For female breast cancer, the meta-analysis described here confirms the existence of a strong dose-risk relationship between alcohol consumption level and breast cancer risk. It is possible, however, that for breast cancer and other types of cancer related to disturbances in female hormone levels, alcohol may act by altering the metabolism and blood levels of female hormones, such as estrogen (Longnecker 1994). Moreover, a recent study suggests that the association may be limited to women with a family history of breast cancer (Vachon et al. 2001). However, based on more recent, comprehensive studies, public health experts now generally agree that alcohol—including wine—does not have a so-called “cardioprotective” effect. 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. The results of eight appropriate studies were pooled to determine the relationship between alcohol consumption and the risk of cancer at all sites combined.
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Drinking 20 to 60 grams, two to six drinks, of ethanol alcohol per day, which the authors defined as “risky drinking,” represented 39.4% of alcohol-attributable cancer cases. Moderate drinking – defined as 20 or fewer grams, or up to two drinks, per day – contributed to nearly 14%, or 1 in 7, cases. And the highest rates of alcohol-attributable cancers were among men who drank 30 to 50 grams of ethanol alcohol per day, and in women who consumed 10 to 30 grams every day. 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.
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. For all chronic disease categories for which detailed data are available, those data show that women have a higher risk of these conditions than men who have consumed the same amount of alcohol; however, the differences are small at lower levels of drinking (Rehm et al. 2010a). The existing evidence shows that there is little difference in cancer risk whether consumption is spread out over several occasions throughout the week or the same amount of alcohol is consumed all at once. Men accounted for about three quarters of the total alcohol-attributable cancer cases. The cancer types with the largest numbers of alcohol-attributable cases were oesophageal cancer, liver cancer, and female breast cancer. Because cancer risk increases with the amount of ethanol consumed, all alcoholic beverages pose a risk.
The results, the study team argued, should be a wake-up call for all those involved in cancer care. An essential round-up of science news, opinion and analysis, delivered to your inbox every weekday. Jürgen Rehm, highwatch zoom meetings Ph.D., received a salary and infrastructure support from the Ontario Ministry of Health and Long-Term Care. Zero (0) indicates that fewer than 500 alcohol-attributable DALYs in the disease category.
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Alcohol probably also increases the risk of cancer of the stomach, and might affect the risk of some other cancers as well. Greater collaboration with other specialties and clinicians who regularly interact with people with cancer, such as oncology nurses, to develop ways to reduce risky drinking behaviors will be needed moving forward, Dr. Agurs-Collins said. Binge drinking was most common among men, people under the age of 50, and former and current smokers.
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Of the 741,300 new alcohol-attributable cancer cases diagnosed last year, men represented 568,700 cases, while women accounted for 172,600 cases, the researchers found. Nearly 47% of the alcohol-attributable cancers were linked to heavy drinking, which the authors defined as 60 or more grams of ethanol alcohol (the alcohol found in alcoholic beverages), or more than six drinks, per day. The association between various levels of alcohol consumption and an increased risk of liver cancer remains difficult to interpret even with the pooled data used in this meta-analysis. This difficulty results from the fact that, as discussed earlier, the association between alcohol consumption and liver cancer is only indirect. 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).
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This effect was noted for several digestive tract cancers, specifically cancers of the esophagus and the nonglandular forestomach5 (Doll et al. 1999). The significantly greater risks seen in men carrying the low-alcohol tolerability ALDH2 gene variant who still drank regularly suggests that greater accumulation of acetaldehyde may directly increase cancer risk. There’s also strong evidence that consumption of alcoholic drinks helps protect against kidney cancer.
- 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.
- The analysis did not identify a threshold level of alcohol consumption below which no increased risk for cancer was evident.
- Of particular concern is the rising rates of colorectal cancer among younger people, and it is often diagnosed in life-threatening late stages.
- In people who produce the defective enzyme, acetaldehyde builds up when they drink alcohol.
A RR among the people with the variable (e.g., drinkers) of greater than 1.0 indicates that the variable increases the risk for the disease. The curves shown here were obtained by fitting certain statistical models to the data from several studies (i.e., a meta-analysis). Blue dotted lines indicate 95-percent confidence intervals; that is, the range of RR that is 95 percent likely to show a true RR.
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