Sex and tumor-site differences in the association of alcohol intake with the risk of early-onset colorectal cancer

The authors of a paper published in the Journal of Clinical Oncology argue that given the increasing incidence of early-onset colorectal cancer (CRC; diagnosed before age 50 years) worldwide, it is important to identify modifiable risk factors. Their study investigated whether alcohol consumption in the young population correlated with an increased early-onset colorectal cancer risk that differed by tumor location and sex.
The association between average daily alcohol consumption and the risk of early-onset colorectal cancer was investigated among 5,666,576 individuals aged 20-49 years using data from the Korean National Health Insurance Service (2009-2019). Alcohol consumption levels of nondrinker, light (reference), moderate, and heavy drinker were defined as 0, <10, 10 to <30, and ≥30 g/d for men and 0, <10, 10 to <20, and ≥20 g/d for women, respectively.
8,314 incident early-onset colorectal cancer cases were identified during the follow-up period. Moderate and heavy drinkers showed an increased risk of early-onset colorectal cancer compared with light drinkers (aHR, 1.09 [95% CI, 1.02 to 1.16] and aHR, 1.20 [95% CI, 1.11 to 1.29], respectively). Subgroup analysis by tumor location showed positive dose-response significance for early-onset distal colon and rectal cancers, but not for proximal colon cancer. The dose-response association between drinking frequency and risk of early-onset colorectal cancer was significant, with a 7%, 14%, and 27% increased risk for 1-2, 3-4, and ≥5 d/wk compared with nondrinkers, respectively.
Excessive alcohol consumption increases the risk of colorectal cancer onset before age 50 years. The authors of the paper argue that effective interventions are required to discourage alcohol consumption among young people and to tailor colorectal cancer screening approaches for high-risk individuals.
Source: Jin EH, Han K, Shin CM, Lee DH, Kang SJ, Lim JH, Choi YJ. Sex and tumor-site differences in the association of alcohol intake with the risk of early-onset colorectal cancer. J Clin Oncol. 2023 Aug 1;41(22):3816-3825.