Alcohol and cancer: Marcy's emergency call

Surgeon General Vivek Murthy, MD, MBA, last week called for cancer warnings to be included on alcohol labels, noting that at least the following links exist: 7 types of cancer.¹

U.S. Dietary Guidelines for Americans will be updated soon, with the latest guidelines covering 2020 to 2025²— Action from Congress is needed to make this change, and past research shows that “habitual to mild to moderate alcohol consumption is associated with lower mortality rates, coronary artery disease, diabetes, congestive heart failure, and stroke.” It has been shown that there is a potential relationship between³ There is a renewed debate about both the benefits and risks of moderate drinking.¹

In 1987, the World Health Organization's International Agency for Research on Cancer first classified alcohol as a human carcinogen, citing ethanol's rapid metabolism to acetaldehyde as the main reason.⁴ According to the CDC, this naturally occurring byproduct, when manufactured artificially, is used to make industrial chemicals and as a solvent in the paper industry, among other things.⁵– Can damage DNA through cuts and changes and may have genotoxic properties, or the ability to induce changes (mutations) in the genetic material of cells.⁶

“Alcohol is a well-established and preventable cause of cancer…yet, the majority of Americans are unaware of this risk,” says Vivek H. Murthy, MD, MBA | Image credit: © HHS

In his call to action, Murthy cited research showing a correlation between recommended guidelines for alcohol consumption and the seven types of cancers mentioned above (oral cavity, pharynx, larynx, esophagus, colorectal, liver, and breast). .^1,4 Her report also distinguishes between absolute and relative risks, which she explains differ within men and women, and even between the sexes.¹ For example, if you drink less than one drink a week, the absolute risk of breast cancer for women is about 11.3%, but for men, the absolute risk of alcohol-related cancer is closer to 10%. For two drinks a day, the risk jumps to 15.3% and 13%, respectively.

Overall, alcohol is the third leading cause of preventable death after tobacco and obesity.¹

“Alcohol is a well-established cause of preventable cancer, accounting for approximately 100,000 cancer cases and 20,000 cancer deaths annually in the United States; “Alcohol-related traffic deaths account for more than 13,500 people each year, yet the vast majority of Americans are unaware of this risk,” Murthy said. in a statement. “This advisory raises awareness of the cancer risks of alcohol and sets out steps we can all take to minimize harm.”⁷

However, a new presidential administration will be inaugurated on January 20th, and health leaders may be included under it. General surgeon candidate Dr. Janet Neshewat, Candidate for Secretary of Health No one knows whether Robert F. Kennedy Jr., Marcy's recommendations will come true.

What we do know is that the updated dietary guidelines will incorporate research from two scientific reviews on alcohol consumption. When developing the current guidelines, the authors considered evidence showing that alcohol is a carcinogen, but ultimately the potential for limiting men's daily intake to one standard drink omitted recommendations. In other words, the daily limit remained at two drinks.¹ However, the definition of a standard drink depends on the amount of alcohol consumed, according to the National Institute on Alcohol Abuse and Alcoholism. For example, a standard glass of wine (5 fluid ounces) contains about 12% alcohol. Brandy or Cognac (1.5 fl oz), 40% alcohol. Fortified wine (3-4 fl oz), 17% alcohol.⁸

Globally, only 47 countries have alcohol warning labels, but only South Korea has a specific warning about liver cancer.¹ Ireland will start using labels on beer, wine and spirits in 2026 warning of the direct link between alcohol and deadly cancer.⁹

Current alcohol warning labels in the United States only warn that pregnant women should not drink alcohol and that alcohol impairs the ability to safely operate machinery or drive a vehicle.¹⁰ It hasn't changed since 1988.¹ Murthy's push comes amid a determined pushback from the alcohol industry, which has historically pushed back against labels that mention links to cancer.

References

1. Rabin RC. The Surgeon General has issued a cancer warning against alcohol. new york times. January 3, 2025. Accessed January 6, 2025. https://www.nytimes.com/2025/01/03/health/alcohol-surgeon-general-warning.html

2. United States Department of Agriculture. Dietary Guidelines for Americans, 2020-2025, 9th edition. Accessed January 6, 2025. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_guidelines_for_Americans_2020-2025.pdf

3. O'Keefe JH, Batty SK, Bajwa A, DiNicolantonio JJ, Lavie CJ. Alcohol and cardiovascular health: The amount you consume can be both poison and medicine. Mayo Clin Procedure. 2014;89(3):382-393. doi:10.1016/j.mayocp.2013.11.005

4. IARC Cancer Prevention Handbook, Volume 20A: Reducing or Ceasing Alcohol Intake: Questions and Answers. World Health Organization. Accessed January 6, 2025. https://www.iarc.who.int/faq/iarc-handbooks-of-cancer-prevention-volume-20a-reduction-or-cessation-of-alcohol-consumption/#:~:text=In%201987% 2C%20the%20IARC%20Book,%20Human%20(Group%201)

5. Acetaldehyde. Australian Government Department of Climate Change, Energy, Environment and Water. Accessed January 6, 2025. https://www.dcceew.gov.au/environment/protection/npi/substances/fact-sheets/acetaldehyde

6. Update 55: Carcinogenicity of acetaldehyde and malonaldehyde and mutagenicity of related low molecular weight aldehydes. National Institute for Occupational Safety and Health. September 1991. Accessed January 6, 2025. https://www.cdc.gov/niosh/docs/91-112/default.html

7. The U.S. Surgeon General has issued new recommendations regarding the link between alcohol and cancer risk. H.H.S. News release. January 3, 2025. Accessed January 6, 2025. https://www.hhs.gov/about/news/2025/01/03/us-surgeon-general-issues-new-advisory-link-alcohol-cancer-risk.html

8. Health Effects of Alcohol: What is the Standard Drink? National Institute on Alcohol Abuse and Alcoholism. Updated December 2024. Accessed January 6, 2025. https://www.niaaa.nih.gov/alcohols-Effects-health/what-standard-Drink

9. Alcorn T. Should alcoholic beverages have cancer warning labels? New York Times. April 9, 2024. Accessed January 6, 2025. https://www.nytimes.com/2024/04/09/health/alcohol-cancer-warning.html

10. Surgeons warn of cancer risks from alcoholic drinks. CBS News. January 4, 2025. Accessed January 6, 2025. https://www.cbsnews.com/news/surgeon-general-alcohol-cancer-risk-warning-label-beverages/#:~:text=Warning%20labels%20are%20currently%20required,and%20may%20cause% 20Health%20Problems.%22