Author: James Anderson

Does Drinking Alcohol Cause Cancer? Learn About the Risks Memorial Sloan Kettering Cancer Center

This superactive ADH enzyme speeds the conversion of alcohol (ethanol) to toxic acetaldehyde. Among people of Japanese descent, those who have this form of ADH have a higher risk of pancreatic cancer than those with the more common form of ADH (30). For example, one way the body metabolizes alcohol is through the activity of an enzyme called alcohol dehydrogenase, or ADH, which converts ethanol into the carcinogenic metabolite acetaldehyde, mainly in the liver.

1. “We are worried that 10 to 20 years down the road, we’re going to see a substantial increase in alcohol-related cancers,” Dr. Klein said.
2. There have been decades of public education campaigns about the health risks of tobacco, warning labels on tobacco products, and smokefree laws.
3. People who said they had searched for cancer information were more likely to know about the cancer risks posed by drinking beer and by drinking liquor than those who did not.
4. Among people of Japanese descent, those who have this form of ADH have a higher risk of pancreatic cancer than those with the more common form of ADH (30).

And little has been done to understand how to help those who are heavier drinkers change their behavior. Educating the public about the cancer risk from drinking alcohol, regardless of the beverage type, is especially urgent given the increase in drinking during the COVID-19 pandemic, Dr. Klein said. Participants in the survey are a nationally representative sample of adults aged 18 and older. The nearly 4,000 people who took part in the survey were asked how much does drinking several types of alcohol (wine, beer, and liquor) affect the risk of getting cancer. Because cancer risk increases with the amount of ethanol consumed, all alcoholic beverages pose a risk.

Some people, particularly those of East Asian descent, carry a variant of the gene for ALDH2 that encodes a defective form of the enzyme. In people who produce the defective enzyme, acetaldehyde builds up when they drink alcohol. The study also found that people who believed drinking alcohol increased the risk of heart disease were more aware of the alcohol–cancer risk than those who were unsure or believed drinking lowered the effect on heart risk. Numerous changes need to be made to raise public awareness of the fact that drinking alcohol raises the risk of several types of cancer. Smaller studies, including several conducted in Europe, have found potentially harmful drinking behaviors among both people being treated for cancer and longer-term survivors. Only a few studies have tried to capture the drinking behaviors of cancer survivors, including those still undergoing treatment, said Dr. Agurs-Collins, who was not involved in this new study.

What is the evidence that alcohol drinking can cause cancer?

Even as rates of heavy drinking have skyrocketed in the United States over the last few years, driven largely by the COVID pandemic, so has the realization that drinking has definite and serious harms, she continued. “We are worried that 10 to 20 years down the road, we’re going to see a substantial increase in alcohol-related cancers,” Dr. Klein said. “I try to normalize asking [patients] things like, if they’re drinking, how much and how they feel it affects them,” she explained. More research is needed to understand some of the disparities seen in this study, such as with age, Dr. LoConte said.

Noelle LoConte, M.D., an oncologist at the University of Wisconsin-Madison who studies alcohol and cancer risk, said that these findings confirm what doctors have long observed. Dr. LoConte said that she has direct conversations with her patients about drinking and other behaviors that could affect their treatment. And often she directs some of that discussion to family members and loved ones who are with the patient, essentially recruiting them to help manage the patient’s drinking. At the moment, however, proven ways to help people with cancer limit drinking during or after completing treatment are extremely limited, Dr. DuVall said. More research is needed to better understand alcohol use among people with cancer, the study team wrote.

The results, the study team argued, should be a wake-up call for all those involved in cancer care. Alcoholic beverages may also contain a variety of carcinogenic contaminants that are introduced during fermentation and production, such as nitrosamines, asbestos fibers, phenols, and hydrocarbons. “We need to better understand these root causes and how best to address them,” she said. But results from a new study suggest that this information may not be reaching people who fall into either of these two categories.

According to the study’s findings, male long-term survivors and younger people being treated for cancer were among those who were particularly likely to be heavy or frequent drinkers. There is strong and consistent evidence that drinking alcohol increases your risk of developing a cancer, based on a growing body of research. Alcohol is estimated to account for 6% of cancer cases in the U.S. — more than 75,000 per year — and nearly 19,000 cancer deaths, according to the American Cancer Society. Alcohol is the third biggest controllable risk factor for the disease, after tobacco smoking and excess weight. The study confirmed that most American adults aren’t aware of the link between alcohol consumption and cancer.

Can people’s genes affect their risk of alcohol-related cancers?

Binge drinking was most common among men, people under the age of 50, and former and current smokers. Among those who drank, binge and hazardous drinking was also much more common in those diagnosed and treated for cancer before the age of 18. The plant secondary compound resveratrol, found in grapes used to make red wine and some other plants, has been investigated for many possible health effects, including cancer prevention. However, researchers have found no association between moderate consumption of red wine and the risk of developing prostate cancer (32) or colorectal cancer (33). According to the federal government’s Dietary Guidelines for Americans, 2020–2025, individuals who do not drink alcohol should not start drinking for any reason. The Dietary Guidelines also recommends that people who drink alcohol do so in moderation by limiting consumption to 2 drinks or less in a day for men and 1 drink or less in a day for women.

The researchers cited the change in public perceptions and tighter regulations for tobacco, which show the importance of public health campaigns and physicians explaining risks to their patients. Dr. Klein noted, “[In] less than half a century, we’ve seen major changes in the way people think about tobacco.” Given the study’s findings, “there’s also a need to better understand why so many cancer survivors have such high alcohol consumption,” she continued. As with most questions related to a specific individual’s cancer treatment, it is best for patients to check with their health care team about whether it is safe to drink alcohol during or immediately following chemotherapy treatment. The doctors and nurses administering the treatment will be able to give specific advice about whether it is safe to consume alcohol while undergoing specific cancer treatments. There is a strong scientific consensus that alcohol drinking can cause several types of cancer (1, 2).

Evidence from Western countries already strongly indicates that alcohol is a direct cause of cancer in the head, neck, oesophagus, liver, colon and breast. But it has been difficult to establish whether alcohol directly causes cancer, or if it is linked to possible confounding factors (such as smoking and diet) that could generate biased results. It was also unclear whether alcohol is linked to other types of cancer, including lung and stomach cancers.

What is alcohol?

The mechanisms by which alcohol consumption may decrease the risks of some cancers are not understood and may be indirect. The first mutation is a loss-of-function mutation in the gene for the enzyme aldehyde dehydrogenase 2 (ALDH2). New data from a large-scale genetic study led by Oxford Population Health confirms that alcohol directly causes cancer. Launched in 2018, All of Us captures information on participants’ lifestyle and other behaviors and personal background via comprehensive surveys. Participants can also allow access to their electronic health records (with all identifying information removed), providing important insights on treatments received and other relevant health information.

A study published in 2023 found widespread mistaken beliefs that the risk varies by beverage type, with the lowest cancer risk assigned to wine. Another study published in 2021 showed that nearly 70% of people did not even know that alcohol was a cancer risk factor. Another enzyme, called aldehyde dehydrogenase 2 (ALDH2), metabolizes toxic acetaldehyde to nontoxic substances.