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Higher alcohol consumption may increase risk of colorectal cancer


A new peer-reviewed study shows that high alcohol consumption may lead to a higher risk of colorectal cancer, particularly distal colon and rectal cancers. Alcohol consumption is well known to be a risk factor for all cancers, and this study provides good evidence that there is a correlation.

As I usually do, I’ll discuss what is colorectal cancer and then, review and critique the new study.

spilled red wine from a glass
Photo by Polina Tankilevitch on Pexels.com

Colorectal cancer

Colorectal cancer, which develops in the colon or rectum, hits over 100,000 people each year in the USA. When colorectal cancer is found early (that’s why colonoscopies are recommended when you are in your later 40s), treatment for the cancer is usually very successful. However, late-stage cancers are difficult to treat successfully.

There are numerous known risk factors for colorectal cancer:

  • Being older — your risk of getting colorectal cancer increases as you age.
  • Having a personal or family history of colorectal cancer.
  • Having a history of adenomas. Adenomas are colorectal polyps (growths) that look abnormal under a microscope or are 1 centimeter or larger. Adenomas are not cancer, but they can sometimes turn into cancer over time.
  • Having a genetic syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colorectal cancer).
  • Having chronic ulcerative colitis or Crohn’s disease for 8 years or more.
  • Having three or more alcoholic drinks per day.
  • Smoking cigarettes.
  • Being Black — black individuals have an increased risk of colorectal cancer and death from colorectal cancer compared to other ethnic groups.
  • Obesity.

As you can see, the link between alcohol and colorectal disease has been known for years. And that’s why this study is so interesting, it continues to reinforce the link between alcohol and colorectal cancer.

Colorectal cancer and alcohol study

In a paper published on 14 June 2023 in the Journal of Clinical Oncology, Eun Hyo Jin, MD, Ph.D., of the Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea, and colleagues retrospectively compared average daily alcohol consumption with early-onset CRC risk among nearly 5.7 million adults younger than 50 years, using data from the Korean National Health Insurance Service.

For this study, Alcohol consumption levels were defined as nondrinker, light (<10 g of alcohol per day), moderate (10–30 g/day for men, 10–20 g/day for women), and heavy (≥30 g/day for men, ≥20 g/day for women). For Americans who don’t use the metric system, one drink per day would be around 14 g of alcohol per day.

The primary outcome of this study was to determine the incidence of early-onset colorectal cancer before age 50 compared to the amount of alcohol consumed. The results were adjusted for age, sex, smoking status, exercise, income, and other comorbidities.

Here are the key results from the study:

  • Compared with light drinking, moderate and heavy drinking was associated with a significantly elevated risk of early-onset CRC, with a 9% and 20% increased risk, respectively.
  • Among men, heavy drinking vs light drinking was associated with a 26% increased risk of distal colon cancer, a 17% higher risk of rectal cancer, and a 29% higher risk of unspecified colon cancer (but not proximal colon cancer).
  • Among women, moderate drinking was associated with a 47% increased risk of distal colon cancer.
  • Among nondrinkers, there was a 14% reduced risk of rectal cancer compared with light drinkers.

The authors concluded that “Excessive alcohol consumption increases the risk of colorectal cancer onset before age 50 years.”

Summary of alcohol and colorectal cancer study

Before I get to my thoughts on this study, I need to lay out a few limitations of the study. Like many nutrition-based studies, alcohol consumption levels are self-reported. This is not like a clinical trial where the amount would be controlled carefully, so we have to rely upon the honesty and accuracy of the individuals.

Also, this study includes only a Korean population. To confirm these results, we would need a larger study that includes a larger demographic population with more diverse ethnic groups.

That being said, this study confirms what has been found before — there is a direct link between alcohol consumption, even in small amounts, and an increased risk of colorectal cancer. And this study shows that alcohol might be linked to early-onset colorectal cancer, meaning younger individuals might be a risk if they drink even moderate amounts.

I give this study 3.5 stars out of 5. It provides crucial evidence showing a link, and it should sound a warning to individuals who drink alcohol regularly

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Michael Simpson

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