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Alcohol consumption and molecular subtypes of colorectal cancer: pooled observational and Mendelian randomization analyses.

The American journal of clinical nutrition 2026 p. 101308 Alcohol Consumption and Health Effec
OpenAlex 토픽 · Alcohol Consumption and Health Effects Colorectal Cancer Screening and Detection Liver Disease Diagnosis and Treatment

Chalitsios CV, Chan WC, Markozannes G, Aglago EK, Berndt SI, Buchanan DD, Campbell PT, Cao Y, Dimou N, Drew DA, French AJ, Gallinger S, Georgeson P, Giannakis M, Gruber SB, Gunter MJ, Harrison TA, Brenner H, Hoffmeister M, Urruchúa-Rodríguez MJ, Hsu L, Huang WY, Hullar MA, Huyghe JR, Jenkins MA, Jayasekara H, Moreno V, Newton CC, Nowak JA, Obón-Santacana M, Ogino S, Pellatt AJ, Peoples A, Qu C, Schmit SL, Steinfelder RS, Sun W, Thomas CE, Toland AE, Trinh QM, Ugai T, Um CY, Van Guelpen B, Zaidi SH, Peters U, Phipps AI, Tsilidis KK

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[BACKGROUND] Alcohol consumption is associated with colorectal cancer (CRC) risk, yet its association with distinct molecular subtypes remains unclear.

🔬 핵심 임상 통계 (초록에서 자동 추출 — 원문 검증 권장)
  • 표본수 (n) 11,826
  • OR 1.25

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BibTeX ↓ RIS ↓
APA Christos V. Chalitsios, Wing Ching Chan, et al. (2026). Alcohol consumption and molecular subtypes of colorectal cancer: pooled observational and Mendelian randomization analyses.. The American journal of clinical nutrition, 101308. https://doi.org/10.1016/j.ajcnut.2026.101308
MLA Christos V. Chalitsios, et al.. "Alcohol consumption and molecular subtypes of colorectal cancer: pooled observational and Mendelian randomization analyses.." The American journal of clinical nutrition, 2026, pp. 101308.
PMID 42031341

Abstract

[BACKGROUND] Alcohol consumption is associated with colorectal cancer (CRC) risk, yet its association with distinct molecular subtypes remains unclear. Clarifying this could reveal insights into alcohol's carcinogenic mechanisms.

[OBJECTIVES] We examined the association between alcohol consumption and the risk of CRC subtypes defined by individual tumor markers (and marker combinations), namely microsatellite instability (MSI) status, CpG island methylator phenotype (CIMP) status, BRAF, and KRAS mutations.

[METHODS] Pooled observational (n = 11,826, n = 10,888; n = 10) and genome-wide association data (n = 8178, n = 10,472; n = 10) were used. Multivariable logistic regression models and Mendelian randomization (MR) analyses were conducted to assess the association between alcohol consumption, modeled in MR as genetically predicted average drinks per week per 1 SD increase (≈2.9 drinks/wk), and risk of CRC subtypes defined by individual tumor markers (and marker combinations). Case-only analyses tested for differences between molecular subtypes. Bonferroni correction was applied for multiple tests.

[RESULTS] Among drinkers, each additional 14 g/d of alcohol was associated with a 10% higher CRC risk [odds ratio (OR) = 1.10; 95% confidence interval (CI): 1.07, 1.13], but this association was primarily driven by heavy alcohol consumption (>28 g/d). Including nondrinkers revealed a J-shaped association (P-nonlinearity = 0.002). The associations with higher alcohol consumption were stronger in males compared with females. No significant heterogeneity was observed across MSI, CIMP, BRAF, or KRAS-defined subtypes. All associations were similar across smoking status, folate intake, tumor anatomical site, study design, early/late-onset CRC, and across individual studies (P-heterogeneity > 0.05). MR analyses supported that higher genetically predicted alcohol consumption was associated with CRC risk (OR = 1.25; 95% CI: 1.01, 1.57), but similarly to the observational analysis, without evidence of heterogeneity across molecular subtypes.

[CONCLUSIONS] Heavy alcohol consumption may initiate colorectal carcinogenesis through mechanisms that operate across all examined molecular pathways for CRC. Although the largest available data were used, power is lower for subtype heterogeneity analyses, and modest interaction effects cannot be excluded.

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