Alcohol consumption is linked to seven types of cancer, including breast cancer in women and bowel cancer. In this post, Nicole Musuwo, Senior Research Interpretation Officer, and Olivia Rogers, Health Information Officer at World Cancer Research Fund (WCRF) look at the scientific evidence on alcohol and cancer, how alcohol increases the risk of cancer and ways in which you can reduce consumption.
There are many well-known health risks associated with alcohol consumption. Globally, alcohol consumption is one of the leading risk factors for illness, disability and death. Whilst the increased risk of conditions such as liver disease, pancreatitis and diabetes are well known, reports have shown that public awareness on the causal link between alcohol and cancer is less known. In the UK, almost 17,000 new cancer cases were linked to alcohol in 2020 – equivalent to around 46 new diagnoses every day.
The evidence on alcohol and cancer risk
Alcohol, also known as ethanol, has been causally linked to several types of cancer. Our Continuous Update Project (CUP) – the world’s largest programme investigating the links between diet, nutrition, physical activity and cancer – analysed the effect of alcohol on cancer risk. The CUP found strong evidence that alcohol increases the risk of developing seven types of cancer: mouth, throat, oesophageal, breast, stomach, bowel, and liver.
Alcohol has also been classified as a Group 1 carcinogen for humans by the International Agency for Research on Cancer. The extent to which alcohol is a cause of various types of cancer depends on the amount and frequency of consumption. The CUP found no threshold for which there was no risk for some cancers, such as those of the breast, whilst the risk of developing other types of cancer substantially increased with the consumption of two or more drinks a day. Whilst spreading consumption across the week is thought to better than binge drinking – in terms of cancer, any amount consumed can increase an individual’s risk.
How does alcohol cause cancer?
There are multiple ways in which alcohol is thought to increase cancer risk. All types of alcoholic drinks (including beer, cider, wine and spirits) are linked to cancer, as ethanol is the active agent in alcoholic drinks responsible for the development of cancer.
Alcohol is broken down in the liver and the main metabolite formed is acetaldehyde. Experimental evidence has shown that acetaldehyde can directly damage DNA function and repair, leading to cancer growth. Alcohol can also act as a carrier for other known cancer-causing compounds (such as those found in tobacco) from the mouth and throat into cells, which then leads to disruption of DNA synthesis and repair. For this reason, drinking alcohol and smoking together increases the risk of cancer more than if a person either smokes or drinks.
When alcohol is broken down in the liver, it influences the functional state of the liver and its ability to break down other nutrients and hormones. This can lead to elevated levels of hormones such as oestrogen and insulin. An elevated level of oestrogen is an established risk factor for breast cancer, while there is a growing body of evidence demonstrating a causal association between insulin and cancer development.
More recent research has shown that alcohol can have a significant impact on an individual’s healthy gut bacteria, with chronic alcohol intake reducing the number and variety of beneficial bacteria.
Is red wine better than other types of alcohol?
The idea that red wine may protect against cardiovascular disease has gained traction over the years. Red wine contains higher levels of plant compounds compared with other alcoholic drinks, particularly resveratrol from the grape skins used to make wine. While very small amounts of alcohol (around one drink a week) have been linked to cardiovascular benefits in some groups, evidence has shown that for every case of cancer that resveratrol in wine may prevent, 100,000 cancer cases are caused by alcohol.
There are safer and more health-promoting ways of obtaining nutrients derived from plant compounds, such as consuming a variety of fruits, vegetables and wholegrains, which have been shown to reduce the risk of cancer and other non-communicable diseases.
What can you do to reduce your risk of cancer?
WCRF recommends limiting alcohol consumption and ideally not drinking alcohol at all to reduce your cancer risk. Cutting down on alcohol intake can also help improve our general health. The UK government recommends that everyone should aim to drink no more than 14 units of alcohol a week.
Research shows there are several reasons why people drink. Some of these include being sociable, for stress relief, following social norms, and doing so out of habit. Identifying what’s causing you to drink more than you normally would, and finding other ways to manage these feelings, can be helpful to reduce alcohol consumption. Some find keeping a diary or writing down how they are feeling and why they want to drink helpful.
Although avoiding alcohol is the best option, if you do decide to drink, we would encourage moderation. We have a couple of tips below you can use to help keep your alcohol intake to a minimum and reduce your cancer risk.
If you often drink alcohol when you are socialising or stressed, try to manage these situations in other ways. Going for a walk or doing another form of physical activity you enjoy is a great way to reduce stress, and we know that physical activity can also help reduce the risk of certain cancers. Or, instead of going to the pub after work, suggest going to a coffee shop instead.
In addition, here are a few tips for the times you are going to drink:
- Opt for low-alcohol or alcohol-free alternatives.
- Replace every other alcoholic drink with a non-alcoholic drink.
- Choose smaller serving sizes of alcohol.
- Dilute alcoholic drinks with a low-calorie mixer to make them last longer.
- Plan ahead and keep track of the number of drinks you have – set yourself a drinks limit.
For ideas on alcohol-free drink options, see WCRF’s range of recipes here.
Written by Nicole Musuwo and Olivia Rogers
For more information on WCRF’s evidence and recommendation to limit alcohol consumption, visit their website.
If you have been diagnosed with cancer and are in need of support, The Macmillan Support Line offers free, confidential support to people living with cancer and their loved ones.
If you are worried about your own or someone else’s drinking, there is help available.
Drinkline is the national alcohol helpline. Calls are free and confidential. Call 0300 123 1110 (weekdays 9.00am to 8.00pm, weekends 11.00am to 4.00pm).
More information about organisations which offer help and support can be found on our support page.
This blog was published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Alcohol Health Alliance or its members.