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The Association Between Alcohol & The Risk of Cancer

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Chronic alcohol abuse can increase the risk of various cancers, such as breast cancer, liver cancer, and esophageal.

Many adults enjoy drinking alcohol, but as with anything, moderation is important. Unfortunately, you can develop issues with alcohol abuse without intending to do so. In addition, many adults falsely believe that they don’t exhibit problematic drinking, while in truth the amount of alcohol they consume is considered excessive by the medical community.

Although some would argue that moderate drinking can be relatively safe, there is an increased risk of several significant health issues, such as certain cancers and liver disease, associated with long-term alcohol use. Quitting may reduce some of these risks, although the impact may not be obvious right away.

Moderate Consumption vs. Alcohol Abuse

 You may think that the amount of alcohol you consume makes you a moderate or social drinker; however, the latest consensus on the definition of moderate drinking outlines the following:3

  • For women, no more than one drink per day.
  • For men, no more than two drinks per day.

You may be surprised that your alcohol consumption is greater than these limits noted above. Furthermore, you may also be surprised to learn that alcohol consumption guidelines are different for men and women. However, in general, women have relatively less water in their bodies than men do and, since alcohol distributes throughout water in the body, females more readily attain a higher blood alcohol concentration than their male counterparts based on the same volume of alcohol consumed.1

Some individuals may also be unwitting binge drinkers. What some might characterize as merely an occasional multi-drink session may actually be engaging in a potentially-dangerous form of alcohol abuse, since it can increase the risk of unintentional injuries, alcohol poisoning, violent behaviors, unintended pregnancies, sexually transmitted diseases, and many other detrimental consequences.2 Binge drinking is defined as having enough alcohol to bring your blood alcohol level up to 0.08% or above. This typically occurs after consuming:2

  • 5 or more drinks in 2 hours, for men.
  • 4 or more drinks in 2 hours, for women.

About 17% of U.S. adults report engaging in binge drinking four times per month. Of those who drink excessively, about 90% have reported past-month binge drinking. Binge drinking is more common among males and people aged 18–34.2

There is some evidence that limited alcohol consumption may confer some health benefits. The most well-researched of these benefits is the reduction of cardiovascular disease in moderate drinkers vs. nondrinkers. There is some evidence that people who drink moderately may sleep better, have fewer problems with their weight, and have a lower incidence of developing gallstones.3 As always, it’s best to talk to your doctor about your drinking habits and how they’re impacting your overall health.

Types of Cancer

Alcohol consumption can be linked to an increased risk of cancer in some people. In 2012, it was estimated that worldwide, 5.5% of all new cases of cancer and 5.8% of all cancer deaths could be attributed to alcohol use.4 The categories of cancer most associated with alcohol use are:5

  • Colorectal cancer has also been linked with alcohol consumption. For people who drank 3.5 drinks per day, there was a 1.5 % increased risk of developing colorectal cancer.
  • Breast cancer, which is also associated with alcohol consumption. Women who drank 3 drinks per day had a 1.5 times increased risk of breast cancer than those who did not.
  • Esophageal cancer, with an increase in a type of cancer known as squamous cell carcinoma. This increase is greater in those who genetically lack an enzyme that helps them metabolize alcohol.
  • Head and neck cancers, which include the mouth, larynx, and throat. When a person uses tobacco (which is common among drinkers), the risk of these forms of cancer is significantly higher.
  • Liver cancer, of which alcohol abuse is a major cause.

That being said, according to several studies, alcohol consumption is associated with a reduced risk of two types of cancers: non-Hodgkin lymphoma and kidney cancer. More research is needed to understand how alcohol decreases the risk of these two cancers.5 The health risks of chronic alcohol consumption far outweigh any conferred benefits, and these findings are certainly no reason for anyone to begin drinking.

How Does Alcohol Increase the Odds?

You may be wondering why alcohol increases the risk of cancer. Alcohol is a carcinogen, meaning it is a substance which can cause or promote the development of cancer. A carcinogenic agent can induce a process known as carcinogenesis, which means that healthy cells are turned into cancer cells as the result of cumulative, cellular genetic damage.7

The carcinogenic properties of alcohol mainly occur due to:5

  • The process by which the ethanol in alcohol breaks down into a chemical called acetaldehyde. Acetaldehyde is toxic and a suspected carcinogen. It has the ability to damage cellular proteins and DNA.
  • Another process called oxidation, in which chemically reactive molecules that hold oxygen are produced. These molecules, called free radicals, may harm fats, proteins, and DNA.
  • The alcohol-related decrease in efficiency for metabolizing and fully absorbing nutrients which might otherwise help reduce the risk of cancer, such as carotenoids and vitamins A, B, C, D, and E.
  • The increased level of estrogen in the body caused by alcohol. Estrogen is a hormone associated with an increased incidence of breast cancer.

You may also unknowingly carry a genetic predisposition to develop cancer more easily than others. Some genetic variations that impact a person’s alcohol-related cancer risk are:5

  • Many people of Chinese, Korean, and Japanese heritage carry a gene that, when expressed, codes for a highly active variant of an enzyme known as alcohol dehydrogenase. In people with this variant, this “superactive” form of the enzyme quickly converts alcohol to the toxic chemical acetaldehyde, which builds up before being able to itself be metabolized. Those people of Japanese descent who carry this genetic variation in particular have an increased risk of pancreatic cancer.
  • Aldehyde dehydrogenase is an enzyme that helps metabolize toxic acetaldehyde to nontoxic substances. Many people, especially those of East Asian descent, have a dysfunctional enzyme (encoded for by a variant of the ALDH2 gene) that causes acetaldehyde to build up when they drink alcohol. Most people express this form of the enzyme find that drinking an amount of alcohol that others would consider normal results in symptoms, such as heart palpitations and facial flushing, which makes them very uncomfortable. For this reason, most people with this defective gene don’t have alcohol-related cancer, as they don’t drink as much alcohol. However, some people develop a tolerance to the unwanted side effects and drink large amounts of alcohol. These people have an increased risk of esophageal, head, and neck cancer than those with the functioning enzyme who have similar drinking habits.

How Many Cancer Deaths Result from Alcohol?

In 2009, approximately 3.5% of all cancer deaths (about 19,500 people) in the United States were related to alcohol.8

That same year, between 56% and 66% of all alcohol-related cancer deaths in women were from breast cancer, and between 53% and 71% of alcohol-related cancer deaths in men were from mouth and throat cancers.8

One study found that about 18 years of potential life (based on the average lifespan) were lost for each alcohol-related cancer death.8

Can Quitting Drinking Reduce Your Risk?

Some studies have evaluated the outcome of quitting drinking on a person’s risk of developing cancer. These studies have primarily focused on head and neck cancer and esophageal cancers. The outcomes indicated that the risk of developing cancer is not immediately reduced, and perhaps will take as long as 16 years for the cancer risk to return to the risk level that was present before becoming a heavy drinker.5

Although it will take time to reduce alcohol-related cancer risk, quitting now is better than continuing to drink, as cancer is not the only risk associated with heavy alcohol abuse; drinking can cause many other detrimental consequences on a person’s mental and physical health, social life, occupational or educational life, and interpersonal relationships. The first step towards getting substance abuse treatment is often the hardest, but entering a comprehensive program that can help rectify your problematic drinking patterns and build healthy coping skills is the best choice you can make for your health and happiness.


  1. National Institutes of Health. (N.D.). Rethinking Drinking.
  2. Centers for Disease Control. (2017). Fact Sheets: Binge Drinking.
  3. Harvard University. (2018). Alcohol: Balancing Risks and Benefits.
  4. LoConte, N. K., Brewster, A. M., Kaur, J. S., Merrill, J. K., & Alberg, A. J. (2017). Alcohol and Cancer: A Statement of the American Society of Clinical Oncology. Journal of Clinical Oncology, JCO–2017.
  5. National Cancer Institute. (2013). Alcohol and Cancer Risk.
  6. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  7. Cancer Australia. (2018). Carcinogenesis.
  8. Nelson, D. E., Jarman, D. W., Rehm, J., Greenfield, T. K., Rey, G., Kerr, W. C., … & Naimi, T. S. (2013). Alcohol-Attributable Cancer Deaths and Years of Potential Life Lost in the United States. American Journal of Public Health103(4), 641–648.


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