Alcohol and Cancer Risk: Can Alcohol Increase Your Risk for Cancer?

Liver cirrhosis is a well-known disease caused by chronic heavy alcohol use. However, you may not have known that alcohol and cancer risk are connected closely. The Centers for Disease Control and Prevention (CDC) considers heavy alcohol use a significant risk factor for cancer.1 Fortunately, there are things you can do to lower your likelihood.

In this article:

Correlation Between Alcohol and Cancer Risk

Alcohol impacts and impairs several bodily processes. In turn, this contributes to cancer risks. Roughly 740,000 cases of cancer throughout the world in 2020 were caused directly by imbibing alcohol.2

What is Acetaldehyde?

Your body metabolizes alcohol into a chemical called acetaldehyde. This chemical damages your DNA and impedes your ability to repair the damage.1

Because your DNA controls the normal growth and function of cells, if damaged, it can fail to control their growth rate. This can create a cancer tumor.1

The Role of Oxidative Stress

Scientists also know acetaldehyde binds itself to certain proteins. For example, one protein called glutathione plays a part in reducing oxidative stress. When acetaldehyde binds to glutathione, it can change it in such a way that it cannot reduce oxidative stress as well.2

Oxidative stress occurs when free radicals in the body exceed the antioxidants that control them.3 Free radicals remain critical because they destroy viruses, bacteria, and damaged cells. At the same time, they damage DNA and various parts of the cells in your body as well.4 This DNA damage may lead to cancer.

Your body generates free radicals naturally as byproducts of normal cellular processes. However, your body also needs enough antioxidants to disarm them and help minimize the damage they can cause. Your body produces some antioxidants, and vitamins C and E in the food you eat supplement these.4

When Inflammation Rises

Alcohol use also can increase inflammation; in turn, inflammation can progress cancer development. Alcohol does this by promoting white blood cell production of pro-inflammatory proteins.2

Inflammation is the normal reaction of your body to stress or foreign invaders like bacteria. Once a wound is healed, the inflammation ends. However, with chronic inflammation, the process might begin even without injury and does not end when it should. Over time, chronic inflammation can cause DNA damage, possibly leading to cancer.5

Scientists also speculate that pro-inflammatory proteins help accumulate white blood cells in the liver, leading to even more inflammation.2

Can Alcohol Harm the Immune System?

Alcohol has various adverse effects on your immune system. One way is that it disrupts protein production needed for immune cells to function. Alcohol also stops these immune cells from being released into your body.2

Using alcohol disrupts your immune system by activating cells associated with liver injury. Finally, alcohol can curb white blood cell count, in turn decreasing the anti-tumor function of your immune system and increasing the risk of cancer.2

Scientists have linked alcohol to several different cancers, including cancer of the esophagus, colon cancer, liver cancer, breast cancer, stomach cancer, pancreatic cancer, prostate cancer, and oral cancers (head and neck cancers).2

Alcohol and Breast Cancer

Having three or more drinks per day can increase your risk of breast cancer by 40% to 50%. Alcohol increases estrogen levels to such an extent that it can harm breast tissue.6

Some cancer cells depend on estrogen to grow, making estrogen receptors that grab onto the estrogen floating in your blood. This process can function as fuel to grow the cancer.7

A scientific review of various studies found that consumers of alcohol had increased risks for breast tumors associated with estrogen.2

Alcohol and Prostate Cancer

Studies that have examined the link between alcohol use and prostate cancer have had mixed results. However, a recent longitudinal twin study of 11,372 Finnish twins found that moderate and heavy drinkers had a greater prostate cancer risk when compared to light drinkers. Because this was a twin study, the scientists controlled for genetics and concluded that alcohol significantly increased the risk for cancer.8

Alcohol and Cancer Risk from Liver Cirrhosis

Heavy alcohol use can cause liver cirrhosis, which shows as lesions in the liver. These lesions can lead to cancerous growth in the liver.2

Alcohol and Colon Cancer

The research findings for the relationship between alcohol consumption and colon cancer also have been inconsistent. However, one study used a U.S. representative sample of 10,220 individuals. Researchers followed these participants for over a decade.9

This study found that those participants who had one or more alcoholic beverages per day had about a 70% greater risk of colon cancer. Additionally, those who drank for more than 34 years had a risk of colon cancer greater than 70% compared to non-drinkers.9

Alcohol and Stomach Cancer

While no direct causal link was established, one study found the probability of stomach cancer increased with heavy drinking. Light or moderate drinking habits did not show higher risk factors, but in a non-linear dose-analysis, daily heavy drinking exceeding 45 grams of alcohol showed greater chances for stomach cancer development.2

Alcohol and Oral Cancers

Most research on alcohol and cancer only verifies that alcohol use puts you at greater risk. Various concerns about research methodology make it difficult to determine that alcohol was the cause of the cancer.2

However, in a recent study, researchers used statistical analysis so they could explore causality. This study included 6,034 oral cancer cases and 6,585 control subjects. The researchers found that alcohol use did have a causal impact on oral cancers. They found this to be the case even after controlling for cigarette smoking.10

Given that they found this causal link between alcohol use and colon cancer, the researchers speculate that previous studies may have underestimated how much alcohol use can cause cancer.10

Alcohol and Pancreatic Cancer

As with stomach cancer, pancreatic cancer did not show significant spikes in risk rates for light to moderate alcohol use. However, one study speculated that with daily doses exceeding a 60-gram threshold, the chances of pancreatic cancer could increase. This was corroborated by another study that found heavy drinking increased the risk rate for pancreatic cancer significantly.2

Additional Risk Factors for Cancer

In addition to alcohol use, other risk factors for cancer include:11

  • Age
  • Diet
  • Obesity
  • Sunlight and other sources of radiation
  • Infectious agents such as viruses, bacteria, and parasites

Using alcohol impacts cancer risk in conjunction with other factors. These include tobacco use, immunosuppression, and additional illnesses.11,12,13

Tobacco Use

A review of research literature concluded that using both alcohol and tobacco amplifies their effects, including cancerous ones, on the liver and the upper digestive and respiratory tract. The latter includes the oral cavity, pharynx, larynx, and esophagus.12

Immunosuppression

Providers prescribe immunosuppressive drugs to patients who have organ transplants. The purpose of these drugs is to repress your immune system so that your body does not reject the organ. At the same time, these drugs make your body less able to fight off infections or detect and destroy cancer cells.11

For someone with a liver transplant, relapse to alcohol use harms the immune system further and develops cirrhosis of the new liver. In addition, one study with 128 liver transplant patients found that those who drank heavily post-transplant (26 patients) also had poor compliance with their immunosuppressive drugs.13

Thus, it is possible that not taking the needed drugs was related to the heavy alcohol use in this study. All liver rejection episodes were related to poor compliance with the immunosuppressive drugs.13

Co-occurring Illnesses

Since chronic inflammation could lead to cancer, those with certain chronic inflammatory diseases have an increased risk of cancer. For example, those with the bowel diseases such as ulcerative colitis and Crohn’s disease are at increased risk for colon cancer.5

Moreover, alcohol can cause the depletion of gut bacteria that have anti-inflammatory functions. This can lead to both intestinal and liver damage. Cigarette smoking changes gut bacteria that can have a protective effect concerning ulcerative colitis and Crohn’s disease. Scientists speculate that there is a relationship between how alcohol and cigarette smoking together change gut bacteria but more research is needed.14

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If you notice any signs or symptoms of alcohol-related cancers, it is vital to tell your primary care provider so that:

  • You can be tested for cancer because early detection is key for a better prognosis
  • You can learn prevention measures to reduce your cancer risk

Signs of Alcohol-Related Cancers

Signs of potential cancer or risk of cancer that you should report to your doctor include:15,16,17

  • Gastric reflux
  • Breast lumps or changes in skin appearance and texture
  • Enlarged prostate
  • Changes in bowel habits, blood in stool, diarrhea, constipation, abdominal pain or cramps, or unexplained weight loss
  • Nausea, loss of appetite, heartburn, or feeling bloated after eating
  • Lump or pain on right side of stomach
  • Jaundice
  • Reoccurring stomach ulcers
  • Abdomen pain that spreads to the back
  • Rash on face, stomach, or legs
  • High or low blood pressure
  • Blood clots in lungs, arms, or legs
  • Sore tongue or sores on mouth corners
  • Headache, some vision loss, or a lump of fat on the back of the neck
  • Easy bruising, stretch marks on chest or abdomen
  • Fine hair growth on face, upper back, or arms
  • Sore throat, persistent cough, trouble swallowing, ear pain, lump in neck or throat, a change or hoarseness in voice
  • Anxiety, irritability, and depression

Note that this is not an exhaustive list of potential signs or symptoms of the various cancers, so it is best to report anything new or unusual to your provider.15

How to Reduce Using Alcohol and Cancer Risk

You may have heard that drinking red wine helps prevent cancer. However, researchers have found no link between drinking red wine in moderation and risk for prostate or colorectal cancer.11

In addition to reporting physical signs to your doctor, there are things related to your alcohol use that you can do to help lower your cancer risk. Follow guidelines for safe and moderate drinking and seek treatment if you are concerned about your alcohol use.1

Guidance to Reduce Alcohol Use

Do not drink at all if you:

  • Are under the legal drinking age
  • Are pregnant or may become pregnant
  • Have health problems worsened by alcohol consumption
  • Engage in dangerous behaviors, such as drinking and driving
  • Are recovering from an alcohol use disorder (AUD) or find it hard to control how much you drink

Though research has found that alcohol use remains strongly linked to various types of cancer, it is never too late to reduce your risk. Though it may take some time, abstinence or even reducing drinking can reduce your risk for cancer.1,11 By seeking treatment for alcohol issues and eliminating or reducing your use, you give yourself a greater chance of facing a healthier future.

For assistance with finding alcohol addiction treatment programs or providers, please call 800-839-1686Who Answers? to speak to one of our specialists.

Resources

  1. Centers for Disease Control and Prevention. (2019, July 8). Alcohol and cancer.
  2. Rumgay, H., Murphy, N., Ferrari, P., & Soerjomataram, I. (2021). Alcohol and cancer: Epidemiology and biological mechanisms. Nutrients, 13(9), 1-13.
  3. Pizzino, G., Irrera, N., Cucinotta, M., Pallio, G., Mannino, F., Arcoraci, V., Squadrito, F., Altavilla, D., & Bitto, A. (2017). Oxidative stress: Harms and benefits for human health. Oxidative Medicine and Cellular Longevity, 2017, 1-13.
  4. Harvard Medical School. (2019, January 31). Understanding antioxidants. Harvard Health Publishing.
  5. National Institutes of Health. (2015, April 29). Chronic inflammation. National Cancer Institute.
  6. Seitz, H.K., Pelucchi, C., Bagnardi, V., & Vecchia, C.L. (2012). Epidemiology and pathophysiology of alcohol and breast cancer: Update 2012. Alcohol and Alcoholism, 47(3), 204-212.
  7. University of Rochester Medical Center. (n.d.). Immunohistochemical test for estrogen and progesterone receptors.
  8. Dickerman, B.A., Markt, S.C., Koskenvuo, M., Pukkala, E., Mucci, L.A., & Kaprio, J. (2016). Alcohol intake, drinking patterns, and prostate cancer risk and mortality: A 30-year prospective cohort study of Finnish twins. Cancer Causes Control, 27, 1049-1058.
  9. Su, L.J., & Arab, L. (2004). Report: Alcohol consumption and risk of colon cancer: Evidence from the national health and nutrition examination survey I epidemiologic follow-up study. Nutrition and Cancer, 50(2), 111-119.
  10. Gormley, M., Dudding, T., Sanderson, E., Martin, R.M., Thomas, S., Tyrrell, J., Ness, A.R., Brennan, P., Munafo, M., Pring, M., Boccia, S., lshan, A.F., Diergaarde, B., Hung, R.J., Liu, G., Smith, G.D., & Richmond, R.C. (2020). A multivariable Mendelian randomization analysis investigating smoking and alcohol consumption in oral and oropharyngeal cancer. Nature Communications, 11, 1-10.
  11. National Institutes of Health. (2015, December 23). Cancer causes and prevention. National Cancer Institute.
  12. Pelucchi, C., Gallus, S., Garavello, W., Bosetti, C., & La Vecchia, C. (2008). Alcohol and tobacco use, and cancer risk for upper aerodigestive tract and liver. European Journal of Cancer Prevention, 17(4), 340-344.
  13. Pageaux, G., Bismuth, M., Perney, P., Costes, V., Jaber, S., Possoz, P., Fabre, J., Navarro, F., Blanc, P., Domergue, J., Eledjam, J., & Larrey, D. (2003). Alcohol relapse after liver transplantation for alcoholic liver disease: does it matter? Journal of Hepatology, 38(5), 629-634.
  14. Capurso, G., & Lahner, E. (2017). The interaction between smoking, alcohol and the gut microbiome. Best Practice and Research Clinical Gastroenterology, 31(5), 579-588.
  15. National Institutes of Health. (n.d.). Cancer types. National Cancer Institute.
  16. National Institutes of Health. (2022, January 12). Breast self-exam. Medline Plus.
  17. Centers for Disease Control and Prevention. (2021, February 8). Colorectal (colon) cancer.

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