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A warning for alcohol drinkers

​An article in the Nov. 7 issue of The New York Times includes a lengthy article about the dangers of drinking alcohol, and it quotes Susan Gapstur, PhD, MPH, our vice president for epidemiology. She suggests that one way alcohol may lead to cancer is because the body metabolizes it into acetaldehyde, which causes changes and mutations in DNA. The formation of acetaldehyde starts when alcohol comes in contact with bacteria in the mouth, which may explain the link between alcohol and cancers of the throat, voice box and esophagus.

The article was prompted by a statement published Tuesday in the Journal of Clinical Oncology by the American Society of Clinical Oncology, which represents many of the nation’s top cancer doctors. The warning cites evidence that even light drinking can slightly raise a woman’s risk of breast cancer and increase a common type of esophageal cancer.

Heavy drinkers face much higher risks of mouth and throat cancer, cancer of the voice box, liver cancer and, to a lesser extent, colorectal cancers, the group cautions.

“The message is not, ‘Don’t drink.’ It’s, ‘If you want to reduce your cancer risk, drink less. And if you don’t drink, don’t start,’” said Dr. Noelle LoConte, an associate professor at the University of Wisconsin-Madison and the lead author of the ASCO statement. “It’s different than tobacco where we say, ‘Never smoke. Don’t start.’ This is a little more subtle.”

The doctors’ group is also calling for new public health initiatives to curb alcohol use, from taxes to restrictions on ads targeting minors, like the new ban on alcohol advertising on New York City’s subways and buses slated to go into effect in January. 

For women, just one alcoholic drink a day can increase breast cancer risk, according to a report released in May from the American Institute for Cancer Research and the World Cancer Research Fund that was cited by ASCO.

Susan notes in the article that the International Agency for Research on Cancer, part of the World Health Organization, first classified the consumption of alcoholic beverages as carcinogenic to humans in 1987, tying consumption to cancers of the mouth, throat, voice box, esophagus and liver. Since then, she said, more and more evidence has accumulated tying alcohol to a broader group of cancers, including colorectal cancer and, in women, breast cancer. A more recent I.A.R.C. report concluded that alcohol “is a cause of cancers of the oral cavity, pharynx, larynx, esophagus, colorectum, liver, and female breast.” 

“The story of alcohol has been quite consistent and has been peeled away like an onion over time, and we’re continuing to learn more about the mechanisms involved,” Susan said. “We don’t have randomized trials, but sometimes when you start looking at the coherence of all the evidence, including the observational epidemiology, the lab studies, the mechanistic studies, you begin to see a picture and get more clarity.”

Read the full article here.

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