Researchers from Stony Brook University have reported that people who drink more than eight glasses of beer or eight alcohol spirits per week may be more than twice as likely to have colorectal neoplasia detected during screening colonoscopy than people who did not drink or who drank less. They also observed that drinking one to eight glasses of wine per week had a 45% reduction in colorectal neoplasia. The details of this study appeared in the September 2005 issue of the American Journal of Gastroenterology.

Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Screening colonoscopy is recommended beginning at age 50 for average risk individuals. Factors that are thought to increase the risk of developing colorectal cancer include family history, diet, lack of exercise, obesity, eating red and processed meats and smoking. Alcohol consumption, particularly beer and spirits, has also been reported to increase the risk for developing colorectal cancer. Evidence associating wine consumption and colorectal cancer is less consistent than for other types of alcohol.

In order to further evaluate the association between consumption of specific types of alcohol and risk of colorectal neoplasia, researchers in New York surveyed 2291 patients undergoing a screening colonoscopy about their alcohol intake and other health behaviors. The study collected information about beer, wine, and spirits. For each of these types of alcohol, patients were classified as heavy drinkers (more than eight glasses per week), moderate drinkers (one to eight glasses per week), or non-drinkers (less than one glass per week). Colorectal neoplasia was identified through colonoscopy and included adenocarcinoma, high-grade dysplasia, villous tissue, adenomatous polyps at least one centimeter in diameter, or multiple adenomatous polyps of any size.

Compared to patients who drank eight or fewer glasses of beer per week, patients who drank more than eight glasses of beer per week were almost two-and-a-half times more likely to have colorectal neoplasia. Findings were similar for patients who drank more than eight glasses of spirits per week. In contrast, moderate or heavy wine drinkers were less likely to have colorectal neoplasia.

In each of these comparisons, the reference category (the lowest level of alcohol consumption for that type of alcohol) included moderate and heavy drinkers of other types of alcohol; this complicates interpretation of the results. For example, in the case of wine, it’s not clear whether wine is truly protective, or whether it simply doesn’t increase risk the way beer and spirits appear to.

These researchers conclude that heavy consumption of beer or spirits, but not wine, may increase the risk of colorectal neoplasia. In this population, one in five people who drank more than eight glasses of beer or spirits per week had colorectal neoplasia detected by screening colonoscopy.

Comments:  These data support other studies suggesting that alcohol consumption is associated with an increased incidence of a variety of cancers. These data also support the observation that wine consumption, especially red wine, is associated with a reduced incidence of a variety of cancers.

Reference: Anderson JC, Alpern A, Sethi G et al. Prevalence and risk of colorectal neoplasia in consumers of alcohol in a screening population. American Journal of Gastroenterology. 2005;100:2049-2055.

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