Does Moderate Alcohol Consumption Increase Risk of Cancer?

Check out this answer from Consensus:

Moderate alcohol consumption is associated with an increased risk of certain cancers, particularly breast cancer in women and cancers of the upper aerodigestive tract. The risk for colorectal and liver cancers may also be slightly elevated with moderate drinking. However, there is no consistent evidence linking moderate alcohol consumption to increased risks of several other cancers, and some studies even suggest a protective effect for certain types. Overall, while moderate alcohol consumption does not pose as high a risk as heavy drinking, it is not without potential cancer risks.

The relationship between moderate alcohol consumption and cancer risk has been a subject of extensive research. While heavy alcohol consumption is a well-established risk factor for various cancers, the effects of moderate alcohol intake remain less clear. This synthesis aims to provide a cohesive understanding of whether moderate alcohol consumption increases the risk of cancer based on multiple research studies.

Key Insights

• Colorectal Cancer (CRC) Risk:
  • Moderate alcohol consumption (up to 30g/day) does not significantly increase the risk of colorectal cancer. However, risks may increase with higher intakes and in the presence of other factors like obesity and folate deficiency1 3 7.
  • Some studies suggest a J-shaped association, where light to moderate drinking may be associated with a slightly reduced risk of CRC, but heavy drinking increases the risk significantly8.
• Breast Cancer Risk:
  • Even light to moderate alcohol consumption is associated with a slight increase in the risk of breast cancer in women2 4 6 7.
• Upper Aerodigestive Tract Cancers:
  • Moderate alcohol consumption increases the risk of cancers of the oral cavity, pharynx, esophagus, and larynx, although the risk is more pronounced with heavy drinking2 5 6 7 9.
• Liver Cancer Risk:
  • Moderate alcohol consumption is associated with a slight increase in liver cancer risk, with stronger associations observed at higher levels of intake5 7.
• Other Cancers:
  • There is no consistent evidence linking moderate alcohol consumption to increased risks of stomach, pancreatic, lung, prostate, or bladder cancers5 6 9 10.
  • Some studies suggest a decreased risk of thyroid cancer, non-Hodgkin lymphoma, and renal cell carcinoma with moderate alcohol consumption6 7.

 

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Does moderate alcohol consumption increase risk of cancer?

Peter Miller has answered Near Certain

An expert from Deakin University in Psychology, Sociology, Epidemiology

In the ABC news report mentioned, the president of the American Society of Clinical Oncology (ASCO) referred to their statement on alcohol and cancer (1), which suggested that even moderate drinking is associated with risks of various forms of cancer.

The International Agency for Research on Cancer (IARC) classed alcohol as a Group 1 carcinogen in 1988 (the highest IARC classification, meaning alcohol is a cause of cancer), for cancers of the mouth, pharynx, larynx, oesophagus and liver (2). A position statement from Australia’s National Cancer Council (3) states that consumption of any amount of alcohol causes an increase in cancer risk, with heavier consumption being linked with higher risks (i.e., a positive dose-response relationship). Further, the World Cancer Research Fund suggests that there is not yet a level of alcohol consumption below which a risk of cancer is not developed (4), and further evidence consolidates positive dose-response relationships between alcohol consumption and cancer (5).

Other reviews of research show generally consistent findings, with light to moderate drinkers showing, even if minimal, increased risks of cancer compared to non-drinkers (6, 7), with risks of cancer being evident with light consumption, and increasing with heavier consumption for various cancer types (8, 9, 10). Research can of course be limited by several factors; alcohol consumption has been found to be linearly related with other risk-taking behaviours such as smoking, poor dieting behaviours, and artificial sunlight exposure, which may confound the results of alcohol’s unique contribution to cancer risks (e.g., 11, 12, 13).

Consumption of alcohol is the second largest contribution to the global burden of disease for cancer, second only to tobacco use according to recent estimates made for the World Health Organization (WHO) (14). In the last decades, the total number of alcohol-attributable cancer cases has increased to approximately 770,000 worldwide or 5.5% of the total number of cancer cases. Correspondingly estimated cancer deaths attributable to alcohol consumption are estimated to be approximately 480,000 or 5.8% of the total number of cancer deaths. Alcohol-attributable cancer cases are particularly high in the Western Pacific, European and South-East Asia WHO regions (15).

Unfortunately, a major factor in the discussion around the relationship between alcohol and cancer has been the massive push by the alcohol industry to muddy the waters and deny links. Just like the tobacco industry (which controls substantial shareholdings and boards of the alcohol industry), they employ ‘merchants of doubt’ and advocate strongly to government, often controlling the policy discussion. For example, one body which often challenges the link between alcohol and cancer is the International Scientific Forum on Alcohol Research (ISFAR), which has been reported to receive alcohol industry funding (16, 17). In this context, it is crucial to be critical about the stories that circulate in the media, and the claims of industry representatives. In short, yes, even moderate alcohol consumption can cause cancer.

References

1. LoConte, N. K., Brewster, A. M., Kaur, J. S., Merrill, J. K., & Alberg, A. J. (2018). Alcohol and Cancer: A statement of the American Society of Clinical Oncology. Journal of Clinical Oncology, 36(1), 83-93. http://dx.doi.org/10.1200/JCO.2017.76.1155
2. International Agency for Research on Cancer. (1988). IARC monographs on the evaluation of carcinogenic risks to humans – volume 44: Alcohol drinking. Lyon: IARC. Retrieved from: http://monographs.iarc.fr/ENG/Monographs/vol44/index.php
3. Cancer Council Australia. (2015). Position Statement – Alcohol and cancer risk. Retrieved from https://wiki.cancer.org.au/policy/Position_statement_-_Alcohol_and_cancer#cite_note-Citation:World_Cancer_Research_Fund_International.2C_American_Institute_for_Cancer_Research._2015-7
4. World Cancer Research Fund & American Institute for Cancer Research. (2007). Food, nutrition, physical activity, and the prevention of cancer: A global perspective. Retrieved from https://www.wcrf.org/sites/default/files/english.pdf
5. World Cancer Research Fund International & American Institute for Cancer Research. (2015). Diet, nutrition, physical activity, and liver cancer. Retrieved from https://www.wcrf.org/sites/default/files/Liver-Cancer-2015-Report.pdf
6. Cao, Y., Willett, W. C., Rimm, E. B., Stampfer, M. J., Giovanucci, E. L. (2015). Light to moderate intake of alcohol, drinking patterns, and risk of cancer: Results from two prospective US cohort studies. British Medical Journal, 351. http://dx.doi.org/10.1136/bmj.h4238
7. Praud, D., Rota, M., Rehm, J., Shield, K., Zatoński, W., Hashibe, M., Vecchia, C. L., & Boffetta, P. (2016). Cancer incidence and mortality attributable to alcohol consumption. International Journal of Cancer, 138(6), 1380-1387. http://dx.doi.org/10.1002/ijc.29890
8. Turati, F., Galeone, C., Rota, M., Pelucchi, C., Negri, N., Bagnardi, V., Corrao, G., Boffetta, P., La Vecchia, C. (2014). Alcohol and liver cancer: A systematic review and meta-analysis of prospective case studies. Annals of Oncology, 25(8), 1526-1535. http://dx.doi.org/10.1093/annonc/mdu020
9. Shield, K. D., Soerjomataram, I., & Rehm, J. (2016). Alcohol use and breast cancer: A critical review. Alcoholism: Clinical and Experimental Research, 40(6), 1166-1181. http://dx.doi.org/10.1111/acer.13071
10. Bagnardi, V., Rota, M., Botteri, E., Tramacere, I., Islami, F., Fedirko, L., … La Vecchia, C. (2015). Alcohol consumption and site-specific cancer risk: A comprehensive dose-response meta-analysis. British Journal or Cancer, 112, 580-593. http://dx.doi.org/10.1038/jbc.2014.579
11. can Assema, P., Pieterse, M., Kog, G., Erikson, M., & de Vries, H. (1993). The determinants of four cancer-related risk behaviours. Health Education Research, 8(4), 461-472. http://dx.doi.org/10.1093/her/8.4.461
12. Hashibe, M., Brennan, P., Chuang, S. C., Boccia, S., Cadtellsague, X., Chen, C., … Boffetta, P. (2009). Interaction between tobacco and alcohol use and the risk of head and neck cancer: Pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiological Biomarkers and Prevention, 18(2), 541-550. http://dx.doi.org/10.1158/1055-9965.EPI-08-0347
13. Islami, F., Sauer, A. G., Miller, K. D., Siegel, R. L., Fedewa, S. A., Jacobs, E. J. … Jemal, A. (2018). Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA: A Cancer Journal For Clinicians, 68(1). http://dx.doi.org/10.3322/caac.21440
14. Institute for Health Metrics and Evaluation (IHME). (2015). GBD Compare. Retrieved 2016-07-19, from http://vizhub.healthdata.org/gbd-compare.
15. Praud, D., Rota, M., Rehm, J., Shield, K., Zatoński, W., Hashibe, M., . . . Boffetta, P. (2016). Cancer incidence and mortality attributable to alcohol consumption. Int J Cancer, 138(6), pp. 1380-7.
16. Babor, T. F. and P. G. Miller (2014). “McCarthyism, conflict of interest and Addiction’s new transparency declaration procedures.” Addiction 109(3): 341-344.
17. Siegel, M. (2017) “International Scientific Forum on Alcohol Research (ISFAR) is Still Hiding Conflicts of Interest of Its Members”. Available at: http://tobaccoanalysis.blogspot.com/2018/01/international-scientific-forum-on.html).

 

Does moderate alcohol consumption increase risk of cancer?

Richie Gun has answered Near Certain

An expert from University of Adelaide in Epidemiology

The International Agency for Research on Cancer has categorised alcohol as a cause of cancer of the upper gastro-intestinal tract (including the oesophagus), colon and rectum, liver, larynx and female breast. So what about moderate alcohol intake? It’s fairly safe to say that the probability of cancer increases with increasing intake. My own research on a male-only working population has indicated increasing risk with increasing intake. (By the way, it also showed that alcohol has a protective effect from coronary artery disease mortality up to moderate intake, which helps to offset the contribution to all-cause mortality from increased cancer mortality.) For female breast cancer, a review published in 2011 concluded that the risk of cancer rises about 10% per drink per day (one drink is about 10g of alcohol). For cancer of the upper-respiratory tract (mouth, tongue and pharynx), my research shows a powerful interactive effect between alcohol and tobacco. The effect of tobacco is much greater than that of alcohol. In other words tobacco without alcohol has a stronger carcinogenic effect than alcohol without tobacco. So for good health, alcohol in strict moderation, especially for women. For tobacco – complete and permanent abstinence.

 

Does moderate alcohol consumption increase risk of cancer?

Matteo Rota has answered Near Certain

An expert from Università degli Studi di Milano in Epidemiology, Biostatistics

Starting from the beginning of the twentieth century, when an excess of cancer mortality due to alcohol consumption was firstly reported (Newsholme, 1903), several studies investigated the association between alcohol consumption and cancer risk.

In the wake of the accumulating evidence on the carcinogenicity of alcohol, in 1988 the International Agency for Research on Cancer (IARC) listed alcohol among the carcinogens for oral cavity and pharynx, oesophagus, liver and larynx (IARC Working Group, 1988). Afterwards, given the consolidating data for a link between alcohol and cancer of colorectum and female breast, these two sites were added to the above list in 2010 (IARC Working Group, 2010).

A global study published in 2015 (Bagnardi et al., 2015) including all the available evidence from epidemiological studies investigating the association between alcohol consumption and cancer risk, showed that a moderate consumption – i.e. more than one and less than 4 drinks per day – of alcohol is associated with an increased risk of the following cancer types:

– Oral cavity and Pharynx cancers, with a nearly two times increased risk for moderate drinkers as compared to non drinkers;

– Laryngeal cancer, with a 50% increased risk for moderate drinkers as compared to non drinkers;

– Oesophageal Squamous cell carcinoma, with more than two times increased risk for moderate drinkers as compared to non drinkers:

– Colorectum cancer, where men consuming moderate amount of alcohol were showed to have a 20% increased risk as compared to non drinking ones;

– Liver cancer, for which there is evidence for an increased risk for alcohol intakes above about 3 alcoholic drinks per day;

– Female breast cancer, with a 20% increased risk for women consuming moderate amount of alcohol as compared to non drinking ones. There is also a growing body of literature showing that a moderate consumption of alcohol is associated with an increased risk of gastric cancer, prostate cancer and melanoma.

In the light of the available evidence, moderate alcohol consumption can cause cancer. As part of its guidelines on nutrition and physical activity for cancer prevention, the American Cancer Society recommends that people who drink alcohol limit their intake to no more than 2 drinks per day for men and 1 drink a day for women.

References: Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V, Scotti L, Jenab M, Turati F, Pasquali E, Pelucchi C, Galeone C, Bellocco R, Negri E, Corrao G, Boffetta P, La Vecchia C. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer. 2015 Feb 3;112(3):580-93. doi: 10.1038/bjc.2014.579. Epub 2014 Nov 25. PubMed PMID: 25422909; PubMed Central PMCID: PMC4453639. Newsholme A (1903) The possible association of the consumption of alcohol with excessive mortality from cancer. Br Med J 2(2241): 1529–1531. LoConte NK, Brewster AM, Kaur JS, Merrill JK, Alberg AJ. Alcohol and Cancer: A Statement of the American Society of Clinical Oncology. J Clin Oncol. 2018 Jan 1;36(1):83-93. doi: 10.1200/JCO.2017.76.1155. Epub 2017 Nov 7. PubMed PMID: 29112463. Rota M, Pelucchi C, Bertuccio P, Matsuo K, Zhang ZF, Ito H, Hu J, Johnson KC, Palli D, Ferraroni M, Yu GP, Muscat J, Lunet N, Peleteiro B, Ye W, Song H, Zaridze D, Maximovitch D, Guevara M, Fernández-Villa T, Vioque J, Navarrete-Muñoz EM, Wolk A, Orsini N, Bellavia A, Håkansson N, Mu L, Persiani R, Kurtz RC, Lagiou A, Lagiou P, Galeone C, Bonzi R, Boffetta P, Boccia S, Negri E, La Vecchia C. Alcohol consumption and gastric cancer risk-A pooled analysis within the StoP project consortium. Int J Cancer. 2017 Nov 15;141(10):1950-1962. doi: 10.1002/ijc.30891. Epub 2017 Aug 8. PubMed PMID: 28718913.

 

Does moderate alcohol consumption increase risk of cancer?

Dirk Lachenmeier has answered Near Certain

An expert from Chemical and Veterinary Investigation Agency Karlsruhe in Food Science, Oncology, Toxicology, Chemistry

Many studies show a linear behaviour between alcohol dose and cancer risk. Therefore, it is assumed that also light or moderate consumption (slightly) increases the risk.

 

Does moderate alcohol consumption increase risk of cancer?

Dieter Meyerhoff has answered Likely

An expert from University of California, San Francisco in Medicine, Neuroscience

The evidence for a causal link is mixed and depends strongly on the type of cancer.

Systematic reviews of the past and current literature report both increased risk of cancer and no increased risk of cancer with moderate alcohol consumption (up to 1 drink/day for women and up to 2 drinks/per day for men; one drink contains about 14 g of pure alcohol, corresponding to a 360 mL can of beer or a 150 mL glass of wine). And here we are talking about cancers that have been shown to be associated with clearly increased risks at higher amounts of alcohol consumption.

While there is evidence that light-to-moderate drinking increases risks for several common cancers (including colorectal, breast, liver, and oral), the evidence is strongest for breast cancer in women and colorectal cancer. There is little – if any – convincing evidence in the literature that light-to-moderate alcohol consumption reduces risks for any cancers.

The stated upper drinking limits are meant for healthy individuals who do not engage in even occasional binge-drinking (i.e., having about 4 drinks in 2 hours for women or 5 drinks for men). Furthermore, smoking, liver disease, a bad diet, little physical exercise, less frequent health services utilization, and a family history of cancer all increase cancer risks further. These findings derive from large epidemiological studies that consider many confounding factors and appropriate control groups in cross-sectional designs.

A most definitive long-term clinical trial into the effects of moderate drinking on cancer risk is yet to be conducted. For now, if you do not drink, do not take up light-to-moderate drinking in hopes of decreasing your cancer risk; if you do drink, stick to light-to-moderate amounts of alcohol (if you do not have the risk factors stated) or reduce your drinking, especially if your family has a history of cancer.

 

Does moderate alcohol consumption increase risk of cancer?

Jay Kaufman has answered Unlikely

An expert from McGill University in Epidemiology, Biostatistics

There are contradictory results in the literature, and there has never been a randomized trial in humans (nor is this possible), so one should be skeptical of all the observed associations. Nonetheless, most studies, like the recent one attached, show no increased risk of cancer at moderate consumption levels. There are some other studies that show mildly increased risk of cancer, but an overall mortality advantage for light drinkers because of protective effects on CVD, which is a more common cause of death.

 

Does moderate alcohol consumption increase risk of cancer?

Catherine Berkey has answered Likely

An expert from Harvard University in Medicine

Speaking only from my own area of expertise, there is evidence that alcohol consumption increases risk for breast cancer and for benign breast disease, itself a risk factor for breast cancer.

 

Does moderate alcohol consumption increase risk of cancer?

Edward Giovannucci has answered Near Certain

An expert from Harvard University in Oncology, Epidemiology

 The simple answer is “almost definitely”. However, considering sex and cigarette smoking is critical in better understanding this relationship. These factors are key because alcohol-related cancers are also smoking-related, except for breast cancer, which occurs primarily in women. The evidence for moderate alcohol intake as a risk factor for breast cancer in women is strong. Breast cancer is very common and well-studied. Even a drink every other day to one day shows a 10-15% increased risk of breast cancer. While we should be cautious in inferring a causal association with a modest-sized increased in risk, the risk is linear and approaches two-fold at high levels of drinking. Thus, it is reasonable to infer there is no clear threshold, and that there is likely to be a real, albeit moderate-sized increased risk of breast cancer at moderate levels of alcohol. The mechanism is not clear, but breast cancer is strongly related to estrogen level and alcohol may cause a subtle shift in estrogen level, which could plausibly increase risk. It is also relevant that smoking is not an appreciable risk factor for breast cancer, and thus unlikely to confound this association. The association  between alcohol and breast cancer is observed with remarkable consistency across numerous study populations, in different countries across continents, regardless of socio-economic status and drinking pattern (wine, liquor, beer) supports a causal association. If we accept the association for breast cancer, the answer for women is “yes”.

Most of the alcohol-related cancers (colorectum, oral cavity, pharynx, larynx, liver, and (squamous) esophagus), other than female breast cancer are also smoking related. This fact is relevant for 3 reasons. First, in most populations, there is overlap between high alcohol consumers and heavy smokers; thus, smoking rather than alcohol could account for the association. Studies do statistically adjust for smoking, but if the correlation between smoking and alcohol is high and if smoking is a strong risk factor for the cancer, it is difficult to exclude confounding from smoking. Secondly, there may be biologic interaction between smoking and alcohol such that both are required to enhance risk, or alcohol increases risk only in the presence of smoking. If this true, the answer may be different from smokers and non-smokers. Thirdly, because smoking is a very strong risk factor for some cancers (oral cavity, pharynx, larynx, and (squamous) esophagus), if alcohol is a risk factor for these cancers, the magnitude of the effect in absolute numbers is much greater in smokers than for non-smokers. For illustration, if smokers increases risk of a cancer 10-fold, and alcohol doubles risk of this cancer, the same amount of alcohol will lead to 10 times more cancers in smokers than in non-smokers. If smoking biologically enhances the effect of alcohol (point #2), this difference will be even greater.

For these above reasons, my group examined the association of moderate drinking in smokers and non-smokers separately, in men and women, to provide a clearer answer (Cao Y, et al). Smokers, as expected, had a much higher risk of cancer overall, and this increased risk was further magnified by alcohol, especially for intakes of alcohol beyond moderate levels. Among the non-smokers, moderate alcohol was associated with an increased risk of breast cancer in women. Yet, in non-smokers, we could not detect any association for overall cancer nor for alcohol-related cancer (other than breast cancer I nwomen) in the moderate range (<2 drinks per day) in men nor women. While it is difficult to rule out a very small effect, these results suggest that if any effect of moderate alcohol in non-smokers exists, it is very small. While further study to confirm these findings is warranted, I believe that the answer is likely to be very different in non-smokers and smokers. To date, most studies have not separated smokers from non-smokers, and have given an average effect, which may be incorrect for both smokers and non-smokers.

Cao, Y., Willett, W. C., Rimm, E. B., Stampfer, M. J., Giovannucci, E. L. (2015). Light to moderate intake of alcohol, drinking patterns, and risk of cancer: Results from two prospective US cohort studies. British Medical Journal, 351. http://dx.doi.org/10.1136/bmj.h4238

 

Does moderate alcohol consumption increase risk of cancer?

Simon Moore has answered Likely

An expert from Cardiff University in Health

Cancer takes a while to appear and levels of alcohol consumption across the lifespan are poorly recorded. So the epidemiology is not there at the moment. There is also uncertainty in the mechanisms through which alcohol can cause cancer, we know it shortens telomeres, so there is that, also levels of folate are lower in those who drink, then there are the aldehydes.

Aldehydes are an intermediary of ethanol as it is processed and removed from the body, they peak when you binge drink (why you have a headache after a heavy night is because you’ve poisoned yourself with acetaldehyde) and it is believed to be a class A carcinogen. So in terms of the research base I would say there is still a bit to be done.

So a definitive statement along the lines of – the research evidence conclusively demonstrates a causal relationship between the consumption of alcohol and cancer – is perhaps not warranted. There is enough to warn people. There is, of course, the frothy happy-clappy end of the alcohol epidemiology world not known for stoicism and quite able to issue decrees… which kind of leads to a second point. …we use alcohol to clean the bugs of surfaces, we can use it to power engines, we know that if you drink enough of the stuff you will most definitely die. And on the way to your early grave it will destroy your organs, including your brain. Using alcohol is a part of an unhealthy lifestyle with a host of risks and the bottom line is very much that if you want to maximise the chances of living a long, healthy and happy life then reducing the amount you drink is important. So why are we interested in isolating one possible outcome that is probably associated with alcohol consumption?

 

Does moderate alcohol consumption increase risk of cancer?

Ji-Eun Park has answered Near Certain

An expert from Korea Institute of Oriental Medicine in Epidemiology

Alcohol consumption has been considered a major risk factor for various diseases, and WHO reported that alcohol consumption has been identified as carcinogenic for many kinds of cancer. Several studies suggested the beneficial effect of mild alcohol consumption, and WHO also reported that alcohol consumption showed complex relationship, which mild alcohol consumption was beneficial, especially in cardiovascular disease. However, previous studies have reported that the beneficial effects of mild alcohol consumption were attributed to reference group misclassification. It means that alcohol-related risk varies according to the reference group (e.g., former drinkers, non-drinkers, or lifetime abstainers). As one of those bias, many studies pointed out ‘sick quitter effect’ which former drinkers abstaining from alcohol because of health concerns or prescription medication. Another studies reported that lifetime abstainers, which used as reference group in many studies assessing the risk of alcohol consumption, might cause some bias because of their validity and characteristics. Considering those bias of reference group, the risk of modest alcohol consumption might be underestimated. It means that light or modest alcohol consumption could cause the cancer risk.

 

Does moderate alcohol consumption increase risk of cancer?

Hui Zhang has answered Likely

An expert from Washington State University in Immunology, Oncology

Yes. Alcohol consumption increases the risk of multiple types of cancer, specifically upper aerodisgestive cancers in both men and women and breast cancers in women. Epidemiological data indicate that even light or moderate alcohol consumption can significantly increase the risk of breast cancer in women.

 

Does moderate alcohol consumption increase risk of cancer?

Bosco Rowland has answered Likely

An expert from Deakin University in Psychology, Health

There are no safe limits of alcohol consumption. All alcohol consumption increases the risk of developing cancer. That is why the Australian National Health and Medical Council (NHMRC, 2009) guidelines are titled ” Australian Guidelines to reduce health risks from drinking alcohol”. see: https://www.nhmrc.gov.au/health-topics/alcohol-guidelines It is not titled “Safe drinking guidelines”. However, often people do refer to them like this. Thus, drinking approximately 2 standard drinks a day, increases the risk of developing an alcohol to approximately 1 in 100. Less then this amount per day reduces the risk, but the risk still remains.

 

Does moderate alcohol consumption increase risk of cancer?

M Katherine  Jung has answered Likely

An expert from National Institute on Alcohol Abuse and Alcoholism in Health

The International Agency for Research on Cancer (IARC) classifies ethanol as carcinogenic (cancer-causing) to humans(1). According to the IARC, cancers linked to alcohol use include those of the upper respiratory tract, liver, colon/rectum, and female breast(2). Alcohol consumption increases the risk of these cancers, so the greater the alcohol exposure, the greater the likelihood of developing cancer. In answer to the more specific question: “Does moderate alcohol intake increase cancer risk?” — In the United States, moderate drinking is defined as up to 1 drink (14 grams of alcohol) per day for women and up to 2 drinks (28 grams of alcohol) per day for men(3). According to recent studies, consuming 10 grams of alcohol per day (less than one standard drink) increases a woman’s chance of developing breast cancer by about 10-12% (4, 5, 6) Further, the risk of developing breast cancer increases with every increasing 10 grams of alcohol consumed per day(4). Thus, moderate alcohol consumption can increase the risk for breast cancer in women(5). Moderate drinking may increase the risk for other alcohol-associated cancers as well. According to Nelson et al., consumption of 20 grams or less of alcohol per day (approximately 1.5 standard drinks) accounted for 26% to 35% of cancer deaths in the U.S. that were attributed to alcohol use(6). For more on alcohol and cancer, visit: https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet https://pubs.niaaa.nih.gov/publications/Hangovers/beyondHangovers.pdf For information on standard drink size: https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/What-counts-as-a-drink/Whats-A-Standard-Drink.aspx About the National Institute on Alcohol Abuse and Alcoholism (NIAAA): The National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, is the primary U.S. agency for conducting and supporting research on the causes, consequences, diagnosis, prevention, and treatment of alcohol use disorder. NIAAA also disseminates research findings to general, professional, and academic audiences. Additional alcohol research information and publications are available at: https://www.niaaa.nih.gov. 1 Baan et al. (2007) Carcinogenicity of alcoholic beverages. Lancet Oncol 8: 292-293. 2 IARC. (2010) IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Alcohol Consumption and Ethyl Carbamate Lyon. IARC, Lyon, France. http://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Evaluation-Of-Carcinogenic-Risks-To-Humans/Alcohol-Consumption-2010. 3 United States Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. http://health.gov/dietaryguidelines/2015/guidelines/appendix-9/ 4 Allen NE, Beral V, Casabonne D, et al. (2009) Moderate alcohol intake and cancer incidence in women. Journal of the National Cancer Institute 101(5):296-305. 5 Yin Cao et al. (2015) Light to moderate intake of alcohol, drinking patterns, and risk of cancer: results from two prospective US cohort studies. BMJ 351:h4238 6 S. J. Lowry, K. Kapphahn, R. Chlebowski, C. I. Li. (2016) Alcohol Use and Breast Cancer Survival among Participants in the Women’s Health Initiative. Cancer Epidemiology Biomarkers & Prevention 25 (8): 1268. 7 National Institute on Alcohol Abuse and Alcoholism. “Beyond Hangovers.” https://pubs.niaaa.nih.gov/publications/Hangovers/beyondHangovers.pdf 6 Nelson et al. (2013) Alcohol-Attributable Cancer Deaths and Years of Potential Life Lost in the United States. Am J Public Health 103(4): 641–648.

 

Does moderate alcohol consumption increase risk of cancer?

Wayne Hall has answered Likely

An expert from University of Queensland in Behavioural Science

There is good epidemiological evidence that alcohol is a carcinogen, i.e. a cause of cancer. It has a causal role in 7 types of cancer: oropharynx, larynx, oesophagus, liver, colon, rectum and breast. Alcohol has been estimated to account for 5.8% of cancers globally. The cancer risk increases with the typical daily dose of alcohol and the frequency with which we drink. We do not know if there is a safe level of alcohol for cancer because it is difficult to discriminate risks at lower levels of alcohol consumption. In the case of other carcinogens, the usual advice is that there is no minimum risk level. The cancer risks of alcohol increase if a person drinks alcohol daily and especially if they drink in excess of recommended levels. The risk of developing cancers of the oral cavity, larynx and oesophagus also increase dramatically if a person drinks alcohol in the form of spirits like whisky and also smokes cigarettes. The risks of these two factors are multiplicative meaning that you can multiply the risks of smoking and drinking together. Alcohol is a cause of a multitude of diseases in addition to cancer, such as accidental injuries, liver disease, gastrointestinal disease, high blood pressure, some types of heart disease and stroke. This makes it good advice to avoid drinking above recommended levels of alcohol, to drink when consuming food, and to have several days per week that are alcohol free to allow the liver and other bodily organs to recover from the adverse effects of alcohol.

 

Does moderate alcohol consumption increase risk of cancer?

Yedy  Israel has answered Unlikely

An expert from Universidad de Chile in Biochemistry

Some studies indicate that in women who drink moderately there is more breast cancer. But whether this is due to alcohol or to the lifestyle of women who consume alcohol in low levels its not known.

 

Does moderate alcohol consumption increase risk of cancer?

Andrew Kunzmann has answered Likely

An expert from Queen’s University Belfast in Epidemiology

Alcohol appears to share a complex relationship with health. Whilst the evidence is pretty conclusive that heavy drinking is linked with a number of detrimental health effects, the evidence is less clear for light-moderate drinking. The evidence seems to suggest that alcohol shares a linear relationship with cancer risk (I.e. the more someone drinks the higher their risk of cancer will be), particularly for breast cancer and bowel cancer. Though the increased risk for light-moderate drinkers appears to be modest (http://www.bmj.com/content/351/bmj.h4238+) However, alcohol appears to show a more complicated relationship with cardiovascular disease, in that light-moderate drinkers (who drink less than 7 drinks per week) seem to be at a reduced risk of heart attacks compared to never, very occasional or heavier drinkers (http://www.bmj.com/content/356/bmj.j909). Nevertheless, the evidence does not confirm whether light-moderate alcohol consumption actively prevents heart attacks or whether light-moderate drinkers are simply healthier for other reasons outside the control of the studies. The UK recently updated their alcohol guidelines to suggest both men and women drink less than 7 drinks (~14 units) per week, spread over a week but with a few alcohol free days in between, which seems to be a good fit with the available evidence on cancer and other health outcomes (https://www.drinkaware.co.uk/alcohol-facts/alcoholic-drinks-units/latest-uk-alcohol-unit-guidance/).