Kidney cancer is the seventh most prevalent tumor in men and the ninth most prevalent in women in the United States, with approximately 64,000 new diagnoses of kidney cancer in 2014. Renal cell carcinoma accounts for approximately 80 percent of all kidney cancers. Known risks for the disease are male, African-American, family history of kidney cancer, smoking, hypertension and overweight. Recent epidemiological evidence suggests that alcohol may reduce the risk of renal cell carcinoma. In particular, several case-control studies have shown a negative association between alcohol intake and renal cell carcinogenesis. There have also been some prospective pairwise studies that have found this association, but these results are based on a small sample of cases. A limitation of previously published studies is that it is difficult to state definitively whether alcohol intake and renal cell carcinogenesis are also associated with gender and type of alcoholic beverage. To better understand the relationship between alcohol consumption and the risk of renal cell carcinoma, Sara K et al. from the National Cancer Center designed the trial. The results of the study were published in the International Journal of Cancer. Over 1236486.5 person-years of follow-up (mean follow-up 11.4 years), 408 renal cell carcinomas were diagnosed (266 men and 142 women). Compared with nondrinkers, drinkers were generally lower in age and BMI, had higher educational attainment, and were more likely to be white and to smoke more than nondrinkers. Compared to non-drinkers, HRs were 0.98, 0.77, and 0.67 for drinking less than 1.75, less than 9.75, and more than 9.75 grams per day, respectively. This study also found an association between alcohol consumption and subjects’ smoking status. A negative association was found between alcohol consumption and previous or current smoking status, excluding never smokers. The study also showed that alcohol intake was not associated with BMI, obesity, diabetes, race or hypertension. The large prospective cohort study showed that alcohol consumption was negatively associated with the risk of renal cell carcinoma in both men and women. The results are consistent with previous studies. In a newly published meta-analysis that included 3 cohort studies and integrated 12 prospective studies, alcohol consumption was shown to reduce the risk of renal cell carcinoma by approximately 29%. And independent of gender, all alcohol showed a significant protective effect. However, when analyzing the association between alcohol consumption and the risk of renal cell carcinoma, no association was observed among subjects living in Washington State. This may be related to the different lifestyle habits of the different geographic regions, which may be more health conscious, without alcohol consumption habits and with a higher intake of fruits and vegetables. The reduced incidence of renal cell carcinoma by alcohol consumption may be related to several biochemical mechanisms. Alcohol can increase insulin sensitivity. Obesity, a known risk factor for renal cell carcinoma, increases the odds of insulin resistance. In addition, experimental data suggest that insulin-like growth factors may play an important role in renal tumor formation. Alcohol reduces oxidative stress due to its antioxidant phenolic complex, a complex that removes oxidative carcinogens and reduces lipid peroxidation as well as anti-proliferative and pro-apoptotic effects. Appropriate alcohol consumption may also lower lower blood pressure. A Finnish smoking cohort study showed that smoking altered the risk of renal cell carcinoma by spirits intake. The results of this study are consistent with those of the present study. However, a pooled analysis of 12 prospective cohort studies showed that smoking did not modify the effect between the two. The biological mechanism of this effect is unknown. One possibility is that alcohol reduces renal cell carcinogenesis by lowering blood pressure, insulin resistance, and oxidative stress, and that smoking increases these mechanisms, and consequently, the cancer-reducing effect of alcohol may be stronger in smokers compared with nonsmokers. However, the results of this study should be read with caution given the small size of such samples at the time of stratified analysis and the inconsistent findings of the before and after studies. In conclusion, this study provides more detailed data on the association of alcohol consumption with reduced risk of renal cell carcinoma, independent of gender and type of alcohol. More research is needed to explore the mechanisms between alcohol and the development of renal cell carcinoma.