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Is Alcohol Good, Bad, or a Little Bit of Both?

Christina Miller, MD and Rob Orman, MD
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Alcohol can reduce cardiovascular risk in certain patients, but it’s also a strong carcinogen. All things in moderation, but what does that mean when considering the benefits and harms of a glass of wine?

 

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Stephen P. -

Are there any cancers with risk not increased by alcohol?

Christina M., MD -

Thanks for your question! Yes, there actually are.
Alcohol is known to increase the risk of cancer (about 3.5% of all cancer deaths in the US or about 19,500 deaths per year in 2009) for the following cancers: Head and neck (especially oral cavity, pharynx, and larynx), esophageal, liver, breast, and colorectal.
For the following cancers, numerous studies show either inconsistent data or no association with alcohol use: pancreas, ovary, prostate, stomach, uterus, and bladder.
Finally, there are 2 cancers where alcohol use is actually associated with a decrease risk of cancer: renal cell and non-Hodgkin lymphoma.
Of course, there are many more types of cancers, and we don't have data about possible effects of alcohol (at least, not yet).
Hope that helps!
Source/References:
1. http://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet
2. http://www.cancer.org/cancer/cancercauses/dietandphysicalactivity/alcohol-use-and-cancer
3. Bellocco R, Pasquali E, Rota M, et al. Alcohol drinking and risk of renal cell carcinoma: results of a meta-analysis. Annals of Oncology 2012;23(9):2235-2244. [PubMed Abstract]
4. Tramacere I, Pelucchi C, Bonifazi M, et al. A meta-analysis on alcohol drinking and the risk of Hodgkin lymphoma. European Journal of Cancer Prevention 2012;21(3):268-273. [PubMed Abstract]

Robert S., MD -

I don't think that I heard it mentioned in the talk, but if I did I am sorry for this question: What it the number needed to consume. If I am going to talk to patients about cutting out alcohol, they need to know how important this is. Do the studies on humans show a 10% absolute risk reduction or a 0.1%. As James McCormick said: “General practitioners would do better to encourage people to live lives of modified hedonism, so that they may enjoy, to the full, the only life that they are likely to have.” – James McCormick, Lancet, 1994. Most reasonable people would not want to take a statin for 5 years for a 1 in 100 chance of benefit and most reasonable people are not going to be concerned about a 1 in 1000 increase in risk from a daily drink of alcohol. The French paradox seems to suggest that the effect in humans is small.

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Some Alcohol, Some Empathy, and a Little Restless Genital Full episode audio for MD edition 208:03 min - 98 MB - M4AHippo Primary Care RAP July 2015 Summary 449 KB - PDF