Putting a cancer warning on alcohol is overdue, doctors say

Doctors on Friday applauded a new report from the U.S. surgeon general that highlights links between alcohol consumption and seven types of cancer and suggests that alcoholic beverages should come with cancer warning labels.

The association between alcohol and cancer is well established, and many doctors have long called on the federal government to clarify the connection for the public.

“For years, the AMA has said that alcohol consumption at any level, not just excessive alcohol consumption or addictive alcohol consumption, is a modifiable risk factor for cancer,” said Bruce Scott, president of the American Medical Association. American, in a statement. “And yet, despite decades of compelling evidence of this connection, many people in the public remain unaware of the risk of alcohol.”

In the new report, Surgeon General Vivek Murthy describes the scientific evidence linking alcohol to cancer and offers recommendations to reduce rates of alcohol-related cancers. In addition to proposing warning labels on alcoholic beverages, Murthy suggests reevaluating recommended limits for alcohol consumption in the US.

Six in 10 American adults report that they drink, but several doctors told NBC News that their patients are generally unaware that alcohol consumption can cause cancer of the mouth, throat, esophagus, larynx, liver, breast and colon.

“We haven’t done a good job with public health messaging about alcohol in the United States,” said Dr. Rotonya Carr, chief of gastroenterology at the University of Washington.

The new report may raise questions for some people about the long-term harm of alcohol consumption, safe limits and how to reverse negative health effects. Here’s what medical experts across the country think people should know.

Is any level of alcohol consumption safe?

The World Health Organization says there is no safe amount of alcohol consumption. As alcohol breaks down in the body, it can damage DNA and proteins in a way that can allow cancer to develop. It can also alter hormone levels and make it easier for the body to absorb other carcinogens such as tobacco smoke, thereby increasing the risk of breast, mouth or throat cancer.

“The safest thing for all types of health outcomes, not just cancer, is not to consume alcohol,” said Paul Gilbert, an associate professor at the University of Iowa College of Public Health. “But, of course, not many people follow that path, because alcohol is a very important and central part of our social and cultural customs.

The health risks associated with alcohol consumption are lower if you drink less and higher if you drink more. A 2020 study found that among women, the lifetime risk of developing alcohol-related cancer was 17% for those who consumed less than one drink per week, but 22% for those who consumed two drinks a day. For men, the risks were 10% and 13%, respectively.

How does alcohol consumption compare to other factors that increase cancer risk?

Alcohol is the third-leading preventable cause of cancer in the U.S., behind tobacco and obesity, according to the surgeon general’s report. It is estimated that alcohol contributes to almost 100,000 cases of cancer and about 20,000 cancer deaths each year.

The WHO International Agency for Research on Cancer classifies alcohol as a “Group 1” carcinogen, meaning there is sufficient evidence that it can cause cancer in humans. Other carcinogens in that group include tobacco, asbestos and radiation.

With this in mind, Carr said, people should be as concerned about the health risks of drinking as they are of smoking.

If someone stops drinking, can they reverse the damage?

Compared with smoking, doctors said, there is less research on how long it takes to see reductions in cancer risk after a person stops drinking. (Studies have estimated that people who quit smoking 10 years ago have half the risk of dying from lung cancer as someone who currently smokes cigarettes.)

While some research has found that a single month of sobriety (a dry January, say) can lead to weight loss and improved blood pressure and cholesterol levels, the story is less rosy when it comes to cancer risk, Carr said. He noted that it can take at least 20 years after someone stops drinking for their risk of liver cancer to equal that of a person who has abstained from alcohol.

“Alcohol causes damage at the cellular level,” he said. “That damage can sometimes be reversed, but over a very, very long period of time.”

Dr. Frances Lee, a hepatologist at Mount Sinai in New York, said many factors could influence the degree to which a person might see benefits from reducing their alcohol consumption, including their family history.

“For someone who has drunk a lot, there is likely to be a lot of DNA damage,” he said. “If there is a history of certain cancers, then they may not be able to undo that risk.”

What about the US dietary guidelines on alcohol?

Current guidelines recommend no more than one drink per day for women and two per day for men, based on an overall assessment of the health risks associated with alcohol. According to a study last year, about 83% of annual alcohol-related cancer deaths could be prevented if adults reduced their consumption to those limits.

However, the guidelines also point to “emerging evidence” that even drinking within recommended limits can increase the overall risk of cancer, heart disease or death.

The guidelines will be updated this year, so Murthy’s suggestion that alcohol limits be reevaluated may influence that process. An upcoming report from a group at the Department of Health and Human Services will likely also report on the update.

Last year, Canada issued new guidance stating that no amount of alcohol is healthy.

What about the research that suggests alcohol has health benefits?

Some studies over the years have pointed out the possible health benefits of drinking in moderation. That includes research suggesting that antioxidants in red wine could improve heart health, and a December report from the National Academies of Sciences, Engineering and Medicine that said moderate drinking is linked to a lower risk of death than abstaining from alcohol. drink alcohol

However, many doctors and scientists remain unconvinced.

“In years past there was a lot of talk about the potential benefits of red wine. A lot of that has been difficult to validate in subsequent studies,” said Dr. William Dahut, chief scientific officer of the American Cancer Society.

Even if alcohol consumption had any health benefits, experts said, they would be outweighed by the risks.

“I don’t think you’ll ever find a doctor who tells a patient, ‘You don’t drink anything.’ Go ahead and drink two glasses at night,’” Lee said.

Are certain types of alcohol better than others?

Doctors said it’s more important to pay attention to the amount or concentration of the alcohol, rather than whether it’s liquor, beer or wine, since the alcohol molecules themselves are responsible for increasing a person’s cancer risk. .

Several experts also warned that it is not always easy to know how much alcohol a drink contains.

Dr. Kenneth Nahum, an oncologist at Hackensack Meridian Jersey Shore University Medical Center, said carbonated drinks and teas in particular, which have become popular among young people, could be misleading in terms of alcohol content.

“They drink it like a soft drink,” he said. “They don’t even realize they’re drinking so much.”

Will the surgeon general’s warning make any difference?

Gilbert said it’s unlikely people will immediately change their drinking habits after Friday’s report, but noted it could eventually lead to changes in how people perceive their risk.

“This advisory is a good step in the direction of getting the word out so everyone can be better informed and make the best decision for themselves,” he said.

According to a 2023 analysis, adults under 35 are already less likely to drink alcohol than that group was decades ago. However, alcohol consumption has increased among people aged 55 and older. Experts suggested that young adults may socialize less in person than previous generations, or they may simply prefer other substances.

“Some are drinking less, and that could be because there are more vapes and edibles available,” said Elizabeth Kovacs, a professor of surgery at the University of Colorado Anschutz Medical Campus.