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

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

Yongfeng Lao  1   2   3   4 , Xiaolong Li  1   2   3   4 , Lijuan He  1 , 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 Wang  1 , Xu Li  1   2   3   4 , Shuai Liu  1   2   3   4 , Zhilong Dong  1   2   3   4
Affiliations

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

Yongfeng Lao et al. Front Oncol. .

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.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the literature search and study selection process.
Figure 2
Figure 2
Forest plot of relative risk (RR) of bladder cancer for alcohol consumption (Any versus none) in the entire population and different gender subgroups.
Figure 3
Figure 3
Forest plot of relative risk (RR) of bladder cancer for alcohol consumption (Any versus none) of different sources in the entire population and different gender subgroups.
Figure 4
Figure 4
Forest plot of relative risk (RR) of bladder cancer for alcohol consumption (Light, moderate, and heavy versus none) in the entire population.
Figure 5
Figure 5
Linear and nonlinear fitting of alcohol consumption and risk of bladder cancer (A) linear association in entire population; (B) nonlinear association in entire population; (C) linear association in entire population who consumed alcohol for liquor or spirits; (D) nonlinear association in entire population who consumed alcohol from liquor or spirits; (E) linear association in males who consumed alcohol form liquor or spirits; (F) nonlinear association in males who consumed alcohol from liquor or spirits. (Bubbles were weighted by the number of cases at each dose point).
Figure 6
Figure 6
Sensitivity analysis of the association between alcohol consumption (any vs none) and risk of bladder cancer (The two ends of the dotted lines represented the 95%CI).
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