Drinking Alcohol and Cancer Risk

by David J. Hanson, Ph. D.

Drinking alcohol, especially along with smoking, increases the risk of cancers of the mouth, esophagus, pharynx and larynx.¹ Fortunately, these cancers are all very rare, accounting in total for only 1% of all cancer deaths in the U.S.²

Kidney Cancer

Drinking reduces the risk of kidney cancer. For example:

Moderate drinking reduces the risk of kidney cancer 30% compared to teetotalers (abstainers or non-drinkers), according to an analysis of 12 prospective studies involving 760,044 men and women who were tracked for seven to 20 years.¹⁶
A large prospective study of 59,237 Swedish women found that light and moderate drinkers had a 38% lower risk of kidney cancer than did abstainers. For women over age 66, the risk dropped by two-thirds (66%).¹⁷
A study of a large cohort of Finnish male smokers found that risk of kidney cancer declined as total consumption of alcohol increased.¹⁸
Data from 88,759 women who were tracked for 20 years and from 47,828 men who were observed for 14 years suggest that alcohol reduces the risk of kidney cancer in both men and women.¹⁹
Compared to nondrinkers, men who drank one or more drinks per day had a 31% lower risk of kidney cancer among 161,126 Hawaii–Los Angeles Multiethnic Cohort participants.²⁰
A study of postmenopausal women in Iowa over a 15-year period found that those who drank alcohol, compared to nondrinkers, had a significantly lower risk of developing kidney cancer. This relationship persisted after taking into account many other confounding factors.²¹

Non-Hodgkin's Lymphoma

Alcohol reduces the risk of non-Hodgkin lymphoma. For example:

A review of research from nine international studies found that drinking alcohol (beer, wine, or spirits) reduces the risk of non-Hodgkin's lymphoma by an average of over one-fourth (27%). For developing the form of non-Hodgkin's known as Burkitt's lymphoma, the risk for drinkers drops about half compared to teetotalers.²²
A very large prospective study examining lifestyle factors among 473,984 participants (285,079 men and 188,905 women) found that drinkers had a significantly lower risk of developing non-Hodgkin's lymphoma than did nondrinkers. For example, those who consumed over 28 drinks per week, the risk of developing non-Hodgkin lymphoma was about 25% lower than among nondrinkers. This relationship existed for beer, wine and distilled spirits.²³
A cohort of 35,156 women aged 55-69 years who participated in the Iowa Women's Health Study was analyzed over a nine-year follow-up period. Alcohol consumption was associated with a significantly lower risk of developing non-Hodgkin lymphoma compared to abstaining from drinking alcohol and the amount of alcohol consumed, rather than the form of alcoholic beverage (beer, wine, or distilled spirits), appeared to provide the protection against the disease.²⁴
In a population-based case-control study of adult women and men from four U.S. Surveillance, Epidemiology, and End Results Study centers, researchers found that those who drank alcohol had a significantly lower risk of developing non-Hodgkin's lymphoma than did nondrinkers.²⁵
In a multi-center case-control study in Spain, France, Germany, Italy, Ireland and Czech Republic, researchers found that alcohol consumption significantly reduced the risk of developing non-Hodgkin lymphoma among men and among people living in non-Mediterranean countries.²⁶

Hodgkin's Lymphoma

The consumption of alcohol also reduces the risk of Hodgkin's lymphoma. For example:

Alcohol reduced the risk of Hodgkin's lymphoma (HL) for both men and women but more so for men, whose risk was lowered by 53%. The population-based case-control study was conducted in Germany.²⁷
A protective effect of alcohol consumption on risk of Hodgkin's lymphoma among non-smokers in Italy was reported in a population-based case-control study.²⁸
Drinking alcohol reduced the risk of Hodgkin's lymphoma among both smokers and non-smokers in an analysis of data from a series of case-control studies in northern Italy.²⁹
A multi-center case-control study of subjects in Spain, France, Italy, Germany, Ireland and the Czech Republic found results "consistent with previous studies, suggesting a protective effect of alcohol on HL."³⁰

Not only does drinking alcoholic beverages reduce the risk of Hodgkin lymphoma, but a common symptom of the disease is pain in the lymph nodes. This is reduced following the consumption of alcohol.³¹

Thyroid Cancer

Drinking alcohol also reduces the risk of developing thyroid cancer. For example:

A country-wide population-based case-control study in New Caledonia found that the incidence of thyroid cancer was negatively associated with drinking alcohol among both men and women.³² That is, consuming alcohol was found to be associated with a lower risk of developing thyroid cancer.
Data from almost one-half million (490,000) men and women in the U.S. found that increased alcohol consumption decreased the risk of thyroid cancer.³³
A study of women identified through the Cancer Surveillance System (CSS), a population-based cancer registry in Washington State, found that higher levels of alcohol consumption were associated with lower risk of developing thyroid cancer.³⁴
A prospective study of over one and one-quarter million (1,280,296) women in the U.K. confirmed the finding that drinking alcohol is protective of thyroid cancer.³⁵

The Alcohol and Breast Cancer Debate

The National Institute on Alcohol Abuse and Alcoholism has conducted an exhaustive analysis of the scientific medical evidence regarding alcohol and breast cancer. It concludes that "The effect of alcohol on the risk for breast cancer remains controversial" and describes it as "inconclusive." ³⁶ Consistent with this conclusion, the National Cancer Institute does not include alcohol consumption as a risk factor in its Breast Cancer Risk Assessment Tool. ³⁷

Some studies find a relationship between alcohol and increased risk of breast cancer, others find no relationship, and still others find that alcohol reduces the risk of breast cancer. See Alcohol and Breast Cancer.

It appears that drinking alcohol increases the risk of invasive ductal carcinoma, a major form of breast cancer. However, it does not increase the risk of:

Inflammatory breast cancer (the most aggressive and dangerous breast cancer),³⁸
Basal-like carcinoma breast cancer,³⁹
Invasive lobular carcinoma breast cancer,⁴⁰
Medullary carcinoma breast cancer,⁴¹
Mucinous carcinoma breast cancer,⁴²
Pagets disease (cancer of the nipple),⁴³
Phyllodes breast tumors,⁴⁴
Triple-negative breast cancer,⁴⁵
Adenoid cystic carcinoma of the breast,⁴⁶
Papillary carcinoma of the breast,⁴⁷
Ductal carcinoma in situ (DCIS) breast cancer,⁴⁸
Hereditary breast cancer,⁴⁹
Metaplastic breast cancer,⁵⁰ or
Male breast cancer.⁵¹

Fortunately, it appears that the consumption of adequate folate folic acid or vitamin B9) may reduce or even eliminate any increased risk of breast cancer that might be caused by drinking alcohol.⁵²

The overall risk of breast cancer is low. "A typical 50-year-old woman has a five-year breast cancer risk of about 3 percent. If her risk jumps by 30 percent, her individual risk is still only about 4 percent."⁵³ The risk of dying from heart disease is about twelve times greater than dying from breast cancer among women in the U.S.

Because the moderate consumption of alcohol reduces the risk of dying from heart disease by as much as over half, the National Cancer Institute recommends that women discuss with their doctors whether or not to reduce their consumption of alcohol.

Alcohol and Colorectal Cancer

There's a lack of medical consensus about whether or not alcohol consumption is a risk factor for colorectal cancer. The National Cancer Institute,⁵⁴ the National Library of Medicine,⁵⁵ the American Society of Clinical Oncology,⁵⁶ the Memorial Sloan-Kettering Cancer Center,⁵⁷ and Cancer Research⁵⁸ have concluded that alcohol is not a risk factor.

Alternatively, the American Cancer Society,⁵⁹ the Mayo Clinic,⁶⁰ and the Colorectal Cancer Coalition⁶¹ suggest that "heavy use" or "heavy drinking" may increase the odds of the disease.

Alcohol and Liver Cancer

Alcohol consumption is not listed as a risk factor for liver cancer by the American Cancer Society⁶² and the American Society of Clinical Oncologists,⁶³ but is listed by the Mayo Clinic ("excessive alcohol consumption")⁶⁴ and About.com. ("excessive, long-term alcohol use").⁶⁵

The reason for the difference in considering whether or not alcohol is a risk factor is that alcohol itself doesn't cause liver cancer. However, heavy and abusive alcohol consumption over a period of many years is one of the causes of alcohol cirrhosis (along with hepatitis B and hepatitis C virus). It is the liver cirrhosis itself that is one of the risk factors for liver cancer.

The usual setting is an individual with alcoholic cirrhosis who has stopped drinking for ten years, and then develops liver cancer. It is somewhat unusual for an actively drinking alcoholic to develop liver cancer. What happens is that when the drinking is stopped, the liver cells try to heal by regenerating (reproducing). It is during this active regeneration that a cancer-producing genetic change (mutation) can occur, which explains the occurrence of liver cancer after the drinking has been stopped.⁶⁶

Alcohol is Not Considered a Risk Factor for any of the following Cancers

There is medical consensus, based on the totality of scientific evidence, that alcohol is not a risk factor for any of the following cancers, which are listed below alphabetically.

Acral lentiginous melanoma⁶⁷
Acute lymphocytic leukemia (ALL)⁶⁸
Acute myleoid leukemia (AML)⁶⁹
Adamantinoma⁷⁰
Adenoid cancer⁷¹
Adenoid cystic carcinoma⁷²
Adenoid cystic carcinoma of the breast⁷³
Adenomatoic odontogenic tumor⁷⁴
Adenocarcinoma of the lung⁷⁵
Adrenocortical carcinoma⁷⁶
Adrenal gland cancer⁷⁷
Alveolar Soft Part Carcinoma⁷⁸
Ampullary carcinoma⁷⁹
Anal cancer⁸⁰
Anaplastic thyroid cancer⁸¹
Angiosarcoma⁸²
Appendix cancer⁸³
Astrocytoma⁸⁴
Atypical teratoid rhabdoid tumor⁸⁵
Bartholin's gland cancer⁸⁶
Basal cell carcinoma⁸⁷
Basal-like carcinoma of the breast⁸⁸
B-cell leukemia⁸⁹
Bile duct cancer⁹⁰
Bladder cancer⁹¹
Bone cancer⁹²
Brain cancer⁹³
Cancer of unknown primary origin⁹⁴
Carcinoma of the Ampulla of Vater⁹⁵
Carcinoma with t(15;19) translocation⁹⁶
Cardiac sarcoma⁹⁷
Central nervous system (CNS) cancer⁹⁸
Cervical cancer⁹⁹
Childhood acute myeloid lymphoma¹⁰⁰
Childhood astrocytoma¹⁰¹
Childhood brain stem glioma¹⁰²
Childhood central nervous system (CNS) cancer¹⁰³
Childhood crangiopharyngioma¹⁰⁴
Childhood ependymoma¹⁰⁵
Childhood Ewing's family of tumors¹⁰⁶
Childhood Hodgkin's lymphoma¹⁰⁷
Childhood lymphoblastic leukemia¹⁰⁸
Childhood medulloblastoma¹⁰⁹
Childhood neuroblastoma¹¹⁰
Childhood non-Hodgkin's lymphoma¹¹¹
Childhood osteosarcoma¹¹²
Childhood rhabdimyosarcoma¹¹³
Childhood Wilms tumor¹¹⁴
Chordoma¹¹⁵
Choriocarcinoma¹¹⁶
Choroidal melanoma¹¹⁷
Chronic lymphocytic leukemia (CLL)¹¹⁸
Chronic myeloid leukemia (CML)¹¹⁹
Chrondosarcoma¹²⁰
Clear cell sarcoma of the kidney¹²¹
Crangiopharyngioma¹²²
Dermatofibrosarcoma protuberans¹²³
Demoplastic infantile ganglioma
Desmoplastic small round cell tumor¹²⁴
Ductal carcinoma in situ (DCIS) breast cancer¹²⁵
Ear cancer¹²⁶
Endometrial cancer¹²⁷
Ependymoma¹²⁸
Eosinophilic leukemia¹²⁹
Esthesioneuroblastoma¹³⁰
Extragonadal germ cell cancer¹³¹
Extrahepatic bile duct cancer¹³²
Ewing's family of cancers¹³³
Eye cancer¹³⁴
Eyelid cancer¹³⁵
Fallopian tube cancer¹³⁶
Familial adenomatous polyposis¹³⁷
Familial malignant melanoma¹³⁸
Gallbladder cancer¹³⁹
Gastrinoma¹⁴⁰
Gastrointestinal carcinoid tumors¹⁴¹
Gastrointestinal stromal cell tumors¹⁴²
Germ cell tumor of the brain¹⁴³
Gestational trophoblastic neoplasia¹⁴⁴
Glucagonoma¹⁴⁵
Hairy cell leukemia¹⁴⁶
Hemangioendothelioma¹⁴⁷
Hepatoblastoma¹⁴⁸
Hereditary breast cancer¹⁴⁹
Hereditary diffuse gastric cancer¹⁵⁰
Hereditary leiomyomatosis¹⁵¹
Hereditary non-polyposis colorectal cancer¹⁵²
Hereditary non-VHL clear cell renal cell carcinoma¹⁵³
Hereditary papillary renal cell carcinoma¹⁵⁴
HIV and AIDs-related cancers¹⁵⁵
Hurtle cell carcinoma¹⁵⁶
Inflammatory breast cancer¹⁵⁷
Insulinoma¹⁵⁸
Intraocular melanoma¹⁵⁹
Invasive lobular carcinoma of the breast¹⁶⁰
Kaposi's sarcoma¹⁶¹
Keratoacanthoma¹⁶²
Kidney cancer¹⁶³
Lacrimal gland cancer¹⁶⁴
Large cell cancer of the lung¹⁶⁵
Leiomyosarcoma¹⁶⁶
Leukemia¹⁶⁷
Liver cancer¹⁶⁸
Lung cancer¹⁶⁹
Lymphangiosarcoma¹⁷⁰
Male breast cancer¹⁷¹
Malignant fibrous histiocytoma¹⁷²
Malignant melanoma¹⁷³
Malignant mesothelioma¹⁷⁴
Mastocytosis¹⁷⁵
Medullary carcinoma of the breast¹⁷⁶
Medullary thyroid cancer¹⁷⁷
Medulloblastoma¹⁷⁸
Melanoma¹⁷⁹
Meninglioma¹⁸⁰
Merkel cell carcinoma¹⁸¹
Metaplastic breast cancer¹⁸²
Mucinous carcinoma of the breast¹⁸³
Mucosa-associated lymphoid tissue (MALT) lymphoma¹⁸⁴
Multiple endocrine neoplasia, Type 1¹⁸⁵
Multiple endocrine neoplasia, Type 2¹⁸⁶
Multiple myeloma¹⁸⁷
MYH-associated polyposis (MAP)¹⁸⁸
Nasal cavity cancer¹⁸⁹
Nasopharynageal cancer ¹⁹⁰
Neurolblastoma¹⁹¹
Neuroendocrine tumor¹⁹²
Neurofibromatosis¹⁹³
Non-Hodgkin lymphoma¹⁹⁴
Non-small cell lung cancer¹⁹⁵
Oligodendroglioma¹⁹⁶
Oral malignant melanoma¹⁹⁷
Osteosarcoma¹⁹⁸
Ovarian cancer¹⁹⁹
Paget's disease of the nipple (breast cancer)²⁰⁰
Pancreatic cancer²⁰¹
Papillary carcinoma of the breast²⁰²
Paraganglioma²⁰³
Paranasal sinus cancer²⁰⁴
Parathyroid cancer²⁰⁵
Penile cancer²⁰⁶
Pheochromocytoma²⁰⁷
Phyllodes breast tumors²⁰⁸
Pineal region tumor²⁰⁹
Pituitary gland cancer²¹⁰
Plasma cell leukemia²¹¹
Pleuropulmonary blastoma²¹²
Primitive neuroectodermal tumors²¹³
Prostate cancer²¹⁴
Rectal cancer²¹⁵
Retinoblastoma²¹⁶
Sacrococcygeal teratoma²¹⁷
Salivary gland cancer²¹⁸
Sebaceous gland carcinoma²¹⁹
Scrotal (soot wart) cancer²²⁰
Skin cancer²²¹
Small intestine cancer²²²
Soft tissue cancers²²³
Somatostatinoma²²⁴
Spine or spinal cancer²²⁵
Squamous cell carcinoma²²⁶
Squamous cell lung cancer²²⁷
Synovial cell sarcoma²²⁸
Stomach cancer²²⁹
T-cell leukemia²³⁰
Temporal bone cancer²³¹
Testicular cancer²³²
Testicular germ cell tumors²³³
Thymoma²³⁴
Thymus cancer²³⁵
Thyroid cancer²³⁶
Transitional cell cancer of renal pelvis²³⁷
Triple-negative breast cancer²³⁸
Tubular carcinoma of the breast²³⁹
Ureter cancer²⁴⁰
Urethra or urethral cancer²⁴¹
Uveal melanoma²⁴²
Vaginal cancer²⁴³
Vulvar cancer²⁴⁴
Verrucous carcinoma²⁴⁵
Waldenstrom macroglobulinema²⁴⁶
Wilms tumor²⁴⁷

Drinking alcohol is not a risk factor for developing most cancers. On the other hand, the moderate consumption of alcohol is associated with better health and greater longevity than is either abstaining from alcohol or drinking abusively.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has recommended that a man consume no more than four drinks on any day and no more than an average of 14 drinks per week. For women, it recommends no more than three drinks in any one day and an average of no more than seven drinks per week.

Standard Drinks

Standard Drinks graphically illustrates information on the equivalence of standard drinks of beer, wine and distilled spirits or liquor.

A standard alcoholic drink is:

A 12-ounce can or bottle of regular beer
A 5-ounce glass of dinner wine
A shot (one and one-half ounces) of 80 proof liquor or spirits such as vodka, tequila, or rum either straight or in a mixed drink.

Standard drinks contain equivalent amounts of alcohol. To a breathalyzer, they're all the same.

There is no evidence that any form of alcohol (beer, wine, or liquor - distilled spirits) confers greater health benefits than an other.

Nothing on this page constitutes medical opinion or advice. For medical diagnosis, opinion, advice or treatment consult a qualified physician.

Readings on Alcohol as a Risk Factor for Cancer:

(listing does not imply endorsement)
Allen, Naomi E., et al. Moderate alcohol intake and cancer incidence in women. Journal of the National Cancer Institute, 2009, 101(5), 296-305.
Bagnardi., A., et al. A meta-analysis of alcohol drinking and cancer risk. British Journal of Cancer, 2001, 85(11), 1700-1705.
Bofetta, P. and Hashibe, M. Alcohol and cancer. The Lancet (oncology), 2006, 7(2), 149-156.
Bofetta, P., et al. The burden of cancer attributable to alcohol drinking. International Journal of Cancer/Journal International du Cancer, 2006. 119(4), 884-887.
Breimer, L. H. and Theobald, H. Re: Moderate alcohol intake and cancer incidence in women. Journal of the National Cancer Institute, 2009, 101(15), 1093.
Cho, C.H. and Purohit, V. Alcohol, Tobacco and Cancer. Basel & New York: Karger, 2006.
Hamnpton, T. Alcohol and cancer. JAMA: Journal of the American Medical Association, 2005, 294(12), 1481.
Hausdorf, K., et al. Prevalence and correlates of multiple cancer risk behaviors in an Australian population-based survey: results from the Queensland Cancer Risk Study. Cancer Causes and Control, 2008, 19(10), 1339-1347.
Homann, N. and Seitz, H. K. Alcohol's effect on the development and progression of cancer. Nutrition in Clinical Care, 2000, 3(2), 83-89.
Inoue, M., et al. Alcohol drinking and total cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population. Japanese Journal of Clinical Oncology, 2007, 37(9), 692-700.
Lewis, S. Alcohol as a Cause of Cancer. Eveleigh, N.S.W., Australia: Cancer Institute NSW, 2008.
McPherson, K. Moderate alcohol consumption and cancer. Annals of Epidemiology, 2007, 17(5), S46-S48.
Poschi, G. and Seitz, H.K. Alcohol and cancer. Alcohol and Alcoholism, 2004, 39(3), 155-165.
Seitz, H.K. and Becker, P. Alcohol metabolism and cancer risk. Alcohol Research & Health, 2007, 30(1), 38-47.
Wang, Xiang-Dong. Alcohol, vitamin A, and cancer. Alcohol, 2005, 35(3), 251.

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