Alcohol

AvoidCaution

4 studies · 2 recommendations

Last updated: February 25, 2026

Avoid2 studies

Alcohol consumption increases gastric cancer risk and worsens treatment outcomes

Across 2 studies including a clinical guideline and a cohort study of 30 patients, alcohol consumption is linked to both gastric cancer development and poorer treatment tolerability. The Uganda Cancer Working Group guideline identifies alcohol as a direct risk factor in the multistage oncogenesis of gastric cancer, contributing to a 7-fold incidence increase from 0.8 to 5.6 per 100,000. In post-surgical patients receiving adjuvant S-1 chemotherapy, regular alcohol intake was significantly associated with earlier treatment withdrawal (P=0.044), with only 63% completing planned therapy cycles. Alcohol avoidance serves as both a primary prevention strategy and a factor in improving treatment completion rates for those already diagnosed.

Evidence

Adjuvant S-1 chemotherapy after curative resection of gastric cancer in Chinese patients: assessment of treatment tolerability and associated risk factors

Authors: Au, KH, Chiang, CL, Lam, KC, Lam, KO, Law, LYA, Lee, CCY, Li, L, Mo, KF, Ng, WT, So, TH, Yeo, W

Published: January 1, 2017

In a multicentre retrospective cohort of 30 Chinese patients with stage II-IIIC gastric adenocarcinoma who underwent curative resection and received adjuvant S-1 chemotherapy, univariate analysis showed that patients with a history of regular alcohol intake were significantly more likely to have earlier treatment withdrawal (P=0.044). Overall, only 63% of patients completed the planned eight cycles of therapy, with 73.3% requiring dose reductions and 40.0% experiencing dose delays. The association between alcohol history and treatment discontinuation suggests alcohol use may compound treatment toxicity or reduce tolerability in this population.

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Gastric cancer diagnosis and treatment guidelines 2008: Uganda Cancer Working Group

Authors: Fualal, J, Gakwaya, A, Galukande, M, Jombwe, J, Kanyike, A, Kigula-Mugamba, J, Luwaga, A

Published: June 2, 2016

The 2008 Uganda Cancer Working Group clinical guideline identifies alcohol consumption as a risk factor for gastric cancer within the multistage oncogenesis process. Given the 7-fold increase in gastric cancer incidence in Uganda from 0.8/100,000 to 5.6/100,000, the guideline emphasizes primary prevention including alcohol avoidance as the most effective management strategy, particularly because gastric cancer traditionally presents at advanced stages with poor outcomes.

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Caution2 studies

Alcohol consumption linked to increased gastric cancer risk through multiple pathways

Two studies involving over 289,000 participants connect alcohol intake to elevated gastric cancer risk. A large UK Biobank cohort study of 288,802 participants found that each 1-point increase in WCRF/AICR lifestyle adherence score—which includes alcohol restriction—reduced stomach cancer risk by 11% (HR 0.89; 95% CI 0.79–0.99) over 8.2 years of follow-up. A nested case-control study of 191 gastric cancer cases and 569 controls from a Shanghai cohort of 18,244 men identified a significant association between alcohol consumption and urinary N-nitroso compounds, known gastric carcinogens, with nitrate exposure raising risk nearly fivefold among H. pylori-negative individuals (OR 4.82; 95% CI 1.05–22.17). Limiting alcohol intake may reduce gastric cancer risk both directly and by lowering exposure to carcinogenic N-nitroso compounds.

Evidence

Abbreviated Score to Assess Adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and Risk of Cancer in the UK Biobank

Authors: Celis-Morales C, Ho FK, Malcomson FC, Mathers JC, Parra-Soto S, Sharp L

Published: January 9, 2024

Among 288,802 UK Biobank participants (mean age 56.2 years, cancer-free at baseline) with a median follow-up of 8.2 years, each 1-point increment in the abbreviated WCRF/AICR adherence score—incorporating alcohol restriction, body weight, physical activity, diet quality, and meat limitation—was associated with an 11% lower stomach cancer risk (HR 0.89; 95% CI 0.79–0.99). The confidence interval upper bound of 0.99 indicates borderline statistical significance. A total of 23,448 cancer cases occurred during the study period. Multivariable Cox models adjusted for confounders.

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Urinary levels of N-nitroso compounds in relation to risk of gastric cancer: Findings from the Shanghai cohort study

Authors: A Jemal, AJ Cross, AR Tricker, AR Tricker, C La Vecchia, CA Gonzalez, CL Sun, D Pobel, DM Parkin, DR Scott, E De Stefani, FD Ji, G De Bernardinis, H Ohshima, H Ohshima, H Ohshima, H Suzuki, Heather H. Nelson, JC Lunn, JE Stuff, Jeffrey S Chang, JG Kusters, JH Hotchkiss, Jian-Min Yuan, JM van Maanen, JM Yuan, JM Yuan, JM Yuan, JS Griesenbeck, KA Moy, Ling Xu, M Carboni, M McCracken, NE Breslow, NP Sen, P Jakszyn, P Jakszyn, P Knekt, R Schoental, Renwei Wang, RK Ross, S Calmels, SL He, SS Mirvish, T Herod-Leszczynska, W Lijinsky, Xin-Di Chu, Y Grosse, Yong-Hua Qu, Yu-Tang Gao

Published: February 6, 2015

Within this nested case-control study of 191 gastric cancer cases and 569 individually matched controls drawn from a prospective cohort of 18,244 middle-aged and older men in Shanghai, urinary NMTCA levels showed a statistically significant association with alcohol consumption. Exposure to nitrate, a precursor of N-nitroso compounds, was associated with increased gastric cancer risk among H. pylori seronegative individuals, with an odds ratio of 4.82 (95% CI: 1.05–22.17) for the highest versus lowest tertile (P for trend = 0.042).

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