Alcohol

Avoid

4 studies · 1 recommendation

Last updated: February 25, 2026

Avoid4 studies

Alcohol consumption increases colorectal cancer risk in a clear dose-dependent pattern

Four cohort studies encompassing over 428,000 participants consistently link alcohol intake to elevated colorectal cancer risk. In the Melbourne Collaborative Cohort (38,149 participants), each 10 g/day increase in lifetime alcohol raised colorectal cancer risk by 8% (HR 1.08, 95% CI 1.04–1.12), with stronger effects for rectal cancer. The EPIC study (380,395 participants) found extreme drinkers faced 27–53% higher overall mortality from alcohol-related cancers. Among 8,670 UK adults, men consuming 15–28 units weekly had a 2.28-fold increased colorectal cancer risk (95% CI 1.13–4.57). Even genetically predisposed individuals (1,925 MMR mutation carriers) showed dose-dependent risk: up to 14 g/day elevated colon cancer risk by 78% (HR 1.78, 95% CI 1.27–2.49), rising to 94% at >28 g/day. No safe consumption threshold was identified across any study population.

Evidence

Alcohol consumption and risk of common cancers: evidence from a cohort of adults from the United Kingdom

Authors: Betts, Georgina, Grainge, Matthew J., Opazo-Breton, Magdalena, Ratschen, Elena

Published: September 11, 2017

Among 8,670 UK adults tracked from 1984/85 through 2009 via cancer registry linkage, men consuming 15–28 units of alcohol per week had a hazard ratio of 2.28 (95% CI 1.13–4.57) for colorectal cancer after multivariable adjustment including cigarette smoking. Alcohol intake was measured using a detailed weekly consumption diary, providing more precise exposure data than standard frequency questionnaires. The elevated risk at this moderate-to-heavy consumption level, along with higher risks at greater intake levels, demonstrates a clinically significant dose-response pattern for colorectal cancer in male drinkers.

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Lifetime alcohol intake is associated with an increased risk of KRAS+ and BRAF-/KRAS- but not BRAF+ colorectal cancer.

Authors: Buchanan, Daniel D, Clendenning, Mark, English, Dallas R, Giles, Graham G, Hodge, Allison M, Hopper, John L, Jayasekara, Harindra, Jenkins, Mark A, MacInnis, Robert J, Milne, Roger L, Room, Robin, Rosty, Christophe, Southey, Melissa C, Walters, Rhiannon, Williamson, Elizabeth J

Published: December 26, 2016

A prospective cohort study of 38,149 participants aged 40-69 years from the Melbourne Collaborative Cohort Study with a mean follow-up of 14.6 years identified 596 colon and 326 rectal cancer cases. A positive dose-dependent association between lifetime alcohol intake and overall colorectal cancer risk was observed (HR = 1.08, 95% CI: 1.04-1.12 per 10 g/day increment). The risk was greater for rectal than colon cancer (p_homogeneity = 0.02). Alcohol intake was associated with increased risks of KRAS+ tumors (HR = 1.07, 95% CI: 1.00-1.15) and BRAF-/KRAS- tumors (HR = 1.05, 95% CI: 1.00-1.11), with significant heterogeneity across molecular subtypes (p_homogeneity = 0.01).

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Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study

Authors: Agnoli, Claudia, Arriola, Larraitz, Barricarte, Aurelio, Benetou, Vasiliki, Beulens, Joline Wj, Boeing, Heiner, Bradbury, Kathryn E, Brennan, Paul, Dartois, Laureen, Dossus, Laure, Duell, Eric J, Fagherazzi, Guy, Ferrari, Pietro, Gunter, Marc, Johansson, Mattias, Kaaks, Rudolf, Khaw, Kay-Tee, Kragh Andersen, Per, Li, Kuanrong, Licaj, Idlir, Lund University., Lund University., Molina-Montes, Esther, Muller, David C, Norat, Teresa, Nunes, Luciana, Olsen, Anja, Overvad, Kim, Palli, Domenico, Peeters, Petra, Riboli, Elio, Romieu, Isabelle, Sacerdote, Carlotta, Sanchez, Carmen Navarro, Tjønneland, Anne, Trichopoulos, Dimitrios, Trichopoulou, Antonia, Tumino, Rosario, Wallström, Peter,, Wareham, Nick, Weiderpass, Elisabete

Published: January 1, 2014

In this prospective cohort of 380,395 participants across 10 European countries followed for an average of 12.6 years, 2,053 deaths from alcohol-related cancers (ARC) were recorded, including colorectal cancer. Extreme drinkers (≥60 g/day in men, ≥30 g/day in women) compared to moderate drinkers (0.1–4.9 g/day) had HRs of 1.53 (95% CI 1.39–1.68) in men and 1.27 (95% CI 1.13–1.43) in women for overall mortality. Strong associations were observed specifically for ARC mortality, particularly in men. Beer consumption showed stronger associations with overall mortality than wine, especially in men.

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Cancer Epidemiol Biomarkers Prev

A cohort study of 1,925 MMR gene mutation carriers from the Colon Cancer Family Registry found that 769 (40%) developed colorectal cancer at a mean age of 42.6 years (SD 10.3). Compared with abstention, ethanol consumption up to 14 g/day was associated with increased colorectal cancer risk (HR 1.50; 95% CI 1.09–2.07) and consumption >28 g/day showed further elevated risk (HR 1.69; 95% CI 1.07–2.65; P-trend=0.05). The association was stronger for colon cancer specifically: up to 14 g/day (HR 1.78; 95% CI 1.27–2.49) and >28 g/day (HR 1.94; 95% CI 1.19–3.18; P-trend=0.02). No clear association was observed with rectal cancer risk. Weighted Cox proportional hazard regression models were used to estimate hazard ratios.

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