Nearly 2 billion people worldwide drink alcohol regularly. The average consumed by one person is 13 grams per day (about 1 drink). Beer, wine, and spirits are the main drinks, but any alcohol is known to a main risk factor for cancer which can be modified. Rates of alcohol use are rising worldwide, increasingly in low and middle income countries. Rates have remained high in high income countries. The result is that more attention must be paid to alcohol-related cancers.
Ethanol and acetaldehyde (the first chemical produced by metabolism of ethanol in the body) have been listed as “group 1 carcinogens”. They have been shown by research to have the “highest level of evidence for a carcinogenic effect in both humans and animals”.
This study was done to clarify the effect of alcohol intake on a risk of developing cancer and is based on two large reports. The International Agency for Research of Cancer (IARC) studied alcohol as a carcinogen in 1988 and in 2012. The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) published an extensive review of food, nutrition, exercise, and cancer in 2007.
Breast cancer in women is the most common cancer around the world and is the most common cause of cancer death in women. It has increased rapidly in middle and low income countries, and is linked to industrialization and urbanization. Alcohol use has been shown to increase breast cancer risk. Being hormone-related, breast cancer is different in pre-menopausal and post-menopausal women, but risk is increased in both groups by alcohol use. ER+ and PR+ breast tumors* show a positive association between cancer and alcohol use. ER- and PR- breast tumors showed no association. There is evidence that a high folate blood level reduces breast cancer risk from high alcohol intake.
Colorectal cancer is the 3rd most common cancer, especially in men. Also, it is linked to industrialization and urbanization, and is slightly more common in men. There is a 10% increased risk of colorectal cancer when drinking 10 g ethanol/day (1 small drink).
Liver cancer is the 6th most common cancer and the 3rd most common cause of death from cancer. It is nearly always fatal, and nearly half of the cases are in China. Most cases of liver cancer related to alcohol use develop following cirrhosis. The risk is increased in people who have had hepatitis B or hepatitis C.
Oral, laryngeal, and pharyngeal cancers are the 7th most common cancers, and occurrence is 3 times as high in men as in women. Case studies show increased risk of these cancers in people with the highest alcohol intakes compared to those with the lowest.
Cancer of the esophagus is the 8th most common cancer. The incidence is higher in men than in women and is increasing in high income countries.
No safe level of alcohol use without cancer risk has been identified. With cessation of drinking, it takes more than ten years for cancer risk to return to normal. No difference is seen in the type of alcohol used. Interestingly, there is a synergistic effect on cancer incidence with combined alcohol and tobacco use.
CONCLUSION: Alcohol use is strongly correlated with increased risk of developing the following cancers: Oral, pharynx, larynx, esophagus, colorectal (mainly in men), and breast (mainly in women).
NOTES: *Breast cancers are classified as estrogen positive (ER+) or estrogen negative (ER-) and prednisone positive (PR+) or prednisone negative (PR-).
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