Dr. Anthony Alberg, professor and chair of the epidemiology and biostatistics department in the University of South Carolina Arnold School of Public Health, has authored “Alcohol and Cancer: A Statement of the American Society of Clinical Oncology”. The paper appears in the Journal of Clinical Oncology, a leading publication in the area of cancer research. The statement, which Dr. Alberg co-authored* with scientists from organizations such as the Mayo Clinic and the MD Anderson Cancer Center, includes evidence related to the cancer risks of alcohol as well as recommendations for policies to minimize excessive alcohol drinking.
[Photo: Dr. Anthony Alberg]
With 3.3 million deaths estimated to occur worldwide annually as a result of harmful alcohol use, the authors note that this lifestyle behavior has already been established as a significant public health problem. What often goes unnoticed, however, is the strong linkage between alcohol use and cancer. Considered in total, in 2012 it was estimated that 5.5 percent of all new cancer cases and 5.8 percent of all cancer deaths worldwide (3.5 percent in the United States) were attributed to alcohol.
Alcohol’s role as a significant contributor to the population burden of cancer is due to the high prevalence of use and its role as a risk factor for several types of cancer. The World Cancer Research Fund/American Institute for Cancer Research and the International Agency for Research on Cancer, a branch of the World Health Organization, have both linked alcohol use to cancers of the oral cavity, pharynx, larynx, esophagus, liver, breast and colon. The risks of these cancers among alcohol drinkers vary according the amount of alcohol consumed. Small increases in cancer risk have been detected among individuals who engage in low levels of alcohol consumption, but the greatest risks are evident among moderate and heavy drinkers.
The cancer risk linked to alcohol drinking may be increased even further when combined with other risk factors. Alcohol drinking and cigarette smoking, for example, have been shown to establish a synergistic interaction in some cases such as oral cancer — making the cancer risks much greater for individuals who engage in both compared with those who only drink alcohol.
There is still progress to be made in completely characterizing the impact of alcohol drinking on the population burden of cancer, sometimes because drinking alcohol goes hand in hand with other risk behaviors. “For some malignancies, alcohol drinking is clearly statistically associated with increased risk but due to its strong correlation with other risk factors, it is difficult to discern if alcohol drinking is truly an independent risk factor,” explains Dr. Alberg. “For example, alcohol drinking has consistently been statistically strongly associated with increased lung cancer risk. However, cigarette smokers are also more likely to be alcohol drinkers and cigarette smoking is such an overwhelming lung cancer risk factor that it is difficult to separate the two.”