Medical experts have long recognized alcohol as a risk factor for cancer, but research indicates that few Americans are aware of the health risks posed by alcohol consumption. Now, as alcohol misuse surges amid the pandemic, officials are doubling down on their warnings—with some even going so far as to recommend adding cancer warnings to alcohol labels, Anahad O'Connor writes for the New York Times.

A long-established risk factor

According to the Times, scientists have long known that alcohol consumption increases people's risk of cancer, primarily because all alcoholic beverages contain ethanol, which can damage DNA, cause oxidative stress, and spur cells to proliferate. As early as 1987, in fact, the World Health Organization in 1987 classified alcohol consumption as cancer-causing.

In the United States specifically, the American Cancer Society (ACS) estimates that about 41% of men and 39% of women will eventually develop cancer, and of newly diagnosed cases, about 5.6% are caused by alcohol. And while heavy drinking is recognized as posing the greatest risk when it comes to alcohol and cancer, even moderate drinking—currently defined as two drinks per day for men and one drink per day for women—can cause health issues, according to ACS.

In fact, according to the Times, a study published earlier this year in Cancer Epidemiology found that alcohol causes an estimated 75,000 new cancer cases—and results in 19,000 cancer deaths—per year in America.

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Americans remain unaware of the risks

However, despite this well-established link between cancer and alcohol consumption, few Americans appear to be aware of the risk, the Times reports.

For instance, a survey conducted by the American Society for Clinical Oncology (ASCO) in 2017 found that of 4,016 respondents, fewer than one-third recognized that alcohol can cause cancer. Similarly, a 2019 survey from the American Institute for Cancer Research (AICR) found that fewer than 50% of respondents recognized the cancer risks posed by alcohol.

According to experts, this widespread lack of awareness stems in part from the common perception that moderate alcohol consumption—particularly of red wine—is beneficial for heart health.

However, recent studies debunk the idea that moderate drinking has any health benefits, the Times reports. For example, the American Heart Association has said that "no research has established a cause-and-effect link between drinking alcohol and better heart health," and that people who consume red wine may report lower rates of heart disease because of other factors, such as higher socioeconomic status.

Similarly, other research has suggested that moderate drinking only seems beneficial in large population studies because the nondrinkers against whom they are compared often include people who refrain from drinking because of serious health issues or because they formerly misused alcohol. In fact, "[w]hen studies take these factors into account, the apparent cardiovascular benefits of moderate drinking disappear," O'Connor writes.

Amid a rise in alcohol misuse, experts take a stand

The acknowledged link between alcohol consumption and cancer—as well as the widespread lack of awareness about that link—is particularly worrying to experts now, amid the Covid-19 pandemic, when alcohol sales are surging and alcohol misuse appears to be on the rise, the Times reports.

According to the Times, hospitals over the past year have reported an increase in admissions for alcohol-related health issues, including liver failure and hepatitis. At least one study found that alcohol consumption increased sharply among those who lost their jobs or were required to stay at home amid the pandemic—and that the widespread shift toward working from home made it easier for people to drink during the day without others noticing

In response, experts in America and elsewhere are taking bigger steps to try and increase overall awareness of the health risks posed by alcohol, O'Connor writes.

For instance, both the European Union and the French government are taking steps to raise public awareness of the health risks posed by alcohol to curb overall cancer rates. And in America, a coalition of organizations—including ASCO, AICR, the American Public Health Association, and five other groups—in October 2020 asked the government to put a cancer warning on alcohol labels, arguing that the available scientific evidence indicates that alcohol can cause several types of cancer.

In addition, an expert panel last year advised the federal government in its Dietary Guidelines for Americans to lower its recommended daily limit for alcohol consumption to just one drink for both men and women. While that didn't happen—in part due to fierce lobbying from the alcohol industry—the guidelines for the first time did include strong warnings about the link between alcohol and cancer, noting that even moderate drinking can "increase the overall risk of death from various causes, such as from several types of cancer and some forms of cardiovascular disease" and that drinking even less than one drink a day can increase the risk of "some types of cancer."

Separately, ACS in its 2020 guidelines for the first time included a strong caution on drinking alcohol, stating that when it comes to preventing cancer, "there is no safe level of consumption."

"We're not expecting everyone to become teetotalers," Nigel Brockton, vice president of research at AICR, said. "But if you're going to drink, then one is better than two, and not every day, because those are the behaviors that across all of these cancers increase your risk." (O'Connor, New York Times, 3/4).