The New England Journal of MedicineThe IARC Perspective on Alcohol Reduction or Cessation and Cancer Risk

Alcohol Cessation: A Vital Step in Cancer Prevention – Exploring the Impact on Various Cancer Risks

The recent report from The New England Journal of Medicine presents a thorough investigation into the relationship between alcohol consumption, cessation, and the risk of various cancers. This pivotal study by an international team of scientists, led by the International Agency for Research on Cancer (IARC), delves into the epidemiological and mechanistic evidence linking alcohol consumption to an increased risk of several cancer types and examines the potential benefits of alcohol reduction or cessation in mitigating these risks.

Key Points

• Global Alcohol Consumption: Alcohol, mainly ethanol in beverages, is widely consumed globally, with significant variations in prevalence across regions.
• Classification as Carcinogen: Alcoholic beverages are classified as carcinogenic, linked to cancers such as oral, pharyngeal, laryngeal, esophageal, liver, colorectal, and breast cancer.
• Epidemiologic Review: The IARC Working Group reviewed studies assessing the impact of alcohol reduction or cessation on cancer risk.
• Oral and Esophageal Cancer: There is sufficient evidence that quitting alcohol decreases the risk of oral and esophageal cancers.
• Laryngeal, Colorectal, and Breast Cancer: Limited evidence suggests a potential reduction in risk for these cancers upon alcohol cessation.
• Pharyngeal and Liver Cancer: Inadequate evidence was found to conclude that alcohol cessation reduces the risk of these cancers.
• Mechanistic Studies: Strong evidence from mechanistic studies shows that alcohol cessation reduces alcohol-related carcinogenesis.
• Alcohol and Carcinogenic Effects: The carcinogenic effects of alcohol are primarily due to the conversion of ethanol to acetaldehyde, a potent genotoxic metabolite.
• Impact of Cessation: Alcohol cessation leads to a rapid decrease in salivary acetaldehyde concentrations and reduces DNA damage.
• Synergistic Effects with Tobacco: The harmful effects of alcohol consumption are exacerbated when combined with tobacco smoking.

HCN Medical Memo
According to the World Cancer Research Fund, alcohol is estimated to be responsible for about 4% of all cancers in high-income countries, and the risk increases with the amount consumed.

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