Alcohol and cigarettes have been a mainstay pairing at parties for generations.
But a major study warns the combination of drinking and smoking raise the risk one of America’s fastest-growing cancers in under-50s.
Researchers in Germany analyzed just over two dozen studies comparing regular drinkers and smokers to teetotalers.
Just 100 cigarettes in a person’s lifetime – the equivalent of one per week for two years – was linked to a 59 percent higher risk than people who have never smoked.
They found drinking alcohol every day raised the risk of developing early-onset colon cancer by 39 percent, even if it’s just one or two drinks per day.
And each can of beer or glass of wine per day further increased the chance by an additional two percent.
However, fewer millennials and Gen Zers drink alcohol or smoke cigarettes than ever before, which makes the findings difficult to interpret.
Researchers say alcohol and cigarettes are likely just one part of the problem, with diet, sedentary lifestyles, obesity and other factors likely also playing a role.
Drinking and smoking is a classic party combo, but the latest research shows both may raise the risk of colon cancer in young people (stock image)
The researchers wrote: ‘Alcohol consumption and smoking are significant risk factors for EOCRC and should be addressed in the context of prevention.’
Alcohol and smoking have both been linked to colon cancer in the past, as they release chemicals that destroy DNA and cause cancer cells to mutate.
But the new study is one of the first to compare both factors at once in relatively low amounts.
The American Cancer Society estimates over 154,000 Americans will be stuck by colorectal cancer this year, including about 20,000 under 50.
While this is roughly in line with two decades ago, the disease is rising sharply in younger groups.
According to the latest data, early-onset colon cancer diagnoses in the US are expected to rise by 90 percent in people 20 to 34 years old between 2010 and 2030.
In teens, rates have surged 500 percent since the early 2000s.
While the new data shows a link between colon cancer and using alcohol and tobacco, it contradicts the recent decline of both habits in younger groups.
Since the 1960s, smoking rates in the US have fallen 73 percent in adults and 86 percent in children and teens.
Millennials and Gen Z are also drinking less than their parents. The latest Gallup research shows 62 percent of adults under 35 drink alcohol compared to 72 percent in the early 2000s.
However, binge drinking - four or more drinks for women and five or more drinks for men - is also on the rise in Gen Z women. Research published last month in JAMA found women ages 18 to 25 had higher rates of binge drinking than men in the same age group for the first time.
Research also shows even former smokers are at an increased risk of colon cancer up to 25 years after quitting due to long-term DNA damage.
The review, published this week in the journal Clinical Colorectal Cancer, looked at 12 studies on alcohol consumption and 13 on smoking.
Overall, the team found daily alcohol consumption in general increased the risk of early-onset colorectal cancer 39 percent compared to lower amounts.
They also looked at moderate alcohol consumption and high consumption. Moderate was considered one daily drink for women and two for men. High is four or more daily drinks for women and five or more for men.
The team found people who consumed moderate to high amounts of alcohol every day had a 30 percent greater risk of colon tumors and 34 percent greater risk of rectal tumors than those who consumed low amounts of alcohol per day.
The strongest association they found was in a 2022 study published in the Canadian Journal of Gastroenterology and Hepatology, which looked at colorectal cancer patients with a history of alcoholism.
Marisa Peters, a mother-of-three from California (pictured here), was diagnosed with stage three rectal cancer at age 39
Trey Mancini (pictured here) was a professional baseball player when he was stuck by stage three colon cancer at age 28
Compared to patients who never abused alcohol, those with a history of alcohol addiction were 90 percent more likely to develop colon cancer.
The researchers in the new review also found the risk of colon cancer increased 2.3 percent for every 10 grams per deciliter (g/d) of ethanol, pure alcohol, consumed per day. This is the equivalent of one standard drink per day.
In the US, one standard drink is considered a 12-ounce can of beer with five percent alcohol volume, a five-ounce glass of wine at 12 percent alcohol volume or a 1.5-ounce shot glass of distilled spirits with 40 percent alcohol content, according to the National Institute on Alcohol Abuse and Alcoholism.
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The team behind the new review wrote: 'These results clearly suggest that alcohol consumption is associated with a significantly increased risk of CRC at any age.'
Experts believe when the liver breaks down ethanol, it creates the toxic chemical acetaldehyde, which damages triggers inflammation in the colon.
This damages DNA and leads to uncontrolled cell growth.
Alcohol also inhibits the body's ability to absorb folate, an essential nutrient for DNA repair. Low folate has consistently been linked to higher colon cancer rates.
The review also evaluated the effect of smoking on colon cancer risk.
Overall, the researchers found a 39 percent increased risk of colorectal cancer in people who smoked cigarettes regularly compared to those who never smoked.
'Ever smokers,' or people who have had at least 100 cigarettes in their lifetime, were at a 59 percent increased risk compared to non-smokers or former smokers while current smokers were at a 14 percent greater risk.
Current smokers were shown to have a 43 percent greater likelihood of developing a rectal tumor than those who never smoked, and colon tumors were linked to a 26 percent increased risk.
The researchers wrote: 'The results on smoking showed a significant association of smoking with EOCRC, while former smoking was not associated with EOCRC.'
Smoking also exposes the body to thousands of carcinogens and free radicals that destroy healthy DNA and cause cells to mutate into cancer cells.
There were several limitations to the new review, including the small number of included studies and data on alcohol and smoking was self-reported, leaving it subject to bias.