Does Alcohol Intake Increase Colorectal Cancer Risk?

Alcohol intake may increase colorectal cancer risk. However, the magnitude of this risk and intake level at which it occurs are unknown. To examine the association between alcohol intake and colorectal cancer, researchers pooled primary data from 8 large prospective cohort studies in 5 countries that reported incident cases of colorectal cancer (4687) in a total of 489,979 men and women.

• Consuming >=45 g of alcohol (roughly 3 standard drinks) per day, compared with not drinking, significantly increased risk of colorectal cancer (relative risk, RR, 1.4). Consuming 30 g to <45 g per day also increased risk (RR 1.2) at a borderline level of significance.
• These results were consistent among men and women, by type of alcoholic beverage (i.e., beer, wine, liquor), and regardless of multivitamin use, folate and methionine intake, and smoking.
• Those with a lower body mass index (BMI) who consumed alcohol had a higher risk of colorectal cancer.
• The effect of alcohol consumption, regardless of beverage type, was similar for all colon cancer sites.

Comments:

The increased risk of colorectal cancer observed in this study is modest and occurs at a level of alcohol intake that is above the usual recommended threshold for low-risk drinking. Healthcare providers should be aware of these findings and incorporate them into discussions with patients about the risks and benefits of alcohol consumption.

Kevin L. Kraemer, MD, MSc

Reference:

Cho E, Smith-Warner SA, Ritz J, et al. Alcohol intake and colorectal cancer: a pooled analysis of 8 cohort studies. Ann Intern Med. 2004;140(8):603–613.
(view abstract)