By Mary C. White, ScD, MPH
At a recent college alumni dinner, a friend and wine expert pulled me aside and asked, “Is it true that wine increases the risk of breast cancer?” She knew I worked in the cancer division at the Centers for Disease Control and Prevention (CDC), so it was a reasonable question. I’ve been at wine tastings she’s hosted, and I needed to be straight.
“Yes,” I said, “the evidence is clear: drinking alcohol of any kind increases breast cancer risk.”
She looked troubled. “I’ve made wine my livelihood for years,” she said, “and I had no idea.”
We live in a culture where many people drink alcohol, even researchers who study cancer. Alcohol is often part of our social life. We share drinks with friends and raise our glasses to toast celebrations. I was tempted to reassure my friend, but the evidence linking alcohol and female breast cancer is strong. Alcohol raises the risk of other cancers as well, such as cancers of the colon and rectum, mouth, pharynx, larynx, esophagus, and liver. Drinking even one glass of wine or other alcoholic beverage a day carries a small level of cancer risk.
Many things can affect a woman’s risk for breast cancer. The science shows that breast cancer develops from of a combination of different factors over a woman’s lifetime. No single thing that a woman does will cause or stop her from developing breast cancer. Several well-known health behaviors can lower breast cancer risk. My friend nodded as I mentioned that breastfeeding, keeping a healthy weight, and being physically active can lower risk for breast cancer.
I wasn’t surprised that my friend was unaware about the link between alcohol and cancer. Indeed, the media has promoted the idea that a glass of red wine is good for the heart. But within the scientific community, the proposed benefit of moderate drinking is facing increased skepticism, with many now believing that the alleged benefits of alcohol consumption may not be real, and that the overall risk of death from all causes increases with any alcohol consumption.
Alcohol control efforts at CDC have focused on the prevention of harms from excessive drinking, which includes underage drinking, binge drinking (drinking five or more drinks on an occasion for men or four or more drinks on an occasion for women), and drinking while pregnant.
The U.S. Dietary Guidelines say people who don’t currently drink alcohol should not start drinking for any reason (Office for Disease Prevention and Health Promotion, 2015). The recommended limits for adults of legal drinking age who consume alcohol are up to one drink per day for women and up to two drinks per day for men. For cancer prevention, the American Institute for Cancer Research recommends not drinking alcohol at all.
Late last year, the American Society of Clinical Oncology (ASCO) published its first statement about alcohol and cancer. ASCO supports education for oncology providers on excessive alcohol use and policy efforts to prevent excessive alcohol consumption. CDC has also produced a policies and practices brief for our partners that summarizes recommended strategies for reducing excessive alcohol use for cancer prevention.
What You Can Do
We owe it to our friends—and to patients and their families too—to be honest about alcohol use. If you work in cancer care, you can screen patients for excessive alcohol use and then recommend or offer treatment services to those at risk. As an oncology professional, you can serve as a leader in your community to raise awareness about the link between alcohol and cancer and promote evidence-based policy efforts to reduce excessive alcohol use as well.