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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 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]
In the citing paper
“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]
In the citing paper
“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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Estimates of the current and future burden of cancer attributable to alcohol consumption in Canada
Grevers, X., Ruan, Y., Poirier, A. E., Walter, S. D., Villeneuve, P. J., Friedenreich, C. M., & Brenner, D. R. (2019) · Preventive Medicine · doi:10.1016/j.ypmed.2019.03.020 · Cited by 16
Pancreatic cancer trends in Europe: epidemiology and risk factors
Hawksworth, G., Hales, J., Martinez, F., Hynes, A., Hamilton, A., & Fernández, V. (2019) · Medical Studies · doi:10.5114/ms.2019.86336 · Cited by 16
“A meta-analysis has shown that the risk of pancreatic cancer is 20% higher in those who consume > 50 g of alcohol when compared to non-drinkers or occasional drinkers [47].”
BackgroundSolans, M., Romaguera, D., Gràcia‐Lavedan, E., Molinuevo, A., Benavente, Y., Sáez, M., Marcos‐Gragera, R., Costas, L., Robles, C., Alonso, E., et al. (2019) · Cancer Epidemiology · doi:10.1016/j.canep.2019.101629 · Cited by 16
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Alvanzo, A. A. H., Storr, C. L., Reboussin, B. A., Green, K. M., Mojtabai, R., Flair, L. N. L., Cullen, B., Susukida, R., Seamans, M. J., & Crum, R. M. (2020) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2020.104624 · Cited by 16
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Jankhotkaew, J., Bundhamcharoen, K., Suphanchaimat, R., Waleewong, O., Chaiyasong, S., Markchang, K., Wongworachate, C., Vathesatogkit, P., & Sritara, P. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-038198 · Cited by 16
Alcohol and tobacco consumption: What is the role of economic security?
Bentley, R., Baker, E., Martino, E., Li, Y., & Mason, K. (2021) · Addiction · doi:10.1111/add.15400 · Cited by 16
Iwase, M., Matsuo, K., Koyanagi, Y. N., Ito, H. M., Tamakoshi, A., Wang, C., Utada, M., Ozasa, K., Sugawara, Y., Tsuji, I., et al. (2021) · International Journal of Cancer · doi:10.1002/ijc.33478 · Cited by 16
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Matzopoulos, R., Cois, A., Probst, C., Parry, C. D. H., Vellios, N., Sorsdahl, K. R., Joubert, J. D., Wyk, V. P., Bradshaw, D., & Pacella, R. (2022) · South African Medical Journal · doi:10.7196/samj.2022.v112i8b.16487 · Cited by 19
“Relative risks (RRs) for the partially attributable conditions with reference to the counterfactual minimum risk of no alcohol use were obtained from three sources.[1,56,57] PAFs for each condition were calculated by applying RRs for different levels of daily use to current HEDs and drinkers who did not binge.”
MethodCybulski, C., Lubiński, J., Huzarski, T., Lynch, H. T., Randall, S., Neuhausen, S. L., Senter, L. A., Friedman, S., Ainsworth, P., Singer, C. F., et al. (2015) · Breast Cancer Research and Treatment · doi:10.1007/s10549-015-3393-4 · Cited by 16
“61 for heavy alcohol consumption, compared to non-drinkers and occasional drinkers [10].”
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García, M. R., Vitelli‐Storelli, F., Molina, A. J., Zamora‐Ros, R., Aragonés, N., Ardanáz, E., Castaño‐Vinyals, G., Obón‐Santacana, M., Gómez‐Acebo, I., Molina‐Barceló, A., et al. (2020) · Nutrients · doi:10.3390/nu12113281 · Cited by 16
“Nevertheless, the role of wine consumption in gastric carcinogenesis is a controversial topic due to its alcohol content, which is a probable risk factor for GC [51,52].”
BackgroundBouajila, N., Domenighetti, C., Aubin, H., & Naassïla, M. (2024) · Frontiers in Epidemiology · doi:10.3389/fepid.2024.1385064 · Cited by 18
Burden of Cancer Due to Cigarette Smoking and Alcohol Consumption in Korea
Jung, Y.-S., & Yoon, S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19063493 · Cited by 15
Doyle, A., O’Dwyer, C., Mongan, D., Millar, S., & Galvin, B. (2023) · BMC Public Health · doi:10.1186/s12889-023-15455-8 · Cited by 14
Cho, E. J., Chung, G. E., Yoo, J., Cho, Y., Shin, D. W., Kim, Y. J., Yoon, J., Han, K., & Yu, S. J. (2023) · PLoS Medicine · doi:10.1371/journal.pmed.1004244 · Cited by 17
Reynales-Shigematsu, L. M., Barnoya, J., Cavalcante, T. M., Aburto, T. C., Romieu, I., Stern, M. C., Barquera, S., Corvalán, C., Hallal, P. C., Canelo‐Aybar, C., et al. (2023) · Cancer Epidemiology · doi:10.1016/j.canep.2023.102413 · Cited by 16
Alcohol and dementia — risk or protective factor?
Anstey, K. J., & Peters, R. K. (2018) · Nature Reviews Neurology · doi:10.1038/s41582-018-0073-0 · Cited by 14
Oh, J., Han, M., Kim, B., & Park, E. Y. (2022) · Cancer Research and Treatment · doi:10.4143/crt.2021.1031 · Cited by 17
“A meta-analysis including 222 articles comprising more than 92,000 light drinkers (up to one drink per day) and 60,000 nondrinkers with cancer shows that even light consumption increases the risk of cancer of the oral cavity and pharynx, esophagus, and female breast [16].”
BackgroundMethodInfluentialGuo, J., Koopmeiners, J. S., Walmsley, S. J., Villalta, P. W., Yao, L., Murugan, P. J., Tejpaul, R., Weight, C., & Turesky, R. J. (2022) · Chemical Research in Toxicology · doi:10.1021/acs.chemrestox.2c00012 · Cited by 15
Filiberti, R., Fontana, V., Ceglie, A. D., Blanchi, S., Grossi, E., Casa, D. D., Lacchin, T., Matthaeis, M. D., Ignomirelli, O., Cappiello, R., et al. (2017) · British Journal Of Nutrition · doi:10.1017/s0007114517000940 · Cited by 15
“Alcohol is an established risk factor for oesophageal squamous cell carcinoma((6)), but reports about the association between alcohol and reflux E and BE, as well as EAC are still inconsistent.”
BackgroundCaradonna, F., Cruciata, I., & Luparello, C. (2020) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2020.1850416 · Cited by 15
Anaesthesia for reconstructive free flap surgery for head and neck cancer
McCauley, P., Moore, M., & Duggan, E. (2022) · British Journal of Hospital Medicine · doi:10.12968/hmed.2021.0668 · Cited by 14
Metadata
- 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
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