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ASCO: Even light alcohol use increases risk for cancer

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November 7, 2017

Bruce Johnson

Alcohol use — whether light, moderate or heavy — increases cancer risk, and public health measures are needed to reduce high-risk alcohol consumption, according to an ASCO statement.

Further, 5.5% of global cancer incidence and 5.8% of cancer deaths can be attributed to alcohol.

However, as HemOnc Today previously reported, ASCO’s National Cancer Opinion Survey showed up to 70% of Americans do not recognize alcohol as a cancer risk factor.

“People typically don’t associate drinking beer, wine and hard liquor with increasing their risk for developing cancer in their lifetimes,” Bruce Johnson, MD, FASCO, president of ASCO, said in a press release. “However, the link between increased alcohol consumption and cancer has been firmly established and gives the medical community guidance on how to help their patients reduce their risk for cancer.”

Alcohol consumption is particularly linked to increased risk for breast, colon, esophageal, and head and neck cancers.

Study data show the risk for cancer among heavy drinkers ranged from a summary RR (sRR) of 1.44 (95% CI, 1.25-1.65) for colorectal cancer to 4.95 (95% CI, 3.86-6.34) for esophageal squamous cell carcinoma and 5.13 (95% CI, 4.31-6.1) for oral cavity and pharynx cancer.

However, even light drinking increased cancer risk compared with nondrinking for breast cancer (sRR = 1.04; 95% CI, 1.1-1.07), esophageal squamous cell carcinoma (sRR = 1.26; 95% CI, 1.06-1.5), and oral cavity and pharynx cancer (sRR = 1.13; 95% CI, 1-1.26).

Also, mortality risk increased among patients with cancer who are moderate drinkers (RR = 1.79; 95% CI, 1.26-2.53) or heavy drinkers (RR = 3.65; 95% CI, 2.63-5).

However, ASCO’s survey also showed that only 38% of Americans limit their alcohol intake to reduce their cancer risk.

Because alcohol consumption is a modifiable risk factor, ASCO issued guidance on the needs for future research, as well as strategies for the reduction of high-risk alcohol consumption.

The most urgent research need within this area is to better define the impact alcohol has on cancer treatment and outcomes, according to the statement. A better understanding of the mechanistic effects of alcohol on cancer-related pathways and treatments also would help researchers understand alcohol’s role in disease progression and response to therapy.

The statement also included public health strategies to reduce high-risk alcohol consumption, including to:

  • screen adults, including pregnant women, for excessive alcohol use, and offer treatment services for those at risk;
  • regulate alcohol outlet density, such as by reducing the sites where alcohol is sold;
  • increase alcohol taxes and prices;
  • limit the days and hours alcohol may be sold;
  • enhance the enforcement of laws prohibiting the sale of alcohol to minors;
  • restrict youth exposure to advertising of alcohol;
  • resist further privatization of retail alcohol sales in communities with current government control; and
  • include alcohol control strategies in comprehensive cancer control plans.

Oncology leaders are well positioned to serve as community advisers and leaders to raise awareness about alcohol’s risks and to help implement and identify strategies to reduce them.

“ASCO joins a growing number of cancer care and public health organizations in recognizing that even moderate alcohol use can cause cancer,” Noelle K. LoConte, MD, lead author of the statement and associate professor of medicine at University of Wisconsin, said in the release. “Therefore, limiting alcohol intake is a means to prevent cancer. The good news is that, just like people wear sunscreen to limit their risk for skin cancer, limiting alcohol intake is one more thing people can do to reduce their overall risk for developing cancer.” – by Alexandra Todak

Disclosures: LoConte reports a consulting/advisory role with Celgene. One other author reports honoraria and travel accommodations or expenses from Eli Lilly. The other authors report no relevant financial disclosures.