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Alcohol drinking and cutaneous melanoma risk: a systematic review and dose–risk meta-analysis

Authors

  • M. Rota,

    1. Department of Health Sciences, Centre of Biostatistics for Clinical Epidemiology, University of Milan-Bicocca, Milan, Italy
    2. Department of Epidemiology, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
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  • E. Pasquali,

    1. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
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  • R. Bellocco,

    1. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
    2. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
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  • V. Bagnardi,

    1. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
    2. Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
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  • L. Scotti,

    1. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
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  • F. Islami,

    1. The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
    2. Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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  • E. Negri,

    Corresponding author
    1. Department of Epidemiology, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
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  • P. Boffetta,

    1. The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
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  • C. Pelucchi,

    1. Department of Epidemiology, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
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  • G. Corrao,

    1. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
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  • C. La Vecchia

    1. Department of Epidemiology, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
    2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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  • Funding sources This work was supported by the Italian Association of Cancer Research, project nos 10068 and 10258. M.R. was supported by a fellowship of the Fondazione Umberto Veronesi. R.B. was partially supported by the Italian Ministry of University and Research, project number PRIN-2009, X8YCBN.
  • Conflicts of interest None declared.
  • Plain language summary available online

Summary

It has been suggested that alcohol intake increases sunburn severity, a major risk factor for cutaneous melanoma (CM). Several epidemiological studies have investigated the relationship between alcohol consumption and CM, but the evidence is inconsistent. Therefore, we aimed to quantify this relationship better, using a meta-analytical approach. The dose–risk relationship was also modelled through a class of flexible nonlinear meta-regression random effects models. The present meta-analysis included 16 studies (14 case–control and two cohort investigations) with a total of 6251 cases of CM. The pooled relative risk (RR) for any alcohol drinking compared with no/occasional drinking was 1·20 [95% confidence interval (CI) 1·06–1·37]. The risk estimate was similar in case–control (RR 1·20, 95% CI 1·01–1·44) and cohort studies (RR 1·26, 95% CI 1·19–1·35). The pooled RR was 1·10 (95% CI 0·96–1·26) for light alcohol drinking (≤ 1 drink per day) and 1·18 (95% CI 1·01–1·40) for moderate-to-heavy drinking. The pooled RR from 10 studies adjusting for sun exposure was 1·15 (95% CI 0·94–1·41), while the RR from six unadjusted studies was 1·27 (95% CI 1·20–1·35). No evidence of publication bias was detected. This meta-analysis of published data reveals that alcohol consumption is positively associated with the risk of CM. However, caution in interpreting these results is required, as residual confounding by sun exposure cannot be ruled out.

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