Alcohol, smoking and rectal cancer risk in a Mediterranean cohort of adults

Rectal cancers (Rcs) represent one-third of all Colorectal cancers. Cigarette smoking and alcohol drinking are two underestimated risk factors for RC. A project evaluated the role of alcohol consumption and cigarette smoking in modulating RC risk and to estimate the attributable fraction in a Mediterranean population.
In the Italian section of the European Prospective Investigation into Cancer and Nutrition, 45,553 healthy men and women were recruited, who provided information about lifestyle and dietary habits. During 14.0 years of median follow-up, 154 incident RC cases were identified.
An increase in RC risk was found among subjects drinking more than 3 drinks/day, overall (hazard ratio [HR] = 1.74; 95% confidence interval [CI] 1.08-2.80), and in females (HR= 2.80; 95% CI 1.23-6.35), compared with drinkers of less than 1 drink/day. An increase in risk also emerged for current- compared with never-smokers, overall (HR = 1.57; 95% CI 1.06-2.35) and among males
(HR = 2.04; 95% CI 1.02-4.07). Overall, 9% (95% CI
4-14%) of RC cases were attributable to drinking more than 3 drinks/day and 12% (95% CI 3-19%) were attributable to current smoke and 20% (95% CI 11-27%) of RC cases were attributable to the independent effects of these two exposures.
The study supports a strategy to avoid a relevant proportion of rectal cancer cases through stopping cigarette smoking and drinking less than three drinks a day.
Source: Alcohol, smoking and rectal cancer risk in a Mediterranean cohort of adults: the European Prospective Investigation into Cancer and Nutrition (EPIC)-Italy cohort.Bendinelli B, Palli D, Assedi M, Facchini L, Grioni S, Agnoli C, Ricceri F, Macciotta A, Panico S, Mattiello A, Tumino R, Giurdanella MC, Saieva C, Masala G. Eur J Gastroenterol Hepatol. 2019 Dec 9.