Academic journal article Alcohol Research

Alcohol Consumption and the Risk of Cancer: A Meta-Analysis

Academic journal article Alcohol Research

Alcohol Consumption and the Risk of Cancer: A Meta-Analysis

Article excerpt

Alcohol consumption has been linked to an increased risk for various types of cancer. A combined analysis of more than 200 studies assessing the link between alcohol and various types of cancer (i.e., a meta-analysis) sought to investigate this association in more detail. This meta-analysis found that alcohol most strongly increased the risks for cancers of the oral cavity, pharynx, esophagus, and larynx. Statistically significant increases in risk also existed for cancers of the stomach, colon, rectum, liver, female breast, and ovaries. Several mechanisms have been postulated through which alcohol may contribute to an increased risk of cancer. Concurrent tobacco use, which is common among drinkers, enhances alcohol's effects on the risk for cancers of the upper digestive and respiratory tract. The analysis did not identify a threshold level of alcohol consumption below which no increased risk for cancer was evident.

KEY WORDS: AOD (alcohol or other drug) consumption; chronic AODE (effects of AOD use, abuse, and dependence); cancer; carcinogenesis; oral disorder; esophageal disorder; dose-response relationship; gender differences; tobacco in any form; distilled alcoholic beverage; drug concentration; risk analysis; meta -analysis

Regular alcohol consumption can have numerous consequences, beneficial or detrimental, on the health of the drinker. For example, light-to-moderate alcohol consumption (1) may protect against certain types of heart disease and stroke. Conversely, heavy drinking has been associated with liver disease; cardiovascular disease; disorders of the digestive tract; and illness or death from alcohol-related injuries, motor vehicle crashes, and violence. Another group of disorders that has been linked to drinking is cancer, particularly cancers of the upper airway and digestive tract (e.g., mouth, pharynx, larynx, and esophagus). Although alcohol has not been shown to cause cancer (i.e., be carcinogenic) in animal studies, strong epidemiological evidence indicates that consumption of alcoholic beverages increases the risk of those cancers. Alcohol consumption also is associated with primary liver cancer. This relationship is difficult to investigate in epidemiological studies, however, because it is more indirect. Thu s, alcohol causes cirrhosis of the liver in a substantial proportion of heavy drinkers, which then can lead to liver cancer. In addition, heavy alcohol consumption can increase the drinker's risk for infection with the hepatitis C virus (HCV), which in turn can also result in liver cancer (for more information on the relationship between alcohol consumption and HCV infection, see the article in this issue by Lieber, pp. 245-254).

Alcohol consumption also has been linked to cancers of the large bowel (i.e., colon and rectum) in both men and women and to breast cancer in women, although these associations have not yet been proven unequivocally. Nevertheless, because these are the two most common types of cancer in developed countries after lung cancer, even a moderate increase in risk may result in a relatively large number of additional cases and therefore have important public health implications. The association between alcohol consumption and other types of cancer (e.g., stomach, pancreatic, prostate, and endometrial cancer) is still controversial (International Agency for Research on Cancer [IARC] 1988; Doll et al. 1999).

The increased risk of cancer among heavy drinkers is primarily attributed to the alcohol (chemically referred to as ethanol) in alcoholic beverages. Thus, the risk rends to increase with the overall amount of ethanol consumed. It is still unclear, however, whether any defined consumption threshold exists below which no increased risk for cancer is evident (IARC 1988; Doll et al. 1999).

To evaluate the overall effects of alcohol on the cancer risk of a population, one must accurately quantify its effects on various types of tumors. …

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