The harmful use of alcohol is one of the leading risk factors for population health worldwide. Alcoholic drinks are a cause of various cancers, irrespective of the type of alcoholic drink consumed. The causative factor itself appears to be ethanol. The evidence indicates that the more alcohol a person drinks – particularly the more alcohol a person drinks regularly over time – the higher his or her risk of developing an alcohol associated cancer. Even light drinkers (those who have no more than 1 drink per day) and binge drinkers, have a modestly increased risk of some cancers.
The link between alcohol use and cancer development
There is an established causal link between alcohol use and cancer development in the mouth, oropharynx, larynx, esophagus, liver, stomach, colon, rectum and female breast (both pre and postmenopausal). The risks are generally higher for women than men. Even moderate alcohol intake has been shown to increase the risk of developing female breast cancer. Pathways by which alcohol influence cancer development include permanent damage of cellular DNA and inhibiting DNA repair mechanisms leading to increased cell mutations and risk of developing cancer. Alcohol is also thought to modulate estrogen pathways leading to the increased risk for development of breast cancer in females.
In 2016, 4.6% of all cancer deaths were attributable to alcohol consumption in the Americas. The largest contributors to alcohol related cancer burden were colorectal, liver and esophageal cancers.
If a person stops drinking alcohol, what happens to their cancer risk?
Most studies indicate that stopping alcohol consumption is not associated with an immediate reduction in cancer risk. Cancer risk will eventually decline, although it may take years (in some cases, oral cavity, pharyngeal and larynx 16-35 years) for the risks of cancer to return to those of never drinkers.
A recent paper published in 2018 sums up the health risks of alcohol very succinctly: “the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimizes health loss is zero”.
What is the bottom line?
The safest level of drinking alcohol is none.
1) Diet, Nutrition, Physical Activity and Cancer: A Global Perspective. The third expert report. World Cancer Research Fund and American Cancer Research Fund. 2018.
2) Global Status Report on Alcohol and Health 2018. WHO
3) Alcohol Use and Burden for 195 Countries and Territories, 1990-2016: A Systematic Analysis for the Global Burden of Disease Study 2016. The Lancet. 2018;392:1015-1035.