Drinking alcohol, especially above the recommended upper limits, boosts the risk of several cancers, according to a new European study published in the British Medical Journal this week.

The study followed hundreds of thousands of people in eight European countries (Italy, France, Spain, The Netherlands, Greece, Germany, Denmark and the United Kingdom), and concluded that nearly one in ten (9.6%) cancers in men and one in 33 (3%) cancers in women can be tied to alcohol consumption.

The authors, led by led by Madlen Schütze an epidemiologist at the German Institute of Human Nutrition in Potsdam- Rehbruecke, said that a substantial proportion of the cancers occurred in men and women who drank more than the recommended upper limits of two standard drinks a day for men and one per day for women.

A standard drink has 12g of alcohol, and is equivalent to about one 125 ml glass of wine, or half a pint of beer.

The researchers said their results support the current political efforts to encourage people to reduce their intake of alcohol, or even stop drinking it altogether, to reduce the incidence of cancer.

“Our data show that many cancer cases could have been avoided if alcohol consumption is limited to two alcoholic drinks per day in men and one alcoholic drink per day in women, which are the recommendations of many health organisations,” Schütze told the press.

“And even more cancer cases would be prevented if people reduced their alcohol intake to below recommended guidelines or stopped drinking alcohol at all,” she added.

When alcohol is broken down in the body it turns into acetaldehyde, a compound that damages DNA, which increases the risk of cells becoming cancerous.

For their prospective cohort study, Schütze and colleagues used risk estimates from the European Prospective Investigation into Cancer (EPIC) Study and representative alcohol consumption data compiled by the World Health Organisation (WHO).

EPIC includes data on 363,988 men and women who were followed for cancer since the 1990s. They were mostly aged between 37 and 70 years when they enrolled and completed a detailed questionnaire about their diet and lifestyle. This included specific questions on the amount, frequency and type of any alcoholic drinks they consumed, both around the time of recruitment and in the past.

The results showed that by 2008, current and former alcohol consumption caused about 21,500 cases of cancer in women in the eight countries, and over 80% of these cases (33,000) were due to drinking more than two alcoholic drinks of beer, wine or spirits per day. The cancers caused in women were of the upper digestive tract, liver, colorectum (bowel), and breast.

For men, the results showed that by 2008, current and former alcohol consumption caused about 57,600 cases of cancer of the upper digestive tract, colorectum and liver in Denmark, Greece, Germany, Italy, Spain, and Great Britain, and that more than half of these (33,000) cancers were due to drinking more than two alcoholic drinks per day.

Co-author Naomi Allen, a Cancer Research UK epidemiologist based at Oxford University in the UK said that this study adds to existing evidence that alcohol consumption causes cancer, and that even drinking moderate amounts can increase the risk.

“The results from this study reflect the impact of people’s drinking habits about ten years ago. People are drinking even more now than then and this could lead to more people developing cancer because of alcohol in the future,” said Allen.

Sara Hiom, director of health information at Cancer Research UK, one of the sponsors of the EPIC study, said:

“Many people just don’t know that drinking alcohol can increase their cancer risk.”

The study is expected to strengthen calls for governments to act more firmly to curb alcohol consumption.

Professor Sir Ian Gilmore, chairman of the UK Alcohol Health Alliance and former president of the Royal College of Physicians told the BBC that this study adds to the pile of evidence that shows waiting for people to change their drinking habits, even with the beverage industry voluntarily collaborating in policy making, is not going to change things.

“If we really want to see preventable deaths coming down in the next decade or so, I think there will have to be some form of tougher regulation by government,” he urged.

“Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study.”
Madlen Schütze,Heiner Boeing, Tobias Pischon, Jürgen Rehm, Tara Kehoe, Gerrit Gmel, Anja Olsen, Anne M Tjønneland, Christina C Dahm, Kim Overvad, Françoise Clavel-Chapelon, Marie-Christine Boutron-Ruault, Antonia Trichopoulou, Vasiliki Benetou, Dimosthenis Zylis, Rudolf Kaaks, Sabine Rohrmann, Domenico Palli, Franco Berrino, Rosario Tumino, Paolo Vineis, Laudina Rodríguez, Antonio Agudo, María-José Sánchez, Miren Dorronsoro, Maria-Dolores Chirlaque, Aurelio Barricarte, Petra H Peeters, Carla H van Gils, Kay-Tee Khaw, Nick Wareham, Naomi E Allen, Timothy J Key, Paolo Boffetta, Nadia Slimani, Mazda Jenab, Dora Romaguera, Petra A Wark, Elio Riboli, and Manuela M Bergmann.
BMJ 2011; 342:d1584
Published online 7 April 2011
DOI: 10.1136/bmj.d1584

Additional sources: BMJ, Cancer Research UK, BBC News.

Written by: Catharine Paddock, PhD