Alcohol Intake and Risk of Incident Melanoma: A Pooled Analysis of Three Prospective Studies in the United States

Background: Alcohol consumption is associated with increased risk of numerous cancers, but existing evidence for an association with melanoma is equivocal. No study has evaluated the association with different anatomic locations of melanoma. Methods: We used data from three large prospective cohort studies to investigate whether alcohol intake was associated with risk of melanoma. Alcohol intake was assessed repeatedly by food-frequency questionnaires. A Cox proportional hazards model was used to calculate multivariate-adjusted hazard ratios (HRs). Results: A total of 1,374 cases of invasive melanoma were documented during 3,855,706 person-years of follow-up. There was an association between higher alcohol intake and incidence of invasive melanoma (pooled multivariate HR 1.14 [95% confidence interval (CI), 1.00-1.29] per drink/day; P-trend-0.04). Among alcoholic beverages, white wine consumption was associated with an increased risk of melanoma pooled multivariate HR 1.13 [95% CI, 1.04-1.24] per drink/day; P-trend < 0.01) after adjusting for other alcoholic beverages. The association between alcohol consumption and melanoma risk was stronger for melanoma in relatively UV-spared sites (trunk) versus more UV-exposed sites (head, neck, or extremities). Compared with nondrinkers, the pooled multivariateadjusted HRs for >= 20 g/day of alcohol were 1.02 (95% CI, 0.64-1.62; P-trend -0.25) formelanomas of the head, neck, and extremities and 1.73 (95% CI, 1.25-2.38; P-trend = 0.02) for melanomas of the trunk. Conclusions: Alcohol intake was associated with a modest increase in the risk of melanoma, particularly in UV-protected sites. Impact: These findings further support American Cancer Society Guidelines for Cancer Prevention to limit alcohol intake. Cancer Epidemiol Biomarkers Prev; 25(12); 1550-8. (C) 2016 AACR.