Alcohol and Colorectal Cancer

There is medical consensus that drinking alcoholic beverages in moderation is not a risk factor for colorectal cancer. The National Cancer Institute,1 the National Library of Medicine,2 the American Society of Clinical Oncology,3 the Memorial Sloan-Kettering Cancer Center,4and Cancer Research5 have concluded that alcohol (even consumed at high levels) is not a risk factor.

However, the American Cancer Society,6 the Mayo Clinic,7 and the Colorectal Cancer Coalition8 have concluded that "heavy use" or "heavy drinking" may increase the odds of the disease.

Risk factors for Colorectal Cancer

No one knows the exact causes of colorectal cancer. A risk factor is anything that may increase the chance of developing a disease. However, the relationship is not a strong one. A person may have a number of risk factors for colorectal cancer and never develop the disease whereas a person may have no risk factors and get the disease.

There are a number of commonly identified risk factors for colorectal cancer:

  • Age. The average at diagnosis is 72.
  • History of colorectal polyps or colorectal cancer.
  • History of inflammatory bowel disease. Inflammatory bowel disease (IBD) includes ulcerative colitis and Crohn's disease, but not irritable bowel syndrome (IBS).
  • Family history of colorectal cancer.
  • Inherited syndromes. The two most common inherited syndromes associated with colorectal cancers are familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC), sometimes called Lynch syndrome. Others are Turcot syndrome and Peutz-Jeghers syndrome:
  • Racial and ethnic background. African American and Ashkenazi Jews are more likely to develop colorectal cancer.
  • Diet. Diets high in red meats, processed meats and animal fat and low in calcium, folate and fiber may increase risk of colorectal cancer whereas those high in vegetables and fruits may reduce risk of colorectal cancer.
  • Physical inactivity
  • Obesity
  • Smoking

Possible Symptoms or Signs of Colorectal Cancer

Colorectal cancer can have any of a number of symptoms. However, in its early stages, there may be no symptoms. Therefore, having regular colorectal cancer screening beginning at age 50 is important.

Symptoms of colorectal cancer can include any of the following:

  • A change in bowel habits such as constipation, diarrhea, alternating constipation and diarrhea, or a change in stool consistency lasting for more than two weeks.
  • Stools that are thinner than usual.
  • Rectal bleeding or blood (sometimes very dark) or stool that is black or tar-like.
  • Persistent abdominal pain or discomfort.
  • A sensation that the bowels can't be emptied completely.
  • Unexplained weight loss.
  • Loss of appette.
  • Nausea or vomiting.
  • Unexplained fatigue.
  • Anemia.
  • Jaundice (yellow skin color).

Having any of these symptoms does not mean that a person has colorectal cancer. However, they should be discussed with a doctor if they last more than two weeks.

Drinking in Moderation is Beneficial

Drinking alcohol in moderation is not a risk factor for developing colorectal cancer. However, the moderate consumption of alcohol is clearly associated with better health and greater longevity than is either abstaining from alcohol or drinking abusively.

Drinking in moderation has been described by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as a man consuming four drinks on any day and an average of 14 drinks per week. For women, it is consuming three drinks in any one day and an average of seven drinks per week.

A standard alcoholic drink is:

  • A 12-ounce can or bottle of regular beer
  • A 5-ounce glass of dinner wine
  • A shot (one and one-half ounces) of 80 proof liquor or spirits such as vodka, tequila, or rum either straight or in a mixed drink.

Standard drinks contain equivalent amounts of alcohol. To a breathalyzer, they're all the same.

There is no evidence that any particular form of alcoholic beverage (beer, wine, or distilled spirits) confers greater health benefits than any other.

Note: This website is informational only. It does not provide health or medical advice and none should be inferred. If contraindicated, alcohol should be avoided.

Readings on Drinking Alcohol and Colorectal Cancer:

  • (note: listing does not imply endorsement)
  • Acott, A.A., et al. Association of tobacco and alcohol use with earlier development of colorectal cancer. American Journal of Surgery, 2009, 196(6), 915-919.
  • Bongaerts, B.W., et al. Alcohol consumption and distinct molecular pathways to colorectal cancer. British Journal of Nutrition, 2007, 97(3), 430-434.
  • Bongaerts, B.W., et al. Alcohol and risk of colon and rectal cancer with mutations in the K-ras gene. Alcohol, 2009, 38(3), 147-154.
  • Brown, Gina. Colorectal Cancer. Cambridge, UK: Cambridge University Press, 2007.
  • Cassidy, Jim, et al. Colorectal Cancer. NY: Informa Health Care, 2007.
  • Cho, E., et al. Alcohol intake and colorectal cancer. Annals of Internal Medicine, 2004, 140(8), 603.
  • Flood, Andrew, et al. Folate, methionine, alcohol, and colorectal cancer in a prospective study of women in the United States. Cancer Causes and Control, 2002, 13(6), 551-561.
  • Ford, E.S. Body mass index and colon cancer in a national sample of adult US men and women. American Journal of Epidemiology, 1999, 150, 390-398.
  • Fujimori, K., et al. Influence of alcohol consumption on the association between serum lipids and colorectal adenomas. Scandinavian Journal of Gastroenterology, 2002, 37(11), 1309-1312.
  • Glynn, S.A., et al. Alcohol consumption and risk of colorectal cancer in a cohort of Finnish men. Cancer Causes and Control, 1996, 7, 214- 223.
  • Guillem, Jose G., and Sigurdson, Elin R. Colorectal Cancer. Philadelphia, PA: W.B. Saunders Co., 2002.
  • Homann, Nils, et al. Alcohol and colorectal cancer. Alcoholism: Clinical and Experimental Research, 2009, 33(3), 551-556.
  • Jedrychowski, W., et al. Risk of colorectal cancer from alcohol consumption at lower vitamin intakes. Reviews in Environmental Health, 2001, 16(3), 213-222.
  • Kato, I., et al. Serum folate, homocysteine and colorectal cancer risk in women: a nested case-control study. British Journal of Cancer, 1999, 79, 1917-1922.
  • Kerr, David, et al. ABC of Colorectal Cancer. London: BMJ Books, 2001.
  • Koop, C. Everett, and Matson, Boyd. Colorectal Cancer. Timonium, MD: Milner-Fenwick, Inc., 2008.
  • de Leon, M. Ponz. Colorectal Cancer. NY: Springer, 2002.
  • Levin, Bernard, et al. American Cancer Society's Complete Guide to Colorectal Cancer. Atlanta, GA: American Cancer Society, 2006.
  • McArdle, C.S., et al. Colorectal Cancer. Oxford, UK: Isis Medical Media, 2000.
  • Meyerhardt, Jeffrey A., et al. Colorectal Cancer. NY: Mosby/Elsevier, 2007.
  • Mizoue, T., et al. Alcohol drinking and colorectal cancer in Japanese. American Journal of Epidemiology, 2008, 167(12), 1397-1406.
  • Otani, T., et al. Alcohol consumption, smoking, and subsequent risk of colorectal cancer in middle-aged and elderly Japanese men and women: Japan Public Health Center- based prospective study. Cancer Epidemiology, Biomarkers and Prevention, 2003, 12, 1492-1500.
  • Pedersen, A, et al. Relations between amount and type of alcohol and colon and rectal cancer in a Danish population based cohort study. Gut, 2003, 52, 861-867.
  • Sidney, S., et al. Serum cholesterol and large bowel cancer. A case-control study. American Journal of Epidemiology, 1986, 124, 33-38.
  • Swan, Elaine. Colorectal Cancer. Philadelphia, PA: Whurr, 2005.
  • Tsong, Wan H. Cigarettes and Alcohol in Relations to Colorectal Cancer within the Singapore Chinese Health Study. Thesis. University of Southern California, 2005.
  • Wei, E.K., et al. Comparison of risk factors for colon and rectal cancer. International Journal of Cancer, 2004, 108, 433-442.


  • 1. Cancer of the Colon and Rectum - Risk Factors.
  • 2.
  • 3. Colorectal Cancer: Risk Factors and Prevention.
  • 4. Colon Cancer Risk Reduction.
  • 5. High Risk Groups for Bowel Cancer.
  • 6. Causes of Colorectal Cancer. Risk Factors.
  • 7. Colon Cancer Risk Factors.
  • 8. Risk for Colorectal Cancer.

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