Alcohol And Cancer: Drink At Your Own Risk

Craft beers, fine wines, champagne, and cocktails are considered by many to be natural accompaniments to good food and good company. The last thing anyone wants to hear is that alcoholic beverages can cause cancer. The connection between alcohol and cancer, however, was first reported in 1988, when the International Agency for Research on Cancer (IARC) declared that alcohol was a carcinogen.

Millions of cancer deaths are linked to alcohol consumption. The World Cancer Report, released in 2014, presented data that show that 3.5 percent of cancer deaths worldwide, about 3 million deaths over the last 10 years, can be attributed to consumption of alcohol. A report released in 2015 found that the rates of alcohol-related cancer deaths are accelerating, to about 5.8 percent of all cancer deaths, as more people all over the world drink alcohol and the amount of alcohol they drink is increasing, especially in women.

Dr. Jürgen Rehm,  Director of the Social and Epidemiological Research Department at the Centre for Addiction and Mental Health in Toronto, Ontario, Canada, describes the situation this way: “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."

What Kinds of Cancer Are Linked to Drinking Alcoholic Beverages?

The specific types of cancer to which Dr. Rehm refers are those in the mouth, larynx, pharynx, esophagus, stomach, colon, rectum, liver, and breast. There are also studies that suggest that pancreatic cancer is causally linked to drinking, but the data are inconclusive. Melanoma and cancers of the prostate and lung are also associated with use of alcohol, but only at higher levels of consumption.

Are There Any Patterns of Drinking That Are Linked to Risk of Cancer?

In 2015, researchers published findings from two studies of American health professionals, the Nurses' Health Study and the Health Professionals Follow-up Study, which enlisted 88,084 women and 47,881 men, respectively. Together, the participants in these two studies reported a total of 26,840 cases of cancer. When the data are analyzed, there are no doubts that alcohol consumption is linked to risk of cancer. However, the way that alcohol contributes to cancer risk is cumulative. The more drinks of alcohol you consume over a period of years, the greater your risk of cancer. There is no added risk for “tying one on” on weekends or holidays, but there is no added protection for having just one drink a day. Women seem to be more sensitive to alcohol, with regard to cancer risk, than men.

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Smoking, Drinking, and Cancer

The data also showed an unexpected relationship between smoking tobacco, drinking alcohol, and the risk of cancer.

• Men who had never smoked did not have a higher risk of cancer if they drank, but
• Women who ever drank had increased risk of cancer even if they did not smoke.

Just How Much Does Drinking Increase Your Risk of Cancer?

The Nurses' Health Study and the Health Professionals Follow-up Study offered some stark statistics of the increased risk of dying from cancer among heavy drinkers. Compared to people who never drinked alcohol at all, heavy drinkers (people who drink more than three alcoholic beverages per day) were:

• 44 percent more likely to develop colon cancer.
• 61 percent more likely to develop breast cancer.
• 165 percent more likely to develop cancer of the larynx.
• 395 percent more likely to develop squamous cell carcinoma of the esophagus.
• 413 percent more likely to develop cancers of the mouth and throat (oral and pharyngeal cancers).

However, drinking seemed to lower the risk of Hodgkin’s and non-Hodgkin’s lymphomas, and while the relative risk of developing cancer among heavy drinkers was high, the absolute risk of developing cancer among heavy drinkers offers a different perspective:

• In the United States, your absolute risk of developing colon cancer at some point during your lifetime is 4.95 percent. If you are a heavy drinker, it is 7.15 percent.
• Worldwide, if you are a woman, your lifetime risk of developing breast cancer is 12 percent. If you are a heavy drinker, it is 19.2 percent.

Still, even though the absolute risk of cancer is relatively low, if your family has a history of these cancers, or if you are a smoker, it can be worth considering cutting back on alcohol just to avoid cancer, especially if you have a family history of esophageal cancer or cancers of the mouth and throat.

Is There a Safe Amount of Alcohol Consumption?

The studies use a definition of a “drink” as any alcohol beverage than contains 14 g of alcohol. Different types of alcoholic beverages can have very different alcohol content. There are 14 g of alcohol in:

• 12 fluid oz (360 ml) of regular beer (5 percent alcohol),
• 8-9 fluid oz (240-270 ml) of malt liquor (7 percent alcohol),
• 5 fluid oz (150 ml) of wine (12 percent alcohol), or
• 1.5 fluid oz (45 ml) of 80-proof spirits, such as whiskey, rum, tequila, or vodka (40 percent alcohol).

Three or more of these choices every day clearly adds to the risk of cancer, but is there a safe middle ground between too much alcohol and no alcohol at all?

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Unfortunately, the data simply don’t show that any amount of alcohol is entirely safe for breast cancer. There are studies that find that risk of breast cancer goes up for women who consume as little as 10 g of alcohol (about 2/3 of a drink) daily. For other kinds of cancer,  however, and for men, the data are a little fuzzier. It’s possible that one drink per day is not detrimental for males or for women who have passed menopause.

It probably doesn’t make any difference what kind of alcohol you drink. At one time researchers thought that beer raised the rates of rectal cancer among Irish and Swedish brewery workers, and the custom of drinking hot apple cider raised the rates of esophageal cancer in Normandy in France. However, later studies disproved these associations, and all kinds of alcohol probably have very similar effects.