New study examines link between alcohol consumption and cancer
By Josh Birch
September 16, 2021
Whether heavy alcohol consumption increases the risk of cancer is a growing concern for researchers and one that affects around 10% to 20% of Americans. According to a new population-based study published in The Lancet Oncology, researchers attributed over 700,000 new cases of cancer in 2020 to alcohol consumption. Researchers found that cancers of the esophagus, liver and breast contributed the most cases.
The results are of particular interest to MUSC Hollings Cancer Center researcher Matthew Carpenter, Ph.D., who co-leads Hollings’ Cancer Control Research Program.
“I think this an example of the importance of research on modifiable lifestyle behaviors that have known association with various cancers,” Carpenter said. “Just as with smoking cessation, diet and physical exercise and limiting sun exposure, it’s important to remember the burden of excessive alcohol use on cancer risk.”
Hollings is committed to educating the public about behavioral choices that could have negative impacts as part of the mission to reduce the burden of cancer in South Carolina. Ben Toll, Ph.D., director of MUSC’s Tobacco Treatment Program, said the link between smoking and alcohol consumption can’t be ignored.
“There is a big focus on reducing tobacco use in South Carolina, but I think it is better to quit both smoking and heavy alcohol consumption because the behaviors are linked,” Toll said. “It’s common for someone with a drinking problem to also smoke.”
Toll said there are a lot of misconceptions when it comes to alcohol use and the impact it could have on health. For one, there is no worldwide consensus on measurement of a standard drink. According to a National Cancer Institute article, some people measure a standard drink by how much they can fit in a single glass. However, the National Institute on Alcohol Abuse and Alcoholism defines a standard drink as 12 ounces of regular beer, 5 ounces of wine and 1.5 ounces of distilled spirits.
“I think people are confused because it is a common perception that if you don’t drink heavily, it isn’t risky, but if you do drink heavily, it is risky,” Toll said. “The line is blurred. There should be more awareness of the impacts alcohol can have on your health.”
It’s a point that Raymond Anton, M.D., the Strom Thurmond Wellness and Fitness Endowed Chair and professor in MUSC’s Department of Psychiatry and Behavioral Sciences, agrees with.
“There’s nothing that smoking does that is good for somebody’s health,” Anton said. “But with alcohol, there are social benefits, and studies that show that small amounts can have positive health effects.”
Anton is particularly interested in the role that alcohol can play on epigenetics, which refers to changes in the genetic structure that is caused by interaction with the environment and a person’s behaviors. Unlike genetics inherited from parents, Anton said epigenetics can change over the course of one’s life.
“If someone drinks frequently enough, cells in the body don’t have enough time to recover and more permanent damage can occur,” he said. “It really is a combination of how much and how frequently you are drinking.”
In a large South Korean population-based study, researchers found that the frequency at which one drinks, versus the amount of alcohol consumed during each occasion, can increase the risk of a person developing gastrointestinal cancers, including esophageal, stomach, colorectal, liver, biliary and pancreatic.
Anton estimates that among the 90% of Americans old enough to drink alcohol, 10% to 20% are categorized as heavy drinkers. He said when alcohol enters the body, it is absorbed into the outer membranes of cells and affects how they function and communicate with one another.
“Genes in cells can turn on and off like a light switch. When the chemical is on, it is working. When the chemical is off, it’s not working and vice versa,” he said. “Alcohol messes up that light switch-type of mechanism, so the genes start becoming dysfunctional. They may cause cells to divide inappropriately, or they may not allow the cell to turn off its activity level. All of this can cause cells to behave in unhealthy ways and lead to things like high blood pressure and cancer.”
Anton said that while the body is resilient, too much damage from heavy alcohol consumption can limit cells’ ability to repair themselves and hinder the immune system from recognizing cells that are behaving abnormally. He said raising awareness about the dangers of alcohol consumption is critical.
“Alcohol doesn’t cause cancer in everybody. The question is who is most vulnerable? If you have an increased risk of cancer, whether hereditary or an early diagnosis yourself, you should probably reconsider how much you’re drinking because it’s not going to be helpful.”