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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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Álvarez-Avellón, S. M., Fernández‐Somoano, A., Navarrete‐Muñoz, E. M., Vioqué, J., & Tardón, A. (2017) · Medicina Clínica · doi:10.1016/j.medcli.2016.12.033 · Cited by 14
“D/D 691 (81,9) 645 (81,8) 1,00 1,00 D/C 141 (16,7) 135 (17,1) 0,97 (0,75-1,26) 0,97 (0,68-1,38) C/C 12 (1,4) 9 (1,1) 1,24 (0,52-2,97) 1,83 (0,58-5,74) C carriersb 153 (18,1) 144 (18,2) 0,99 (0,77-1,28) 1,02 (0,72-1,43)”
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BackgroundRole of cell-free network communication in alcohol-associated disorders and liver metastasis
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ResultInfluentialTemporal Trends in Fecal Occult Blood Test: Associated Factors (2009–2017)
Cobo‐Cuenca, A. I., Laredo‐Aguilera, J. A., Rodríguez-Borrego, M.-A., Santacruz‐Salas, E., & Carmona‐Torres, J. M. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16122120 · Cited by 12
Global Epidemiology of Gastrointestinal Cancers
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EPIDEMIOLOGY OF COLORECTAL CANCER
Осомбаев, М. Ш., Dzhekshenov, M. D., Сатыбалдиев, О. А., Абдрасулов, К. Д., Макимбетов, Э. К., & Анатольевич, К. М. (2021) · Научное обозрение Медицинские науки (Scientific Review Medical Sciences) · doi:10.17513/srms.1169 · Cited by 12
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“of alcohol consumption and cancer risk demonstrates the highest relative risk of ESCC development whereas the relative risk of esophageal adenocarcinoma (ADC) remains nearly unchanged, suggesting that oncogenic insults implicating ROS may preferentially drive SCC development [56].”
BackgroundAgrest, M., Tapia‐Muñoz, T., Encina, E. P., Wright, J., Ardila-Gómez, S. E., Alvarado, R., Leiderman, E. A., & Reavley, N. J. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03749-x · Cited by 11
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BackgroundAlcohol as a Non-UV Social-Environmental Risk Factor for Melanoma
Yamauchi, T., Shangraw, S., Zhai, Z., Menon, D. R., Batta, N., Dellavalle, R. P., & Fujita, M. (2022) · Cancers · doi:10.3390/cancers14205010 · Cited by 12
“Ethanol is associated with the tumor development of various cancers, such as liver and esophagus [76,90].”
BackgroundCombinations of lifestyle behaviors and cancer risk among Korean adults
Luu, N. M., Bui, T. T., Tran, T. P. T., Nguyen, T. H. T., & Oh, J. (2023) · Scientific Reports · doi:10.1038/s41598-023-40819-w · Cited by 11
“Similarly, heavy drinkers have a greater risk of some cancers than have non-drinkers and occasional drinkers, and the dose-risk association is evident 18 .”
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“…studies have reported many potential modifiable factors for HCC, including lifestyle factors (e.g., cigarette smoking, alcohol drinking) [4, 5], serum biomarkers (e.g., C-reactive protein, serum iron) [6, 7], and liver and metabolism-related factors (e.g., viral hepatitis, MASLD) [8, 9].”
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Alcohol Use and Cancers of the Gastrointestinal Tract. Epidemiology and Preventive Implications
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“A meta-analysis on the association between alcohol consumption and site-specific cancers indicated a dose-response relationship.(21) Pooled relative (RR) estimates of data obtained from more than 118 separate breast cancer studies categorised drinkers (light, moderate or heavy drinkers) and compared them with nondrink…”
BackgroundSchulz, F. N., Richter, B., & Hanf, J. H. (2022) · Beverages · doi:10.3390/beverages8040075 · Cited by 11
Dietary Inflammatory Nutrients and Esophageal Squamous Cell Carcinoma Risk: A Case-Control Study
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“5–50 referred to “moderate drinking” and >50 referred to “heavy drinking” [23].”
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“HNSCC develops from the mucosal epithelial cells of the oral cavity, larynx, nasopharynx, oropharynx, hypopharynx, and sinonasal tract, and its development directly correlates with several risk factors that include alcohol [4] and/or tobacco consumption [5], long-term exposure to environmental pollutants [6], and infe…”
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Evaluating an alcohol harm-reduction campaign advising drinkers of the alcohol-cancer link
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“For some conditions, such as liver disease, this relationship is exponential [3], whereas for other conditions, such as some cancers, it is linear [4].”
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Can a gastric cancer risk survey identify high-risk patients for endoscopic screening? A pilot study
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“Even though several studies have suggested the classic J-shaped curve regarding the protective effect of light alcohol consumption for ischemic heart disease and all-cause mortality [20,21], it is well established that there is no safe limit of alcohol consumption for causing cancer [22,23].”
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“In regard to alcohol consumption, heavy drinkers present an increased risk of oral/pharyngeal, esophageal (squamous cell carcinoma), colorectal, laryngeal, and female breast cancer when compared with non-drinkers [15].”
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“” Those who selected (2) “no” regarding past alcohol flushing, and then selected (1) “no” regarding current alcohol flushing were classified as “nonflushers.”
InfluentialManna, E. D. F., Serrano, D., Aurilio, G., Bonanni, B., & Lazzeroni, M. (2023) · Healthcare · doi:10.3390/healthcare11162360 · Cited by 14
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“Among a large number of cancer patients, the mortality rate is significantly higher in smokers compared to non-smokers, such as in lung cancer [35, 36].”
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“Several risk factors proposed to be associated with the development of HNSCC include alcohol [5,6] and tobacco [7] consumption.”
BackgroundAn Assessment of Behavioral Risk Factors in Oncology Patients
Mititelu, M., Licu, M., Neacșu, S. M., Călin, M. F., Matei, R. S., Scafa‐Udriște, A., Stanciu, T. I., Busnatu, Ș., Olteanu, G., Măru, N., et al. (2024) · Nutrients · doi:10.3390/nu16152527 · Cited by 11
Alcohol and mortality in Mexico: prospective study of 150 000 adults
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Alcohol consumption and risk of early onset colorectal cancer: A systematic review and meta‐analysis
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Racial and Ethnic Disparities in Alcohol Consumption and Mortality in the U.S.
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Alcohol, salud y enfermedad cardiovascular
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“These deaths are termed alcohol-related, as they accrue to a health condition whose incident and mortality risk is increased by exposure to alcohol [2,25,26].”
BackgroundCelastrol-mediated autophagy regulation in cancer
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“Alcohol [29,30] and cigarette smoking [11,31] are well established risk factors for HCC.”
Background
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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