How does lifetime alcohol consumption affect colorectal cancer risk?

Studies have demonstrated a link between alcohol consumption and an elevated risk of colorectal cancer. New research now reveals that higher lifetime alcohol consumption is also associated with a higher risk, especially for rectal cancer, and that quitting drinking can lower a person’s risk. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

When investigators analyzed data on US adults enrolled in the National Cancer Institute (NCI) Prostate, Long, Colorectal, and Ovarian (PLCO) Cancer Screening Trial who did not have cancer at baseline, they observed that 1,679 colorectal cancer cases occurred among 88,092 participants over 20 years of follow-up.

Current drinkers with an average lifetime alcohol intake of ≥14 drinks per week (heavy drinkers) had a 25% higher risk of developing colorectal cancer and a 95% higher risk of developing rectal cancer compared with those with an average lifetime alcohol intake of <1 drink per week (light drinkers).

When further considering drinking consistency, heavy drinking throughout adulthood was linked to a 91% higher risk of colorectal cancer compared with consistent light drinking. In contrast, no evidence of increased colorectal cancer risk was observed among former drinkers, and former drinkers had lower odds of developing noncancerous colorectal tumors, or adenomas (which may go on to become cancerous) than current drinkers averaging <1 drink per week, suggesting that alcohol cessation may lower individuals’ risks. These data were limited, however.

The association between alcohol consumption and increased risks observed in this and other studies might be explained by carcinogens produced from alcohol metabolism or alcohol’s effects on gut microbes. Additional studies are needed to test whether these mechanisms are involved.

“Our study is one of the first to explore how drinking alcohol over the life course relates to both colorectal adenoma and colorectal cancer risk. While the data on former drinkers were sparse, we were encouraged to see that their risk may return to that of the light drinkers,” said co–senior author Erikka Loftfield, PhD, MPH, of the NCI, part of the National Institutes of Health.

Additional information
NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage. A free abstract of this article will be available via the CANCER Newsroom upon online publication. For more information or to obtain a PDF of any study, please contact: Sara Henning-Stout, newsroom@wiley.com

Full Citation:
“Associations of alcohol intake over the lifetime with colorectal adenoma and colorectal cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.” Caitlin P. O’Connell, Sonja I. Berndt, Kenechukwu Chudy-Onwugaje, Andrew Kunzmann, Wen-Yi Huang, Kathryn Hughes Barry, and Erikka Loftfield. CANCER; Published Online: January 26, 2026 (DOI: 10.1002/cncr.70201)
URL Upon Publication: http://doi.wiley.com/10.1002/cncr.70201

Author Contact:  National Institutes of Health, nihmedia@nih.gov. Reporters may request an interview by completing this form: https://www.hhs.gov/request-for-comment-form/index.html?Agency=NIH.

About the Journal    
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online. Follow CANCER on X @JournalCancer and Instagram @ACSJournalCancer, and stay up to date with the American Cancer Society Journals on LinkedIn.

About Wiley      
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