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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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Exploring the provision of alcohol advice by clinicians to breast cancer patients
Simapivapan, P., Hodge, A. M., & Boltong, A. G. (2017) · European Journal of Cancer Care · doi:10.1111/ecc.12739 · Cited by 5
Changes in risk habits and influencing factors in the Taiwan oral cancer screening program
Munpolsri, P., Su, C., Yang, H.-F., Hsu, T., Chou, Y.-Y., Lin, L., Wu, C.-C., Chen, S. L., & Yen, A. M. (2025) · PLoS ONE · doi:10.1371/journal.pone.0320461 · Cited by 4
Larsson, S. C., Mason, A. M., Cronjé, H. T., Bassett, E., Horta, G., Kar, S., & Burgess, S. (2025) · BMC Medicine · doi:10.1186/s12916-025-04543-8 · Cited by 4
“Alcohol consumption is strongly associated with an increased risk of squamous cell oesophageal cancer but not oesophageal adenocarcinoma [7, 61], the more common type in European descent populations.”
InfluentialLózsa, R., Szikriszt, B., Németh, E., Szeltner, Z., Martinek, R., Póti, Á., Feik, T., Kollarics, S., Márkus, B. G., Kanu, N., et al. (2026) · Communications Biology · doi:10.1038/s42003-026-09521-1 · Cited by 6
Bokemeyer, F., Gali, K., Kiefer, P., Bleich, C., Freitag, J., Bokemeyer, C., Abel, B., Schulz, H., & Lebherz, L. (2024) · Journal of Cancer Survivorship · doi:10.1007/s11764-024-01673-5 · Cited by 4
Ma, Z., Haworth, J. L., & Hu, J. (2024) · Addictive Behaviors · doi:10.1016/j.addbeh.2024.108229 · Cited by 4
Aja, P. M., Agu, P. C., Musyoka, A. M., Ngwueche, W., Odo, J. U., Alum, E. U., Fasogbon, I. V., Herbert, M., & Eze, E. D. (2025) · American Journal of Men s Health · doi:10.1177/15579883251344571 · Cited by 4
Miya, T. V., Marima, R. M., Marutha, T., Luvhengo, T. E., Mkhize‐Kwitshana, Z. L., Chauke-Malinga, N., Mazibuko, G., & Dlamini, Z. (2025) · Frontiers in Oncology · doi:10.3389/fonc.2025.1623895 · Cited by 4
Polymorphism of MUC1 Gene in Vietnamese Gastric Cancer Patients: A Multicenter Case–Control Study
Nguyen, N.-L. T., Dang, N.-D. T., Dang, Q.-H., Tran, V.-C., Vo, H.-L., Yamaguchi, M., & Ta, T. (2021) · Frontiers in Oncology · doi:10.3389/fonc.2021.694977 · Cited by 4
Alcohol & cancer: Evidence to action
Mehrotra, R., Kapahtia, S., Kaur, T., Priyanka, K., & Dhaliwal, R. S. (2022) · International Journal of Microbiology Research · doi:10.4103/ijmr.ijmr_4037_20 · Cited by 4
Kanadas Leitlinienempfehlung zu Alkohol und Gesundheit
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The causal relationship between psoriasis and cancers: a two-sample Mendelian randomization analysis
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Stullich, A., Hoffmann, L., Stephan, J., Gehrmann, J., & Richter, M. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-078148 · Cited by 4
Insights into incipient oral squamous cell carcinoma: a comprehensive south-american study
Saldivia‐Siracusa, C., Araújo, A., Arboleda, L. P. A., Abrantes, T. C., Ramos, M. B., Mendonça, N., Cordero‐Torres, K., Gilligan, G., Piemonte, E. D., Panico, R., et al. (2024) · Medicina oral, patología oral y cirugía bucal · doi:10.4317/medoral.26551 · Cited by 4
Alcohol consumption—none is better than a little
Maisch, B. (2024) · Herz · doi:10.1007/s00059-024-05280-z · Cited by 4
Assessment of the frequency and risk factors for colorectal cancer in acromegaly
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Emerging Preclinical and Clinical Evidence on the Impact of Phytochemicals in Oral Cancer Metastasis
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“Several causes, such as alcohol use, cigarette smoking, and HPV infection, have been related to increased incidence rates of oropharyngeal cancer in Australia and New Zealand as well as in Western and Eastern Europe (Bagnardi et al. 2015).”
Forman, D., Yang, M., Chien, R., Nguyen, H., Wong, C., Kim, J. H. J., Ziogas, A., & Park, H. L. (2025) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-24-1296 · Cited by 5
Sun, I. O., Lee, H.-S., Lim, C., Bae, E., Hyun, Y. Y., Chung, S., Kwon, S. H., Cho, J., Yoo, K. D., Park, W. Y., et al. (2025) · Nutrients · doi:10.3390/nu17060983 · Cited by 4
“Excessive alcohol consumption is known to have harmful effects, such as increasing the risk of liver cirrhosis, pancreatitis, and cancers at various sites [1,2].”
Zhang, S., Du, D., Li, P., Chen, Y., & Zhang, X. (2025) · BMC Public Health · doi:10.1186/s12889-025-23343-6 · Cited by 4
“Some factors have been extensively studied and identified as definitive risk factors for laryngeal cancer, such as smoking [11, 23], alcohol consumption [24, 25], exposure to air pollution, and occupational exposure [13].”
Do causes of stress differ in their association with problem drinking by sex in Korean adolescents?
Choi, J. W., Park, E., Kim, J., & Park, S. (2016) · Addictive Behaviors · doi:10.1016/j.addbeh.2016.08.013 · Cited by 4
Promoting Health and Care Transitions in the Long-Term AYA Survivor
Hudson, M. M., Kinahan, K. E., Sharp, L. K., & Freyer, D. R. (2016) · Pediatric oncology · doi:10.1007/978-3-319-33679-4_29 · Cited by 4
Head and Neck Cancer: Epidemiology and Role of MicroRNAs
Khawar, M. B., Fatima, N., Abbasi, M. H., Mehmood, R., Suqaina, S. K., & Sheikh, N. (2017) · InTech eBooks · doi:10.5772/intechopen.69418 · Cited by 4
“reported a positive relationship in between alcohol drinking and head and neck cancer risk [7].”
Background4. Alcohol as a Risk Factor for Chronic Disease: Raising Awareness and Policy Options
Greenfield, T. K., & Martínez, P. (2017) · American Public Health Association eBooks · doi:10.2105/9780875532929ch04 · Cited by 4
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Economic burden of alcohol-related cancers in the Republic of Korea
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“In previous studies, factors related to the risk of HCC included aging (21), smoking (22-24), and alcohol consumption (22, 25, 26).”
BackgroundHistory of alcohol consumption and cancer burden in Italy
Malvezzi, M., Negri, E., & Vecchia, C. L. (2021) · Journal of Health Inequalities · doi:10.5114/jhi.2021.113168 · Cited by 4
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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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