Alcohol consumption has many effects on our health. While lower dose consumption may decrease cardiovascular risk, high alcohol consumption increases the risk of cancer.
Let’s look at the health risks related to high alcohol consumption:
A variety of cancers, including breast, liver, colon, head and neck, and esophageal are related to high consumption of alcohol
Moderate dose alcohol consumption means ≤ 1 drink per day for women and ≤ 2 drinks per day for men. A “drink” is 0.6 fluid ounces of alcohol, which equals 1.5 ounces of distilled spirits, 5 ounces of wine, and 12 ounces of beer. Heavy drinking is defined by the CDC as ≥ 8 drinks per week for women and ≥ 15 drinks per week for men.
In January 2023, the Canadian Centre on Substance Use and Addiction (CCSA) published updated guidelines that recommend limiting alcohol use to 2 or fewer drinks per week to reduce the risk of harm from alcohol (https://www.ccsa.ca/canadas-guidance-alcohol-and-health).
At that level, they say the risk of harm from alcohol is low. Risk is moderate for those who drink three to six servings of alcohol per week and “increasingly high” for those who drink seven or more. The report warns that drinking three to six alcoholic beverages per week is associated with an increased risk of several types of cancer. These recommendations are quite conservative, with other publications based on epidemiologic studies being less constraining.
Alcohol is even more likely to cause cancer in women than in men. Research has shown that women who drink even 1 drink per day have a 5-9% higher chance of developing breast cancer, compared with women who do not drink. The risk is even higher for women who drink more. One reason may be that alcohol affects the amounts of estrogen circulating in the body.
These risks must be considered in the context of the reported reduction in cardiovascular risk in those who consume ≤ 1 drink per day (https://cancerprogressreport.aacr.org/progress/cpr24-contents/cpr24-cancer-in-2024/#contents4).
The highest risk of cancer is seen in those who consume high doses of alcohol, especially binge drinkers (≥ 4 or 5 drinks over 2 hours for women and men, respectively) (https://www.mdanderson.org/cancerwise/does-alcohol-cause-cancer.h00-159383523.html)
Among those who have cancer, heavy drinking caused an 8% increased risk in dying and a 17% increased risk of cancer recurrence. Patients with cancer who abuse alcohol do worse because alcohol causes poorer nutrition, a suppressed immune system, and a weaker heart.
Alcohol increases cancer risk because:
- Alcohol is broken down into acetaldehyde, which is carcinogenic.
- Alcohol promotes free-radical (reactive oxygen species) production.
- Alcohol increases estrogen in the body, which may increase the risk of breast cancer, for example.
- Alcohol impairs the absorption of anti-oxidants (e.g. vitamins A, C, and E) that protect against cancer.
My general recommendation to avoid the health risks related to high alcohol consumption : Limit alcohol consumption to ≤ 1 drink per day for women and ≤ 2 drinks per day for men. More ideal would be to cut this consumption by 50%. For those at high risk for or who already have cancer, consider ≤ 1-2 drinks per week or abstaining from alcohol altogether.
Note: Although I am a physician, the content in this article is not meant to diagnose, treat, cure or prevent illness or disease in the reader – it is for educational purposes only.
References
- Canadian Centre on Substance Use and Addiction, 2023, “Canada’s Guidance on Alcohol and Health: Final Report,” https://www.ccsa.ca/canadas-guidance-alcohol-and-health
- American Association for Cancer Research. (2024, September). Cancer in 2024 – CPR24. Cancer Progress Report. https://cancerprogressreport.aacr.org/progress/cpr24-contents/cpr24-cancer-in-2024/#contents4
- Underferth D, Van Thomme G, “12 things to know aboout alcohol and cancer, MD Anderson Cancer Center, https://www.mdanderson.org/cancerwise/does-alcohol-cause-cancer.h00-159383523.html
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