In a November 2017 special statement, the American Society of Clinical Oncology (ASCO) cited evidence that alcohol consumption directly increases the risk for oropharyngeal and larynx cancer, esophageal cancer, hepatocellular carcinoma, breast cancer, and colon cancer. Although heavy drinking increases risk the most, ASCO noted that even modest consumption puts people at higher risk for these and other cancers. The World Health Organization’s International Agency for Research on Cancer has classified alcohol as a group I carcinogen because it causes cancer in humans.
According to the ASCO statement, 3.5% of cancer deaths in the United States and 5.8% in the world are directly attributed to alcohol, and the risk is consistent regardless of type of alcohol consumed (i.e., beer, wine, or liquor). Several mechanisms are implicated. Some people have an inactive form of ALDH2 protein, which enables excessive accumulation of acetaldehyde and amplifies alcohol’s toxic and mutagenic effects, particularly for oropharyngeal, larynx, and esophageal cancers. Alcohol drinking affects circulating concentrations of androgens and estrogens, which may affect risk for breast cancer. It’s also associated with lower folate concentrations, which may contribute to the etiology of colon cancer.
Because alcohol use is a modifiable risk factor, as part of the statement, ASCO issued recommendations for public health strategies to reduce excessive alcohol consumption.
- Provide alcohol screening and interventions in clinical settings.
- Regulate alcohol outlet density.
- Increase alcohol taxes and prices.
- Maintain limits on days and hours of sale.
- Enforce laws prohibiting sales to minors.
- Restrict youth exposure to alcohol advertising.
- Resist privatizing retail alcohol sales in communities with current government control.
- Include alcohol control strategies in comprehensive cancer control plans.
- Eliminate pinkwashing to market alcoholic beverages (i.e., using the color pink or pink ribbons for breast cancer awareness, given the evidence that alcohol is linked to increased risk for breast cancer).