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Cancer Risk of Heavy Alcohol Use

Alcohol is another name for “ethanol,” the chemical found in beers, spirits, wines, malt liquor, and hard ciders. Alcoholic beverages are classified as a group I human carcinogen, which means it is a substance that causes cancer. Common types of cancers associated with alcohol consumption include—but are not limited to—breast, prostate, oral cavity, skin, liver, colorectal, and neck cancers. 

The link between cancer and alcohol is continuously being studied. However, there are a few potential ways alcohol use can contribute to a person’s risk of cancer, including:

  • Acetaldehyde — When you consume alcohol, your liver breaks down the ethanol into acetaldehyde, a toxic compound (carcinogen) that causes cancer. Acetaldehyde can also damage your body’s proteins and DNA (genetic makeup). This compound is the reason someone feels a hangover, upset stomach, headache, and/or an increased heart rate after drinking. 
  • Increased Estrogen Production — Alcohol increases estrogen levels in the body. Higher and abnormal amounts of estrogen can cause breast cancer in women.
  • Fewer Nutrients — Alcohol damages the body’s ability to break down and absorb essential nutrients. Many vitamins and minerals help prevent diseases, such as cancer. These nutrients include Vitamin A, B, C, D, and, E, as well as folate and carotenoids. 

Drinking alcohol and smoking tobacco regularly increases a person’s risk of developing certain cancers, such as throat, mouth, and esophagus cancer, even more. 

How Drinking Alcohol Affects The Body

Drinking any amount of alcohol increases a person’s risk of developing certain types of cancers. However, heavy alcohol consumption and those with a long-term alcohol use disorder (AUD) are most at risk. Experts recommend not drinking altogether or drinking in moderation to help prevent the development of alcohol-related cancers over time. 

The risk of developing cancer, depending on the type of alcohol use, is as follows:

  • Non-Drinkers — those who rarely drink or do not drink alcohol altogether have the lowest risk of developing alcohol-related cancers. 
  • Moderate Alcohol Consumption — If you do consume alcohol, experts recommend drinking in moderation. This form of alcohol consumption is defined as one alcoholic drink a day for women and two alcoholic beverages a day for men. While this is the safest way to drink alcohol, doing so long-term can still increase your risk of developing cancer. 
  • Binge Drinking— binge drinking is when you consume four or more drinks (women) and five or more drinks (men) within two hours. Binge drinking regularly increases your risk of developing alcohol-related cancers and can also lead to alcohol use disorder (AUD) over time. 
  • Heavy Drinking — drinking alcohol heavily, and for an extended time, dramatically increases a person’s risk of developing certain types of cancers. Heavy drinking is when someone consumes eight or more drinks a week (women) and 15 or more drinks a week (men).
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Types of Cancers Linked to Alcohol

Light drinking, moderate drinking, and heavy drinking all increase a person’s risk of some cancers. For light drinkers, the risk of developing cancer over time is low, but still possible. For heavy drinkers or those with an alcohol use disorder (AUD), the risk of developing certain cancers is much higher as a person ages. The most common cancers that develop due to alcohol use include, but are not limited to:

Breast Cancer

Alcohol increases estrogen (a sex hormone) production in the body. Too much estrogen has been linked to an increased risk of developing breast cancer in women, and rarely men. In the U.S., about 1 percent of breast cancers occur in men. Women who drink lightly have a slightly increased risk of breast cancer. Women who drink heavily for a long time increase their risk of breast cancer 1.6-fold. This means they are more than 1 ½ times more likely to develop breast cancer than women who do not drink alcohol. 

Liver Cancer

There are two types of liver cancer associated with long-term, heavy alcohol use—intrahepatic cholangiocarcinoma and hepatocellular carcinoma. People who drink heavily are two times more likely to develop liver cancer. 

Esophageal Cancer

Esophageal cancer, also called esophageal carcinoma, is a rare form of cancer that affects the tube that connects your throat and stomach (the esophagus). People who drink in moderation throughout life have a slightly higher risk of developing esophageal cancer than non-drinkers. Heavy drinkers, or those struggling with long-term addiction, have a five times greater risk of developing esophagus cancer compared to non-drinkers. 

Head & Neck Cancer 

Moderate to heavy alcohol use is connected to many types of head and neck cancer. This includes cancers of the throat, voice box (larynx), and other areas of the oral cavity (besides the lips). Moderate alcohol users are slightly more likely to develop these cancers compared to non-drinkers. Heavy alcohol users, on the other hand, are over 2 ½ times more likely to develop cancers of the head and neck than non-drinkers. 

Colorectal Cancer

Drinking heavily over many years is associated with an increased risk of colorectal (colon and rectal) cancer. People who never drink or drink lightly are much less likely to develop colon or rectal cancer compared to long-term, heavy alcohol users.

Other Cancers

Prostate cancer, lung cancer, and skin cancer may also be linked to moderate to heavy alcohol use, but are less common.

The Health Effects of Alcohol

What Happens to Cancer Risk Once a Person Stops Drinking Alcohol?

Most of the studies that have assessed whether cancer risk reduces once a person stops consuming alcohol have focused on head and neck cancers and esophageal cancer.

Generally, these studies have discovered that stopping alcohol consumption is not linked with immediate reductions in cancer risk. The cancer risks eventually reduce, but it may take years for cancer risks to match to the same levels as those who have never drunk alcohol.

Ex-drinkers still had higher risks of the oral cavity and pharyngeal cancers than those who had never drunk even 16 years after they stopped drinking alcohol. However, it was lower than before they stopped drinking alcohol.9

One study predicted that it would take more than 35 years for the increased risks of laryngeal and pharyngeal cancers linked with alcohol use to reduce to the same levels of those who have never drunk.10

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Is It Safe for Someone to Consume Alcohol While Undergoing Cancer Chemotherapy?

Like most questions related to a specific patient’s cancer treatment, individuals should check with their health care team whether it is safe to drink alcohol during or after chemotherapy treatment.

The doctors and nurses providing the treatment can give specific advice regarding whether it is safe to drink alcohol while undergoing certain cancer treatments.

Other Long-Term Health Effects from Drinking Alcohol

Most people are aware of the short-term effects of drinking alcohol, such as its effect on concentration, mood, coordination, and judgment. But it can also lead to long-term health effects such as weight gain, liver disease, and heart problems.

These health effects vary from person to person. For some individuals, alcohol is addictive. Drinking can become more excessive over time, resulting in severe health and social problems.

Those who suddenly stop drinking alcohol can experience physical withdrawal symptoms like tremors, confusion, seizures, hallucinations, and other serious issues. For some people, withdrawal symptoms can be life-threatening.

This does not mean that heavy drinkers should carry on drinking. It means that heavy drinkers should discuss their habits with their health care team regarding the safest way to stop drinking.

Resources

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(1) “Alcohol and Cancer Risk Fact Sheet.” National Cancer Institute

(2) Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. British Journal of Cancer 2015; 112(3):580-593

(3) LoConte NK, Brewster AM, Kaur JS, Merrill JK, Alberg AJ. Alcohol and cancer: A statement of the American Society of Clinical Oncology. Journal of Clinical Oncology 2018; 36(1):83-93

(4) Seitz, Helmut K, and Peter Becker. “Alcohol Metabolism and Cancer Risk.” Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism, National Institute on Alcohol Abuse and Alcoholism, 2007

(5) Song, Nan, et al. “Effects of Interactions between Common Genetic Variants and Alcohol Consumption on Colorectal Cancer Risk.” Oncotarget, Impact Journals LLC, 6 Jan. 2018

(6) Bagnardi, V., Blangiardo, M., Vecchia, C. et al. A meta-analysis of alcohol drinking and cancer risk. Br J Cancer 85, 1700–1705 (2001)

(7) Naomi E. Allen, et al. "Moderate Alcohol Intake and Cancer Incidence in Women," JNCI: Journal of the National Cancer Institute, Volume 101, Issue 5, 4 March 2009, Pages 296–305

(8) G. Pöschl, H. K. Seitz, "ALCOHOL AND CANCER", Alcohol and Alcoholism, Volume 39, Issue 3, May 2004, Pages 155–165

(9) Rehm, Jürgen et al. “Alcohol drinking cessation and its effect on esophageal and head and neck cancers: a pooled analysis.” International journal of cancer vol. 121,5 (2007): 1132-7 (10) Ahmad Kiadaliri, Aliasghar et al. “Alcohol drinking cessation and the risk of laryngeal and pharyngeal cancers: a systematic review and meta-analysis.” PloS one vol. 8,3 (2013): e58158
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