Alcohol consumption and site-specific cancer risk: a comprehensive dose–response meta-analysis
Open accessAbstract
BACKGROUND: Alcohol is a risk factor for cancer of the oral cavity, pharynx, oesophagus, colorectum, liver, larynx and female breast, whereas its impact on other cancers remains controversial. METHODS: We investigated the effect of alcohol on 23 cancer types through a meta-analytic approach. We used dose-response meta-regression models and investigated potential sources of heterogeneity. RESULTS: A total of 572 studies, including 486 538 cancer cases, were identified. Relative risks (RRs) for heavy drinkers compared with nondrinkers and occasional drinkers were 5.13 for oral and pharyngeal cancer, 4.95 for oesophageal squamous cell carcinoma, 1.44 for colorectal, 2.65 for laryngeal and 1.61 for breast cancer; for those neoplasms there was a clear dose-risk relationship. Heavy drinkers also had a significantly higher risk of cancer of the stomach (RR 1.21), liver (2.07), gallbladder (2.64), pancreas (1.19) and lung (1.15). There was indication of a positive association between alcohol consumption and risk of melanoma and prostate cancer. Alcohol consumption and risk of Hodgkin's and Non-Hodgkin's lymphomas were inversely associated. CONCLUSIONS: Alcohol increases risk of cancer of oral cavity and pharynx, oesophagus, colorectum, liver, larynx and female breast. There is accumulating evidence that alcohol drinking is associated with some other cancers such as pancreas and prostate cancer and melanoma.
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The increase in risk of developing cancer for increasing average daily alcohol consumed is linear on an exponentiated scale, but the magnitude varies by cancer site.
“The increase in the risk of developing cancer (stratified by cancer site) for increasing average daily amounts of alcohol consumed (measured in grams of pure alcohol consumed per day) has been observed to be linear on an exponentiated scale; however, the magnitude of these risk increases varies by cancer site 169, 170, 171.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [169]
No association was found between excess alcohol consumption and the dementias, CHD, lung or liver cancer.
“However, no association was found between excess alcohol consumption and the dementias,11 CHD,91 lung76 or liver cancer.99”
From Common risk factors for major noncommunicable disease, a systematic overview of reviews and commentary: the implied potential for targeted risk reduction (2019) · cites this paper as [76]
Excess alcohol consumption was associated with an increased risk of stroke, bowel and breast cancer (between 20% and 50%).
“Excess alcohol consumption was associated with an increased risk of stroke, bowel and breast cancer (between 20% and 50%).11,76,97”
From Common risk factors for major noncommunicable disease, a systematic overview of reviews and commentary: the implied potential for targeted risk reduction (2019) · cites this paper as [76]
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- Authors
- Bagnardi, V, Rota, M., Botteri, E., Tramacere, I., Islami, F., Fedirko, V, Scotti, L., Jenab, M., Turati, F., Pasquali, E., Pelucchi, C., Galeone, C., Bellocco, R., Negri, E., Corrao, G., Boffetta, P., & La Vecchia, C.
- Affiliations
- European Institute of Oncology (IT)
- Mario Negri Institute for Pharmacological Research (IT)
- Fondazione IRCCS Istituto Neurologico Carlo Besta (IT)
- American Cancer Society (US)
- Emory University (US)
- University of Milano-Bicocca (IT)
- Centre international de recherche sur le cancer (FR)
- Karolinska Institutet (SE)
- Tisch Cancer Institute (US)
- Corresponding author
- Bagnardi, V
- ORCID
- Venue
- British Journal of Cancer
- Published
- 2014-11-25
- Volume
- 112
- Issue
- 3
- Pages
- 580-593
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC4453639
- OpenAlex
- W1965385210
- Cited by
- 1,342
- References
- 70
- Citations by year
- 2026: 130 · 2025: 149 · 2024: 129 · 2023: 139 · 2022: 158 · 2021: 133 · 2020: 123 · 2019: 108 · 2018: 100 · 2017: 86 · 2016: 64 · 2015: 21
- FWCI
- 42.39
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- www.springer.com/tdm (unspecified)
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion, other-oa)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Funders
- World Health Organization
- Fondazione Umberto Veronesi
- Associazione Italiana per la Ricerca sul Cancro (10258)
- Fondazione Italiana per la Ricerca sul Cancro
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Health Sciences › Medicine › Surgery › Esophageal Cancer Research and Treatment
- Keywords
- alcohol consumption, alcohol and cancer risk, dose-response relationship, heavy drinking, oral and pharyngeal cancer, esophageal squamous cell carcinoma, colorectal cancer, laryngeal cancer, breast cancer, liver cancer, gastric cancer, gallbladder cancer, pancreatic cancer, lung cancer, melanoma, prostate cancer, Hodgkin's disease, non-Hodgkin lymphoma
- MeSH terms
- Esophageal Squamous Cell Carcinoma, Alcohol Drinking, Breast Neoplasms, Carcinoma, Squamous Cell, Dose-Response Relationship, Drug, Esophageal Neoplasms, Female, Humans, Male, Melanoma, Mouth Neoplasms, Neoplasms, Pharyngeal Neoplasms, Prostatic Neoplasms, Risk Factors, Incidence, Case-Control Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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