10 November 2017

The American Society of Clinical Oncology (ASCO) has just released a statement on alcohol and cancer. They note that the importance of alcohol consumption as a contributor to cancer development is under appreciated, and that in the US, approximately 3.5% of all cancer deaths are related to alcohol intake. While the association between alcohol intake (especially heavy consumption) has been known for some time, this is the first formal statement from ASCO on the subject. Alcohol intake is most strongly linked to head and neck, esophageal, liver, colon and breast cancers.

Moderate drinking is defined as one alcoholic drink per day for women and two per day for men. The greatest risk appears to be in those who drink heavily, although there does not appear to be a “safe” level of intake. In a New York Times article, Dr. Clifford Hudis, the chief executive of ASCO, noted that “The more you drink, the higher the risk. It’s a pretty linear dose-response”. ASCO did not recommend that people stop drinking altogether, but they did suggest that more education for both oncology providers and the public is needed about the relationships between alcohol consumption and cancer.

Of course, people who never drink alcohol can still develop cancer, and some who are heavy drinkers will not. Alcohol intake is just one of many lifestyle factors that can contribute to increased risk. And as Aaron Carroll writes, also in the New York Times, “maybe any increase in risk is too much for you”. If you do drink, I recommend that women limit their alcohol intake to 3-6 drinks per week – and don’t save up your weekly allowance for Friday or Saturday night! I think Dr. Carroll’s conclusion stated it best: “The absolute risks of light and moderate drinking are small, while many people derive pleasure from the occasional cocktail or glass of wine. It’s perfectly reasonable even if a risk exists — and the overall risk is debatable — to decide that the quality of life gained from that drink is greater than the potential harms it entails.”