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Abstract: The epidemiologic findings on the relationship between alcohol consumption and colon cancer are inconsistent. The National Health and Nutrition Examination Survey (NHANES) I Epidemiologic Follow-Up Study (NHEFS) included a prospective cohort population representative of the general U.S. population, which had not been fully utilized for examining the risk between colon cancer and alcohol drinking. The NHEFS consisted of 10,220 participants prospectively followed over a decade. Alcohol consumption, amount and type of beverage, and drinking patterns at baseline were considered in examination of the effect of alcohol consumption on the risk of colon cancer. The consumption of one or more alcoholic beverages a day at baseline was associated with approximately a 70% greater risk of colon cancer [relative risk (RR) = 1.69; 95% confidence interval (CI) = 1.03, 2.79], with a strong positive dose-response relationship (P = 0.04). This association appeared to be exclusively related to daily drinking of one or more drinks of liquor (RR = 2.48; 95% CI = 1.66, 4.53). Additionally, more than a 70% increased risk of colon cancer was observed for more than 34 yr of alcohol drinking history compared with nondrinkers (RR = 1.73; 95% CI = 1.08, 2.78). Overall, alcohol consumption was significantly associated with increased risk of colon cancer. The most important factor for colon cancer seems to be liquor consumption. [ABSTRACT FROM AUTHOR]