Scientists are learning more about the association between dietary intake and cancer. This connection is becoming increasingly clear for colorectal cancer and for the link between alcohol and cancers. We’ll take a deep dive into both of these important topics here.
DIET AND COLORECTAL CANCER
Colorectal cancer is the second most common cause of cancer deaths in the U.S. Overall, about one in 26 women and one in 24 men will develop this cancer of the lower intestines (the colon and the rectum) in their lifetime.
Cancer is an uncontrolled division of cells. Each of your body’s cells contains genes that tell it to divide and genes that keep cell division under control or instruct the cell to self-destruct. A mutation that changes the DNA in any of these genes can lead to cells growing out of control. The predisposition to cancerous mutations can be inherited, but environmental factors (including diet) also play a role.
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Colorectal Cancer.
Cancerous tumors in the colon or rectum (the last six inches of the colon) usually begin as polyps. While most polyps are noncancerous, some can change into cancer over time. If polyp cells begin to multiply out of control, they can grow into the wall of the colon or rectum. From there they can get into blood or lymph vessels and travel to other parts of the body. In the case of colorectal cancer, most mutations are acquired rather than inherited.
Prevention.
The best way to minimize your risk of developing colon cancer is to be screened regularly and have any polyps removed before they have a chance to become cancerous. People at average risk should begin screenings at 45 years old. Deaths from colorectal cancer have been decreasing. A study found that treatment advances were responsible for 21 percent of this change, while the other 79 percent of deaths were prevented by screening and removal of precancerous polyps or early detection.
Lifestyle choices that can also lower your risk of developing colorectal cancer.
➧ Avoid or Limit Alcohol. Several studies have found a higher risk of colorectal cancer with increased alcohol intake, especially among men. The American Cancer Society recommends avoiding alcohol or limiting yourself to no more than one drink a day for women or two for men. (See “Alcohol and Cancer” for more information.)
➧ Be Active. Regular moderate to vigorous activity is associated with lower risk. Aim for 150 minutes of moderate or 75 minutes of vigorous activity a week.
➧ Watch Your Weight. Overweight and obesity increase the risk of colorectal cancer, especially in men.
➧ Don’t Smoke. Long-term smoking is associated with a higher risk of colorectal cancer. Quitting may help lower your risk.
Dietary intake also plays an important role. Consuming dairy products may be helpful. An analysis of the dietary intake of over half a million women concluded that consumption of dairy products is associated with lower risk of developing colorectal cancer. (For heart health and calorie control, fat-free or low-fat are recommended.)
According to the American Cancer Society, dietary patterns that are high in vegetables, fruits, and whole grains and low in red and processed meats likely lower colorectal cancer risk. Although not all research findings agree, fiber may play a role. A study found that those who consumed more fiber and unsaturated fatty acids had a lower risk of colorectal cancer than those who consumed less of these nutrients. Whether this is due to these specific nutrients or the fact that they are part of an overall healthier dietary pattern has yet to be determined.
Preliminary research suggested the bacteria in our intestines may be the link between fiber and lower risk of colorectal cancer. When those microorganisms break down fiber, they create byproducts that may help minimize the risk of tumor formation in the gut. (See page 3 for more on the importance of consuming a dietary pattern high in naturally fiber-rich foods like whole grains, vegetables, fruits, beans, lentils, and nuts and seeds.)
ALCOHOL AND CANCER
Alcohol is the third leading preventable cause of cancer in the U.S., following tobacco use and obesity, yet fewer than half of Americans are aware of the risk. Evidence that even moderate drinking is associated with higher cancer risk is conclusive enough that the U.S. Surgeon General has recommended adding a cancer risk warning to labels on beverages containing alcohol.
The Cancer Connection.
Alcohol is considered a carcinogen (cancer-causing agent) by prominent international and U.S. organizations, including the International Agency for Research on Cancer, World Health Organization, American Institute for Cancer Research, U.S. Centers for Disease Control and Prevention, and National Institutes of Health’s National Cancer Institute. Hundreds of high-quality observational studies and meta-analyses of data from millions of cancer cases globally have found a significant association between alcohol consumption and higher cancer risk, including cancers of the mouth, throat, voice box (larynx), esophagus, breast (in women), liver, and colon. For some cancers, such as breast, mouth, and throat cancer, risk may rise with just one or fewer drinks per day. Higher consumption is associated with higher risk.
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All alcoholic beverages contain a type of alcohol called ethanol. When consumed, the body breaks ethanol down into acetaldehyde, a chemical compound that can damage the DNA in your cells. This damage can cause the cells to grow out of control, creating the tumors that are the hallmark of cancer. Alcohol can elelvate oxidative stress in the body, which increases inflammation and damages DNA, proteins, and cells—all of which increase cancer risk. And it can slow the breakdown of estrogen, which can increase risk of breast cancer. Additionally, carcinogens like tobacco smoke dissolve in alcohol, which makes them more easily absorbed by the body, increasing risk of mouth and throat cancers.
Risk.
An individual’s risk for developing cancer, including alcohol-related cancers, is determined by a complex interaction of genetics and environmental factors, so not everyone will have the same risk from the same alcohol intake. Overall, however, women are more likely to experience the harmful effects of alcohol, including higher cancer risk, at lower levels of drinking. Women have less of the enzyme that breaks down alcohol in their stomachs than men, so more alcohol makes it to the intestines to be absorbed in women. So, if a woman and man weigh the same and drink the same amount, the woman will absorb more alcohol and have a higher blood alcohol concentration. Additionally, men are larger, weigh more, and have more muscle mass and blood volume and less body fat, on average, than women. These factors also impact how alcohol intake affects women’s bodies.
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It has been estimated that two drinks a day (compared to not drinking at all) would result in about five more women out of every 100 developing cancer. For men, it is about three more out of every 100.
Recommendations.
The 2020-2025 Dietary Guidelines for Americans recommend people who don’t drink shouldn’t start for any reason, as drinking less is better for health than drinking more. For those who do imbibe, it’s recommended women limit daily drinks to one or less and men to two or less (see “How Much is ‘One Drink?’). New Guidelines being released in 2026 will likely lower those recommended limits.
Quitting or reducing alcohol intake is associated with lower risks of mouth and esophageal cancer. Emerging evidence may determine if this is the case for other types of cancer, as well as if quitting can lower risk to the level of people who have never consumed alcohol.
Alcohol-related cancers are preventable. When deciding how much— or even whether—to drink, keep in mind there is ample evidence that drinking less is better for health than drinking more.
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