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Emily Sonestedt

Emily Sonestedt

Associate senior lecturer

Emily Sonestedt

A longitudinal evaluation of alcohol intake throughout adulthood and colorectal cancer risk


  • Ana Lucia Mayén
  • Vivian Viallon
  • Edoardo Botteri
  • Cecile Proust-Lima
  • Vincenzo Bagnardi
  • Veronica Batista
  • Amanda J. Cross
  • Nasser Laouali
  • Conor J. MacDonald
  • Gianluca Severi
  • Verena Katzke
  • Manuela M. Bergmann
  • Mattias B. Schulze
  • Anne Tjønneland
  • Anne Kirstine Eriksen
  • Christina C. Dahm
  • Christian S. Antoniussen
  • Paula Jakszyn
  • Maria Jose Sánchez
  • Pilar Amiano
  • Sandra M. Colorado-Yohar
  • Eva Ardanaz
  • Ruth Travis
  • Domenico Palli
  • Sieri Sabina
  • Rosario Tumino
  • Fulvio Ricceri
  • Salvatore Panico
  • Bas Bueno-de-Mesquita
  • Jeroen W.G. Derksen
  • Emily Sonestedt
  • Anna Winkvist
  • Sophia Harlid
  • Tonje Braaten
  • Inger Torhild Gram
  • Marko Lukic
  • Mazda Jenab
  • Elio Riboli
  • Heinz Freisling
  • Elisabete Weiderpass
  • Marc J. Gunter
  • Pietro Ferrari

Summary, in English

Background: Alcohol intake is an established risk factor for colorectal cancer (CRC); however, there is limited knowledge on whether changing alcohol drinking habits during adulthood modifies CRC risk. Objective: Leveraging longitudinal exposure assessments on alcohol intake at different ages, we examined the relationship between change in alcohol intake and subsequent CRC risk. Methods: Within the European Prospective Investigation into Cancer and Nutrition, changes in alcohol intake comparing follow-up with baseline assessments were investigated in relation to CRC risk. The analysis included 191,180, participants and 1530 incident CRC cases, with exclusion of the first three years of follow-up to minimize reverse causation. Trajectory profiles of alcohol intake, assessed at ages 20, 30, 40, 50 years, at baseline and during follow-up, were estimated using latent class mixed models and related to CRC risk, including 407,605 participants and 5,008 incident CRC cases. Results: Mean age at baseline was 50.2 years and the follow-up assessment occurred on average 7.1 years later. Compared to stable intake, a 12 g/day increase in alcohol intake during follow-up was positively associated with CRC risk (HR = 1.15, 95%CI 1.04, 1.25), while a 12 g/day reduction was inversely associated with CRC risk (HR = 0.86, 95%CI 0.78, 0.95). Trajectory analysis showed that compared to low alcohol intake, men who increased their alcohol intake from early- to mid- and late-adulthood by up to 30 g/day on average had significantly increased CRC risk (HR = 1.24; 95%CI 1.08, 1.42), while no associations were observed in women. Results were consistent by anatomical subsite. Conclusions: Increasing alcohol intake during mid-to-late adulthood raised CRC risk, while reduction lowered risk.


  • Nutrition Epidemiology
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence of Diabetes Research in Sweden

Publishing year







European Journal of Epidemiology





Document type

Journal article




  • Cancer and Oncology
  • Nutrition and Dietetics


  • Alcohol change
  • Alcohol intake
  • Colorectal cancer
  • Latent class mixed models
  • Longitudinal exposure
  • Trajectory profile analysis



Research group

  • Nutrition Epidemiology


  • ISSN: 0393-2990