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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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MethodAssociation of Alcohol Use and Physical Activity with Body Mass Index in Mexican-Origin Adults
Heredia, N. I., Dong, Q., Chang, S., & McNeill, L. H. (2021) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-021-01019-2 · Cited by 3
Time Perspective, Health Behaviors, and Wellbeing in Adults
Stoltman, J. J. K. (2017) · The Research Repository @ WVU (West Virginia University) · doi:10.33915/etd.6734 · Cited by 2
“, 2010; White, Altmann, & Nanchahal, 2002; Younossi & Henry) and cancer (Bagnardi et al., 2015; Nelson et al., 2013; Pelucchi, Tramacere, Boffetta, Negri, & Vecchia, 2011; Savage, 2014; Testino, Leone, Sumberaz, & Borro, 2015).”
Minimum unit pricing for alcohol: the most cost-effective of cancer prevention strategies?
Stockwell, T. R. (2017) · Expert Review of Anticancer Therapy · doi:10.1080/14737140.2017.1381565 · Cited by 3
Diet, Nutrition and Cancer Prevention
Turati, F., Bravi, F., & Vecchia, C. L. (2018) · Elsevier eBooks · doi:10.1016/b978-0-08-100596-5.22042-8 · Cited by 3
Self-citationLiu, X., Han, Y., Yan, G., & Sun, M. (2024) · European Journal of Nutrition · doi:10.1007/s00394-024-03491-y · Cited by 3
“32 –58. depicts the estimated causative influence of each dietary factor on blood lipids.”
Hirata, T., Hirata, A., Torii, S., Takashima, N., Kadota, A., Choudhury, S. R., Okayama, A., Miura, K., Okamura, T., & NIPPON DATA90 Study Group (2024) · Environmental Health and Preventive Medicine · doi:10.1265/ehpm.24-00164 · Cited by 2
Yang, T., & Cao, C. (2024) · Cancer Management and Research · doi:10.2147/cmar.s484790 · Cited by 2
“4,13,14 Our analyses revealed significant positive associations of alcohol consumption with gastric cancer and colon cancer, but not with esophageal cancer and rectal cancer.”
Antoniussen, C. S., Proust‐Lima, C., Ibsen, D. B., Olsen, A., Overvad, K., Tjønneland, A. M., Ferrari, P., & Dahm, C. C. (2024) · European Journal of Epidemiology · doi:10.1007/s10654-024-01179-5 · Cited by 2
“However, the established evidence associating alcohol consumption with risk of BC is almost exclusively based on studies considering only single measures of the women’s alcohol intake [6].”
Lee, S. K., Han, M., Park, S., Park, S. J., Song, J., Kim, H. J., Kim, J., Lee, H., Shin, H., Kim, K. H., et al. (2025) · Cancer Research and Treatment · doi:10.4143/crt.2024.901 · Cited by 2
“This is the first study to use national-level data to demonstrate the protective effect of increased PA after cancer diagnosis on preventing dementia, covering a wide range of cancer types.”
Shakory, S., Smith, B. T., Jansen, R., Reel, B., & Hobin, E. P. (2025) · Addiction · doi:10.1111/add.70070 · Cited by 2
“Alcohol is a group 1 carcinogen, causing at least seven types of cancer and contributes to chronic diseases of the liver, cardiovascular system and neuropsychiatric system [2, 3].”
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“However, other potential risk factors, such as alcohol consumption, may also play a role [38,39] in the risk development of oral cancer.”
Yuan, Y., Jiang, Y., Hu, C., Wu, D., Chen, H., Tian, Q., He, R., Li, T., Huang, T., Jiang, H., et al. (2025) · BMJ Open Gastroenterology · doi:10.1136/bmjgast-2025-001870 · Cited by 2
Occupational Exposure to Engine Exhausts and Prostate Cancer Risk
Barul, C., Rousseau, M., & Parent, M. (2025) · Environmental Health · doi:10.1186/s12940-025-01205-3 · Cited by 2
“…Other European, Greater Middle Eastern, Latino, other), educational level (primary school or less, high school, college, university, other), alcohol drinking [36, 37] (drink-years), cigarette smoking [38, 39] (ever/ never and cigarette-years) and body mass index [40] (continuous, in kg/m 2 ).”
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“122 Due to the strong evidence of alcohol and human cancers, acetaldehyde has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC).”
Luo, Z., Huang, Y., Ye, R., & Yin, M. (2025) · Cancer Reports · doi:10.1002/cnr2.70287 · Cited by 2
“This could be attributed to changing lifestyle factors such as increased tobacco and alcohol consumption among women [25], as well as occupational exposure to carcinogens, which have traditionally been higher in males.”
Xiang, S., Shan, Y., Shi-hong, X., Wang, J., Luo, M., Zhou, J., & Chen, Q. (2025) · Advanced Science · doi:10.1002/advs.202501820 · Cited by 2
Parada, M. L., Horn, J., & Cambron, C. (2025) · Social Science & Medicine · doi:10.1016/j.socscimed.2025.118534 · Cited by 3
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“We also incorporated RRs on cancer diagnosis from alcohol consumption using results from a large meta-analysis (8).”
Histological types of invasive breast cancer in 830,000 women diagnosed in England during 1988–2016
Probert, J., Broggio, J., Darby, S. C., Dodwell, D. J., McGale, P., Taylor, C., & Gaitskell, K. L. (2025) · The Journal of Pathology Clinical Research · doi:10.1002/2056-4538.70043 · Cited by 2
Ziyanok, S. (2025) · Doğu Karadeniz Sağlık Bilimleri Dergisi · doi:10.59312/ebshealth.1765591 · Cited by 2
Clinical outcomes associated with schistosome infection and alcohol use: A systematic scoping review
Lyne, B., Lang, M. M., Lewington, S., & Chami, G. F. (2026) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0014371 · Cited by 2
Alcohol Consumption and Cervical Carcinogenesis: Time to Draw Conclusions
Kashyap, V. K., Kenchappa, D., Singh, A. K., Singh, B., Yallapu, M. M., Cobos, E., & Chauhan, S. C. (2025) · Cells · doi:10.3390/cells14201639 · Cited by 2
“Some studies suggest an association with pancreatic, prostate, and melanoma cancers [19,20].”
George, G. S., Patil, A., Moirangthem, R., Doibale, P. N., Manjrekar, A., Golapkar, S. V., Panse, N. S., Krishnatreya, M., Mishra, A., Singh, A., et al. (2025) · BMJ Global Health · doi:10.1136/bmjgh-2024-017392 · Cited by 2
“…in alcoholic beverages has been classified by the International Agency for Research on Cancer (IARC) as a Group 1 carcinogen, and acetaldehyde, a by-product of alcohol metabolism, as a possible carcinogen to humans (Group 2B; when associated with alcohol consumption, it is a Group 1 carcinogen).”
Garasky, C. E., Duncan, A., Dong, F., Pandey, G., Zhao, J., Balbona, J. V., Chan, G., Kuang, W., Kamarajan, C., Plawecki, M. H., et al. (2025) · Alcohol and Alcoholism · doi:10.1093/alcalc/agaf085 · Cited by 2
“Additionally, AUD is associated with higher comorbidities of other substance use and psychiatric disorders (Bagnardi et al. 2015).”
Opinions on the effect of alcohol on cancer risk among US adults in 2024
Singh, N. K., Langford, A. T., & Buderer, N. M. F. (2026) · Cancer Causes & Control · doi:10.1007/s10552-025-02084-2 · Cited by 2
“[8] Heavy alcohol users had a higher risk for these cancers as well as cancers in the liver, gallbladder, pancreas, and lung when compared to nondrinkers and occasional drinkers.”
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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