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. Here, we discuss evidence from large meta-analyses of observational studies and emerging evidence from Mendelian randomisation studies. For cancer specifically, an estimated 4.1% of all new cases globally in 2020 (3), and from 2013 through 2016, 4.8% of all cases annually in the U.S., were attributable to alcohol consumption (4). Current evidence suggests that “[t]here is no threshold of alcohol consumption below which cancer risk does not increase, at least for some cancers ” (5), and cancer prevention guidelines indicate that it is best not to drink alcohol (5, 6). Despite the large body of scientific evidence on the topic, the full cancer burden due to alcohol remains uncertain because for many cancer (sub)types associations with risk and survivorship are inconsistent or there are few studies. Moreover, most U.S. adults are unaware of the alcohol-cancer link (7), and the interrelationships of alcohol control regulations and cancer risk is unclear.

  1. The higher ethanol doses (i.e., 2.5 g/kg and 3.5 g/kg) significantly increased the number of lung metastases, whereas the lowest dose (1.5 g/kg) did not.
  2. 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 [21].
  3. However, these bacteria have limited capacity to break acetaldehyde down further into its non-harmful compound acetate, thus the oral epithelia are further exposed to acetaldehyde [21,44].
  4. Increased awareness of the alcohol-cancer link might encourage some people to warn family and friends about consumption, although the efficacy of such communication on behavior is unclear.
  5. Because overt behaviors appear to be more susceptible to normative influence than clandestine behaviors (44), alcohol consumption behaviors in groups might be especially subject to social sanction.

Esophageal cancer was not included because the association with alcohol drinking is confined largely to squamous cell carcinoma whereas most cases of esophageal cancer were adenocarcinoma in the US. Liver cancer was not included as it was not specifically included in the All of Us Research Program survey. Esophageal cancer was not included because the association with alcohol drinking is confined largely to squamous cell carcinoma, whereas most cases of esophageal cancer were adenocarcinoma in the US. They found that the more alcohol people drink, the higher their risk of an alcohol-related cancer.

Epidemiology and pattern of alcohol use in India

The results, the study team argued, should be a wake-up call for all those involved in cancer care. But results from a new study suggest that this information may not be reaching people who fall into either of these two categories. Reported in this paper was undertaken during a PhD studentship at the International Agency for Research on Cancer. One method which might overcome some of the limitations in observational studies is Mendelian randomisation (MR), which uses genetic variants to explore the causal relationship between exposure and disease outcome. 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.

It can also increase blood levels of estrogen, a sex hormone linked to breast cancer, and make the carcinogens found in tobacco smoke easier for the body to absorb. Evidence from Western countries already strongly indicates that alcohol is a direct cause of dmt addiction what is dmt how is it abused and is it addictive cancer in the head, neck, oesophagus, liver, colon and breast. But it has been difficult to establish whether alcohol directly causes cancer, or if it is linked to possible confounding factors (such as smoking and diet) that could generate biased results.

The mechanisms by which alcohol consumption may decrease the risks of some cancers are not understood and may be indirect. Public health campaigns about the cancer risk posed by alcohol in England and Australia have been effective at raising awareness with their target audiences. Noelle LoConte, M.D., an oncologist at the University of Wisconsin-Madison who studies alcohol and cancer risk, said that these findings confirm what doctors have long observed. The NCI Alcohol and Cancer Risk Fact Sheet provides a broad overview of alcohol as a risk factor for cancer, and three recent papers explore Division interest in alcohol awareness (7,8) and research needs related to alcohol and cancer prevention and control (9). Disadvantaged and vulnerable populations have higher rates of alcohol-related death and hospitalization, as harms from a given amount and pattern of drinking are higher for poorer drinkers and their families than for richer drinkers in any given society. What that means is that nations in those areas of Africa should be thinking now about strategies to control drinking.

Can people’s genes affect their risk of alcohol-related cancers?

While such public policies are effective and necessary, says Dr. Amy Justice, professor of medicine and public health at Yale University, we need to go further. She agrees with the authors that the results are, if anything, an understatement of the impact of alcohol on cancer cases. And she has suggestions to reduce the burden of alcohol-related cancers that go beyond governmental action. Given the study’s findings, “there’s also a need to better understand why so many cancer survivors have such high alcohol consumption,” she continued. And although people who identified as Hispanic were less likely than White participants to report drinking alcohol, those who did drink were more likely to drink heavily. The biggest such wins would likely come from helping heavy drinkers cut back or quit, she added.

Alcohol and Cancer

The percentage and number of CD3+NK1.1+ invariant NKT cells was elevated in the blood of alcohol-consuming, B16BL6 melanoma-bearing mice especially at day 14 after tumor inoculation (Zhang et al. 2012). These cells have important regulatory functions and can either promote antitumor immune responses or inhibit them. Initially, these cells express a cytokine profile that favors antitumor immune responses (i.e., a high ratio of IFN-γ to IL-4). After repeated activation, however, these cells become anergic and switch to a cytokine profile that inhibits anti-tumor immune responses and favors tumor progression (i.e., a high ratio of IL-4 to IFN-γ) (Parekh et al. 2005). The invariant NKT cells from the alcohol-consuming, melanoma-bearing mice exhibit a high IL4/IFN-γ ratio, indicating that they express a cytokine profile favoring immune inhibition and tumor progression (Zhang et al. 2015). Educating the public about the cancer risk from drinking alcohol, regardless of the beverage type, is especially urgent given the increase in drinking during the COVID-19 pandemic, Dr. Klein said.

The study confirmed that most American adults aren’t aware of the link between alcohol consumption and cancer. It also found that, even among those who are aware, there’s a belief that it varies by the type of alcohol. For example, more participants were aware of the cancer risks from hard liquor and beer than about the risk from wine, with some participants believing wine lowers your cancer risk. Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago – this is the highest risk group, which also includes asbestos, radiation and tobacco.

The lowest rates of alcohol-related cancers in the world were found in Saudi Arabia and Kuwait, where religious-based policies ensure low rates of drinking. 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. Smaller studies, including several conducted in Europe, have found potentially harmful drinking behaviors among both people being treated for cancer and longer-term survivors. By comparison, according to the most recent data from the Centers for Disease Control and Prevention, about 17% of US adults binge drink and 6% report heavy drinking (15 or more drinks a week for men, 8 for women). It is important to continue studying cancers linked to alcohol, as patterns of alcohol use continue to shift over time, Dr. Abnet said.

(For more information on the processes involved in tumor metastasis, see the sidebar.) The following sections will review the role of alcohol in cancer growth and progression, both in humans and in animal models. Alcoholic drinks contain ethanol, which is a known carcinogen, and there are several ways in which it may cause cancer. For example, ethanol can increase estrogen in the body, which increases the risk of breast cancer. The breakdown of ethanol in the body can also create high levels of acetaldehyde, which can damage DNA and cause liver, head and neck, and esophageal cancers. Most U.S. campaigns to increase public awareness about the health effects of alcohol consumption have focused on underage drinking, binge drinking, or drinking and driving (37–39).

Additionally, the cytokine IL-6 stimulates production of the anti-apoptotic protein Mcl-1, thus avoiding cell death and exposing the cell to further DNA damage [35]. 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. For example, one way the body metabolizes alcohol is through the activity of an enzyme called alcohol dehydrogenase, or ADH, which converts ethanol into the carcinogenic metabolite acetaldehyde, mainly in the liver. Recent evidence suggests that acetaldehyde production also occurs in the oral cavity and may be influenced by factors such as the oral microbiome (28, 29). The new findings are important for understanding which populations are most likely to suffer from medical conditions resulting from alcohol abuse, and contribute to a growing body of literature on health disparities that stem from socioeconomic factors. The researchers recommend that individuals with lower income or education levels might warrant additional screening by clinicians to evaluate their alcohol consumption and identify related conditions.

A study19 from the northeast region of India has suggested that alcohol and tobacco act as important risk factors in the causation of head and neck cancer. The most common histological subtype of liver cancer is hepatocellular carcinoma (HCC) and around 154,700 cases of HCC in 2020 were attributable to alcohol consumption [1]. When restricted to HCC only, meta-analysis of WCRF sources resulted in a 14% increased risk of HCC (RR 1.14 (95% CI 1.04–1.25)) per 10 g alcohol per day [7]. However, a possible threshold effect was observed in the non-linear dose-response analysis by WCRF, where less than 45 g alcohol per day did not significantly increase the risk of liver cancer. This was similar to the findings of Bagnardi and colleagues where light or moderate drinking did not significantly increase liver cancer risk but risk among heavy drinkers doubled (RR 2.07 (95% CI 1.66–2.58)) [8].

But recent changes in taxing policy, which has increased the cost of alcohol in those countries, have caused a drop in alcohol sales. Even as rates of heavy drinking have skyrocketed in the United States over the last few years, driven largely by the COVID pandemic, so has the realization that drinking has definite and serious harms, she continued. Overall, the team found that about 741,300 cancer cases in 2020, or 4.1% of the global total for that year, could be attributed to alcohol consumption. The processes that the body uses to break down alcohol produce a compound called acetaldehyde, a toxin that several organizations have classified as a probable cause of cancer in people.

What’s more, the combination of drinking and smoking might indirectly increase the risk of cancer, with alcohol acting as a kind of solvent for the carcinogenic chemicals in tobacco. It’s the first time, Rumgay says, that research has quantified the risks of different levels of drinking. “Our study highlights the contribution of even relatively low levels of alcohol to the risk of new cancer cases,” says Rumgay. The researchers categorized alcohol use based on responses to several alcohol-specific questions. They also used an assessment tool, called AUDIT-C, that was developed to study drinking behavior.

It was also unclear whether alcohol is linked to other types of cancer, including lung and stomach cancers. Continued research into the detrimental and beneficial effects of alcohol in human cancer patients and animal models of cancer is a key factor to understanding the complex what are the immediate short-term effects of heroin use interactions that affect tumor progression and survival, particularly in the context of alcohol use. This research has a strong potential to discover new immunotherapy and epigenetic approaches to cancer treatment as well as treatment of other alcohol-induced diseases.