Alcohol-related Cancer Risk Research Articles

Alcohol-related cancer risk awareness and support for cancer warning labelling among adults in Estonia

ObjectivesThe aim of this study was to describe alcohol-related cancer risk awareness and examine sociodemographic and alcohol-related variance in attitudes towards implementation of cancer warning labelling on alcohol containers in Estonia. Study designNationally representative data from a 2022 cross-sectional survey (n = 2059) among the 15–74-year-old population in Estonia were used. MethodsDescriptive statistics on the prevalence of alcohol-related cancer risk awareness and support for the implementation of cancer risk warning labelling on alcohol containers are presented. Poisson regression analysis was used to investigate whether support for warning labelling varied by sociodemographic variables, individual alcohol consumption and cancer risk awareness indicators. ResultsStudy found that 73.2% of respondents associated alcohol consumption with increased cancer risk for one or more cancer sites, but implementation of alcohol cancer risk labelling was only supported by 54%. Women, younger age groups, non-Estonians and those with lower education level expressed higher support for warning labelling, whereas lower support was found among those with high-risk alcohol consumption. As expected, awareness of alcohol-related cancer risk and perceiving individual alcohol consumption as a cancer hazard were associated with support for warning labelling. ConclusionsThese findings emphasise the need for better communication of alcohol-related cancer risks as public awareness on the link between alcohol consumption and site-specific cancer risk was low. Increased awareness of alcohol as a cancer risk factor would potentially build public support for introducing cancer-risk warning labelling on containers of alcoholic drinks.

"I Thought Cancer was a Tobacco Issue": Perspectives of Veterans with and without HIV on Cancer and Other Health Risks Associated with Alcohol and Tobacco/Nicotine Use.

U.S. Veterans and people living with HIV (PWH) experience higher rates of unhealthy alcohol and tobacco/nicotine use than non-Veterans and people without HIV (PWoH). Both groups are susceptible to adverse health outcomes associated with alcohol and tobacco/nicotine use. We explored awareness of alcohol- and tobacco/nicotine-related cancer and immune health risks among Veterans Health Administration (VA) patients with and without HIV. Among a sample of 41 (46% PWH; 73% male; 39% Black) purposively-selected VA patients receiving care 2020-2021 we conducted semi-structured interviews via telephone; interviews were recorded, transcribed and analyzed using a Rapid Assessment Process. Purposive selection was based on HIV status, alcohol and/or tobacco/nicotine use, and demographics. Among participants, 66% reported current smoking, and most screened positive for unhealthy alcohol use. Participants had high awareness of cancer and other health risks related to smoking but low awareness of synergistic risks and cancer risks associated with alcohol use despite awareness of a range of other alcohol-related risks. Awareness of alcohol and/or tobacco/nicotine's impacts on the immune system was variable. Findings did not distinctly differ between PWH and PWoH. Low awareness of alcohol-related cancer risk, risks of co-occurring use, and varying awareness of the impacts of alcohol and tobacco/nicotine on the immune system suggest a need for improved messaging regarding substance use-related cancer and immune risk. This may be especially important among PWH, for whom the prevalence and adverse effects of alcohol and tobacco use, and immune dysfunction are higher.

Alcohol availability, consumption, and knowledge of alcohol-related cancer risk among citizens of Warsaw

Alcohol availability, consumption, and knowledge of alcohol-related cancer risk among citizens of Warsaw

Cancer incidence among Chernobyl cleanup workers from Estonia: A 34-year follow-up.

From 1986 to 1991, 4831 men from Estonia were sent to clean up radioactively contaminated areas near Chernobyl (Chornobyl). Their cancer incidence during 1986 to 2019 was compared to that of the male population of Estonia. The cohort of cleanup workers was linked to national population and cancer registers based on unique personal identification numbers. Nineteen (0.4%) workers could not be traced. A total of 4812 men contributing 120 770 person-years of follow-up were eligible for the analyses. Standardized incidence ratios (SIR) and adjusted relative risks (ARR, expressed as ratios of SIRs) with 95% confidence intervals (CI) were calculated. A total of 687 incident cancer cases were registered in the cohort (SIR 1.11, 95% CI 1.03-1.19). Presumptive radiation-related cancers combined were in excess, but not when smoking- and alcohol-related cancers were excluded (SIR 0.92, 95% CI 0.71-1.18). For smoking-related cancers, the SIR was 1.24 (95% CI 1.13-1.36) and for alcohol-related cancer the SIR was 1.53 (95% CI 1.31-1.75). Less educated workers had a higher risk of all cancers (ARR = 1.21, 95% CI 1.02-1.44) and smoking-related cancers (ARR = 1.42, 95% CI 1.14-1.76). An elevated risk of alcohol-related cancers was evident 15 to 24 years (vs <15 years) after return from the Chernobyl area. This updated register-based follow-up of Chernobyl cleanup workers from Estonia revealed an excess of radiation-related cancer sites combined, but the excess was not apparent after excluding cancers associated with smoking and alcohol.

Association Between Changes in Alcohol Consumption and Cancer Risk

Although numerous studies have shown an association between alcohol consumption and cancer, how changes in drinking behavior increase or decrease the incidence of cancer is not well understood. To investigate the association between the reduction, cessation, or increase of alcohol consumption and the development of alcohol-related cancers and all cancers. This population-based cohort study analyzed adult beneficiaries in the Korean National Health Insurance Service. Participants (aged ≥40 years) included those who underwent a national health screening in both 2009 and 2011 and had available data on their drinking status. Data were analyzed from April 16 to July 6, 2020. Alcohol consumption level, which was self-reported by participants in health screening questionnaires, was categorized into none (0 g/d), mild (<15 g/d), moderate (15-29.9 g/d), and heavy (≥30 g/d) drinking. Based on changes in alcohol consumption level from 2009 to 2011, participants were categorized into the following groups: nondrinker, sustainer, increaser, quitter, and reducer. The primary outcome was newly diagnosed alcohol-related cancers (including cancers of the head and neck, esophagus, colorectum, liver, larynx, and female breast), and the secondary outcome was all newly diagnosed cancers (except for thyroid cancer). Among the 4 513 746 participants (mean [SD] age, 53.6 [9.6] years; 2 324 172 [51.5%] men), the incidence rate of cancer was 7.7 per 1000 person-years during a median (IQR) follow-up of 6.4 (6.1-6.6) years. Compared with the sustainer groups at each drinking level, the increaser groups had a higher risk of alcohol-related cancers and all cancers. The increased alcohol-related cancer incidence was associated with dose; those who changed from nondrinking to mild (adjusted hazard ratio [aHR], 1.03; 95% CI, 1.00-1.06), moderate (aHR, 1.10; 95% CI, 1.02-1.18), or heavy (aHR, 1.34; 95% CI, 1.23-1.45) drinking levels had an associated higher risk than those who did not drink. Those with mild drinking levels who quit drinking had a lower risk of alcohol-related cancer (aHR, 0.96; 95% CI, 0.92-0.99) than those who sustained their drinking levels. Those with moderate (aHR, 1.07; 95% CI, 1.03-1.12) or heavy (aHR, 1.07; 95% CI, 1.02-1.12) drinking levels who quit drinking had a higher all cancer incidence than those who sustained their levels, but when quitting was sustained, this increase in risk disappeared. Compared with sustained heavy drinking, reduced heavy drinking levels to moderate levels (alcohol-related cancer: aHR, 0.91 [95% CI, 0.86-0.97]; all cancers: aHR, 0.96 [95% CI, 0.92-0.99]) or mild levels (alcohol-related cancer: aHR, 0.92 [95% CI, 0.86-0.98]; all cancers: aHR, 0.92 [95% CI, 0.89-0.96]) were associated with decreased cancer risk. Results of this study showed that increased alcohol consumption was associated with higher risks for alcohol-related and all cancers, whereas sustained quitting and reduced drinking were associated with lower risks of alcohol-related and all cancers. Alcohol cessation and reduction should be reinforced for the prevention of cancer.

Impacts of ADH1B rs1229984 and ALDH2 rs671 polymorphisms on risks of alcohol-related disorder and cancer.

ADH1B rs1229984 and ALDH2 rs671 are the specifically prevalent functional variants in the East Asians. These variants, which result in a dramatic change in enzyme activity, are highly associated with alcohol-related disorders and cancer. Previous studies focusing on the additive and synergic effects of the variants are few and inconsistent. The aim of the research was to evaluate the associations of ADH1B rs1229984 and ALDH2 rs671 with the risks of alcohol-related disorder and cancer. This cohort study enrolled 42,665 participants from the Taiwan Precision Medicine Initiative database, including 19,522 and 20,534, ADH1B and ALDH2 carriers, respectively. The associations between the two variants and cancer risk were analyzed by univariable and multivariable logistic regression. Compared with the noncarriers, the ADH1B rs1229984 variant had a stronger effect on alcohol-related disorders and was related to an increased risk of alcohol-related cancers. The CC genotype of ADH1B rs1229984 was significantly associated with cancer of the larynx, pharynx, and nasal cavities [odds ratio (OR)=1.56, p=0.0009], cancer of the pancreas (OR=1.66, p=0.018), and cancer of the esophagus (OR=4.10, p < 0.001). Participants who carried the rs1229984 TC/CC and rs671 GG genotypes were at higher risk of esophageal cancer (OR=3.02, p < 0.001). The risk of esophageal cancer was increased by 381% (OR=4.81, p < 0.001) in those carrying the rs1229984 TC/CC and rs671 GA/AA genotypes. rs1229984 and rs671 are common and functionally important genetic variants in the Taiwanese population. Our findings provide strong evidence of additive and synergic risks of ADH1B and ALDH2 variants for alcohol-related disorders and cancer. The results suggested that are reduction in alcohol consumption should be advised as a preventive measure for high-risk patients carrying ADH1B rs1229984 C or the ALDH2 rs671 A allele.

Social Media Use and Demographics Predicted Knowledge About Alcohol as a Cancer Risk Factor.

To determine whether social media use, alcohol consumption, and sociodemographic factors predicted Americans' knowledge about alcohol-related cancer risk. Health Information National Trends Survey (2020). United States. A nationally representative sample (N = 3865; response rate = 36.7%). Knowledge about cancer risk of beer, wine, and liquor; social media use; demographics; smoking status; alcohol consumption; and cancer history. Data were analyzed using multinomial multiple logistic regression with jackknife replicate weights. Less than a third of U.S. adults (20.34-31.20%) were aware of cancer risk of alcohol. People who watched health-related YouTube videos were more likely to be well-informed (odds ratio [OR] = 1.55 [95% confidence interval 1.01, 2.36] for beer) and misinformed (OR = 1.68 [1.17, 2.43] for wine). Alcohol consumption predicted higher likelihoods of being misinformed about cancer risk of beer (OR = 1.03 [1.003, 1.05]). People who were older and had less education were less likely to be well-informed for all types of alcohol. Females (for liquor) and Blacks (for beer) were less likely to be well-informed and misinformed. Social media can be a source of both correct information and misinformation about alcohol and cancer risk. Health promotion should target older adults, people with less education, racial minorities, females, and people who consume alcohol.

Alcohol intake trajectories during the life course and risk of alcohol-related cancer: A prospective cohort study.

We examined associations between sex-specific alcohol intake trajectories and alcohol-related cancer risk using data from 22 756 women and 15 701 men aged 40 to 69 years at baseline in the Melbourne Collaborative Cohort Study. Alcohol intake for 10-year periods from age 20 until the decade encompassing recruitment, calculated using recalled beverage-specific frequency and quantity, was used to estimate group-based sex-specific intake trajectories. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated for primary invasive alcohol-related cancer (upper aerodigestive tract, breast, liver and colorectum). Three distinct alcohol intake trajectories for women (lifetime abstention, stable light, increasing moderate) and six for men (lifetime abstention, stable light, stable moderate, increasing heavy, early decreasing heavy, late decreasing heavy) were identified. 2303 incident alcohol-related cancers were diagnosed during 485 525 person-years in women and 789 during 303 218 person-years in men. For men, compared with lifetime abstention, heavy intake (mean ≥ 60 g/day) at age 20 to 39 followed by either an early (from age 40 to 49) (early decreasing heavy; HR=1.75, 95% CI: 1.25-2.44) or late decrease (from age 60 to 69) (late decreasing heavy; HR=1.94, 95% CI: 1.28-2.93), and moderate intake (mean <60 g/day) at age 20 to 39 increasing to heavy intake in middle-age (increasing heavy; HR=1.45, 95% CI: 1.06-1.97) were associated with increased risk of alcohol-related cancer. For women, compared with lifetime abstention, increasing intake from age 20 (increasing moderate) was associated with increased alcohol-related cancer risk (HR=1.25, 95% CI: 1.06-1.48). Similar associations were observed for colorectal (men) and breast cancer. Heavy drinking during early adulthood might increase cancer risk later in life.

Gender differences in the relationship between alcohol consumption and gastric cancer risk are uncertain and not well-delineated.

The role of alcoholic and other beverage consumption in the etiology of gastric cancer is unknown. Several studies have summarized and established a significant association between heavy alcohol consumption and gastric cancer risk, but evidence on alcohol-related cancer risk is conflicting.

Association between ALDH2 rs671 polymorphism and susceptibility to head and neck carcinoma: A meta-analysis

It is known that the polymorphism of genes involved in ethanol metabolism can influence the risk of alcohol-related cancers, mainly head and neck cancers (HNCs). The present meta-analysis aims to assess the association between ALDH2 rs671 polymorphism and susceptibility to HNC, based on genetic models and evaluating 15 case-control studies. Medline, Cochrane Library, Web of Science, and Scopus databases were searched without any restrictions until April 15, 2020. Odds Ratio (OR) was the effect estimate used to demonstrate the association between the gene polymorphism and HNC, RevMan 5.3 software was used to conduct the meta-analysis. The CMA 2.0 software was used to evaluate publication bias through funnel plots and to perform sensitivity analysis and meta-regression. Out of 225 records retrieved through four databases, 15 full-texts were included in the meta-analysis. The pooled ORs for the risk of HNC based on allele, homozygote, heterozygote, recessive, and dominant models of ALDH2 rs671 polymorphism were 1.08 (95% CI: 0.93, 1.24; P = 0.31), 0.64 (95% CI: 0.51, 0.81; P = 0.0002), 1.41 (95% CI: 1.17, 1.71; P = 0.0004), 1.53 (95% CI: 1.15, 2.05; P = 0.003), and 0.56 (95% CI: 0.46, 0.68; P < 0.00001), respectively. The present meta-analysis illustrated an association between ALDH2 rs671 polymorphism and HNC susceptibility. In particular, the GA genotype were linked to high-risk NHC, while the AA genotype was associated with reduced HNC risk.

'Alcohol causes cancer': a difficult message for Australians to swallow.

Alcohol is a modifiable risk factor for cancer. Public awareness of the link between alcohol and cancer risk is poor; thus, alcohol consumers may be unknowingly putting themselves at increased risk of cancer. One way to raise awareness of alcohol-related cancer is through placing labels warning of cancer risk on alcoholic beverage containers; however, little is known about the impact of such labels. We conducted seven focus groups, comprising participants who self-identified as low-to-moderate alcohol consumers, to gauge public attitudes towards the labels and messages relating to alcohol-related cancer risk. Transcripts of discussions were coded to identify emergent themes. Participants expressed a negative response to the alcohol warning labels, and their talk worked to challenge the legitimacy of alcohol-related cancer messages, and the entities responsible for disseminating the information. These responses functioned to counter any implied recommendation for reduction in speakers' alcohol consumption. These findings illustrate how the general population make sense of information about health risks, using this knowledge to make decisions about personal behaviour. In combination with other public health initiatives, alcohol-warning labels have the potential to increase awareness of cancer risk and help in the fight against cancer, but any messaging will need to account for probable consumer resistance.

Does adequate physical activity attenuate the associations of alcohol and alcohol-related cancer mortality? A pooled study of 54 686 British adults.

The potential of physical activity (PA) to attenuate the effects of alcohol consumption on the risks of alcohol-related cancer mortality is unknown. We used data from participants aged 30 years and over in 10 British population-based surveys (Health Surveys for England 1994, 1997, 1998, 1999, 2003, 2004, 2006 and 2008 and the Scottish Health Surveys 1998 and 2003). Alcohol-related cancer mortality included oral cavity, throat, larynx, oesophagus, liver, colorectal, stomach and female breast (conservative definition), and additionally pancreas and lung (broad definition). Alcohol consumption was categorised into six groups based on the UK units/week: (a) never-drinkers, (b) ex-drinkers, (c) occasional drinkers, (d) within guidelines (<14 UK units/week [women]; <21 UK units/week [men]), (e) hazardous (14-35 [women]; 21-49 [men]) and (f) harmful (>35 [women]; >49 [men]). PA was categorised using two dichotomous classifications based on the lower (7.5 Metabolic Equivalent Task [MET]-hours/week) and upper (15 MET-hours/week) recommended limits. Using Cox proportional hazard models, we found a strong direct association between alcohol consumption and mortality risk of alcohol-related cancers, with a significantly higher risk among ex-drinkers (Hazard ratio [HR] = 1.46, 95% confidence interval [CI] = [1.09, 1.94]), drinkers who consumed hazardous (HR = 1.39, 95% CI = [1.06, 1.83]) and harmful amounts of alcohol (HR = 1.62, 95% CI = [1.13, 2.30]) compared to never-drinkers in the fully adjusted model. The increased mortality risks were substantially attenuated when participants in these drinking groups exercised >7.5 MET-hours/week. PA could be promoted as an adjunct risk minimisation measure for alcohol-related cancer prevention.

Baseline Assessment of Alcohol-Related Knowledge of and Support for Alcohol Warning Labels Among Alcohol Consumers in Northern Canada and Associations With Key Sociodemographic Characteristics

Objective:Evidence-informed alcohol warning labels (AWLs) are a promising, well-targeted strategy to increase consumer awareness of health risks. We assessed consumers’ baseline knowledge of alcohol-related cancer risk, standard drinks, and low-risk drinking guidelines as well as levels of support for AWLs. We further assessed associations with sociodemographic factors.Method:Forming part of a larger study testing new evidence-informed AWLs in a northern Canadian territory compared with a neighboring territory, baseline surveys were completed among liquor store patrons systematically selected in both sites. Chi-square and multivariable logistic regression analyses were performed to assess outcomes.Results:In total, 836 liquor store patrons (47.8% female) completed baseline surveys across both sites. Overall, there was low knowledge of alcohol-related cancer risk (24.5%), limited ability to calculate a standard drink (29.5%), and low knowledge of daily (49.5%) and weekly (48.2%) low-risk drinking guideline limits. There was moderate support for AWLs with a health warning (55.9%) and standard drink information (51.4%), and lower support for low-risk drinking guideline labels (38.7%). No sociodemographic characteristics were associated with cancer knowledge. Identifying as female and having adequate health literacy were associated with support for all three AWLs; high alcohol use was associated with not supporting standard drink (adjusted odds ratio = 0.60, 95% CI [0.40, 0.88]) and low-risk drinking guideline (adjusted odds ratio = 0.57, 95% CI [0.38, 0.87]) labels.Conclusions:Few consumers in this study had key alcohol-related health knowledge; however, there was moderate support for AWLs as a tool to raise awareness. Implementation of information-based interventions such as evidence-informed AWLs with health messages including alcohol-related cancer risk, standard drink information, and national drinking guidelines is warranted.

Impact of alcohol drinking on cancer risk with consideration of flushing response: The Japan Public Health Center-based Prospective Study Cohort (JPHC study)

Alcohol drinking is a risk factor for cancer. The degree of risk is increased in subjects showing the flushing response, which is due to aldehyde dehydrogenase 2 (ALDH2) polymorphism. The attributable risk of alcohol drinking for cancer in Japan has not been sufficiently investigated with consideration of flushing response.We followed 78,825 Japanese in JPHC study cohort II. The association between alcohol consumption and cancer incidence was assessed according to self-reported flushing response using Cox proportional hazards regression models. The population-attributable fraction (PAF) of cancer incidence was also estimated. During 1993–2013 (average follow-up, 16.8 years), 8486 incident cancers (included 4386 alcohol-related cancers) were reported. Half of men and 36% of women had flushing response. In men with flushing response, moderate or higher alcohol drinking increased the risk of alcohol-related cancers compared with non-drinkers (150–299 g/week, HR 1.63, 95% CI, 1.43–1.99; 300–449 g/week, HR 2.02 95% CI, 1.67–2.44; ≥450 g/week, HR 1.75, 95% CI, 1.39–2.21). When flushing response was considered in comparisons between non-drinkers and non-flushers, non-flushing heavy drinkers had a slightly higher PAF than flushers (all cancers: flushers, 2.0% and non-flushers, 2.2%; alcohol-related cancers: flushers, 3.8% and non-flushers, 5.8%). Although the risk of alcohol-related cancer in men with flushing response increased with increasing alcohol consumption, heavy drinkers were also at high risk regardless of flushing response. Considering the PAF of alcohol consumption on cancer, efforts to discourage heavy alcohol consumption to reduce the incidence of alcohol-related cancers appear warranted regardless of flushing response.

A comparison of gender-linked population cancer risks between alcohol and tobacco: how many cigarettes are there in a bottle of wine?

BackgroundIn contrast to our knowledge about the number of cancers attributed to smoking, the number of cancers attributed to alcohol is poorly understood by the public. We estimate the increase in absolute risk of cancer (number of cases per 1000) attributed to moderate levels of alcohol, and compare these to the absolute risk of cancer attributed to low levels of smoking, creating a ‘cigarette-equivalent of population cancer harm’.MethodsAlcohol and tobacco attributable fractions were subtracted from lifetime general population risks of developing alcohol- and smoking-related cancers, to estimate the lifetime cancer risk in alcohol-abstaining non-smokers. This was multiplied by the relative risk of drinking ten units of alcohol or smoking ten cigarettes per week, and increasing levels of consumption.ResultsOne bottle of wine per week is associated with an increased absolute lifetime cancer risk for non-smokers of 1.0% (men) and 1.4% (women). The overall absolute increase in cancer risk for one bottle of wine per week equals that of five (men) or ten cigarettes per week (women). Gender differences result from levels of moderate drinking leading to a 0.8% absolute risk of breast cancer in female non-smokers.ConclusionsOne bottle of wine per week is associated with an increased absolute lifetime risk of alcohol-related cancers in women, driven by breast cancer, equivalent to the increased absolute cancer risk associated with ten cigarettes per week. These findings can help communicate that moderate levels of drinking are an important public health risk for women. The risks for men, equivalent to five cigarettes per week, are also of note.

Effectiveness of Warning Labels at Increasing Awareness of Alcohol-Related Cancer Risk Among Heavy Drinkers

Background: Although alcoholic beverages were classed as a Group 1 carcinogen over a quarter of a century ago, there is a lack of public awareness of this cancer risk relative to other alcohol-related risks. Increasing drinkers’ awareness of the cancer risk associated with alcohol consumption has therefore been identified as an important component of alcohol harm minimization strategies, with mandatory health warning labels on alcoholic beverage containers considered an important component of such strategies. Aim: To assess the overall effectiveness of a warning statement advising of the cancer risk associated with alcohol consumption and effectiveness relative to statements advising of other health risks. Methods: An online survey was administered to 364 Australians (72% male) who reported drinking at levels associated with long-term risk of harm. Respondents were randomly exposed to one of five statements relating to the risks associated with alcohol consumption (cancer, liver damage, diabetes, mental illness, heart disease). Pre and post measures of risk beliefs and drinking intentions were taken. Results: Exposure to a warning statement advising of the cancer risk associated with alcohol consumption resulted in (i) a significant increase in the extent to which respondents exposed to that statement believed alcohol to be a risk factor for cancer and (ii) a significant reduction in consumption intentions. Exposure to the cancer risk statement was associated with the second largest pre to post change in consumption intentions behind the diabetes risk statement. Conclusion: Warning statements informing drinkers of the cancer risk associated with alcohol consumption can produce (i) increases in the awareness of alcohol-related cancer risk and (ii) favorable changes in drinking intentions.

National Cancer Societies and their public statements on alcohol consumption and cancer risk.

Studies have shown that alcohol consumption is a risk factor for oral, pharyngeal, laryngeal, esophageal, liver, colon, rectal and breast cancer. It would therefore be expected that cancer prevention organizations would incorporate these facts into their public stance on the consumption of alcohol. The aims of this study were to: (1) assess how national cancer societies in developed English-speaking countries [i.e. English-speaking countries belonging to the Organization for Economic Co-operation and Development (OECD)] communicate alcohol-related cancer risk to the public and (2) compare whether these organization's advocacy of increased alcohol taxes is in line with their advocacy of tobacco tax increases to reduce cancer risk. We searched the websites of the following national cancer organizations for all statements related to the relationship between alcohol consumption and cancer risk: Cancer Council Australia, Canadian Cancer Society, Irish Cancer Society, Cancer Society New Zealand, Cancer Research UK and the American Cancer Society. A categorical system was developed to code the qualitative data for health statements, alcohol consumption recommendations, and tax policy recommendations. Websites were analyzed in March of 2017. All organizations, with the exception of the American Cancer Society and Canadian Cancer Society, state that alcohol is a group 1 carcinogen and that even low-level alcohol consumption increases risk for some cancers. Additionally, while the American Cancer Society supports increasing tobacco taxes through its cancer action network, it has not advocated for increased alcohol taxes in relation to support for tobacco tax increases. Analysis in 2017 of the websites for national cancer societies in Australia, Canada, Ireland, New Zealand, the United Kingdom and the United States-including Cancer Council Australia, the Canadian Cancer Society, the Irish Cancer Society, Cancer Society New Zealand, Cancer Research UK and the American Cancer Society-shows that only the American Cancer Society and Canadian Cancer Society websites fail to state that alcohol is a group 1 carcinogen and can cause cancer at low doses, and that there is no safe threshold for cancer risk.

Roles of defective ALDH2 polymorphism on liver protection and cancer development.

Because serum transaminases elevate alcohol dose dependently as a consequence of liver injury, they serve as useful biological markers of excessive drinking. However, these markers are inadequate in individuals with a defective allele of the aldehyde dehydrogenase 2 gene, ALDH2*2, because they show a different correlation with the amount of ethanol. For example, the serum alanine aminotransferase (ALT) level could become even lower than the baseline after alcohol intake in ALDH2*2 carriers. In fact, multiple studies suggest that ALDH2*2 is a hepato-protective factor in healthy individuals. Importantly, excessive drinking is particularly dangerous in carriers of ALDH2*2 because the risk of alcohol-related cancer is much higher than that for ALDH2*1/*1 carriers. Without recognizing the genotype interaction on serum transaminase, the opportunity to warn people about potential cancer risks is missed owing to incorrect interpretation. This is particularly important in East Asian countries where approximately half of the population carries the ALDH2*2 allele. To date, the mechanism of liver protection from ethanol load in individuals with ALDH2*2 has not been fully elucidated. However, some reasonable mechanisms have been suggested by experimental studies, including remodelling of detoxifying systems. Further studies to uncover the whole mechanism are anticipated.

‘Everything causes cancer’: how Australians respond to the message that alcohol causes cancer

Over 5000 Australians are diagnosed with alcohol-related cancers annually, with growing evidence that low-levels of chronic alcohol consumption significantly increases cancer risk. Public knowledge of the link between alcohol and cancer is limited and, therefore, alcohol consumers may be inadvertently putting themselves at increased risk of developing cancer. Informing the community of alcohol-related cancer risk is important to reduce the burden of disease, however, the message that alcohol causes cancer may challenge current understanding of the risks and benefits associated with alcohol consumption. We examine how Australian adults who self-identify as light-to-moderate alcohol consumers, respond to the message that alcohol causes cancer. Seven focus groups with males and females aged between 18 and 65 years of age were audio–visually recorded, with transcripts thematically analysed within a social constructionist epistemology informed by critical realism. Cancer was represented as an inevitable part of life and something over which participants had no control: consequently, altering alcohol consumption to reduce cancer risk was not justifiable. Participants worked to present themselves as ‘normal’ consumers of alcohol by recounting personal experiences and depicting an obligation to uphold societal expectations to consume alcohol. Through the construction of cancer as an inescapable disease, and their own alcohol consumption as unproblematic and socially sanctioned, participants were able to resist the message that alcohol causes cancer, and any implied need to alter personal alcohol consumption to reduce the risk of cancer.

Light to moderate intake of alcohol, drinking patterns, and risk of cancer: results from two prospective US cohort studies

Objectives To quantify risk of overall cancer across all levels of alcohol consumption among women and men separately, with a focus on light to moderate drinking and never smokers; and...