Another study published in 2021 showed that nearly 70% of people did not even know that alcohol was a cancer risk factor. This recommendation is based on strong, consistent, and growing evidence that drinking alcohol increases your risk of developing a cancer. Furthermore, this meta-analysis found that the association of alcohol with the risk for oral and pharyngeal cancer appears to be stronger than the association with esophageal or laryngeal cancer across increasing levels of alcohol intake. For example, the analysis was unable to identify a threshold level of alcohol consumption below which no increased risk for cancer is evident.
The final meta-analysis comprised 106 articles, which included an additional key study for a comprehensive analysis. Data extraction included information such as End Stage Alcoholism first author, year of publication, country, follow-up duration, cohort size and cases, sex, alcohol consumption level, OR/RR/HR and 95% CI, confounders considered, and outcomes (cancer incidence or death). We also concentrated on a variety of cancer types identified as alcohol-related carcinomas by the IARC . Among them, 106 studies were included in the meta-analysis after a quantitative synthesis.
In addition, heavy episodic alcohol use might reduce the immune system’s defence against infection by disrupting the production of pro-inflammatory cytokines and increasing the expression of anti-inflammatory cytokines . Additionally, alcohol may suppress T cell immune responses therefore decreasing the anti-tumour regulation of the immune system. Alcohol increases CYP2E1 activity (Section 3.2) which also functions to metabolise retinoic acid resulting in the production of toxic metabolites . Alcohol can alter retinoid metabolism by inhibiting the oxidation of vitamin A to retinoic acid .
- One pathway by which ethanol achieves this is through increased CYP2E1 activity which produces high quantities of ROS whilst oxidising ethanol to acetaldehyde .
- There are several mechanistic pathways by which the consumption of alcohol, as ethanol, is known to cause cancer, though some are still not fully understood.
- However, it should be noted that their study focused only on light drinking patterns and therefore could not determine the effects of varying alcohol consumption levels.
- We conducted a comprehensive study selection process, which is presented in Figure 1.
- In a Q&A, Peter Monti, a professor of alcohol and addiction studies at Brown University and a leading researcher of alcohol and disease exacerbation, shared his perspective on alcohol and cancer.
- Assuming that analyses are conducted appropriately, due to the random distribution of these genetic variants at birth, MR studies should be less prone to conventional confounding and reverse causality.
- Along with new warning labels, the surgeon general’s report also recommends reassessing the guideline limits for alcohol consumption to account for cancer risk.
There are several medications for alcohol use disorder that are approved by the FDA to help reduce drinking, and there are some that are used off label. Many patients aren’t aware of the cancer link when they start to make decisions about their alcohol consumption. An estimated 20,000 U.S. cancer deaths a year can be attributed to alcohol synthetic cannabinoids national institute on drug abuse nida use, mostly among men, a 2024 study says.
Which Cancers Are Most at Risk From Drinking Alcohol?
This meta-analysis includes most published information on alcohol and cancer and, the limitations discussed above notwithstanding, consequently provides the most accurate estimates of the RRs for common cancers considered to be alcohol-related. Researchers have made several attempts to determine whether different types of alcoholic beverages have different effects on cancer risk. For example, in a series of case-control studies conducted in Italy, the RRs for the highest exposure levels to both risk factors were 80 for cancers of the oral cavity and pharynx, 12 for laryngeal cancer, and 18 for esophageal cancer (Franceschi et al. 1990). Researchers have known about the relationship between heavy alcohol consumption and the risk for esophageal and other upper digestive and respiratory tract cancers since the beginning of the last century. Furthermore, patients with liver cancer resulting from cirrhosis typically have reduced their alcohol consumption by the time they develop liver cancer (Aricò et al. 1994). For laryngeal cancer, tobacco use also substantially influences the risk, though a strong association with alcohol consumption, indicated by a RR of 3.24, remained even when considering only studies presenting adjusted estimates.
Tobacco, for example, dissolves in alcohol, which could make it easier for the body to ingest, the study says. Murthy said all alcoholic beverages should have cancer warning labels on them, a measure Congress would have to design and approve. WHO calls for action to protect young people from alcohol-related harm WHO in the Western Pacific supports countries in the dissemination and implementation of WHO’s technical guidance through the SAFER initiative, which outlines 5 evidence-based recommendations to preventing and reducing alcohol-related harms.
In the past, moderate drinking was thought to be linked with a lower risk of dying from heart disease and possibly diabetes. And drinking raises the risk of problems in the digestive system. As consumption goes up, the risk goes up for these cancers. In the United States, moderate drinking for healthy adults is different for men and women. Moderate alcohol use may not mean the same thing in research studies or among health agencies. The evidence for moderate alcohol use in healthy adults is still being studied.
Global strategy to reduce the harmful use of alcohol
Cancers of the larynx were also observed to have an increased RR (1.09 (95% CI 1.05–1.13) per 10 g alcohol per day) in the WCRF meta-analysis . The dose-response relationship for the risk of cancer at different sites per 10 g/day increase in alcohol consumption. The effects of alcohol consumption on cancer risk have been studied for many decades and an association with alcohol has been observed for multiple cancer sites. In this review, we aim to summarise the epidemiological evidence on alcohol and cancer risk and the mechanistic evidence of alcohol-driven carcinogenesis. In this review, we summarise the epidemiological evidence on alcohol and cancer risk and the mechanistic evidence of alcohol-mediated carcinogenesis.
It also includes binge drinking — a pattern of drinking where a male has five or more drinks within two hours or a female has at least four drinks within two hours. This disorder also involves having to drink more to get the same effect or having withdrawal symptoms when you rapidly decrease or stop drinking. Although it is well established that alcohol can cause cancer, this fact is still not widely known to the public in most countries.
Alcohol Consumption and the Risk of Cancer
- This increased toxicity of retinoids may explain the observation of excess lung cancer risk in smokers who took β-carotene supplements and consumed 11 g or more of ethanol per day in the α-tocopherol, β-carotene cancer prevention study (ATBC trial) study .
- These analyses found that tobacco use had a substantial modifying effect not only on the alcohol-related risks for lung and bladder cancer but also on the risk for laryngeal cancer.
- This approach allowed us to encompass a broader range of literature than previous meta-analyses, thereby enabling us to present up-to-date findings.
- Some researchers have suggested that drinks containing higher alcohol concentrations are more deleterious per gram of alcohol than drinks with lower alcohol concentrations.
- People who choose not to drink make that choice for the same reasons.
- Alcohol is broken down in the body into acetaldehyde, which is a metabolite that binds to our DNA.
Some researchers have suggested that drinks containing higher alcohol concentrations are more deleterious per gram of alcohol than drinks with lower alcohol concentrations. Accordingly, the cessation or moderation of tobacco and/or alcohol use could avoid the majority of these cancer cases. This effect was noted for several digestive tract cancers, specifically cancers of the esophagus and the nonglandular forestomach5 (Doll et al. 1999).
The Global alcohol action plan 2022–2030, endorsed by WHO Member States, aims to reduce the harmful use of alcohol through effective, evidence-based strategies at national, regional and global levels. Alcoholic beverages are classified as carcinogenic by the International Agency for Research on Cancer and increase the risk of several cancer types. In this context, it is easy to overlook or discount the health and social damage caused or contributed to by drinking.
Public Health
Alcohol and its metabolite acetaldehyde can drive cancer development through several pathways. Firstly, alcohol can disrupt the production of proteins such as perforin and granzymes A and B, which are necessary for natural killer (NK) cells to function in targeting and destroying potentially cancerous cells . Elevated concentrations of oestrogen due to alcohol use may lead to increased transcriptional activity of ER (up to 15 times higher than normal activity), resulting in proliferation of ER+ cells . ERs are important transcription factors within cells and may provide the main pathway by which alcohol promotes breast tumour growth . Alcohol might interfere with oestrogen pathways by increasing hormone levels and enhancing the activity of ERs, important in breast carcinogenesis .
Alcohol consumption may play a preventive role in the development of thyroid cancer by reducing thyroid-stimulating hormone levels . This heightened risk can be attributed to alcohol’s impact on the mammary gland, including elevating estrogen and insulin-like growth factor concentrations, altering structural development, and stimulating cell proliferation . Notably, this risk was prominently observed in Asians (RR, 1.49; 95% CI, 1.12 to 1.98) , potentially due to genetic variations in ethanol metabolism . From 2019 to 2020, the drinking rate of adults aged 19 and older in Korea was 74.8%, higher than the global average drinking rate of 43% (≥15 years) 29,30. The 2021 Korean National Cancer Prevention Awareness and Practice Survey showed that the guideline to “avoid alcohol consumption” was challenging for many respondents .
How Does Alcohol Increase Cancer Risk?
For example, when the investigators considered only studies reporting RRs not adjusted for tobacco use, the pooled RR for lung cancer at the highest level of alcohol consumption was 6.30. These analyses found that tobacco use had a substantial modifying effect not only on the alcohol-related risks for lung and bladder cancer but also on the risk for laryngeal cancer. One of the strengths of this meta-analysis is Psychological vs physical addiction that the investigators performed a separate analysis of studies that also reported estimates adjusted for tobacco use, which contributes to various forms of cancer, prominently lung cancer.
The link between alcohol and breast cancer, particularly among women, has been known for a long time, so that link is certainly not news to the research community. To Monti, the actions recommended by the surgeon general are reminiscent of those that public health experts advised in the 1970s to address the health risks of tobacco. Peter Monti, a professor of alcohol and addiction studies at Brown University, has been studying the bio-behavioral mechanisms that underlie addictive behavior, as well as its prevention and treatment, for several decades. What does this mean for people who drink alcohol and for the public at large?
This means that when alcohol is administered together with other known cancer-inducing agents (i.e., carcinogens), it promotes or accelerates cancer development. Nevertheless, the mechanisms underlying alcohol-related cancer development remain largely unclear. When they excluded such studies from the analysis and considered only studies reporting estimates adjusted for tobacco use, however, the pooled RR declined to 1.07. Such analyses were conducted for most cancers of the upper airways and digestive tract, as well as for lung and bladder cancer. The number of individual studies does not add up to the total shown because several studies examined more than one type of cancer.
We use the data you provide to deliver you the content you requested. Be sure to ask your healthcare professional about what’s right for your health and safety. When taking care of children, avoid alcohol.
Public health campaigns about the cancer risk posed by alcohol in England and Australia have been effective at raising awareness with their target audiences. For all beverage types, those aged 18–39 were more likely to be aware of the cancer risk from alcohol than those aged 40–59 or 60 and older. In fact, about 10% of participants believed that drinking wine actually decreases cancer risk. Nevertheless, the research team also asked participants about the purported heart health benefits of alcohol, to see if it was related to their awareness about alcohol and cancer risk.
With the immune system being compromised, alcohol consumption can exacerbate damage from viral infections such as hepatitis C virus, which is common among chronic alcoholic liver disease patients . However, some of the associations among alcohol drinking premenopausal women were limited to those taking oral contraceptives . DHEAS is metabolised to oestrogen by aromatase, the activity of which is also increased in chronic alcohol consumers .
Our study revealed a strong association between esophageal cancer and alcohol consumption across all levels. As safe drinking limits for cancer risk have not been identified, it is crucial to develop appropriate interventions to address drinking behavior. Significant associations were found between light alcohol consumption and esophageal, colorectal, prostate (in male), and breast (in female) cancers. There was no evidence for publication bias for Esophageal, colorectal, lung, prostate, or breast cancer (except for light to moderate drinking) (Supplementary Material 5). At moderate to heavy consumption levels, both male and female demonstrated heightened risks of cancer, with the exception of liver cancer, lung cancer, and pancreatic cancer in female. Except for thyroid cancer, all other cancers showed a dose–response relationship with alcohol consumption, where the RR increased as the level of alcohol consumption increased.