Alcohol vs. Cancer

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jswordy

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"The New York Tmes" today ran a guest column headlined, "You'll Have to Take My Glass From My Cold, Wine-Stained Hand." It was a rebellion against all the knocks drinking alcohol has been taking, as well as a celebration of wine. I loved this passage...

Two bottles of the same wine, if well made, have never tasted the same. Recently asked which of his wines was his favorite, the winemaker Rodolphe de Pins, of Château de Montfaucon in France’s southern Rhône Valley, said, “It depends on the day, the meal, the friend, the occasion.” The thrill of every discovery comes with a sacrifice: It will never happen exactly like this again.

https://www.nytimes.com/2024/10/26/opinion/wine-sober-october.html?searchResultPosition=1
 
It was a rebellion against all the knocks drinking alcohol has been taking,
Don’t get worked up over these types of reports. The “wine causes cancer” reports are just as click-baity as the “wine is good for you” headlines. Of course alcohol is bad for you! Most everything we enjoy is bad for us! If I wanted to maximize the days I spend on this planet I would eat a calorie restricted vegan diet, exercise 2 hours a day, never expose my skin to the sun, and never have sex (look it up). But I prefer to live… we all make choices.
 
Don’t get worked up over these types of reports. The “wine causes cancer” reports are just as click-baity as the “wine is good for you” headlines. Of course alcohol is bad for you! Most everything we enjoy is bad for us! If I wanted to maximize the days I spend on this planet I would eat a calorie restricted vegan diet, exercise 2 hours a day, never expose my skin to the sun, and never have sex (look it up). But I prefer to live… we all make choices.

https://www.axios.com/2025/01/03/alcohol-stocks-cancer-surgeon-general
 
Don’t get worked up over these types of reports. The “wine causes cancer” reports are just as click-baity as the “wine is good for you” headlines. Of course alcohol is bad for you! Most everything we enjoy is bad for us! If I wanted to maximize the days I spend on this planet I would eat a calorie restricted vegan diet, exercise 2 hours a day, never expose my skin to the sun, and never have sex (look it up). But I prefer to live… we all make choices.

I don't get worked up over them, but I do keep up with the research. There is no safe place. Literally everything in life is relative risk and how much to mitigate it. For example, for 30 years, I have had only liability insurance on my vehicles. It has saved me a ton of cash, but I risk having to buy one if I wreck and it is my fault. Many people would never do that! But the savings have done well for me invested in stocks – another risk many would not make. Shrug. Nobody gets out of this alive.
 
I'm doing my best to support the wine industry! ;)
Here's some math to ponder:
If your background risk of a certain cancer is 10% (some types are more, some less), and your alcohol consumption raises your risk by 20%, then 10%x20% = 2%,so your new risk is 12%. I'm calling that acceptable.
The mathematically challenged would argue that would raise the risk to 30%. 🤦‍♂️
 
The mathematically challenged would argue that would raise the risk to 30%. 🤦‍♂️

There are two fallacies in the calculation. First, it considers only a certain type of cancer, not all cancers. According to the National Cancer Institute (NCI), about 40.5% of Americans will be diagnosed with cancer at some point in their lives. The lifetime risk of developing cancer is higher for men than women, with an estimated 42.05% for men and 37.58% for women.

The second fallacy is that it arbitrarily assigns a fixed percentage background risk. Here are some real ones from the National Cancer Institute:
  • Mouth and throat cancer: Moderate drinkers raise their risk of mouth cancer by 80% and throat cancer by 40% versus nondrinkers. Heavy drinkers increase their risk 400% and 160% for mouth and throat cancer, respectively.
  • Esophageal cancer: Alcohol in any amount raises the risk of an esophageal cancer known as esophageal squamous cell carcinoma. When compared with no alcohol consumption, the risk was found to increase by 30% for light drinkers and up to 400% for heavy drinkers.
  • Liver cancer: Heavy consumption has been linked to a 100% increase in two forms of liver cancer known as hepatocellular carcinoma and intrahepatic cholangiocarcinoma.
  • Breast cancer: A link has been found between increased risk of breast cancer and increased alcohol consumption. In data collected from 118 studies, light drinkers were found to increase their breast cancer risk by 4%, moderate drinkers by 23%, and heavy drinkers by 60% compared with nondrinkers.
  • Colon cancer: Moderate-to-heavy drinking increases the risk of colon or rectal cancer by 20% to 50%, respectively.

So, what does that mean in the real-world aggregate? According to the National Institutes of Health (NIH), about 5.5% of all new cancer diagnoses and 5.8% of all deaths from cancer are attributed to drinking alcohol. In the United States, about 20,000 adults die from alcohol-related cancers each year.
 
There are two fallacies in the calculation. First, it considers only a certain type of cancer, not all cancers. According to the National Cancer Institute (NCI), about 40.5% of Americans will be diagnosed with cancer at some point in their lives. The lifetime risk of developing cancer is higher for men than women, with an estimated 42.05% for men and 37.58% for women.

The second fallacy is that it arbitrarily assigns a fixed percentage background risk. Here are some real ones from the National Cancer Institute:
  • Mouth and throat cancer: Moderate drinkers raise their risk of mouth cancer by 80% and throat cancer by 40% versus nondrinkers. Heavy drinkers increase their risk 400% and 160% for mouth and throat cancer, respectively.
  • Esophageal cancer: Alcohol in any amount raises the risk of an esophageal cancer known as esophageal squamous cell carcinoma. When compared with no alcohol consumption, the risk was found to increase by 30% for light drinkers and up to 400% for heavy drinkers.
  • Liver cancer: Heavy consumption has been linked to a 100% increase in two forms of liver cancer known as hepatocellular carcinoma and intrahepatic cholangiocarcinoma.
  • Breast cancer: A link has been found between increased risk of breast cancer and increased alcohol consumption. In data collected from 118 studies, light drinkers were found to increase their breast cancer risk by 4%, moderate drinkers by 23%, and heavy drinkers by 60% compared with nondrinkers.
  • Colon cancer: Moderate-to-heavy drinking increases the risk of colon or rectal cancer by 20% to 50%, respectively.

So, what does that mean in the real-world aggregate? According to the National Institutes of Health (NIH), about 5.5% of all new cancer diagnoses and 5.8% of all deaths from cancer are attributed to drinking alcohol. In the United States, about 20,000 adults die from alcohol-related cancers each year.
So, according to the American Cancer Society, the lifetime risk of esophageal cancer for men is 1 in 127 (. 79%), and is much lower for women. increasing that risk by 400% means an elevated risk of 4 in 127 or 3%. Context is important. I could do that math for the other cancers you mention, but it's more work than I care to do.
Another way of looking at 5.8% of all cancer deaths being attributed to alcohol is that 94.2% of cancer deaths are not attributed to alcohol.

I suspect that drinking and driving kills more drinkers than all alcohol related cancers, but I do not have statistics to back that up. (EDIT: nope, I'm wrong. Only 10,000 people die (2023) from drunk driving. Not all of them would have been drunk at the time)
 
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ie all chemical exposure risk is dosage related, and skin cancer is related to time in the sun, or when I lived in Texas the in-laws worked in chemical plants and cancer rate in Beaumont / county was nine times national average.
So, what does that mean in the real-world aggregate?
. . . . . We as a species don’t learn very fast? , , , poor manufacturing, watch your total package oxygen? acetaldehyde flavor , , , cancer happened after we reproduced so the species goes on? , , , folks who consume more calories have higher cancer risk?

No it means we are off topic
 
This popped up on my feed today..........

From Dr. Brian Lawenda a radiation Oncologist in FL.

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For years, public health messages have painted all alcoholic beverages with the same broad brush: alcohol is a carcinogen, no exceptions. Yet, a growing body of research suggests that this narrative oversimplifies a complex issue, particularly when it comes to wine. A landmark meta-analysis of over 4.3 million participants challenges the conventional wisdom, revealing that moderate wine consumption may not increase cancer risk—and might even lower it for certain types of cancer.
https://www.frontiersin.org/.../10.../fnut.2023.1197745/pdf
This nuanced evidence raises an uncomfortable question: Are we unfairly lumping wine into the same category as beer and spirits, overlooking its unique properties and potential health benefits? Here’s a closer look at the evidence, the controversies, and what it means for your next glass of red.
—The Landmark Study: Unpacking the Findings
The meta-analysis, published in Frontiers in Nutrition, is among the largest and most rigorous reviews to date. Analyzing data from 73 studies, it specifically examined the relationship between moderate wine consumption—defined as up to one drink per day for women and two for men—and cancer risk.
—The Results:
1. No Overall Increased Risk: Across all cancer types, moderate wine consumption showed no significant association with an increased risk:

• Relative Risk (RR): 1.00 (95% CI: 0.97–1.03).
2. Protective Trends for Specific Cancers:

• Colorectal Cancer: 8% lower risk (RR = 0.92; p = 0.03).
• Pancreatic Cancer: 10% lower risk (RR = 0.90; p = 0.04).
• Lung Cancer: 15% lower risk (RR = 0.85; p = 0.02).
• Skin Cancer: 12% lower risk (RR = 0.88; p = 0.01).
3. No Significant Risk for Breast or Ovarian Cancer:

• Breast Cancer: RR ≈ 1.00 (p = 0.45).
• Ovarian Cancer: RR ≈ 1.00 (p = 0.38).
—Why Wine Stands Apart
Unlike beer and spirits, wine contains a unique cocktail of bioactive compounds, particularly in red wine, that may offset the harmful effects of alcohol. These include:

• Resveratrol: Found in grape skins, resveratrol has been shown to inhibit tumor growth, reduce inflammation, and enhance DNA repair.
• Polyphenols and Flavonoids: These antioxidants suppress oxidative stress and tumor-promoting pathways, promoting cellular health.
• Anti-Inflammatory Effects: Wine’s compounds may counteract the inflammatory damage that contributes to cancer development.
These properties, largely absent in other alcoholic beverages, make wine a distinct case in the alcohol-cancer conversation.
—The Broader Context: Alcohol and Cancer
Public health agencies worldwide, including the WHO and the American Cancer Society, classify alcohol as a Group 1 carcinogen. The risks are clear for heavy drinkers: alcohol contributes to cancers of the mouth, throat, esophagus, liver, breast, and colon. The mechanisms are well understood:

• Acetaldehyde Production: Alcohol metabolizes into acetaldehyde, a carcinogen that damages DNA.
• Oxidative Stress: Alcohol increases free radicals, overwhelming the body’s ability to repair cellular damage.
• Hormonal Effects: Alcohol raises estrogen levels, a driver of breast cancer.
But here’s the rub: these conclusions often stem from studies that lump all forms of alcohol together, obscuring beverage-specific effects. The nuances of wine—its antioxidant properties, moderate alcohol content, and bioactive compounds—are lost in this aggregated data.
—The Controversy: Is Public Health Oversimplifying the Message?
Critics argue that public health messaging around alcohol has prioritized simplicity over nuance, resulting in blanket statements that may mislead the public. While the intent—reducing alcohol-related harm—is noble, it risks distorting the evidence.
—Points of Contention:
1. Aggregated Data Masks Differences:

• Most studies fail to differentiate between wine, beer, and spirits, treating a shot of whiskey the same as a glass of red wine.
2. Lifestyle Confounders:

• Moderate wine drinkers often follow healthier diets, smoke less, and exercise more—all factors that independently reduce cancer risk. Critics argue that these confounders may exaggerate wine’s protective effects.
3. Individual Variability:

• The effects of wine may vary based on genetics, pre-existing conditions, and lifestyle. A “one-size-fits-all” approach overlooks this complexity.
—What Does This Mean for Physicians?
For healthcare providers, the evidence invites a more nuanced approach to counseling patients about alcohol consumption:
1. Moderation is Key:

• The study reinforces the importance of moderation. Exceeding the recommended limits negates any potential benefits and significantly increases cancer risk.
2. Wine as a Safer Choice:

• For patients who consume alcohol, wine may represent a safer option compared to beer or spirits, particularly when paired with a healthy lifestyle.
3. Individualized Recommendations:

• Patients with a strong family history of cancer or genetic predispositions should be advised more cautiously, as even moderate alcohol intake may carry risks.
—Critiques of the Study
No study is without limitations, and this meta-analysis is no exception:

• Residual Confounding: While the study adjusted for smoking, diet, and physical activity, some unmeasured variables may have influenced the results.
• Observational Nature: Correlation does not equal causation. Without randomized controlled trials, causality cannot be definitively established.
Yet, the study’s size, scope, and rigorous methodology make it one of the strongest analyses to date. With over 4.3 million participants, the statistical power ensures that even modest trends are detectable.
—Red versus White Wine
The question of whether red wine offers unique benefits compared to white wine is an important one that the meta-analysis does not address. Red wine is rich in bioactive compounds, including resveratrol and polyphenols, which have demonstrated anti-inflammatory, antioxidant, and anti-carcinogenic properties in laboratory studies. These compounds, derived from prolonged contact with grape skins during fermentation, are far less concentrated in white wine. For cancers driven by inflammation and oxidative damage—such as colorectal and lung cancer—the protective trends observed in the meta-analysis may reflect red wine’s unique composition, but further research is needed to confirm these effects.
However, when it comes to breast cancer, the evidence suggests no difference between red and white wine. A 2009 study examining over 6,300 breast cancer cases found that neither red nor white wine increased or decreased breast cancer risk. https://aacrjournals.org/.../No-Difference-Between-Red...
These findings align with the meta-analysis, which reported no significant association between wine consumption and breast cancer risk. This neutral effect highlights that the mechanisms driving breast cancer, such as hormone modulation, may not respond to wine’s bioactive compounds in the same way as cancers linked to inflammation or oxidative stress.
The distinction between red and white wine underscores the need for more targeted studies. While red wine may hold promise for reducing the risk of certain cancers, studies like the 2009 breast cancer analysis remind us that its benefits are not universal. Future research should investigate how the differences in polyphenol and antioxidant content between red and white wine influence outcomes for a broader range of cancer types. Additionally, long-term studies that separate the effects of red and white wine on cancer risk are critical for refining our understanding.
—My Takeaway
The evidence surrounding alcohol and cancer is complex, and wine occupies a unique position in this debate. While heavy alcohol consumption is undeniably harmful, the data suggest that moderate wine consumption may not only lack the same risks but could offer protective benefits against certain cancers.
For those who choose to drink, a glass of wine enjoyed as part of a balanced lifestyle—think Mediterranean diet—appears to be a reasonable and safe choice. However, public health officials and clinicians alike must walk a fine line, promoting moderation while acknowledging wine’s unique properties.

In a world hungry for simple answers, the story of wine reminds us that health is rarely black and white.
 

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