The types of cancer with the most cases linked to alcohol use were cancers of the esophagus and liver and, in women, breast cancer, the researchers reported July 13 in The Lancet Oncology. Eastern Asia and central and eastern Europe had the highest numbers of alcohol-related cancers in proportion to their populations, while northern Africa and western Asia had the lowest. Nearly 750,000 cases of cancer diagnosed worldwide in 2020, or 4%, can be attributed to alcohol consumption, according to a new study from the World Health Organization (WHO). While heavy drinking accounted for the most cases, light and moderate drinking accounted for more than 100,000 of those cases, the study found. The study also found that people who believed drinking alcohol increased the risk of heart disease were more aware of the alcohol–cancer risk than those who were unsure or believed drinking lowered the effect on heart risk.
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“We need to really make sure that we reinforce the message that all alcohol increases cancer risk,” she said. 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. 3Interestingly, the same cell type was decreased in the peripheral blood in the cancer patients compared with control patients. Overall, very few studies have addressed the role of and interaction among alcohol, cancer, and the immune system once the cancer is established.
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But the All of Us study, Dr. Cao and her colleagues explained, offered a unique opportunity to take a robust look at people in these groups in the United States. As it is highly reactive towards DNA, acetaldehyde may bind to DNA to form DNA adducts which alter its physical shape and potentially block DNA synthesis and repair [21]. These DNA adducts are particularly genotoxic as they can induce DNA point mutations, double-strand breaks, sister chromatid exchanges, and structural changes to chromosomes [21,22]. The DNA adducts in question include N2-ethylidene-2′-deoxyguanosine, N2-ethyl-2′-deoxyguanosine, N2-propano-2′-deoxyguanosine (PdG), and N2-etheno-2′-deoxyguanosine [23]. The PdG adduct may form additional highly genotoxic structures such as DNA-protein cross-links and DNA interstrand cross-links which may confer carcinogenesis [24].
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The study had several limitations, including that it only looked at current alcohol consumption, not past drinking habits, said Dr. Abnet. Surveys worldwide often have not collected information about past alcohol use, “but for a lot of people, there’s a pattern where they drink more heavily when they’re young and moderately as they get older,” he explained. Similarly, for esophageal cancer, the researchers zeroed in on a type called squamous cell carcinoma, which is the only type known to be triggered by alcohol consumption. “This may make the estimates of alcohol-related cancers lower than previous studies, but they’re more precise,” said Dr. Abnet. The methods the WHO team used differ from those used in previous studies, Dr. Abnet explained.
Taken together, these studies and animal models did not allow for general conclusions regarding the impact of alcohol on tumor growth, metastasis formation, and disease progression, as findings differed significantly depending on tumor type. The alcohol model used as well as the duration of alcohol administration also are important variables and can affect the overall outcome (D’Souza El-Guindy et al. 2010), as is the amount of alcohol administered. Several mechanisms have been suggested as to how acute alcohol may enhance metastasis formation, including alcohol-induced formation of as well as inhibition of various signaling molecules (i.e., cytokines and chemokines). However, although both of these mechanisms seem to contribute to the increase of metastases after acute administration, they do not account for the entirety of alcohol’s effects. Another mechanism whereby alcohol could facilitate metastasis of certain cancers may involve disruption of the integrity of the cells lining the blood vessels (i.e., vascular endothelium). Thus, studies found that exposure to 0.2 percent (weight per volume [w/v]) ethanol in vitro, which promotes angiogenesis and invasion, interferes with the integrity of the vascular endothelium by inducing endocytosis of VE-cadherin (Xu et al. 2012).
Moreover, another marker of angiogenesis, VEGF-R1 (Flt-1), also was found in a greater number of tumor cells and endothelial cells in the surrounding tissue from the ethanol group compared with the control group. 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 aa step 1 acceptance is the first step to recovery 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.
Moderate drinking was once thought to have benefits for the heart, but better research methods have thrown cold water on that. Overall, the study findings suggest that cell differentiation may promote resistance to alcohol-induced death but cause these cells to become more susceptible to accumulating oxidatively damaged proteins. It’s not always easy to eat and drink healthily, but we’ve got lots of tips to help you make healthy changes. It can also affect our body’s chemical signals, increasing the chance that cancer will develop. 3In the United States, a standard drink frequently is defined as 0.5 ounces (oz) or 14 grams of pure alcohol. This alcohol amount is found in 12 fluid oz of beer, 5 fluid oz of wine, and 1.5 fluid oz of 80-proof distilled spirits.
“The sooner we start accurately measuring alcohol exposure, the sooner we can understand the true excess burden of cancer attributable to alcohol and effectively intervene,” Dr. Justice wrote. When the researchers analyzed moderate drinking further, they found that 41,300 of those cases could be attributed to light drinking, or consumption of 10 grams or less per day. The 2020–2025 Dietary Guidelines for Americans recommends that adults of legal drinking age can choose not to drink, or to drink in moderation (two drinks or less in a day for men or one drink or less in a day for women). A related study using the same alcohol-feeding regimen confirmed alcohol’s effects on growth and angiogenesis of E0771 inoculated into other female C57BL/6 mice (Lu et al. 2014). In that study, a molecule that can inhibit VEGF receptor 2 blocked alcohol’s stimulatory effect on tumor growth, indicating that alcohol acts via a VEGF pathway.
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]. The effects of chronic alcohol consumption on tumor growth and metastasis of the highly invasive and spontaneously metastatic B16BL6 melanoma inoculated subcutaneously were studied in female C57BL/6 mice administered ethanol in drinking water. In an initial study, consumption of 2.5 percent, 10 percent, or 20 percent w/v ethanol in drinking water for 6 to 8 weeks before tumor inoculation and continuing thereafter did not affect primary tumor growth (Blank and Meadows 1996).
- Smaller studies, including several conducted in Europe, have found potentially harmful drinking behaviors among both people being treated for cancer and longer-term survivors.
- 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).
- A large meta-analysis of 23 health outcomes showed that the number of daily alcohol beverages that minimized harm overall was 0 (95% uncertainty interval 0.00–0.08) (2).
- All of the water- drinking animals had developed visible lung metastases at 16 days after tumor injection, whereas some of the ethanol-drinking mice did not develop lung metastases until 21 days.
- Other sources of ROS during ethanol metabolism include the mitochondrial respiratory chain and some cytosolic enzymes [28].
Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in every corner of the world. She has a Bachelor of Science (B.Sc.) degree and a Master’s of Science (M.Sc.) in biology and human physiology. She has authored more than 10 original research performance-enhancing drugs know the risks articles, all of which have been published in world renowned international journals. WHO had previously released alcohol policy recommendations as part of its “best buys” campaign to help countries focus on the most effective initiatives to prevent noninfectious diseases.
We have discussed evidence on mechanistic and epidemiological research in the field, and this information must be used to decrease the burden of cancers, as well as other diseases and injuries, attributable to alcohol. In one of the first experiments conducted in melanoma, 6- to 8-week-old female CDBA/2F1 mice consumed water or 20 percent alcohol for 52 weeks before being inoculated alcohol addiction in a leg with the Cloudman 8-91 melanoma tumor (Ketcham et al. 1963). When the tumors reached a size of 1.5 to 2.0 cm (about 28 days after tumor inoculation), the groups were divided in half, and half of each group had the primary tumor-bearing leg amputated. At 56 days after tumor implantation, the number and size of pulmonary metastases were recorded for all animals.
The functionality of the innate immune system also can be correlated with tumor progression. A recent study compared innate immune-system functionality with the number of circulating tumor cells in patients with a variety of cancers. In patients with metastatic disease, these circulating tumor cells are promising as biomarkers for tumor progression and overall cancer survival, with relatively high circulating cell numbers correlated with a poor prognosis. Decreased NK cytolytic activity also has been linked with other types of cancer, including colorectal cancer (Kim et al. 2013), metastatic melanoma (Konjevic et al. 2007), and head and neck cancer (Baskic et al. 2013). Although extensive epidemiologic evidence links the etiology of cancer to alcohol, very little information addresses the critical question of whether and how alcohol modulates tumor metastasis, survival, and the response to cancer therapy. Much research regarding the role of the immune response in oncogenesis has centered on hepatocellular cancer (for excellent recent reviews, see Aravalli 2013; Stauffer et al. 2012; Wang 2011).
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. There is mounting evidence that alcohol can negatively affect one-carbon metabolism which is essential for DNA methylation and DNA synthesis [25]. Ethanol and acetaldehyde can reduce the activity of enzymes involved in one-carbon metabolism that regulate DNA methylation, namely methionine synthase, methionine adenosyl transferase and DNMT, thus dysregulating epigenetic patterns and resulting in DNA hypomethylation [20].
Alcohol use is one of the most important preventable risk factors for cancer, along with tobacco use and excess body weight. Alcohol use accounts for about 6% of all cancers and 4% of all cancer deaths in the United States. To address these unknowns, researchers from Oxford Population Health, Peking University and the Chinese Academy of Medical Sciences, Beijing, used a genetic approach by investigating gene variants linked to lower alcohol consumption in Asian populations. Worldwide, alcohol may cause around 3 million deaths each year, including over 400,000 from cancer.
But recent changes in taxing policy, which has increased the cost of alcohol in those countries, have caused a drop in alcohol sales. “I think the perception often is, if you can fit it in a glass, it’s one drink,” Dr. LoConte said. But studies have shown that people pouring their own wine or spirits at home tend to underestimate the amount they’re actually consuming.