Association Between Alcohol Consumption and Risk of Bladder Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies

Yongfeng Lao; Xiaolong Li; Lijuan He; Xin Guan; Rongxin Li; Yanan Wang; Yanyou Li; Yunchang Wang; Xu Li; Shuai Liu; Zhilong Dong

doi:10.3389/fonc.2021.696676

Association Between Alcohol Consumption and Risk of Bladder Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies

Front Oncol. 2021 Sep 15:11:696676. doi: 10.3389/fonc.2021.696676. eCollection 2021.

Authors

Yongfeng Lao^{1

2

3

4}, Xiaolong Li^{1

2

3

4}, Lijuan He¹, Xin Guan^{1

2

3

4}, Rongxin Li^{1

2

3

4}, Yanan Wang^{1

2

3

4}, Yanyou Li^{1

2

3

4}, Yunchang Wang¹, Xu Li^{1

2

3

4}, Shuai Liu^{1

2

3

4}, Zhilong Dong^{1

2

3

4}

Affiliations

¹ Second Clinical Medical College, Lanzhou University, Lanzhou, China.
² Department of Urology, Lanzhou University Second Hospital, Lanzhou, China.
³ Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou, China.
⁴ Institute of Urology, Lanzhou University Second Hospital, Lanzhou, China.

Abstract

Background: Controversial results of the association between alcohol consumption and risk of bladder cancer were reported by the previous meta-analyses.

Objective: To quantitatively investigate the association between alcohol consumption and risk of bladder cancer based on prospective cohort studies, and explore whether there is potential dose-response relation.

Method: PubMed, EMBASE, the Cochrane Library databases, China Biology Medicine disc (CBM), and Chinese National Knowledge Infrastructure (CNKI) were searched for relevant studies. Categorical meta-analysis was performed for risk estimates of any alcohol consumers versus non-drinkers as well as different drinking degrees (light, moderate, and heavy) versus none. And two-stage generalized least-squares regression and restricted cubic spline, as well as fixed-effects dose-response models, were used for linear and nonlinear dose-response relation exploration.

Results: 9 prospective cohort studies including 1,971,396 individuals were finally included. We did not observe a significant association between alcohol intake and the risk of bladder cancer in the entire population. Linear association was detected in those who consumed alcohol from liquor or spirits (P _linear=0.02). One drink increment each day of alcohol could elevate the risk of bladder cancer by 9% (RR=1.09; 95%CI: 1.01-1.17). Alcohol was a risk factor of bladder cancer for male drinkers (RR=1.23; 95%CI: 1.13-1.35; I²=3.7%), while none linear or nonlinear relation was found.

Conclusion: No significant association between alcohol consumption and bladder cancer risk was found in the entire population, but there was a linear dose-response relation in those who consume alcohol from liquor or spirits. Alcohol may elevate the risk of bladder cancer in males in a dose-independent way.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, PROSPERO (CRD42020216195).

Keywords: alcohol; bladder cancer; dose-response; meta-analysis; systematic review.

Publication types

Systematic Review