. Br J Cancer 40:581–589, 1979
Jensen OM: Cancer morbidity and causes of death among Danish brewery workers. Int J Cancer 23:454–463, 1979
Tuyns AJ, Pequinot G, Gignoux M, Valla A: Cancers of the digestive tract, alcohol and tobacco. Int J Cancer 30:9–11, 1982
Klatsky AL, Armstrong MA, Friedman GD, Hiatt RA: The relation of alcoholic beverage use to colon and rectal cancer. Am J Epidemiol 128:1007–1015, 1988
Hirayama T: Association between alcohol consumption and cancer of the sigmoid colon: Observations from a Japanese cohort study. Lancet 2:725–727, 1989
Stemmermann GN, Nomura A, Chyou P-H: The influence of dairy and non-dairy calcium upon subsite large bowel cancer risk. Dis Colon Rectum 33:190–194, 1990
Heilbrun LK, Nomura A, Hankin JH, Stemmermann GN: Diet and colorectal cancer with special reference to fiber intake. Int J Cancer 44:1–6, 1989
Nomura AMY, Stemmermann GN, Heilbrun LK, Salkeld JP: Serum vitamin levels and the risk of cancer at specific sites in men of Japanese ancestry in Hawaii. Cancer Res 45:2369–2372, 1985
Nomura AMY, Heilbrun LK, Morris JS, Stemmermann GN: Serum selenium and the risk of cancer by specific sites. J Natl Cancer Inst 79:103–108, 1987
Krawitt EL: Effect of alcohol ingestion on duodenal calcium transport. J Lab Clin Med 85:665–671, 1975
Garabrant DH, Peters JM, Mack TM, Bernstein L: Job activity and colon cancer risk. Am J Epidemiol 119:1005–1014, 1984
Vena JE, Graham S, Zielezny M, Swanson MK, Barnes RE, Nolan J: Lifetime occupational exercise and colon cancer. Am J Epidemiol 122:357–365, 1985
Gerhardsson M, Norrell SE, Kiviranta H, Pedersen NL, Ahlbom A: Sedentary jobs and colon cancer. Am J Epidemiol 123:775–780, 1986
Wu AH, Paganini-Hill A, Ross RK, Hendersen BE: Alcohol, physical activity and other risk factors for colorectal cancer: A prospective study. Br J Cancer 55:687–694, 1987
Stemmermann GN: Geographic epidemiology of colorectal cancer: The role of dietary fat.In Colorectal Cancer from Pathogenesis to Prevention. HK Seitz, UA Simanowski, NA Wright (eds). Berlin, Springer-Verlag, 1989, pp 3–23
Nomura AMY, Heilbrun LK, Stemmermann GN: Body mass index as a predictor of cancer in man. J Natl Cancer Inst 74:319–323, 1985
Severson RK, Nomura AMY, Grove JS, Stemmermann GN: A prospective analysis of physical activity and cancer. Am J Epidemiol 130:522–529, 1989
Walker EA, Castegnaro M, Garren L, Garren L, Toussaint G, Kowalski B: Intake of volatile nitrosamines from consumption of alcohols. J Natl Cancer Inst 63:949–951, 1979
Nagao M, Takahashi Y, Wakabayashi K, Sugimura T: Mutagenicity of alcoholic beverages. Mutat Res 88:147–154, 1981
Seitz HK, Simanowski UA: Ethanol and colorectal carcinogenesis.In Colorectal Cancer from Pathogenesis to Prevention. HK Seitz, UA Simanowski, NA Wright (eds). Berlin, Springer-Verlag, 1989, pp 177–186
Kagan A, Harris BR, Winkelstein W, Johnson KG, Kalo H, Syme SL, Rhoads GG, Gay ML, Nichaman MZ, Hamilton HB, Tillotson J: Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: Demographic, physical and dietary characteristics. J Chron Dis 27:345–364, 1974
Hinds MW, Kolonel LN, Lee J, Hirohata T: Associations between cancer incidence and alcohol/cigarette consumption among five ethnic groups in Hawaii. Br J Cancer 41:929–940, 1980
Muir C, Waterhouse J, Mack T, Powell J, Whelan S: Cancer Incidence in Five Continents, Vol V. International Agency for Research on Cancer, Lyon, 1987
Diamond M: Adenomas of the rectum and the sigmoid in alcoholics. Am J Dig Dis 19:47–50, 1952
Author information
Authors and Affiliations
Additional information
Supported by grant RO1 CA 33644 from the National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Rights and permissions
About this article
Cite this article
Stemmermann, G.N., Nomura, A.M.Y., Chyou, P.H. et al. Prospective study of alcohol intake and large bowel cancer. Digest Dis Sci 35, 1414–1420 (1990). https://doi.org/10.1007/BF01536750
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01536750