Alcohol and Cancer: Drink at Your Own Risk

A Palatable Carcinogen

Fine wines, craft beers, cocktails, and champagne made by French monks are considered by many as complements to good company and fine cuisine. The last thing anyone wants to hear is that alcohol causes cancer.
However, the sobering truth is that alcohol consumption increases the risk for cancer, and this link has been known for some time. In 1988, the International Agency for Research on Cancer (IARC) declared that alcohol was a carcinogen.[1] The World Cancer Report released in 2014 highlighted the role of alcohol in cancer, finding that alcohol accounts for 3.5% of cancers (about 1 in 30 cancer deaths) globally.[2] Recent data indicate that the proportion of cancers attributable to alcohol worldwide has increased. In 2012, alcohol consumption caused 5.5% of all cases of cancer and 5.8% of all cancer deaths.[3]This increase is believed to be attributable primarily to an increase in the prevalence of drinkers and in the amount of alcohol consumed, particularly by women.
 
The fact that alcohol is a carcinogen has been clearly confirmed.
 
Jürgen Rehm, PhD, Director of the Social and Epidemiological Research Department at the Centre for Addiction and Mental Health in Toronto, Ontario, Canada, describes how our knowledge about the role of alcohol in cancer has advanced during the past year. "Very simply, the cancers that have been determined previously to be caused by alcohol have been confirmed. There is no discussion about whether alcohol causes these cancers. The fact that alcohol is a carcinogen has been clearly confirmed."
The cancers that Dr Rehm refers to include those of the oral cavity, pharynx, larynx, esophagus, breast, colon, rectum, gallbladder, and liver.[4] It is also considered probable that alcohol increases the risk for pancreas cancer, although the evidence is inconclusive.[4]
Recent evidence suggests that melanoma, as well as cancers of the stomach, lung, and prostate, may be associated with alcohol consumption, although only with high levels of consumption and to a moderate excess risk.[3] There are also differences of opinion on whether liver cancer should be considered an alcohol-related cancer and whether the risk for colorectal cancer is increased in both sexes or only in men.[5]

Alcohol-Cancer Link: New Evidence

Several large cohort studies of the association between alcohol and cancer, published in the past year, shed more light on this link.
The increased risk for cancer appears to be significant at lower levels of alcohol consumption in women than in men.
In August of 2015, data were published from two large, prospective, ongoing cohort studies—the Nurses' Health Study and the Health Professionals Follow-up Study.[6] During long-term follow-up (up to 30 years) of 88,084 women and 47,881 men, 19,269 and 7571 incident cancers were diagnosed, respectively (excluding nonadvanced prostate cancers). Alcohol consumption was significantly associated with increased risk for cancer, in both women (P trend<.001) and men (Ptrend=.006), with linear dose-response relations. The increased risk for cancer appears to be significant at lower levels of alcohol consumption in women than in men, and total alcohol consumption, rather than regularity of drinking or heavy episodic drinking, drove the association between alcohol consumption and risk for cancer.

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