Rethinking ethanol consumption and colorectal carcinogenesis: an insight from diet and gut microbiota

Colorectal cancer (CRC) is a pathology highly influenced by lifestyle and dietary habits, with ethanol consumption recognized as one of the most impactful and modifiable risk factors. Intestinal microbiota alterations have been observed both in high alcohol consumers and in the progression of intestinal polyps to CRC. The diet-microbiota-host interplay has a key role in health and disease. This perspective critically evaluates the mechanistic interplay within this triad and its potential role in mediating alcohol-induced toxicity, as well as its implications for the etiological link between alcohol consumption and CRC risk. Furthermore, we synthesize current advances and delineate key challenges for future research in this area. A particular focus is posed on the analysis of the anatomopathological, nutritional and microbiota data collected from individuals with intestinal polyps in a pilot study carried out in the region of Asturias, Northern Spain.