Alcohol and Colorectal Cancer

Researchers in this study from Europe aimed to better understand the relationship between alcohol consumption and colorectal cancer (CRC). They assessed alcohol use in 478,732 subjects without cancer at study enrollment. They followed up these subjects for approximately 6 years, during which 1833 cases of CRC were reported.

Findings from analyses adjusted for potential confounders (e.g., age, weight, energy intake) included the following:

• The risk of CRC significantly increased as drinking increased above approximately 0.5 drinks per day. Hazard ratios (HRs) ranged from 1.05 for a lifetime usual intake of about 0.5–1 drink per day to 2.0 for >5 drinks per day.
• The risk of CRC associated with baseline beer intake (HR, 1.4 for about 1.5–3 versus <0.25 drinks per day) was higher than the risk associated with wine intake (HR, 1.2 for the same amounts), although the two risk estimates were not significantly different.
• The risk associated with baseline alcohol use was higher among those with low folate intake (HR, 1.1 for an increase of about 1 drink per day) than among those with high folate intake (HR, 1.03, a borderline significant finding).

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Comments:

Like a number of other recent studies, this large, multi-country epidemiologic study suggests an increased risk of colorectal cancer from alcohol intake, primarily at higher intakes. The risk was not as high among drinkers of smaller amounts or subjects with higher intakes of folate. Individuals drinking within the current U.S. recommendations for moderate use (2 or fewer drinks for men, 1 or fewer for women) may have a minimal increase in CRC risk that could possibly be attenuated by adequate folate intake.

R. Curtis Ellison, MD

Reference:

Ferrari P, Jenab M, Norat T, et al. Lifetime and baseline alcohol intake and risk of colon and rectal cancers in the European Prospective Investigation into Cancer and Nutrition (EPIC).  Int J Cancer. 2007;121(9):2065–2072.