Experts say evidence has grown over the past decade that even moderate alcohol consumption can increase the risk of certain cancers
January is the time of year when we pause to examine our health habits, and US Surgeon General Vivek Murthy has issued a warning that should be heeded: the link between alcohol consumption and cancer.
Murthy’s warning is a necessary if overdue step in helping Americans better understand the effects of even moderate alcohol consumption.
Ideally, action by policymakers and physicians will follow to help Americans make better choices about alcohol.
The report does not highlight anything new. Experts say evidence has grown over the past decade that even moderate alcohol consumption can increase the risk of certain cancers. And yet, as Murthy’s report points out, fewer than half of US adults are aware of the connection between the two.
This lack of knowledge doesn’t surprise Shelly Greenfield, director of the Alcohol, Drug and Addiction Clinical and Health Services Research Program at McLean Hospital in Massachusetts. Whenever she gives talks about the link between alcohol and cancer, people thank her and say she’s the first to hear it. “That’s why the surgeon general’s advice is so important,” he says. “No one should have to experience this.”
Awareness of the risks is key to helping people make informed decisions about drinking. The messages about what is considered “safe” when it comes to alcohol have been confusing at best. The guidelines recommend that men consume no more than two standard drinks per day and women one or less. But the truth is, no level of alcohol consumption is safe, and consumers need to hear that.
This confusion is partly by design, says Katherine Keyes, an epidemiologist at Columbia University’s Mailman School of Public Health. It comes from “a very profitable industry that sends the message that lower levels of consumption are not harmful – that they can be part of a relaxing or luxurious lifestyle,” he points out.
It was an easy narrative. For years, research has been clear about the harms of heavy drinking: liver damage, pancreatitis, heart disease, mouth and liver cancers, to name a few. But the data on low-to-moderate drinking has been open to many interpretations, with some studies suggesting risks and others suggesting benefits. Anyone who loves a glass of red wine with dinner surely appreciated the headlines touting the habit as protective against heart disease. Now the evidence is considered sketchy at best.
Today, public health researchers have much more information about the long-term effects of alcohol use, and cancer should be considered. Women, in particular, should heed the advice. The data show an alarming increase in problematic drinking among women, including binge drinking among college-age women, alcohol-related liver disease among middle-aged women, and alcohol-related deaths.
As I have written before, women are more susceptible to the negative effects of alcohol and at a much lower level of consumption than men. This is due to a biological trifecta: less water to dilute the alcohol, more fat to hold it, and less enzyme to break it down before it hits the bloodstream.
And while alcohol has been linked to several cancers, Murthy’s report points to breast cancer as the biggest risk. About 16.4% of the 270,000 breast cancer cases in the US are linked to alcohol consumption.
So, does all this mean you should give up alcohol altogether? Not necessarily. “It’s not all or nothing, abstinence or consumption,” says Keyes. Reducing the amount of alcohol you drink can improve your health – even if you don’t quit.
And while researchers agree that there is no safe amount of consumption, we ourselves also make decisions every day about our personal risk tolerance. When it comes to alcohol and cancer, this means weighing the risk of drinking alcohol alongside all the other factors that increase our chances of developing cancer, including genetics and lifestyle choices.
With breast cancer, for example, the three biggest modifiable risk factors are obesity, exercise and consumption, Greenfield says. Some women may decide to focus on exercise and weight loss, but enjoy a glass or two of wine on a night out with friends. Those with a family history of breast cancer may decide that any additional risk is not worth it and stop drinking altogether.
Doctors could play an important role in helping patients cope with the risks. This means asking how many drinks someone drinks each week and repeating the instructions, explaining the health effects of even low levels of consumption.
And there are many things that can be done from a policy perspective to encourage safer habits. “We’re getting into cars, right? However, there is no such thing as a safe car ride,” says Keyes. But, he adds, we have created regulations to make cars safer, such as requiring seat belts and lowering blood alcohol limits for operating a vehicle.
Murthy’s report recommends one good thing: putting cancer warning labels on alcoholic products, like those on cigarettes. A label alone won’t fix everything, but it’s a useful reminder when combined with other prevention measures. Of course, the alcohol industry is sure to fight such efforts, but policymakers should make them happen.
More can also be done to remind people what a regular sized drink is. It’s easy to get carried away with a generous glass of wine or a strong cocktail that may look like one serving but is actually two or three drinks.
While teetotaling will always be the safer option, the public deserves better and clearer guidance on weighing their personal risks. The surgeon general’s report is a move in the right direction.
Lisa Jarvis is a columnist for Bloomberg Opinion covering the biotechnology, healthcare and pharmaceutical industries. She was editor of Chemical & Engineering News.
Source :Skai
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