The strong link between cancer and alcohol

Around one in six deaths annually worldwide are due to cancer. As more countries adopt ‘Western’ lifestyles, by 2035 the number of new cancer cases worldwide is expected to rise to 24 million per year. Our latest report, Diet, Nutrition, Physical Activity and Cancer: a Global Perspective collates, reviews and analyses decades of research on diet, weight, physical activity and cancer risk and survivorship. This report reviews studies on 17 different cancers, comprising 51 million people, of whom 3.5 million were diagnosed with cancer. It identified six cancers linked to drinking alcohol:

• Oesophageal;
• Mouth, pharynx and larynx;
• Liver;
• Bowel;
• Breast;
• Stomach.

Importantly, the new report found strong evidence for a link between alcohol consumption and cancer, irrespective of the type of alcoholic drink consumed. And furthermore, concluded that even small amounts of alcoholic drinks can increase the risk of some cancers. There is no level of consumption below which there is no increase in the risk of at least some cancers.

There are a diverse number of mechanisms and pathways which link alcohol to cancer development. For example, acetylaldehyde, the toxic product of alcohol breakdown in the body, can be carcinogenic to some cells, such as those lining the bowel. Alcohol can also act as a solvent and allow dietary and environmental carcinogens to enter the cells and cause damage. In addition, alcohol is linked to changes in hormone metabolism, which can increase the levels of certain hormones in the body which in turn are linked to cancer development.

Other key findings from our new report include an emphasis on a more holistic approach to lifestyle for cancer prevention, as it appears increasingly unlikely that specific foods, nutrients or other components of foods are themselves important singular factors in causing or protecting against cancer. Instead, different patterns of diet and physical activity combine to create a metabolic state that is more, or less, conducive to the acquisition of cancer. Therefore the more closely you follow our Cancer Prevention Recommendations, the better.

The response from the general public

The mainstream press coverage of our report did focus on the findings for alcohol. However, instead of the usual ‘expert interference’ narrative that is often used when evidence suggests limiting or avoiding alcohol consumption, the coverage was fairly neutral and often even positive. This could reflect changing attitudes towards alcohol and health, particularly amongst young people. According to a 2017 ONS study, more than a quarter of 16- to 24-year-olds are teetotal, four-fold higher than the rest of the population.

What policy action can be taken?

The new policy brief that accompanies our latest cancer prevention report outlines why public policy is critically important to preventing cancer and other diet-related non-communicable diseases (NCDs). It presents a new policy framework – developed to address diet, physical activity, breastfeeding and alcohol consumption – to support governments in taking action to create environments conducive for people and communities to follow our Cancer Prevention Recommendations.

In brief, we call on governments to:

• Provide national leadership in NCD prevention and take a comprehensive approach.
• Focus on implementation to help achieve the 2025 NCD targets and 2030 Sustainable Development Goals.
• Monitor and evaluate implemented policy actions and communicate lessons learned.

The bottom line

We know that around 40 per cent of cancer cases are preventable. After not smoking, eating a healthy diet, being more active each day and maintaining a healthy weight are the most important ways you can reduce your cancer risk. However, as our latest report indicates, the quality of diet and levels of activity of most people living in Western societies do not encourage healthy ageing. So with an ageing global population, this is expected to have a further impact on increasing cancer rates unless action is taken now. We cannot afford to be complacent.