Colorectal Cancer and Alcohol

Chronic alcohol consumption may lead to a variety of diseases and may deteriorate a great number of existing health problems. Among all these diseases the development of certain types of cancer is of major concern. Since decades it has been known that chronic alcohol consumption is a risk factor for cancer of the upper aerodigestive tract (oral cavity, pharynx, larynx and oesophagus), the liver and the female breast. Data with respect to alcohol and cancer concerning other organs do not show such clear correlations. In February 2007 an international group of epidemiologists and alcohol researchers met at the International Agency for Research on Cancer (IARC) in Lyon, France, to evaluate the role of alcohol and its first metabolite acetaldehyde as potential carcinogens in experimental animals and humans. The working group has concluded from the epidemiological data available that the occurrence of malignant tumours mentioned above is related to the consumption of alcoholic beverages. In addition, at this time epidemiologic and experimental data showed that alcohol is also a risk factor for colorectal cancer (Baan et al., 2007). Worldwide a total of approximately 389,000 cases of cancer presenting 3.6 % of oral cancers (5.2 % in men and 1.7 % in women) derive from chronic alcohol consumption (Rehm et al., 2004). Besides the fact that alcohol is a co-carcinogen and may act as a promoter alcohol can also accelerate tumour spread as exemplified for liver metastases of colorectal cancer possibly due to immune suppression and induction of angiogenesis by the expression of vascular endothelial growth factor (VEGF) (Seitz & Stickel, 2010). In addition, it is important to know that ethanol also interacts with the metabolism of chemo-therapeutic drugs which can result in a decreased respond to medication and increased side-effects (De Bruijn & Slee, 1992). This review focuses solely on the effect of chronic alcohol consumption on colorectal cancer, a cancer which is wide spread in Western societies and is No. 3 cancer in men and women in Germany. The present review will, therefore, discuss epidemiology of alcohol and colorectal cancer, will briefly address possible mechanism by which alcohol stimulates colorectal carcinogenesis and may finally give some suggestions and recommendations with respective to earlier detection and identification of high risk groups.