DOCSLIB.ORG

Alcohol and Cancer Risk

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Alcohol and Cancer Risk ALCOHOL AND HEALTH ALCOHOL AND CANCER RISK TABLE OF CONTENTS Preface 1 Introduction 2 Alcohol use and relative cancer risk 3 How alcohol acts on the body to affect cancer risk 6 Risk factors affecting the association between alcohol and cancer 8 Effects of alcohol according to drinking profile 10 Conclusion 12 978-2-924784-47-1 Legal Deposit - Bibliothèque et Archives nationales du Québec, 2018 Legal Deposit - Library and Archives Canada, 2018 ALCOHOL AND HEALTH ALCOHOL AND CANCER RISK 1 PREFACE A recent Éduc’alcool survey on Quebecers and Nevertheless, the subject of alcohol and cancer alcohol revealed that one in ten drinkers felt that risk is particularly charged, because of the fear that drinking was affecting their physical health. More the disease still evokes and the strong emotions it than a third of all respondents (37%) believe that arouses. It’s a fact that one in two Quebecers will health issues are the main problem related to be affected by cancer at some point during their alcohol abuse. It is therefore easy to understand lifetime, and that many myths about cancer are still why nearly two-thirds of Quebecers put health at widely believed. the top of the list of topics of interest with regard to drinking. It is therefore extremely important to provide comprehensive, serious and solidly founded This is no surprise. The media report regularly on information about the relationship between alcohol the results of studies on the impact of alcohol on and cancer risk. Furthermore, the information must human health, because an ever-increasing amount be presented calmly, it must distinguish relative of research is demonstrating the benefits and risks risk from absolute risk, and it must neither trivialize of different amounts of alcohol and approaches to nor terrorize. drinking. Information is being disseminated primarily by the scientific community, but advocacy groups Éduc’alcool intends to contribute to this process are joining the debate, making provocative by clarifying the scientific data and making it statements that are often alarmist and terrifying. At available to the public, so that those who drink the other end of the spectrum are those who alcohol can make enlightened choices. And, as minimize and even trivialize the risks associated always, we hope to convince people that with drinking. moderation is always in good taste. ALCOHOL AND HEALTH ALCOHOL AND CANCER RISK 2 INTRODUCTION We have known for some time that moderate drinking can be According to the Canadian Cancer Society, there were beneficial for cardiovascular health. Moderation is defined as 206,200 new cases of cancer and 80,800 deaths caused no more than 2 drinks a day (maximum 10 a week) for women, by the disease in Canada in 2017. It is estimated that alcohol and no more than 3 drinks a day (maximum 15 a week) for was a factor in 10,310, or 5%, of the new cancer cases and men. This is known as low-risk drinking.1 3,636, or 4.5%, of the cancer deaths.2 And yet, alcohol can also have a harmful impact. It has been This Educ’alcool report begins by illustrating the risk of widely shown that alcohol can increase the mortality rates developing certain kinds of cancer, depending on the amount associated with certain diseases and increase the incidence of alcohol consumed. It then explains the biological of such diseases, including several cancers. The International mechanisms triggered by alcohol and thereby influencing Agency for Research on Cancer (IARC), the World Health cancer risk. There follows a discussion of the various risk Organization (WHO) agency specializing in cancer, reported factors that can affect the link between alcohol and cancer, for the first time in 1988 that drinking alcohol was a risk factor while the last part covers the different ways in which drinking for many types of cancer. profiles can influence cancer risk. Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumours and neoplasms. One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs; the latter process is referred to as metastasizing. Metastases are a major cause of death from cancer.3 1 Butt et al., 2011. 2 Shield, 2017. 3 WHO, 2017. ALCOHOL USE AND RELATIVE CANCER RISK A number of epidemiological studies have shown an have been working to synthesize all the evidence, so as to association between alcohol use and the risk of several kinds determine whether there truly is a connection between drinking of cancer. A search of PubMed—the main search engine for and different types of cancer. To that end, they have bibliographical data in biology and medicine—using the undertaken to combine the results of all the independent keywords “alcohol,” “cancer” and “epidemiology” returned studies on the subject, in an attempt to identify trends. Based more than 200 articles published on the subject between on these studies, it is now acknowledged that drinking alcohol 2012 and 2017. increases the risk of cancers of the mouth, pharynx, larynx, esophagus, liver, pancreas, colon, rectum, prostate and breast. When people drink moderately, the association between Studies have also shown that drinking had no effect, and alcohol and various forms of cancer is low, and thus, when occasionally even had a beneficial effect, on cancer of the examined one at a time, the different studies do not always kidneys (renal cell carcinoma), as well as on Hodgkin’s and come to the same conclusions. Sometimes, low to moderate non-Hodgkin’s lymphoma.5 Of course, this does not mean that drinking is linked to cancer risk, sometimes the opposite is people with kidney cancer are encouraged to drink alcohol. observed, and sometimes no link is established.4 This is why, for a several years now, World Health Organization researchers IN SCIENCE, IT IS IMPORTANT TO DISTINGUISH ASSOCIATION FROM CAUSATION. 4 Rehm and Shield, 2014. 5 INCa, 2007; INRC, 2012; Rehm and Shield, 2014. ALCOHOL AND HEALTH ALCOHOL AND CANCER RISK 4 People sometimes joke that “when you’re sick, you’d better Based on these criteria, the various cancer agencies and not go to the hospital, because you’re more likely to die in a research institutes currently recognize that alcohol causes hospital bed than at home.” While it’s true that there are seven different types of cancer. Drinking alcohol leads to a seriously ill people in hospitals (association), being in a significant increase in the risk of cancers of the mouth hospital does not cause death (causation). This is why, in (including the oral cavity and pharynx), the esophagus and epidemiology, criteria have been developed to determine what the larynx, and there is a moderate increase in the risk of constitutes adequate proof of a causal relationship between cancers of the liver, colon, rectum and female breast. While two events6—in this case, between drinking and cancer. it is possible that the link between drinking and these cancers might differ, depending on whether we are talking about the It can be said that drinking alcohol causes a certain type of risk of developing (morbidity) or dying from (mortality) one of cancer when: these cancers, science does not have enough information at ➊ there is a dose-effect relationship, that is, the more this point to make that distinction. alcohol people drink, the greater the likelihood of a The graphs shown below illustrate these causal relationships certain cancer; and indicate the relative risks of developing these seven a variety of evidence has been collected; and ➋ cancers (morbidity and mortality combined), based on average the mechanism by which alcohol causes a particular ➌ amount of alcohol, in grams consumed per day. cancer can be explained. Figure 1 Combined illustration of the relative risks of cancer of the mouth and oropharynx, the esophagus, the larynx, the colon, the rectum, the liver and the female breast, depending on alcohol use (based on the meta-analyses by Rehm and Shield [2014]). Neoplasms of the upper digestive tract Cancers of mouth and oropharynx Esophageal cancer Laryngeal cancer RISK RISK RISK RELATIVE RELATIVE RELATIVE 0 2.0 4.0 6.0 8.0 10.0 0 2.0 4.0 6.0 8.0 10.0 0 2.0 4.0 6.0 8.0 10.0 0 50 100 150 0 50 100 150 0 50 100 150 ALCOHOL CONSUMPTION (grams/day) ALCOHOL CONSUMPTION (grams/day) ALCOHOL CONSUMPTION (grams/day) Neoplasms of the lower digestive tract Other neoplasms Colon cancer Rectal cancer Liver cancer Cancer of the female breast RISK RISK RISK RISK RELATIVE RELATIVE RELATIVE RELATIVE 0 2.0 4.0 6.0 8.0 10.0 0 2.0 4.0 6.0 8.0 10.0 0 2.0 4.0 6.0 8.0 10.0 0 2.0 4.0 6.0 8.0 10.0 0 50 100 150 0 50 100 150 0 50 100 150 0 50 100 150 ALCOHOL CONSUMPTION (grams/day) ALCOHOL CONSUMPTION (grams/day) ALCOHOL CONSUMPTION (grams/day) ALCOHOL CONSUMPTION (grams/day) 6 Hill, 1965. ALCOHOL AND HEALTH ALCOHOL AND CANCER RISK 5 As these graphs show, whether the increase is linear (such as noted that the risk of death from oral or pharyngeal cancer with oral, colon, rectal and liver cancer) or exponential, i.e. rapid among men and women under the age of 70 is between 0.2% and continuous (such as with esophageal, laryngeal and breast and 0.5%.8 These relative increases of 42% and 96% mean cancer), any amount of alcohol increases the risk of cancer.
Load more

Recommended publications
  • State of Science Alcohol and Cancer Fact Sheet
    Alcohol and Cancer Basic description Research shows that alcohol consumption is linked to an increased chance of developing certain cancers. The more alcohol a person consumes, the higher their risk of developing some kinds of cancer. The way alcohol causes cancer isn’t completely understood. It could be that alcohol itself causes cancer by increasing hormone levels, or it may be carcinogenic because of the way it is metabolized, which can make cells more vulnerable to other carcinogens, like tobacco. People who drink heavily and smoke cigarettes or use other kinds of tobacco are at even higher risk for certain cancers. Cancers affected Oral, esophageal, laryngeal, and pharyngeal cancers are more common in alcohol users than in non-alcohol users. Smokers who also drink are at much higher risk. Although the combination of tobacco and alcohol use significantly increases the risk of developing these cancers, alcohol use alone also increases the risk of developing them. Alcohol is also a major cause of liver cancer. Deaths from liver cancer are higher among heavy alcohol users than among people who don’t drink. By altering the liver’s ability to metabolize some carcinogenic substances into harmless compounds or to disable certain existing carcinogens, alcohol’s effects may influence not only liver cancer but other cancers as well. Many studies have found a link between alcohol use and the risk of breast cancer. The risk increases with the amount of alcohol consumed. It’s highest among heavy alcohol users, but even a few drinks a week may increase a person’s risk. Alcohol use has been linked with a higher risk of cancers of the colon and rectum.
    [Show full text]
  • The Impact of Alcohol on Health
    The impact of alcohol on health Peter Anderson Introduction Apart from being a drug of dependence, alcohol has been known for many years as a cause of some 60 different types of disease and condition, including injuries, mental and behavioural disorders, gastrointestinal conditions, cancers, cardiovascular diseases, immunological disorders, lung diseases, skeletal and muscular diseases, reproductive disorders and pre-natal harm, including an increased risk of prematurity and low birth weight (Anderson & Baumberg, 2006). In recent years, overwhelming evidence has confirmed that both the volume of lifetime alcohol use and the combination of frequency of drinking and amount drunk per incident increase the risk of alcohol-related harm, largely in a dose-dependent manner (WHO Regional Office for Europe, 2009; Rehm et al., 2010) with the higher the alcohol consumption, the greater the risk. For some conditions, such as cardiomyopathy, acute respiratory distress syndrome and muscle damage, harm appears only to result from a sustained level of high alcohol consumption, but even at high levels, alcohol increases the risk and severity of these conditions in a dose- dependent manner. The frequency and volume of episodic heavy drinking are of particular importance for increasing the risk of injuries and certain cardiovascular diseases (coronary heart disease and stroke). Although there is a protective effect of light to moderate drinking on ischaemic diseases, overwhelmingly alcohol is toxic to the cardiovascular system. Alcohol is an intoxicant affecting a wide range of structures and processes in the central nervous system which, interacting with personality characteristics, associated behaviour and sociocultural expectations, are causal factors for intentional and unintentional injuries and harm to both the drinker and others.
    [Show full text]
  • References 263
    7. REFERENeES Abel, E.L. (1978) Effect of ethanol on pregnant rats and their offspring. Psychopharmacology,57, 5-11 Abel, E.L. (1979) Sex ratio in fetal alcohol syndrome. Lancet, ii, 105 Abel, E.L. (1980) Fetal alcohol syndrome: behavioral teratology. Psycho 1. Bull., 87, 29-50 Abel, E.L. (1981) Fetal Alcohol Syndrome, VoL. 1, Boca Raton, FL, CRe Press Abel, E.L. (1985a) Prenatal effects of alcohol on growth: a brief overview. Fed. Proc., 44, 2318-2322 Abel, E.L. (1985b) Alcohol enhancement of marijuana-induced fetotoxicity. Teratology, 31, 35-40 Abel, E.L. & Dintcheff, RA. (1978) Effects of prenatal alcohol exposure on growth and development in rats. J. Pharmacol. exp. Ther., 207,916-921 Abel, E.L. & Dintcheff, RA. (1986) Saccharin preference in animaIs prenatally exposed to alcohol: no evidence of altered sexual dimorphism. Neurobehav. Toxicol. Teratol., 8, 521-523 Abel, E.L. & Greizerstein, H.R (1979) Ethanol-induced prenatal growth deficiency: changes in fetal body composition. J. Pharmacol. exp. Ther., 211,668-671 Abernethy, D.J., Frazelle, J. H. & Boreiko, C.J. (1982) Effects of ethanol, acetaldehyde and acetic acid in the C3Hj lOT1j2 CL8 cell transformation system (Abstract No. Bf-l). Environ. Mutagenesis, 4,331 Adam, L. & Postel, W. (1987) Gas chromatographie analysis of ethyl carbamate (urethane) in spirits (GeL). Branntweinwirtschaft, March, 66-68 Addiction Research Foundation (1985) Statistics On Alcohol and Drug Use in Canada and Other Countries, VoL. 1, Statistics on Alcohol Use, Toronto, pp. 214-218 Adelhardt, M., Jensen, O.M. & Hansen, H.S. (1985) Cancer of the larynx, pharynx, and oesophagus in relation to alcohol and tobacco consumption among Danish brewery workers.
    [Show full text]
  • Alcohol Metabolism and Cancer Risk
    Alcohol Metabolism and Cancer Risk Helmut K. Seitz, M.D., and Peter Becker, M.D. Chronic alcohol consumption increases the risk for cancer of the organs and tissues of the respiratory tract and the upper digestive tract (i.e., upper aerodigestive tract), liver, colon, rectum, and breast. Various factors may contribute to the development (i.e., pathogenesis) of alcohol-associated cancer, including the actions of acetaldehyde, the first and most toxic metabolite of alcohol metabolism. The main enzymes involved in alcohol and acetaldehyde metabolism are alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), which are encoded by multiple genes. Because some of these genes exist in several variants (i.e., are polymorphic), and the enzymes encoded by certain variants may result in elevated acetaldehyde levels, the presence of these variants may predispose to certain cancers. Several mechanisms may contribute to alcohol-related cancer development. Acetaldehyde itself is a cancer-causing substance in experimental animals and reacts with DNA to form cancer-promoting compounds. In addition, highly reactive, oxygen-containing molecules that are generated during certain pathways of alcohol metabolism can damage the DNA, thus also inducing tumor development. Together with other factors related to chronic alcohol consumption, these metabolism-related factors may increase tumor risk in chronic heavy drinkers. KEY WORDS: Alcohol and other drug (AOD) consumption; heavy drinking; chronic AOD use; ethanol metabolism; carcinogenesis; cancer; upper
    [Show full text]
  • Alcohol Use and Cancer
    cancer.org | 1.800.227.2345 Alcohol Use and Cancer Alcohol use is one of the most important preventable risk factors for cancer, along with tobacco use and excess body weight. Alcohol use accounts for about 6% of all cancers and 4% of all cancer deaths in the United States. Yet many people don’t know about the link between alcohol use and cancer. Cancers linked to alcohol use Alcohol use has been linked with cancers of the: 1 ● Mouth 2 ● Throat (pharynx) 3 ● Voice box (larynx) 4 ● Esophagus 5 ● Liver 6 ● Colon and rectum 7 ● Breast Alcohol probably also increases the risk of cancer of the stomach8, and might affect the risk of some other cancers as well. For each of these cancers, the more alcohol you drink, the higher your cancer risk. But for some types of cancer, most notably breast cancer, consuming even small amounts of alcohol can increase risk. Cancers of the mouth, throat, voice box, and esophagus: Alcohol use clearly raises the risk of these cancers. Drinking and smoking together raises the risk of these cancers many times more than drinking or smoking alone. This might be because alcohol can help harmful chemicals in tobacco get inside the cells that line the mouth, 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 throat, and esophagus. Alcohol may also limit how these cells can repair damage to their DNA caused by the chemicals in tobacco. Liver cancer: Long-term alcohol use has been linked to an increased risk of liver cancer. Regular, heavy alcohol use can damage the liver, leading to inflammation and scarring, which might be why it raises the risk of liver cancer.
    [Show full text]
  • Epidemiology of Alcohol and Cancer1
    [CANCER RESEARCH 39, 2840-2843, July1979] 0008-5472/79/0039-0000 $02.00 Epidemiology of Alcohol and Cancer1 A. J. Tuyns International Agency for Research on Cancer, Unit of Epidemiology and Biostatistics, 150 Cours Albert Thomas, 69372 Lyon Cedex 2, France Abstract as Ledermann thought is presently a matter of controversy (2, 3) and will not be discussed here. There is still insufficient knowledge of the distribution of What is undeniable, however, is the need for more surveys drinking habits in human populations, and more descriptive providing a good description of drinking habits in human pop surveysareneeded. ulations. We need to know how people consume alcohol in Both prospective and retrospective epidemiological studies terms of average daily consumption by sex, age, social class, indicate that alcohol consumption is a cancer hazard. Prospec type of drink, rhythm of drinking, and possibly by more param tive studies on excessive drinkers have shown an increased eters. Such a detailed description can only be obtained by risk for cancer of the mouth, pharynx, larynx, esophagus, liver, direct measurement within well-designed surveys. There are and lung. Retrospective studies have confirmed this excess surprisingly few surveys of this kind, and very little is known risk. For cancers of the buccal cavity, pharynx, larynx, and about the way people consume their alcohol throughout the esophagus, the effect of drinking has been shown to be asso world. This is probably the reason why little is known of the ciated with the effect of smoking. In the case of esophageal risks of developing various diseases in relation to alcohol cancer, these two effects are independent, and the observa consumption.
    [Show full text]
  • Epidemiological Studies of Cancer in Humans
    5. EPIDEMIOLOGleAL STUDIES OF eANeER lN HUMANS As early as 1910, it was observed in Paris, France, that about 80% of patients with cancer of the oesophagus and cardiac region of the stomach were alcoholics, who drank mainly absinthe (Lamy, 1910). ln the first half of this century, it was also noted from mortality statistics in various countries that high risks for cancers of the oral cavity, pharynx, oesophagus and larynx occurred among persons employed in the production and distribution of alcoholIc beverages (Young & RusselI, 1926; Clemmesen, 1941; Kennaway & Kennaway, 1947; Versluys, 1949). Later studies showed that cancers at these sites occur at lower rates of incidence (and mortality) in religious groups that proscribe alcohol intake, such as Seventh-day Adventists (Wynder et aL., 1959; Lemon et al., 1964; Philips et al., 1980), compared with corresponding national populations. Although many aspects of the life style of such populations are particular, differences in drinking (and smoking) habits may contribute to the differences in disease rates. Subsequent to these historical observations and studies of religious groups, analytical studies of the cohort and case- control type have been carried out. 5.1 Measurement of alcohol intake in epidemiological studies ln descriptive studies, discussed below, a very crude level of a1cohol intake is typically inferred for a group of individuals, on the basis of characteristics such as treatment for a1coholism. Frequently, even measurements of average a1cohol intake in these groups and in the groups with which they are compared are not avaIlable. ln case-control and cohort studies involving individual subjects, measurements of a1cohol intake are usually obtained by structured interview or questionnaire.
    [Show full text]
  • Alcohol Use in Midlife Women
    Alcohol Use in Midlife Women Connie B. Newman MD, FACP, FAMWA 2018 President, American Medical Women’s Association Adjunct Professor of Medicine Division of Endocrinology, Diabetes and Metabolism New York University School of Medicine [email protected] Disclosures • No disclosures Connie Newman MD Questions • What is known about prevalence of alcohol use, binge drinking, and alcohol use disorder by age and sex? • What is the underlying problem? Why is (alcohol) drinking increasing in middle age women? • How is alcohol metabolized? Is this different in women? • What are health risks? Health benefits? • How can we screen for alcohol problems? • What are treatment options? WHAT CAN CLINICIANS DO TO ADDRESS THIS PROBLEM? Connie Newman MD • Alcohol use disorder (AUD) is not a “moral failing”, but rather a chronic disease with a neurobiological basis • Public and self stigma associated with AUD or excessive drinking is counterproductive • Much of the data available are based on interviews, and therefore may underestimate the magnitude of the disease. Connie Newman MD A Tale of Two Cities Paris 1875-6 London 1751 “Absinthe Drinker” by Edgar Degas “Gin Lane” by William Hogarth Connie Newman MD What is one standard drink? USA: National Institute on Alcohol Abuse and Alcoholism (NIAAA) CANADA: https://www.rethin kyourdrinking.ca/ what-is-a- standard-drink/ Connie Newman MD Low risk drinking, in U.S. https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Is-your- drinking-pattern-risky/whats-Low-Risk-drinking.aspx Connie Newman MD Prevalence Global data 2016 • 32.5% or 2.4 billion people were current drinkers o 25% women o 39% men • Varies by location and by sex • Lowest in low sociodemographic groups • 2.8 million deaths attributed to alcohol o 2.2% of deaths in women o 6.8% of deaths in men GBD 2016 Alcohol Collaborators.
    [Show full text]
  • Awareness of the Link Between Alcohol Consumption and Cancer Across the World: a Review
    Review Cancer Epidemiology, Biomarkers Awareness of the Link between Alcohol & Prevention Consumption and Cancer across the World: A Review Jennifer K. Scheideler and William M.P. Klein Abstract Since 1988, the International Agency for Research on Cancer ally; it is relatively higher in the United Kingdom, Morocco, and has classified alcohol as a Group 1 carcinogen, the highest level Australia. Methodologic differences in assessment obfuscate of risk. Growing evidence suggests that alcohol increases the cross-country and cross-sample comparisons. In general, peo- risk of several types of cancer including breast, bowel, prostate, ple are more likely to endorse alcohol as a risk factor when and liver, and accounts for a significant proportion of prevent- presented with a list of possible risk factors than when asked to able cancers. Despite ample evidence of this relationship, list risk factors in an open-ended format. Attempts to increase publicawarenessislessclear.FollowingPreferredReporting awareness have been limited and constitute a significant public Items for Systematic Reviews and Meta-Analyses (PRISMA) health need. We provide potential strategies to increase aware- guidelines, we reviewed 32 studies examining lay awareness ness, such as alcohol bottle labeling and fostering patient/ of alcohol as a risk factor for cancer in 16 countries. Our results physician discussions regarding the link. Cancer Epidemiol Biomar- show that awareness appears to be low and varies internation- kers Prev; 27(4); 429–37. Ó2018 AACR. Introduction cancer risk is also relatively higher among those who con- sume relatively small amounts of alcohol (16, 17). Nelson and Alcohol accounts for 4.65% of the global burden of injury colleagues (2013) (18) estimate that 31% to 51% of alcohol- and disease, making it one of the most preventable causes of related cancer cases occurred among women who consumed injury and death (1, 2), and an important behavioral risk factor 20 grams or less (approximately 1.5 drinks) per day.
    [Show full text]
  • Moderate Alcohol Intake in Non-Alcoholic Fatty Liver Disease: to Drink Or Not to Drink?
    nutrients Review Moderate Alcohol Intake in Non-Alcoholic Fatty Liver Disease: To Drink or Not to Drink? Maria L. Petroni * , Lucia Brodosi, Francesca Marchignoli, Alessandra Musio and Giulio Marchesini * Department of Medical and Surgical Sciences, “Alma Mater” University, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 1-40135 Bologna, Italy; [email protected] (L.B.); [email protected] (F.M.); [email protected] (A.M.) * Correspondence: [email protected] (M.L.P.); [email protected] (G.M.) Received: 31 October 2019; Accepted: 10 December 2019; Published: 13 December 2019 Abstract: Nonalcoholic fatty liver disease (NAFLD) is defined by hepatic steatosis in the presence of alcohol intake within safe limits, defined by guidelines of scientific associations (usually 20 g or 2 units/day in women, 30 g or 3 units in men). The diagnosis is usually followed by medical counseling of total abstinence, in order to prevent disease progression. This policy has been challenged by epidemiological studies, suggesting that the risk of liver disease and disease progression is lower in modest drinkers than in total abstainers. We revised the literature on the effects of modest alcohol intake on disease burden. Epidemiological data may suffer from several potential biases (recall bias for retrospective analyses, difficulties in the calculation of g/day), limiting their validity. Prospective data suggest that NAFLD patients with regular alcohol intake, although within the safe thresholds, are at higher risk of liver disease progression, including hepatocellular carcinoma; a detrimental effect of modest alcohol drinking is similarly observed in liver disease of viral etiology. Alcohol intake is also a risk factor for extrahepatic cancers, particularly breast, oral, and pharyngeal cancers, with gender difference and no floor effect, which outweigh the possible beneficial effects on cardiovascular system, also derived from retrospective studies.
    [Show full text]
  • Alcoholic Drinks and the Risk of Cancer: a Summary Matrix 7 2
    Alcoholic drinks and the risk of cancer 2018 Contents World Cancer Research Fund Network 3 Executive summary 5 1. Alcoholic drinks and the risk of cancer: a summary matrix 7 2. Summary of Panel judgements 9 3. Definitions and patterns 10 3.1 Alcoholic drinks 10 3.2 Types of alcoholic drinks 12 4. Interpretation of the evidence 13 4.1 General 13 4.2 Specific 13 5. Evidence and judgements 24 5.1 Alcoholic drinks 24 6. Comparison with the 2007 Second Expert Report 59 Acknowledgements 60 Abbreviations 64 Glossary 65 References 71 Appendix 1: Criteria for grading evidence for cancer prevention 78 Appendix 2: Mechanisms 81 Our Cancer Prevention Recommendations 84 2 Alcoholic drinks and the risk of cancer 2018 WORLD CANCER RESEARCH FUND NETWORK Our Vision We want to live in a world where no one develops a preventable cancer. Our Mission We champion the latest and most authoritative scientific research from around the world on cancer prevention and survival through diet, weight and physical activity, so that we can help people make informed choices to reduce their cancer risk. As a network, we influence policy at the highest level and are trusted advisors to governments and to other official bodies from around the world. Our Network World Cancer Research Fund International is a not-for-profit organisation that leads and unifies a network of cancer charities with a global reach, dedicated to the prevention of cancer through diet, weight and physical activity. The World Cancer Research Fund network of charities is based in Europe, the Americas and Asia, giving us a global voice to inform people about cancer prevention.
    [Show full text]
  • Cocarcinogenic Effects of Alcohol in Hepatocarcinogenesis
    132 REVIEW Cocarcinogenic effects of alcohol in Gut: first published as 10.1136/gut.51.1.132 on 1 July 2002. Downloaded from hepatocarcinogenesis F Stickel, D Schuppan, E G Hahn, H K Seitz ............................................................................................................................. Gut 2002;51:132–139 Alcohol is a major aetiological factor in INTRODUCTION hepatocarcinogenesis but our understanding of its Hepatocellular carcinoma (HCC) is the most frequent primary liver tumour among the com- importance as a modulating factor is just beginning to monest malignant tumours today.1 Its prevalence emerge. In the present review, a number of possible is increasing worldwide but differs greatly be- cofactors and mechanisms are discussed by which tween regions, with incidences of approximately 3–4/100 000 in Western countries2–4 and up to alcohol may enhance the development of hepatoma. 120/100 000 in Asia and Southern Africa. In more These include dietary or environmental carcinogens than 80% of European and North American cases, ingested along with alcoholic beverages, alcoholic HCCs develop in cirrhotic livers whereas in Asia near 50% of HCCs may occur in non-cirrhotic cirrhosis as a precancerous condition, and the effects of livers.56The increase in HCC is most likely due to alcohol metabolism. the more widespread chronic infection with .......................................................................... hepatotropic viruses, namely hepatitis B (HBV) and especially hepatitis C (HCV). Epidemiological studies have incriminated both viruses in hepato- SUMMARY carcinogenesis, and the contributory role of alco- The incidence of hepatocellular carcinoma is ris- hol, a major aetiological factor of liver cirrhosis in ing worldwide. Apart from hepatitis B and C Western countries, is undisputed.1 In the follow- viruses, alcohol presents a major aetiological fac- ing, we summarise the evidence and discuss tor in hepatocarcinogenesis, as shown in numer- potential mechanisms of the cocarcinogenic effect ous epidemiological studies.
    [Show full text]