Abstract
Although alcohol intake is known to be associated with the development of colorectal cancer, the effect of alcohol consumption on the development of colorectal neoplasm (CRN) is unclear. We performed a retrospective cohort analysis with 1 to 1 propensity score matching in a single center of Korea. Among 1,448 patients who underwent index and surveillance colonoscopy, 210 matched pairs were analyzed. The 5-year cumulative occurrence of overall CRN after index colonoscopy was higher in the significant alcohol consumption group (defined as alcohol consumption more than 30 g/day in men and 20 g/day in women) (vs. without significant alcohol consumption group) (40% vs. 27.6%, p = 0.004). Significant alcohol consumption increased the development of overall CRN (adjusted hazard ratio [aHR]: 1.86, 95% confidence interval [CI]: 1.28–2.70, p = 0.001) at surveillance colonoscopy. However, this effect was not valid on the development of advanced CRN. In subgroup analysis considering the risk classification of index colonoscopy, significant alcohol consumption increased the overall CRN development at surveillance colonoscopy in the normal group (patients with no detected adenoma in the index colonoscopy) (aHR: 1.90, 95% CI: 1.16–3.13, p = 0.01). Alcohol consumption habits should be considered in optimizing time intervals of surveillance colonoscopy.
Highlights
The role of surveillance colonoscopy has been well-known to prevent the occurrence of metachronous colorectal neoplasm (CRN) and colorectal cancer (CRC) in subjects with CRN at index colonoscopy[1,2]
To identify the potential risk factors of CRN occurrence at surveillance colonoscopy, we analyzed the influence of significant alcohol consumption on CRN development together with the findings of index colonoscopy
Our retrospective study with a well-balanced matched-pair design demonstrated that significant alcohol consumption doubled the risk of the overall CRN occurrence at surveillance colonoscopy, and this association was confined to the subjects with normal or low-risk findings at index colonoscopy
Summary
The role of surveillance colonoscopy has been well-known to prevent the occurrence of metachronous colorectal neoplasm (CRN) and colorectal cancer (CRC) in subjects with CRN at index colonoscopy[1,2]. A recent prospective study showed that metabolic syndrome influenced the development of CRN at surveillance colonoscopy[8], the influence of personalized risk factors other than the findings of index colonoscopy on the occurrence of CRN at the time of surveillance colonoscopy has not been thoroughly elucidated to date. On the basis of the well-recognized adenoma-carcinoma sequence, several studies were conducted to determine the impact of alcohol consumption on the development of CRN, but these studies showed inconsistent results and have not been able to clearly identify the clinical association between alcohol consumption and CRN13–15. Recent meta-analysis showed that increased intake of 25 g per day of alcohol consumption was related to an increased risk of colorectal adenomas. This study aimed to determine if alcohol consumption is associated with the development of CRN at the time of surveillance colonoscopy
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