Colorectal cancer remains one of the most common cancers diagnosed in the United States, and finding factors that can improve prognosis remains an important public health goal. While alcohol consumption is a well-characterized risk factor for the development of colorectal cancer, preliminary evidence suggests the possibility that pre-diagnostic alcohol consumption may be associated with better prognosis after diagnosis. To further evaluate this potential, Drs. Amanda Phipps, Polly Newcomb, and colleagues in the Public Health Sciences Division evaluated different types of alcohol consumption within a large population-based consortium. As recently reported in Cancer, the authors found that wine consumption, but not beer or liquor consumption, was associated with more favorable survival after colorectal cancer.
To evaluate the effect of pre-diagnostic drinking on survival, the researchers analyzed data from the Colon Cancer Family Registry (C-CFR). This international collaboration evaluated nearly 5,000 colorectal cancer patients from sites in Australia, Canada, and the United States between 1997 and 2007. Participants reported their alcohol consumption from the ages of 20-30, 30-50, and after 50, including average servings per week, type, and duration. Follow-up for vital status and cause of death was carried out through 2013. Importantly, participants provided information on a large number of personal characteristics and health factors that could be accounted for in the survival analyses, including age at diagnosis, smoking history, sex, body mass index, educational attainment, and non-steroidal anti-inflammatory drug use.
Taken together, alcohol consumption was not associated with either overall or disease-specific survival. When considered by beverage type, however, the authors observed statistically significant findings indicating that higher levels of wine consumption were associated with more favorable survival. Compared to those who drank less than one drink per week, averaging greater than one serving of wine per day was associated with 30% better survival. Further exploration suggested that this effect was strongest in men and former smokers.
“Our finding that wine consumption prior to colorectal cancer diagnosis was associated with more favorable prognosis is consistent with what we recently found in a clinical trial population,” said lead author Dr. Phipps. “Finding such similar results from such different studies adds a lot of support to the idea that moderate wine consumption before cancer diagnosis has benefits for colorectal cancer outcomes. But, it also begs the question as to the possible benefits of wine consumption after colorectal cancer diagnosis. That’s a question we haven’t been able to address with our studies thus far, but we know the answer to that question is likely to be of great interest to colorectal cancer patients.”
Adds senior author Dr. Newcomb, "we hope we will have some data on this question in a new study in the field right now.” Future research will be needed to evaluate the mechanisms through which pre-diagnostic drinking may differentially affect colorectal cancer survival. Though pre-diagnostic behaviors cannot be changed after diagnosis, the hope is that findings from studies such as this one can highlight biological pathways that could be targeted for future elucidation. Recent evidence regarding potential anti-cancer benefits of wine compounds such as resveratrol lend some biologic plausibility to these findings. Perhaps there are some colorectal cancer-specific effects of wine that can eventually be uncorked for survivors.
Also contributing to this project from the Fred Hutch was Ms. Jamaica Robinson.
Funding for this study was provided by the National Institutes of Health (NCI).
Phipps AI, Robinson JR, Campbell PT, Win AK, Figueiredo JC, Lindor NM, Newcomb PA. 2016. Prediagnostic alcohol consumption and colorectal cancer survival: The Colon Cancer Family Registry. Cancer. doi: 10.1002/cncr.30446. [Epub ahead of print]
Image provided by Dr. Amanda Phipps