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Alcohol and Cancer

Posted 11/12/2014

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  If you are a longtime reader of this blog, you know that the topic of alcohol is a recurring subject. There are many studies about the association between alcohol consumption and cancer risk and/or the risk of cancer recurrence. There are at least a zillion other studies that examine that more general topic of alcohol consumption and general health.

  It is always a popular and a somewhat difficult issue. First off, all health care providers know that everyone minimizes their alcohol use when asked about it. Second, there is a very big difference, fortunately, between moderate and safe and enjoyable alcohol use and problem drinking. For many people, including me, the evening ritual of a glass of wine or a cocktail is important. My husband and I look forward to that time to begin to relax and catch up with one another after long work days.

  When my patients ask me if I drink, I generally say something like the comment above. You may be aware that my husband is a medical oncologist, so I sometimes add something like: "And I really don't think that my husband is trying to kill me." Here is where the conversation begins to get tricky: I surely don't want anyone to think that I am advocating that we all drink daily. What I am trying to do is remind you about common sense and quality of life and the very gray areas about many life style habits.

  This is all an introduction to a very good article from MedScape about alcohol use and health. The article talks about larger health issues, too, but does address cancer risk. Here is an excerpt and a link to read more:

Alcohol and Health: An Interview With Curtis Ellison

Is It True That "No Amount of Alcohol Is Safe"?
Dr Black: This is important, because some physicians feel that no amount of alcohol is safe with respect to some cancers.
Some studies have focused on this, especially in breast cancer. Could you review that data for us?
Dr Ellison: The largest cancer study is the European EPIC study.[5] They continue to report that alcohol is a cause of cancer, and it is if you drink too much. You have problems with upper aerodigestive cancers—cancers of the mouth, throat, larynx, and . Indeed, heavy drinkers have an increased risk for those cancers.
But they also asked, "What about moderate drinkers?" In their last big report,[6] they concluded that of more than 100,000 people followed, the percentage of cancers caused by light to moderate drinking is far less than 1%. It is there because there are some data suggesting that women who have even one drink daily may have a slight increase in breast cancer incidence.[7] There is some evidence that one or two drinks could relate to colon cancer, and these are very common diseases.[8]
Most alcohol-related cancer is from heavy drinking. They have said that 1 of 1000 women and 3 of 100 men who are moderate drinkers are at risk, but they aren't able to determine whether these people are underreporting their alcohol intake. This is a new aspect that we have to apply to our large studies, and we can do that in large studies at Harvard and in such studies as EPIC, the Framingham Heart Study, and others that have repeated records and exams over many decades. We are beginning to do that now. We are finding the same thing in the Framingham study.



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