Red vs. white wine: New study finds little difference in overall cancer risk

By Vijay Kumar MalesuReviewed by Susha Cheriyedath, M.Sc.Feb 3 2025

New research finds no overall difference in cancer risk between red and white wine, but white wine is linked to a higher cancer risk in women and an increased risk of skin cancer.

Review: Consumption of Red Versus White Wine and Cancer Risk: A Meta-Analysis of Observational Studies. Image Credit: grey_and / Shutterstock

In a recent study published in the journal Nutrients, researchers in the United States used a meta-analysis of observational studies to evaluate the association between red and white wine consumption and overall and site-specific cancer risk.

Background

Is red wine truly a healthier choice, or is it just a myth? Alcohol is classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC), contributing to approximately 4.1% of global cancer cases in 2020. Ethanol metabolizes into acetaldehyde, a toxic compound that damages deoxyribonucleic acid (DNA) and promotes mutations leading to cancer.

Despite strong evidence linking alcohol consumption to cancers of the oral cavity, liver, colorectum, and breast, public perception about wine remains divided. Many believe red wine is a healthier alternative due to its antioxidant properties, particularly resveratrol.

However, epidemiological studies yield conflicting results regarding red and white wine's protective or harmful effects on cancer risk. Some studies suggest potential benefits of red wine, while others indicate increased cancer risk for both wine types.

Given these inconsistencies and the rising global wine consumption, further research is needed to clarify the differential effects of red and white wine on cancer risk. Additionally, while red wine contains higher levels of resveratrol, a polyphenol with potential anti-cancer properties, its poor bioavailability raises questions about its actual protective effects.

About the study

A systematic literature search was conducted in Public/Publisher Medline (PubMed) and Excerpta Medica Database (EMBASE) databases to identify observational studies published up to December 2023.

Studies were included if they specifically reported cancer risk associated with red or white wine consumption and provided risk estimates with confidence intervals. Exclusion criteria included non-English articles, reviews, case reports, and experimental studies.

Data extraction focused on study design, population characteristics, wine type, sample size, number of cancer cases, and adjustments for confounders.

Relative risks and odds ratios with 95% confidence intervals were obtained. A random-effects meta-analysis was performed to calculate summary estimates.

Subgroup analyses were conducted based on cancer type, sex, and study design. Heterogeneity across studies was assessed using the I² statistic, and potential publication bias was evaluated using funnel plots and Egger’s test. The study detected signs of publication bias, which could influence the results, but adjustments did not significantly alter the findings.

Studies providing categorical data on wine consumption were included in a separate analysis to assess dose-response relationships.

Wine intake was converted to grams of ethanol per day for standardization. The lowest consumption category (non-drinkers) served as the reference group.

Sensitivity analyses were performed by excluding studies that reported only one type of wine and by restricting analyses to cohort studies to minimize recall bias.

Study results

A total of 42 observational studies (20 cohort and 22 case-control) met the inclusion criteria, representing 95,923 cancer cases from 2.8 million participants. The overall analysis found no significant difference between red and white wine consumption in relation to total cancer risk. However, when restricted to cohort studies, white wine consumption was linked to a higher cancer risk.

The summary relative risk was 0.98 (95% confidence interval (CI): 0.87, 1.10) for red wine and 1.00 (95% CI: 0.91, 1.10) for white wine (p = 0.74).

When restricted to cohort studies, white wine consumption was associated with a 12% higher overall cancer risk (relative risk: 1.12, 95% CI: 1.03, 1.22, p = 0.02), whereas red wine remained non-significant.

Sex-stratified analyses showed that white wine consumption was linked to a significantly increased cancer risk in women (relative risk: 1.26, 95% CI: 1.05, 1.52, p = 0.03), while no such effect was observed in men.

Among specific cancer sites, skin cancer showed a significant difference between red and white wine consumption (p = 0.0003).

White wine intake was linked to a 22% increased risk of skin cancer (relative risk: 1.22, 95% CI: 1.14, 1.30), while red wine was not (relative risk: 1.02, 95% confidence interval: 0.95, 1.09).

Both red and white wine were associated with an increased risk of breast cancer, with no significant difference between the two (red wine: relative risk: 1.17, 95% CI: 0.97, 1.42; white wine: relative risk: 1.12, 95% CI: 1.05, 1.20, p = 0.61).

No significant associations were found between wine type and other cancers, including lung, colorectal, prostate, ovarian, and kidney. The test for heterogeneity indicated moderate variation among studies (I² = 63.9%, p < 0.0001).

Sensitivity analyses confirmed the robustness of findings, and publication bias was detected but did not significantly alter results upon correction.

Conclusions

To summarize, this meta-analysis provides the most comprehensive assessment of the relationship between wine type and cancer risk to date.

The findings challenge the widespread belief that red wine is a healthier choice than white wine in terms of cancer prevention. While no overall difference was observed between red and white wine, cohort-restricted analyses showed that white wine consumption was linked to an increased risk of cancer. Furthermore, white wine intake was associated with a significantly higher risk of skin cancer and increased cancer risk among women.

These findings highlight the need for public health messaging to clarify that wine consumption, regardless of type, does not confer a protective effect against cancer.

Future research should focus on understanding the biological mechanisms underlying these associations and the role of wine constituents beyond ethanol. Meanwhile, public health guidelines should continue to emphasize moderation in alcohol consumption to reduce cancer risk.