Alcohol consumption and Colorectal Cancer: a case-control study in Armenia

Abstract

Objectives: Colorectal cancer is one of the leading causes of cancer mortality in the industrialized world. During the last decade, the incidence rate of colorectal cancer in Armenia has increased. The study aimed to explore an association between alcohol consumption and risk of colorectal cancer in Armenia. Subjects and Methods: The study utilized a case-control design with one control for each case. 144 patients diagnosed with colorectal cancer during the study period from May to August, 2005 were included in the study as cases. The control group included patients seen in the same departments during the same period with diagnoses other than colorectal cancer such as hemorrhoid, perianal fistula, paraproctitis, anal fissure and others that are free of bowel disorders. Information was collected using self-administered questionnaire on various health-related issues, including drinking and smoking habits. All data were analyzed using SPSS and STATA software. Results: The analysis showed that preference of vodka as the type of alcohol increases the risk of having colorectal cancer after controlling for other variables (OR=2.06; 95%CI 1.15-3.69 p-value 0.016) compared with non-drinkers. The risk of having colorectal cancer also increases with alcohol consumption of 3 or more drinks versus 1-2 drinks after controlling for other variables (OR=1.36; 95%CI 1.05-1.76; p-value 0.02). The analysis also showed no association between colorectal cancer and the frequency of alcohol use (OR=1.00; 95%CI 0.72-1.40; p-value 0.98). In addition, usage of alcohol in the participants’ family during childhood significantly increases the risk of developing colorectal cancer (OR=6.45; 95%CI 1.74-13.54; p-value 0.000). There is no confounding effect of smoking and BMI (OR=0.97; 95% CI 0.83-1.14; p-value 0.71). There is a potential confounding effect of age (OR=1.06; 95% CI 1.04-1.09; p-value 0.000). Conclusion: The study has demonstrated evidence that there is a need for educational programs regarding the risks of alcohol consumption to make such information available for the public. Based on the results of the study, the public educational program should recommend avoiding use of vodka as the preferred alcohol type, shifting from amount of 3 or more drinks to a lesser amount of alcohol (1-2 drinks), and also should make people understand and get them acquainted with the result that the common use of alcohol in a child’s upbringing significantly increases the risk of developing colorectal cancer. However, more research is needed to obtain data that might serve for decision-making regarding nation-wide preventive programs. Further, the observed protective effect of the frequent use of wine on developing colorectal cancer needs to be confirmed by additional research, since the results are not in agreement with those of previous studies.