A Drink Too Many - The Health Implications of Alcohol
Evidence reveals that alcohol causes 13,000 cancer cases a year in Britain

There is a misconception that only people who binge drink or get drunk are most at risk of developing health problems.  However, evidence now shows that most people who regularly drink more than the NHS recommended guidelines (3-4 units for men and 2-3 units for women daily) may in fact be damaging their health, and increasing their chance of getting cancer. 

The adverse effects of excessive alcohol consumption were made clear in last weeks health news reports, which used the findings from a large European study to highlight the correlation between cancer and alcohol.   

The research used data from the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort study which examined how diet and lifestyle related to the development of cancer.  The study included 363,988 people who were followed over a nine year period from eight European countries.  Participants taking part in the study, were requested to answer specific questions on the amount, frequency and type of any alcoholic drinks they consumed in the past and at present. 

The results published in the British Medical journal, “Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study” found that one in ten of all cancers in men and one in thirty-three in women were caused by past or current alcohol intake.  It revealed that alcohol consumption above the daily maximum, caused 33,037 of 178,587 alcohol-related cancers in men (18.5 percent) and 17,470 of the 397,043 alcohol-related cancers in women (4.4 percent).

The European study found that although there was a variation in average alcohol consumption across the European countries, alcohol was responsible for the following cancers:

-     - Upper digestive tract cancers (mouth, throat oesophagus) 44% for males and 25% for females

-     - Liver cancer 33% for males and 18% for females

-     - Colorectal cancer (bowel) 17% for males and 4% for females

-     - Female breast cancer 5%

In the UK specifically, drinking has caused 2,500 cases of breast cancers, 3,000 bowel cancers and 6,000 cases of cancers of the mouth, throat or windpipe. 

It is understood that when alcohol is broken down in the body it turns into acetaldehyde, a compound that damages DNA , which increases the risk of cells becoming cancerous.

Professor Sir Ian Gilmore, Chairman of the UK Alcohol Health Alliance said, "In the last 10 years, mouth cancer has become much more common and one reason for this could be because of higher levels of drinking - as this study reflects.”

Information from NHS Choices, The Risks of Drinking Too Much highlights that alcohols hidden harms usually only emerge after a number of years, and these can consist of, liver problems, reduced fertility, high blood pressure, heart attack and increased risk of various cancers.  

The research concluded that there was a stronger association with cancers that are already known to be causally associated with alcohol, such as cancers of the mouth, throat, oesophagus and liver. For these cancers, much of the excess risk was due to drinking above the maximum daily limit, defined in the study as more than 24g of pure alcohol for men (3 units) and more than 12g for women (1.5 units).  

A Call For Action

In light of the evidence, cancer charities have affirmed that people should limit their drinking to lower the risk.  Cancer Partners UK medical director Prof Karol Sikora stated that this is the best data we are likely to get, therefore the message is clear “the more alcohol you drink, some of the common cancers - the four cancers that have been identified - do increase, and that's worrying. So the message has to be 'look at drinking habits, and reduce.'"

Co-author Naomi Allen, a Cancer Research UK epidemiologist based at Oxford University in the UK, said that this study adds to existing evidence that alcohol consumption causes cancer, and that even drinking moderate amounts can increase the risk, "The results from this study reflect the impact of people's drinking habits about ten years ago. People are drinking even more now than then and this could lead to more people developing cancer because of alcohol in the future," said Allen.

Madlen Schutze, lead researcher and study author from the German Institute of Human Nutrition, said that many cancer cases are avoidable if alcohol consumption was limited or stopped all together.   

Charities are now calling on governments to introduce tougher measures  to curb alcohol consumption.  Professor Gilmore told the BBC “that sitting back and waiting for people to change their habits, perhaps with voluntary partnerships with the drinks industry included in policies, will not bring about results”. 

What Can We All Do?

Eating healthily, doing exercise, not smoking and limiting our alcohol intake can all help prevent the risk of developing cancer.  RSPH Training Solutions has developed courses specifically to help people understand and improve their health and well-being.  The level 2 Award in Understanding Health Improvement provides knowledge and understanding of the benefits of good health and well being, and of the barriers to making a change of lifestyle.  This qualification is specifically designed for people who work with the public in a healthcare environment and those who have an interest in developing public health skills.  For further information on the course please click here or contact Nicolette Smith.  

Are We Eating Enough Variety of Fruit and Veg?

We are often being reminded of the many health benefits derived from eating our five portions of fruit and vegetables a day, especially in helping to prevent cancer.  However, The European Prospective Investigation into Cancer and Nutrition (EPIC) study has revealed that in relation to lung cancer, the important thing is not just the quantity but also the variety of fruit.  By consuming a wider variety fruits and vegetables, we can reduce the risk of lung cancer by 23%.    

The EPIC study involves 23 centres from 10 European countries (Germany, Denmark, Spain, France, Greece, Holland, Italy, Norway, the United Kingdom and Sweden, working with a sample of 500,000 European subjects (41,000 of whom live in the Spanish regions of Asturias, Granada, Guipúzcoa, Murcia and Navarre).  The results of the study, which have been published in the journal Cancer Epidemiology, Biomarkers & Prevention, demonstrates that eating "more than eight sub-groups" of vegetables cuts this risk by 23% compared with eating "less than four sub-groups". In addition, this risk falls by a further 4% for each unit added to the diet from another sub-group.  This link was found only in smokers. 

Lung cancer is considered to be the most common type of cancer in the developed countries.  Statistics from Cancer Research UK indicate that lung cancer is also the most common cause of death from cancer for both men and women.  Thus, despite the encouraging evidence produced by the study,  Sánchez Pérez, director of the Granada Cancer Registry at the Andalusian School of Public Health, concludes that "the most effective way of preventing it (lung cancer) continues to be reducing the prevalence of tobacco consumption among the populace".