Surgeon General calls for cancer warnings for alcohol

Alcohol is the leading preventable cause of cancer, and alcoholic beverages should carry a warning label like packs of cigarettes, the U.S. Surgeon General said Friday.

It’s the latest salvo in a fierce debate over the risks and benefits of drinking in moderation as a looming update to the influential U.S. Dietary Guidelines for Americans. For decades, moderate drinking was thought to assist prevent heart attacks and strokes.

This belief has been ingrained in the dietary advice given to Americans. However, a growing body of research has linked drinking alcohol, sometimes even within recommended limits, with various types of cancer.

Labels currently placed on bottles and cans of alcoholic beverages warn against drinking while pregnant or against driving or operating other machinery, as well as general “health risks.”

But alcohol directly contributes to 100,000 cancer cases and 20,000 cancer-related deaths each year, said Surgeon General Dr. Vivek Murthy.

He called for label updates include an increased risk of breast cancer, colon cancer and at least five other malignancies that have now been linked to alcohol consumption in research.

“Many people assume that as long as they drink at or below the limits set in current guidelines – one a day for women and two for men, it does not pose any risk to their health and well-being,” Dr. Murthy said. interview.

“The data does not support this for cancer risk.”

Only Congress can impose recent warning labels like Dr. Murthy’s recommended, and it is unclear whether the incoming administration will support this change.

Despite this, President-elect Donald J. Trump does not drink, and Robert F. Kennedy Jr., who chose to head the Department of Health and Human Services, renounced alcohol and drugs decades ago and claims to regularly attend AA meetings.

There is no doubt that excessive consumption is harmful. But advocates of moderate alcohol consumption – including producers of wine, beer and spirits, as well as some doctors and scientists – say a diminutive amount of alcohol a day can reduce the risk of cardiovascular disease, the No. 1 killer in the United States.

More recent research, however, has criticized the methodology of earlier studies and challenged what was once the consensus view.

Although most cancer deaths occur after drinking more than currently recommended dietary guidelines, the risk of breast, mouth and throat cancers may escalate with consumption of just one drink a day or even less, Dr. Murthy says. on Friday.

Overall, one in six breast cancer cases can be attributed to alcohol consumption, Dr. Murthy said. More recent research has also linked moderate alcohol consumption to some forms of heart disease, including atrial fibrillation and cardiac arrhythmia.

Updated alcohol consumption recommendations in the federal dietary guidelines will be used in two scientific reviews.

Five years ago scientific report which informed about the preparation of dietary guidelines for 2020-2025, admitted that alcohol is a carcinogen and generally unhealthy, and suggested “tightening guidelines” limiting the recommendation for men at one standard drinkor 14 grams of alcohol per day.

However, when the final guidelines were developed, they did not change the recommendation that moderate drinking of up to two drinks a day is acceptable for men.

However, the government acknowledged emerging evidence showing that “even drinking within recommended limits may escalate the overall risk of death from a variety of causes, for example from several types of cancer and some forms of cardiovascular disease.”

Since then, even more research has linked alcoholic beverages to cancer. However, any attempt to change warning labels on alcoholic beverages will likely require challenging work.

The current warning label has not changed since it was adopted in 1988, even though the link between alcohol and breast cancer has been known for decades.

It was first mentioned in the 2000 US Dietary Guidelines. In 2016, the Surgeon General’s Report on Alcohol, Drugs and Health linked alcohol abuse to seven different types of cancer.

Congress recently commissioned a scientific review of research on moderate drinking, conducted under the auspices of the National Academies of Sciences, Engineering, and Medicine.

This analysis found an association between alcohol consumption and a diminutive escalate in the incidence of breast cancer, but no clear association with any other cancers. The report also renewed the theory that moderate drinking is associated with fewer deaths from heart attacks and strokes, and fewer deaths overall, compared with not drinking.

However, the World Health Organization says there is no protected limit for alcohol consumption and 47 countries require warnings on alcoholic drinks. However, cancer is rarely mentioned.

So far, only South Korea has a liver cancer warning label, although manufacturers may choose alternative labels that do not mention cancer. Ireland is now due to introduce labels in 2026 stating there is a “direct link between alcohol and deadly cancers”.

The industry has a powerful history of fighting warning labels mentioning cancer, and alcohol-producing countries have also challenged warning labels under international trade law.

Industry opposition led to the premature end of a federally funded Canadian study on the effects of warning labels mentioning cancer.

The surgeon general’s advice included a brief review of research and reviews published over the past two decades, including a global study spanning 195 countries and territories and involving 28 million people.

They all found that higher alcohol consumption was associated with a higher risk of cancer.

Other studies looked at specific cancers, e.g breast cancer AND oral cancer found that the risk increased by 10 percent and 40 percent, respectively, for people who drank only one drink a day, compared with those who did not drink.

The report describes the biological mechanisms by which alcohol causes cancer at the cellular level.

The most widely accepted theory is that alcohol breaks down in the body into acetaldehyde, a metabolite that binds to and damages DNA, allowing the cell to begin growing uncontrolled and forming a malignant tumor.

Animal experiments have shown that rodents whose drinking water was spiked with ethanol, alcohol used in alcoholic beverages, or acetaldehyde developed a immense number of tumors throughout their bodies.

Studies have shown that alcohol causes oxidative stress, which increases inflammation and can damage DNA.

It also changes levels of hormones such as estrogen, which may play a role in the development of breast cancer, and makes it easier for the body to absorb carcinogens such as tobacco smoke particles, increasing susceptibility to mouth and throat cancers.

The Surgeon General’s report also provides detailed information on the escalate in risk associated with drinking, distinguishing between absolute and relative risk increases.

For example, a woman’s absolute lifetime risk of breast cancer is approximately 11.3 percent (11 in 100) for women who drink less than one drink per week.

The risk increases to 13.1 percent (13 in 100 people) for one drink a day and to 15.3 percent (15 in 100) for two drinks a day.

For men, the absolute risk of alcohol-related cancer increases from about 10 percent (10 in 100 people) for people who drink less than one drink a week to 11.4 percent (11 in 100) for people who drink a drink every week. average day. This increases to 13 percent (13 per 100 people) for people drinking an average of two drinks a day.

Many Americans do not know that there is a link between alcohol and cancer.

Less than half of Americans American adults aged 18 and older identified alcohol utilize as a cancer risk factor, compared with 89 percent who identified tobacco as a carcinogen, according to a 2019 study by the American Institute for Cancer Research.

However, according to the Surgeon General’s report, alcohol consumption is the third most common preventable cause of cancer, after tobacco and obesity.

Dr Murthy said it’s critical to know that the risk increases as alcohol consumption increases. However, each person’s risk of developing cancer is different and depends on family history, genetic makeup and environmental exposures.

“It’s a pity we don’t have a magic border where we can tell people they are protected,” he said. “We know that less is better when it comes to reducing cancer risk.”

“If a person drinks occasionally for special events, or if you have one or two drinks a week, the risk is probably much lower than if you drink every day,” he added.