High lifetime alcohol intake tied to elevated risk for CRC

medwireNews: Analysis of data from the PLCO cancer screening trial has revealed a significant association between higher lifetime alcohol consumption and an increased risk for colorectal cancer (CRC).

The risk was 25% greater for current drinkers with an average lifetime alcohol intake of 14 or more drinks per week than those with an intake of less than one drink per week after adjusting for a host of confounding factors, report the study authors in Cancer.

They also found that “current, consistent heavy drinkers had 91% higher risk of CRC compared with current, consistent light drinkers,” where the former were defined as men and women who consistently reported an intake of more than 21 and 14 drinks per week, respectively, and the latter were those with an intake below dietary guidelines.

Erikka Loftfield (National Cancer Institute, Rockville, Maryland, USA) and fellow researchers explain that “[a]lcohol drinking is associated with higher colorectal cancer risk, but research on lifetime alcohol drinking is limited.”

They therefore collated data from the PLCO (Prostate, Lung, Colorectal, and Ovarian cancer) screening trial, participants of which reported alcohol intake during four age periods (18–24, 25–39, and 40–54 and ≥55 years) using a dietary history questionnaire. The majority (73.4%) of participants were current drinkers.

Of the 88,092 participants without a history of prostate, lung, colorectal, or ovarian cancer or colorectal disease, incident CRC occurred in 1679 over a median follow-up of 14.5 years. The majority (n=1004) of the cases were in the proximal colon, with 390 in the distal colon, 247 in the rectum, and 38 with unknown or multiple anatomic locations.

The risk for rectal cancer was particularly elevated for current drinkers with an average lifetime alcohol intake of at least 14 drinks per week than those with an intake of less than one drink per week, with a hazard ratio (HR) of 1.95 after adjusting for potential confounding factors such as age, BMI, race/ethnicity, education, smoking status, family history of CRC, and diet.

Conversely, current drinkers with an average lifetime alcohol consumption of seven to less than 14 drinks per week had a significantly reduced risk for CRC relative to an intake of less than one drink per week (HR=0.79), and in this case the reduction was especially marked for distal colon cancer (HR=0.64).

The researchers also analyzed the associations for colorectal adenoma, which developed in 812 of the 12,327 participants with a negative baseline screen for CRC, finding that the risk was not significantly increased for current drinkers with higher versus the lowest average lifetime intake of alcohol.

However, the risk for adenoma was slightly lower for people who had stopped drinking compared with current drinkers with an average lifetime alcohol intake of less than one drink per week and this risk reached statistical significance for nonadvanced adenomas (odds ratio=0.58).

Loftfield et al say that their analysis “is a key addition to the literature and is novel in its prospective evaluation of the association between lifetime alcohol drinking and the risk of colorectal adenoma and CRC.”

They continue: “Additional research is needed to understand whether adenoma removal by polypectomy not only lowers CRC risk but also spurs healthy lifestyle changes because our study results suggest that alcohol cessation lowers CRC risk.

“Future research, including consortium efforts and new cohort studies with data on lifetime alcohol intake, is needed to strengthen evidence on the role of alcohol drinking reduction and cessation in the development of colorectal adenoma and CRC.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2026 Springer Healthcare Ltd, part of Springer Nature

Cancer 2026; doi:10.1002/cncr.70201