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The researchers cited the change in public perceptions and tighter regulations for tobacco, which show the importance of public health campaigns and physicians explaining risks to their patients. Dr. Klein noted, “[In] less than half a century, we’ve seen major changes in the way people think about tobacco.” There have been decades of public education campaigns about the health risks of tobacco, warning labels on tobacco products, and smokefree laws. Noelle LoConte, M.D., an oncologist at the University of Wisconsin-Madison who studies alcohol and cancer risk, said that these findings confirm what doctors have long observed.
- There is a strong scientific consensus that alcohol drinking can cause several types of cancer (1, 2).
- For alcohol-related diseases, these included higher sales taxes on alcohol, limits on where and when alcohol can be purchased, and restrictions on marketing to the public.
- Using blood tests to get a more accurate estimate of true alcohol consumption could also benefit future research, wrote Amy Justice, M.D., Ph.D., of Yale University, in an accompanying editorial.
- There have been decades of public education campaigns about the health risks of tobacco, warning labels on tobacco products, and smokefree laws.
- Ethanol, the form of alcohol present in beer, wine and liquor, breaks down to form a known carcinogen called acetaldehyde, which damages DNA and interferes with cells’ ability to repair the damage.
What happens to cancer risk after a person stops drinking alcohol?
In people who produce the defective enzyme, acetaldehyde builds up when they drink alcohol. But most Americans aren’t aware of this link, thanks to seemingly contradictory research and mixed messaging from public health experts. A study published in 2023 found widespread mistaken beliefs that the risk varies by beverage type, with the lowest cancer risk assigned to wine. Another study published in 2021 showed that nearly 70% of people did not even know that alcohol was a cancer risk factor. The types of cancer with the most cases linked to alcohol use were cancers of the esophagus and liver and, in women, breast cancer, the researchers reported July 13 in The Lancet Oncology. Eastern Asia and central and eastern Europe had the highest numbers of alcohol-related cancers in proportion to their populations, while northern Africa and western Asia had the lowest.
Educating the public about the cancer risk from drinking alcohol, regardless of the beverage type, is especially urgent given the increase in drinking during the COVID-19 pandemic, Dr. Klein said. Participants in the survey are a nationally representative sample of adults aged 18 and older. The nearly 4,000 people who took part in the survey were asked how much does drinking several types of alcohol (wine, beer, and liquor) affect the risk of getting cancer. Because cancer risk increases with the amount of ethanol consumed, all alcoholic beverages pose a risk. Numerous changes need to be made to raise public awareness of the fact that drinking alcohol raises the risk of several types of cancer.
thoughts on “What You Should Know About Alcohol Consumption and Cancer Risk ”
Evidence from Western countries already strongly indicates that alcohol is a direct cause of cancer in the head, neck, oesophagus, liver, colon and breast. But it has been difficult to establish whether alcohol directly causes cancer, or if it drinking when bored is linked to possible confounding factors (such as smoking and diet) that could generate biased results. It was also unclear whether alcohol is linked to other types of cancer, including lung and stomach cancers. If findings of alcohol’s impact on cancer risk have yet to deter many people from drinking, it may be because most people aren’t aware of them. According to the American Cancer Society, less than half of the American public recognizes that alcohol is a carcinogen (cancer-causing substance).
The European Code of Cancer and the American Society of Clinical Oncology have also recommend minimizing alcohol consumption for cancer prevention38,39. That recommendation “was intended to prevent people from becoming alcoholics,” psychologist Tim Stockwell, PhD, of the University of Victoria noted in a recent article in Scientific American. While such public policies are effective and necessary, says Dr. Amy Justice, professor of medicine and public health at Yale University, we need to go further. Justice wrote a commentary in Lancet Oncology accompanying the alcohol-related cancer study. She agrees with the authors that the results are, if anything, an understatement of the impact of alcohol on cancer cases. And she has suggestions to reduce the burden of alcohol-related cancers that go beyond governmental action.
The biggest such wins would likely come from helping heavy drinkers cut back or quit, she added. “It’s pretty clear there are no health benefits [from heavy drinking], and there’s lots of risk to health overall,” she said. Approximately 4% of cancers diagnosed worldwide in 2020 can be attributed to alcohol consumption, according to a new WHO report.
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“There’s pretty good data that you can get people to decrease their alcohol consumption with brief motivational information,” she said. What’s more, the combination of drinking and smoking might indirectly increase the risk of cancer, with alcohol acting as a kind of solvent for the carcinogenic chemicals in tobacco. There are a few biological pathways that lead from alcohol consumption to a cancer diagnosis, according to the study.
Among people of Japanese descent, those who have this form of ADH have a higher risk of pancreatic cancer than those with the more common form of ADH (30). These amounts are used by public health experts in developing health guidelines about alcohol consumption and to provide a way for people to compare the amounts of alcohol they consume. However, they may not reflect the typical serving sizes people may encounter in daily life.
Alcohol consumption increases oestrogen levels by altering the hepatic redox state leading to reduced steroid degradation. In addition, chronic alcohol consumption leads to an increase in aromatase activity in peripheral tissues causing increased conversion of androgens to oestrogen17. Oestrogen is known to have proliferative effects on breast tissue and excess exposure to oestrogen is known to promote tumour growth17. Ethanol also has immunomodulatory properties and how to flush alcohol out of your system for a urine test evidence suggests that it may modify innate immune responses by affecting antigen recognition and intracellular signalling18.
And because of the study’s nature, it can also create certain “biases” in the data that may affect its accuracy or how relevant it is to the larger population of people with cancer and long-term survivors. The results remained the same when the data were adjusted for other cancer risk factors, such as smoking, diet, physical activity, body mass and family history of cancer. Researchers and health professionals can do more to help break down these misconceptions, Dr. LoConte added. “We need to really make sure that we reinforce the message that all alcohol increases cancer risk,” she said.
What advice do nutritionists offer about drinking alcohol?
Binge drinking—consuming five or more drinks within a few hours for men or four for women—is also likely more dangerous than any other type of drinking, Dr. Abnet explained. But studies have only begun to look at the associations between binge drinking and cancer, he added. The study had several limitations, including that it only looked at current alcohol consumption, not past drinking habits, said Dr. Abnet. Surveys worldwide often have not collected information about past alcohol use, “but for a lot of people, there’s a pattern where they drink more heavily when they’re young and moderately as they get older,” he explained. Breast cancer in women came in third place for number of cases, with almost 100,000 cases (about 4% worldwide) attributable to alcohol use.
For example, one way the body metabolizes alcohol is through the activity of an enzyme called alcohol dehydrogenase, or ADH, which converts ethanol into the carcinogenic metabolite acetaldehyde, mainly in the liver. Recent evidence suggests that acetaldehyde production also occurs in the oral cavity and may be influenced by factors such as the oral microbiome (28, 29). There is a strong scientific consensus that alcohol drinking can cause several types of cancer (1, 2). In its Report on Carcinogens, the National Toxicology Program of the US Department of Health and Human Services lists consumption of alcoholic beverages as a known human carcinogen. There likely are additional cancers linked to drinking alcohol, Dr. Orlow says, but more well-designed studies (epidemiological and other) are needed to prove that alcohol is a contributing risk factor.
To conduct the study, the researchers used data from more than 15,000 people with a history of cancer who were participating in the National Institutes of Health All of Us Research Program. The physical and biological links between alcohol use can cancer risk aren’t well understood, but several processes are likely at work. Overall, the percentage of Americans who say they occasionally drink alcohol has stayed between 60 and 70% since the late 1930s, without any noticeable decline in recent years, according to polling by the Gallup organization. “I think the perception often is, if you can fit it in a glass, it’s one drink,” Dr. LoConte said. But studies have shown that people pouring their own wine or spirits at home tend to underestimate the amount they’re actually consuming. When the researchers analyzed moderate drinking further, they found that 41,300 of those cases could be attributed to light drinking, or consumption of 10 grams or less per day.
The researchers could not verify, however, if the drinking occurred during treatment. Worldwide, alcohol may cause around 3 million deaths each year, including over 400,000 from cancer. With alcohol consumption rising, particularly in rapidly developing countries such as China, there is an urgent need to understand how alcohol affects disease risks in different populations. They found that the more alcohol people drink, the higher their risk of an alcohol-related cancer. Drinking at least two and as many as more than six drinks a day, defined as risky to heavy drinking, posed the sponsor definition greatest risk of a future cancer. Even moderate drinking, two or fewer drinks a day, accounted for an estimated 14%, or 103,000 cases, of alcohol-related cancers, according to the study.
