Dr. Marc Bardou, from Hopital Antoine Beclere in Clamart, France, and colleagues evaluated 661 patients, who had at least one colorectal adenoma on screening colonoscopy, for the occurrence of high-risk adenomas or colorectal cancer.

The study group included 401 patients who were heavy drinkers (mean intake 117 g/day for a mean duration of 22 years), 152 patients with irritable bowel syndrome (IBS), and 108 patients with a family history of adenomas or cancer. IBS patients are thought to have a cancer risk that is at least equal to the general population, while patients with a positive family history are known to be at increased risk.

Heavy drinkers were 1.8 times more likely to have a 10 mm or greater adenoma than IBS patients, the authors note. Similarly, these patients were 1.6 times more likely to have a high-risk adenoma or cancer than were IBS patients. In addition, the risk of having an adenoma with high-grade dysplasia or cancer was significantly higher in the heavy drinker group than in the IBS group.

Heavy drinkers were more likely than patients with a positive family history to develop high-risk adenomas or cancer, but the difference was not statistically significant, the investigators note.

The current findings indicate that excessive alcohol consumption is a risk factor for high-risk adenomas or colorectal cancer when adenomas are already present. «This suggests that alcoholic patients may benefit from a screening policy of colonic adenomatous polyps when their liver function allows,» Dr. Bardous team concludes.