Epidemiology of alcohol-associated cancers

Background: The International Agency for Research on Cancer concluded in 1988 that 'Alcoholic beverages are carcinogenic to humans'. Methods: Descriptive patterns and time trends in the United States were examined for alcohol use and for the seven alcoholassociated tumors (oral cavity and pharynx, squamous cell carcinoma of the esophagus, larynx, liver, colorectum, breast, and pancreas). The epidemiologic evidence on the relation between alcohol consumption and each tumor type is reviewed. Results: Alcohol, especially in combination with smoking, is a well-established risk factor for cancers of the oral cavity and pharynx, esophagus, and larynx. Rates of these cancers have been decreasing in recent years possibly due to reductions in cigarette smoking and alcohol use. Chronic/heavy alcohol consumption has been linked with increased risk of liver cancer, but rising rates most likely reflect increases in hepatitis B and C infections. Recent epidemiologic evidence has linked light to moderate intake of alcohol to cancers of the colorectum and female breast; a role of heavy alcohol consumption in pancreas cancer is possible. Conclusions: Although rates of smoking and drinking are declining, they remain the major risk factors for cancers of the oral cavity and pharynx, larynx, and squamous cell esophageal cancer. Chronic/heavy alcohol use contributes to the risk of liver cancer and moderate levels of alcohol use are associated with modest increases in the rates of cancers of the colorectum and breast. Heavy intake of alcoholic beverages may be related to a modest increase in pancreas cancer risk.