Alcohol consumption and risk of cutaneous basal cell carcinoma in women and men: 3 prospective cohort studies

Am J Clin Nutr. 2015 Nov;102(5):1158-66. doi: 10.3945/ajcn.115.115196. Epub 2015 Sep 30.


Background: Alcohol consumption has been associated with an increased prevalence of sunburn, which is an established skin cancer risk factor.

Objective: We investigated whether alcohol consumption is associated with risk of cutaneous basal cell carcinoma (BCC).

Design: We conducted a prospective analysis on alcohol consumption and risk of BCC on the basis of data from 167,765 women in the NHS (Nurses' Health Study) (1984-2010) and NHS II (1991-2011) and 43,697 men in the Health Professionals Follow-Up Study (1986-2010). Alcohol intake was repeatedly assessed every 2-4 y over the follow-up period. HRs and 95% CIs for BCC in association with alcohol intake were computed with the use of Cox proportional hazards models with adjustment for sun exposure and other skin cancer risk factors.

Results: A total of 28,951 incident BCC cases were documented over 3.74 million person-years of follow-up. Increased alcohol intake was associated with increased BCC risk in both women and men (both P-trend < 0.0001). Pooled multivariable-adjusted HRs over increasing cumulative averaged alcohol intake categories were 1.00 (reference) for nondrinkers, 1.13 (95% CI: 1.06, 1.20) for 0.1-9.9 g/d, 1.24 (95% CI: 1.14, 1.35) for 10.0-19.9 g/d, 1.27 (95% CI: 1.20, 1.35) for 20.0-29.9 g/d, and 1.22 (95% CI: 1.15, 1.30) for ≥30.0 g/d (P-trend < 0.0001, P-heterogeneity by study = 0.10 ). The association remained consistent when we used alcohol intakes over different latency periods (0-4, 4-8, 8-12, and 12-16 y) as exposures and over categories of sun exposure-related factors. In the individual alcoholic beverages, white wine and liquor were positively associated with BCC risk.

Conclusion: Alcohol consumption is associated with increased risk of cutaneous BCC in both women and men.

Keywords: alcohol; basal cell carcinoma; cohort study; epidemiology; skin cancer; sun exposure.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking / adverse effects*
  • Alcoholic Beverages / adverse effects*
  • Carcinoma, Basal Cell / epidemiology
  • Carcinoma, Basal Cell / etiology*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Meta-Analysis as Topic
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / etiology*
  • United States / epidemiology
  • Wine / adverse effects