The Cooper Institute
 

Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH

 
 
 

Alcohol and Cancer Risk: Can drinking too much cause cancer?

Posted in

Monday, May 11, 2020

For the past several weeks, hundreds of millions of people have been sheltering-in-place due to the COVID-19 pandemic.

While facing the harsh realities of unemployment, school and business closures, bankruptcies, and fear for the future, everyone is looking for a way to cope with the stress. Some have used quarantine as an opportunity to reinvest in their health and fitness through physical activity. But for millions of others, alcohol has become the coping mechanism of choice. 

Shelter-in-place orders effectively shut down our most common outlets for social engagement. Restaurants, bars, concert venues and sporting events all shuttered leaving us with few options to kick back and enjoy a drink or two with friends. Liquor sales have soared at stores and online these past few months giving rise to concerns about substance abuse.

We often tout that moderation is the key, but what are the real risks of alcohol consumption?


Previous research shows that a consistent light to moderate alcohol intake is associated with a significantly decreased risk of cardiovascular disease (CVD) when compared with the CVD risk of non-drinkers or heavy drinkers. Since CVD is the leading cause of death for both U.S. men and women (~800,000 deaths per year), the current guidelines for alcohol consumption for those who choose to drink seem reasonable. A moderate intake is no more than two drinks per day for men and one drink per day for women*. Certain segments of the population should avoid alcohol entirely (e.g., pregnant or nursing women, individuals with health problems that are made worse by alcohol).

No one disputes the fact that excessive/irresponsible/binge drinking causes a myriad of health and social problems such as driving accidents, drownings, missed work, and domestic violence, to name a few. What seems to be missing from the conversation is the connection between alcohol and cancer. Few seem to realize that alcohol was declared a carcinogen in 1988 and cancer is the second leading cause of death among U.S. men and women.

The risk is dose-dependent; the more alcohol that one consumes, the higher the risk. A cause and effect relationship has been shown repeatedly between alcohol consumption and cancers of the esophagus, mouth, pharynx, larynx, colon-rectum, liver, and female breast, and there is growing evidence of increased risk of pancreatic cancer as well. While not all of the mechanisms have been established, more than a dozen carcinogenic compounds have been identified in alcoholic beverages. These include benzene, lead, cadmium, and aflatoxins. However, the most significant carcinogen in alcoholic beverages is ethanol i.e., the alcohol itself.


Light drinkers are not immune to the effects or risks of alcohol consumption. In an analysis of 222 existing studies that included 92,000 light drinkers (less than 7 drinks per day) and 60,000 non-drinkers, research shows that light drinkers had higher rates of cancers of the mouth and larynx (17% higher), esophagus (30% higher), and female breast (5% higher) than non-drinkers.

So does drinking alcohol mean choosing between heart disease or cancer? It doesn’t have to be.
 

There may be a happy medium somewhere for people who choose to drink alcohol. As shown in the table below, keeping alcohol consumption on the very light side may be enough to decrease heart disease risk with only a slight increase in cancer risk. 

Table 1. 
Comparison of cardiovascular disease risk reduction versus cancer risk increase with a regular very light alcohol consumption**.

*1 drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor

**A very light alcohol intake is defined as no more than 3 drinks per week for men and no more than 2 drinks per week for women. 

References

Alcohol drinking.  IARC Working Group, Lyon, 13-20 October 1987. IARC Monograph Evaluation of Carcinogen Risks. 1988:44:1-378.

Bagnardi, V., Rota, M., Botteri, D. 2013. Light alcohol drinking and cancer: a meta-analysis.  Annals of Oncology 24:301-308.