Abstract
AbstractIn industrialized countries, alcohol intake is the major cause of cancer of the esophagus, oral cavity, and pharynx. It is also one of the most important risk factors for laryngeal and hepatocellular cancer. Epidemiologic studies are presently investigating a link between alcohol and an increased risk for breast, left‐sided colon, and rectal cancers. Experimental studies have elucidated some of the mechanisms behind these findings. Alcohol‐associated malnutrition and the fundamental changes of alcohol in the metabolism of other nutrients may explain a part of alcohol‐associated carcinogenesis. Alcohol per se is not carcinogenic but its first metabolite, acetaldehyde, is teratogenic, mutagenic, and carcinogenic. Genetic linkage studies suggest that certain polymorphisms and/or mutations in the genes coding for enzymes responsible for acetaldehyde accumulation and detoxification, namely alcohol dehydrogenases and aldehyde dehydrogenases, are associated with an increased cancer risk. These experiments suggest that the major carcinogenic action of alcohol is likely produced by acetaldehyde. Other pathomechanisms of alcohol are being studied as well. Alcohol and alcoholism also influence the treatment of cancer, as alcoholics are at a greater risk of perioperative morbidity and surgical complications.
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