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December 13, 2019

Alcohol and Cancer Risk: Clinical and Research Implications

Author Affiliations
  • 1Behavioral Research Program, National Cancer Institute, Bethesda, Maryland
  • 2Healthcare Delivery Research Program, National Cancer Institute, Bethesda, Maryland
  • 3Epidemiology and Genomics Research Program, National Cancer Institute, Bethesda, Maryland
JAMA. 2020;323(1):23-24. doi:10.1001/jama.2019.19133

Ample evidence has been available for some time indicating that alcohol use is a preventable risk factor for cancer, and the World Health Organization deemed alcohol a carcinogen more than 30 years ago. In the United States, it is estimated that 5.6% of incident cancer cases (approximately 87 000 each year) are associated with alcohol, including cancers of the oral cavity, pharynx, larynx, liver, esophagus (squamous cell carcinoma), female breast, and colorectum.1 Type of alcohol does not appear to matter; all alcoholic beverages include ethanol, which increases levels of acetaldehyde and in turn promotes DNA damage. Moreover, even moderate levels of consumption (often defined as approximately 14-28 g/d, the equivalent of about 1-2 drinks) appear to be associated with higher risk of some cancers, including cancers of the female breast.2 A protective association has emerged for some cancers, with the most evidence for kidney, Hodgkin lymphoma, and non-Hodgkin lymphoma.2 Nonetheless, the overall cancer burden associated with alcohol use is substantial and comparable with that of other preventable risk factors such as UV exposure and excess body weight.

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