Abstract and Introduction
Background: There is convincing evidence that alcohol consumption increases the risk of cancer of the colorectum, breast, larynx, liver, esophagus, oral cavity and pharynx. Most of the data derive from studies that focused on the effect of moderate/high alcohol intakes, while little is known about light alcohol drinking (up to 1 drink/day).
Patients and methods: We evaluated the association between light drinking and cancer of the colorectum, breast, larynx, liver, esophagus, oral cavity and pharynx, through a meta-analytic approach. We searched epidemiological studies using PubMed, ISI Web of Science and EMBASE, published before December 2010.
Results: We included 222 articles comprising ~92 000 light drinkers and 60 000 non-drinkers with cancer. Light drinking was associated with the risk of oropharyngeal cancer [relative risk, RR = 1.17; 95% confidence interval (CI) 1.06–1.29], esophageal squamous cell carcinoma (SCC) (RR = 1.30; 95% CI 1.09–1.56) and female breast cancer (RR = 1.05; 95% CI 1.02–1.08). We estimated that ~5000 deaths from oropharyngeal cancer, 24 000 from esophageal SCC and 5000 from breast cancer were attributable to light drinking in 2004 worldwide. No association was found for colorectum, liver and larynx tumors.
Conclusions: Light drinking increases the risk of cancer of oral cavity and pharynx, esophagus and female breast.
The broad range of alcohol consumption patterns, from heavy to occasional hazardous drinking, creates significant public health and safety problems in nearly all countries. Globally, 6.2% and 1.1% of all male and female deaths are attributable to alcohol, and in 2004 over 2.2 million deaths were related to alcohol worldwide.
Regarding the association with cancer, 3.6% of all cancers (5.2% in men, 1.7% in women) are attributable to alcohol drinking. There is convincing evidence that alcohol consumption increases the risk of cancer in the colorectum, female breast, larynx, liver, esophagus, oral cavity and pharynx and a substantial increase in the risk of cancer with increasing doses of alcohol was observed for all those cancer sites. Most of the evidence on the alcohol–cancer link derive from studies that focused on high and moderate intake of alcohol, therefore a solid evidence of an association between low levels of alcohol intake and cancer is still lacking. From a public health point of view, it is of considerable interest to establish whether light drinking is associated with cancer, even if it implied only a modest risk increase. In fact, a risk increase of small magnitude affecting a large proportion of population could convert into major negative health impact.[5,6]
Therefore, to clarify this issue, we carried out a meta-analysis of published studies to evaluate the association between light drinking (defined as up to 1 drink/day) and cancer.
Ann Oncol. 2013;24(2):301-308. © 2013 Oxford University Press
Copyright European Society for Medical Oncology. Published by Oxford University Press. All rights reserved.