Does alcohol increase the risk of cancer?
As part of Cancer Prevention Action Week (23–29 June), World Cancer Research Fund is shining a spotlight on alcohol and cancer. By being confident in the evidence behind the risks and in having conversations with patients about alcohol consumption, health professionals can play a vital role in supporting people to reduce their risk of cancer.
Alcohol is a causal factor in more than 200 medical conditions, including liver disease (cirrhosis, fatty liver, alcoholic hepatitis), pancreatitis, infectious diseases, cardiovascular disease and early dementia. In fact, alcohol is the biggest risk factor for death, ill-health and disability for people aged 15–49 in the UK and the fifth biggest risk factor across all ages.
Alcohol is classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC), meaning there is sufficient evidence to show it causes cancer in humans. Other Group 1 carcinogens include UV radiation and tobacco smoke. It has been shown to increase the risk of seven types of cancer: oesophageal, mouth and throat, breast, liver, stomach and bowel.
The evidence on alcohol and cancer risk
The extent to which alcohol is a cause of various types of cancer depends on the amount and frequency of consumption.
In the UK, alcohol causes around 17,000 cases of cancer each year and is the largest attributable risk factor for breast cancer in women, accounting for 8.2% of cases. Among men, 13% of colorectal cancer risk is associated with alcohol consumption.
There is strong evidence that consuming:
Any number of alcoholic drinks INCREASES the risk of:
- mouth, pharynx and larynx cancers
- oesophageal cancer (squamous cell carcinoma)
- breast cancer (pre- and postmenopausal)
Two or more alcoholic drinks a day (30 grams or more) INCREASES the risk of:
- colorectal cancer
Three or more alcoholic drinks a day (45 grams or more) INCREASES the risk of:
- stomach cancer
- liver cancer
Up to two alcoholic drinks a day (up to 30 grams) DECREASES the risk of:
- kidney cancer
It is important to remember that the risks of drinking alcohol far outweigh any possible benefits.
How does alcohol cause cancer?
There are several ways alcohol increases cancer risk. When ethanol (the alcohol found in all alcoholic drinks) is broken down in the liver, it turns into a toxic chemical called acetaldehyde, which can damage DNA and interfere with the body’s ability to repair it – a key process in preventing cancer cell development.
Alcohol also acts as a carrier for other dietary and environmental carcinogens, such as those in tobacco smoke, helping them to penetrate tissues exposed to alcohol, such as those in the mouth and throat. For this reason, drinking and smoking together increases cancer risk more than doing either alone.
In addition, alcohol can raise estrogen levels and increase insulin resistance, which are associated with cancer development.
People who drink heavily may also be at higher risk due to poor nutrition. Alcohol can lower the absorption of certain vitamins and nutrients, increasing the risk of low folate levels, which makes tissues more vulnerable to alcohol-related DNA damage.
Does the type of alcoholic drink matter?
Our evidence shows that all types of alcoholic drinks – beers, wines or spirits – have a similar impact on cancer risk. That’s because it is the amount of ethanol consumed that matters, not the type of drink.
Red wine sometimes gets positive press because it contains antioxidants like resveratrol, which have been linked to cancer prevention in experimental studies. However, the suggested health benefits are misguided. Research shows that it’s not possible to absorb therapeutic doses of resveratrol through wine or food, and resveratrol supplements have shown no clear benefits in humans. Population studies have also found no link between resveratrol intake and reduced risk of cancer.
Many studies examining the health effects of red wine are of questionable quality due to factors like low sample sizes, poor study design, and confounding variables. Drinking even small amounts of red wine, like any alcoholic drink, increases the risk of cancer.
There are safer, more effective ways to gain the potential benefits of plant-based compounds – such as eating a wide range of fruit, vegetables, legumes and wholegrains, all of which are associated with reduced cancer risk.
Alcohol and kidney cancer
Although some studies suggest moderate alcohol consumption is associated with a reduced risk of kidney cancer, the mechanisms are unclear. Hypotheses include improved lipid profiles and increased adiponectin levels. The diuretic effect of alcohol has also been suggested; however, results are inconsistent, and other fluids and diuretics do not show the same protective effects. More research is needed to understand this relationship.
What can people do to reduce their risk of cancer?
For cancer prevention, the advice is simple: it’s best not to drink alcohol at all.
If people do choose to drink, they should aim to stay within the UK Chief Medical Officers’ low-risk guidelines of no more than 14 units a week, spread over three or more days.
Limiting alcohol is one of our Cancer Prevention Recommendations. Our Recommendations are based on rigorous systematic reviews of the evidence relating diet, physical activity and body weight to the incidence of cancer, as well as an expert review of biological pathways (mechanisms) that could plausibly explain a causal link between the exposure and the risk of cancer. The Recommendations should be seen a package of behaviours, the more of which people are able to follow, the greater the benefits.
Our Recommendations
- Be a healthy weight
- Be physically active
- Eat wholegrains, vegetables, fruit and beans
- Limit ‘fast foods’
- Limit red and processed meat
- Limit sugar sweetened drinks
- Limit alcohol consumption
- Do not use supplements for cancer prevention
- For mothers: breastfeed your baby, if you can
- After a cancer diagnosis, follow our Recommendations, if you can
Not smoking, and staying safe in the sun, are also important to reduce your cancer risk.
Supporting health professionals during Cancer Prevention Action Week
As a health professional, you are in a unique position to inform patients and colleagues about alcohol and cancer risk. To support you, World Cancer Research Fund has a free webinar.
📅 Alcohol and cancer risk: What every health professional needs to know
🔗 Watch on demand
This practical webinar will cover the latest evidence, address common myths, and explore how to discuss this topic sensitively with patients. There will also be a live Q&A with experts on alcohol and cancer.
Alcohol and cancer: let’s talk
While the evidence about risk is clear, discussing alcohol and cancer with patients and clients can seem tricky. We have developed a guide to help health professionals have open conversations about alcohol that are compassionate and free of judgement.
Keep up to date with the latest research
Stay informed on the latest evidence around cancer prevention with World Cancer Research Fund’s free package for health professionals.
This package includes:
- A quarterly newsletter and monthly eNews
- A bundle of patient resources
- Access to our CPD-accredited online cancer prevention course
Author profile:
Rachel Clark
Health Promotion Consultant
Rachel Clark is a Registered Public Health Nutritionist and a Health Promotion Consultant. She works with health professionals to increase their awareness and understanding of the lifestyle-related risk factors for cancer.
The opinions expressed in this article are those of the author and do not necessarily reflect the views of Oncology Central or Taylor & Francis Group.