Let's Drink to Cancer

“There is a strong scientific consensus (agreement) that alcohol drinking can cause several types of cancer”

Source: Alcohol and Cancer Risk Fact Sheet - National Cancer Institute

“All alcoholic drinks, including red and white wine, beer, and liquor, are linked with cancer”

Source: Alcohol and Cancer | Centers for Disease Control

“Alcohol drinking is an established risk factor for several malignancies (cancers)”

Source: Alcohol and Cancer: A Statement of the American Society of Clinical Oncology | Journal of Clinical Oncology

The International Agency for Research on Cancer (part of the World Health Organization) has classified alcohol as a Group 1 carcinogen (a carcinogen is something that causes cancer). Group 1 carcinogens are the highest risk group that are known to cause cancer in humans, based on the available scientific evidence. This group also includes tobacco and asbestos.

Source: Agents Classified by the IARC Monographs, Volumes 1–137 – IARC Monographs on the Identification of Carcinogenic Hazards to Humans

There are about 20 million new cancer diagnoses worldwide each year, of which about 4.4% (880,000 cases) are caused by alcohol use. Globally, more than 400,000 cancer deaths per year are due to alcohol consumption.

Source: Alcohol - World Health Organization

Alcohol use accounts for about 6% of all cancer diagnoses in the United States, so about 120,000 of the 2 million cancer cases expected to be diagnosed in the US in 2024.

Source: Alcohol Use and Cancer | Health Effects | American Cancer Society

In the United States, more than 20,000 people die from alcohol-related cancers each year and about 178,000 people die from all alcohol-related causes each year.

Source: Alcohol and Cancer | Centers for Disease Control

The strongest evidence is available for the following cancers, for which it is very clear that alcohol use increases the risk of cancer developing:

• • Breast Cancer (cancer in the female breast)

  • Colon Cancer (cancer in the intestines), also called Colorectal cancer or Bowel cancer

  • Hepatocellular cancer (cancer in the liver)

  • Oral cavity and pharynx cancer (cancer in the mouth and throat)

  • Esophageal cancer (cancer in the tube that carries food to the stomach)

  • Laryngeal cancer (cancer in the voice box in the neck)

For some other cancers such as prostate cancer (cancer in the prostate gland), melanoma (skin cancer), gastric cancer (cancer in the stomach), and pancreatic cancer (cancer in the pancreas), alcohol is suspected of being a risk factor but the evidence is not as strong.

Sources:

• Alcohol and Cancer Risk Fact Sheet - National Cancer Institute

• Alcohol and Cancer | Cancer | Centers for Disease Control

• Alcohol and Cancer: A Statement of the American Society of Clinical Oncology | Journal of Clinical Oncology

The alcohol we drink contains ethanol (pure alcohol). Ethanol is broken down by the body into a substance called acetaldehyde. Acetaldehyde can cause cancer by damaging DNA in cells in a way that allows them to grow unchecked. 

In addition to this general mechanism, certain effects of alcohol can further increase the risk for some specific cancers. For example, drinking alcohol increases levels of estrogen in the blood, which is directly related to the risk for breast cancer.

Sources:

• Alcohol and Cancer Risk Fact Sheet - National Cancer Institute

• Alcohol and Cancer | Cancer | Centers for Disease Control

• Alcohol and Cancer: A Statement of the American Society of Clinical Oncology | Journal of Clinical Oncology

The risk of cancer increases with increased amount and duration of alcohol use. However, even light and moderate drinkers have an increased risk of certain cancer types. The World Health Organization (WHO) stated in 2022 that “no level of alcohol consumption is safe for our health”. According to the WHO, about half of all cancers caused by alcohol are due to “light” and “moderate” alcohol consumption.

Source: No level of alcohol consumption is safe for our health - World Health Organization

“Moderate” drinking is defined by the US Centers for Disease Control (CDC) as up to one drink per day for women and up to two drinks per day for men.

Source: About Moderate Alcohol Use | Alcohol Use | CDC

“Heavy” drinking is defined by the US Centers for Disease Control (CDC) as eight or more drinks per week for women and fifteen or more drinks per week for men.

Source: Alcohol Use and Your Health | Alcohol Use | CDC

For the purposes of quantifying the risk from alcohol use, a drink is defined based on the amount of ethanol (pure alcohol) it contains. In the United States, a standard drink is defined as 14 grams (0.6 fluid ounces) of ethanol. This amount of ethanol is contained in:

•  A 12 ounce can of regular beer (5% alcohol by volume)

•  A glass of wine containing 5 ounces of wine (12% alcohol by volume)

• 1.5 ounces of hard liquor like rum or vodka (40% alcohol by volume)

So a large wine glass with 10 ounces of wine or a strong beer with 10% alcohol content is considered as two drinks when calculating risk from alcohol use.

Source: What Is A Standard Drink? | National Institute on Alcohol Abuse and Alcoholism (NIAAA)

For a light drinker, the risk of cancer is increased between 4% to 26%, compared to non-drinkers, depending on the type of cancer. 

For a moderate drinker, the risk of cancer is increased between 8% to over 100%, compared to non-drinkers, depending on the type of cancer. 

For a heavy drinker, the risk of cancer is increased between 44% to over 400%, compared to non-drinkers, depending on the type of cancer.

Sources:

• Alcohol and Cancer Risk Fact Sheet - National Cancer Institute

• Alcohol and Cancer: A Statement of the American Society of Clinical Oncology | Journal of Clinical Oncology (see Table 1)

For the purposes of this comparison, we consider a non-drinker as having a risk of 1 for breast cancer. 

Compared to a non-drinker, a light drinker has an estimated risk of 1.04 (i.e. 4% higher). With 95% certainty, the research demonstrates that the true risk is between 1.01 to 1.07.

Compared to a non-drinker, a moderate drinker has an estimated risk of 1.23 (i.e. 23% higher). With 95% certainty, the research demonstrates that the true risk is between 1.19 to 1.28.

Compared to a non-drinker, a heavy drinker has an estimated risk of 1.61 (i.e. 61% higher). With 95% certainty, the research demonstrates that the true risk is between 1.33 to 1.94.

The World Health Organization (WHO) estimates that alcohol use causes about 7 of every 100 cases of breast cancer in Europe. Breast cancer has become the most common cancer globally. Out of about 2 million new cases of breast cancer worldwide in 2020, about 100,000 cases were caused by alcohol use.

Sources:

• Alcohol is one of the biggest risk factors for breast cancer - World Health Organization

• Alcohol and Cancer Risk Fact Sheet - National Cancer Institute

• Alcohol and Cancer: A Statement of the American Society of Clinical Oncology | Journal of Clinical Oncology (see Table 1)

For the purposes of this comparison, we consider a non-drinker as having a risk of 1 for colon cancer (also called colorectal cancer or bowel cancer). 

Compared to a non-drinker, research has not clearly demonstrated an increase in risk for light drinkers.

Compared to a non-drinker, a moderate drinker has an estimated risk of 1.17 (i.e. 17% higher). With 95% certainty, the research demonstrates that the true risk is between 1.11 to 1.24.

Compared to a non-drinker, a heavy drinker has an estimated risk of 1.44 (i.e. 44% higher). With 95% certainty, the research demonstrates that the true risk is between 1.25 to 1.65

Sources:

• Alcohol and Cancer Risk Fact Sheet - National Cancer Institute

• Alcohol and Cancer: A Statement of the American Society of Clinical Oncology | Journal of Clinical Oncology (see Table 1)

For the purposes of this comparison, we consider a non-drinker as having a risk of 1 for colon cancer (also called colorectal cancer). 

Compared to a non-drinker, research has not clearly demonstrated an increase in risk for light drinkers.

Compared to a non-drinker, a moderate drinker has an estimated risk of 1.08 (i.e. 8% higher). With 95% certainty, the research demonstrates that the true risk is between 0.97 to 1.20.

Compared to a non-drinker, a heavy drinker has an estimated risk of 2.07 (i.e. more than twice the risk). With 95% certainty, the research demonstrates that the true risk is between 1.66 to 2.58.

Sources:

• Alcohol and Cancer Risk Fact Sheet - National Cancer Institute

• Alcohol and Cancer: A Statement of the American Society of Clinical Oncology | Journal of Clinical Oncology (see Table 1)

For the purposes of this comparison, we consider a non-drinker as having a risk of 1 for mouth and throat cancer. 

Compared to a non-drinker, a light drinker has an estimated risk of 1.13 (i.e. 13% higher). With 95% certainty, the research demonstrates that the true risk is between 1.00 to 1.26.

Compared to a non-drinker, a moderate drinker has an estimated risk of 1.83 (i.e. 83% higher). With 95% certainty, the research demonstrates that the true risk is between 1.62 to 2.07.

Compared to a non-drinker, a heavy drinker has an estimated risk of 5.13 (i.e. more than five times the risk). With 95% certainty, the research demonstrates that the true risk is between 4.31 to 6.10.

Sources:

• Alcohol and Cancer Risk Fact Sheet - National Cancer Institute

• Alcohol and Cancer: A Statement of the American Society of Clinical Oncology | Journal of Clinical Oncology (see Table 1)

For the purposes of this comparison, we consider a non-drinker as having a risk of 1 for cancer of the esophagus (the tube that carries food to the stomach). 

Compared to a non-drinker, a light drinker has an estimated risk of 1.26 (i.e. 26% higher). With 95% certainty, the research demonstrates that the true risk is between 1.06 to 1.50.

Compared to a non-drinker, a moderate drinker has an estimated risk of 2.23 (i.e. more than twice the risk). With 95% certainty, the research demonstrates that the true risk is between 1.87 to 2.65.

Compared to a non-drinker, a heavy drinker has an estimated risk of 4.95 (i.e. almost five times the risk). With 95% certainty, the research demonstrates that the true risk is between 3.86 to 6.34.

Sources:

• Alcohol and Cancer Risk Fact Sheet - National Cancer Institute

• Alcohol and Cancer: A Statement of the American Society of Clinical Oncology | Journal of Clinical Oncology (see Table 1)

For the purposes of this comparison, we consider a non-drinker as having a risk of 1 for cancer of the larynx (voicebox). 

Compared to a non-drinker, research has not clearly demonstrated an increase in risk for light drinkers.

Compared to a non-drinker, a moderate drinker has an estimated risk of 1.44 (i.e. 44% higher). With 95% certainty, the research demonstrates that the true risk is between 1.25 to 1.66.

Compared to a non-drinker, a heavy drinker has an estimated risk of 2.65 (i.e. more than two and a half times the risk). With 95% certainty, the research demonstrates that the true risk is between 2.19 to 3.19.

Sources:

• Alcohol and Cancer Risk Fact Sheet - National Cancer Institute

• Alcohol and Cancer: A Statement of the American Society of Clinical Oncology | Journal of Clinical Oncology (see Table 1)