Are Wine Critics, Winemakers and Somms at Increased Risk for Cancer?
In the past two years, two prominent wine writers died from cancer. Oregon wine writer and critic Cole
Danehower died in 2015 from pancreatic cancer and Greg Walter of the Wine Spectator and Pinot Report
passed away in 2016 from colon cancer. There have been several other wine professionals in the news who
died in recent years as well including Willamette Valley Vineyards winemaker Forest Klaffke (throat cancer,
2012), Poetic Wines owner and winemaker Katy Lovell (pancreatic cancer, 2013), Barossa Valley Australia
winemaker Bob McLean (liver cancer, 2015), Burgundy vintner Ann-Claude Leflaive (cancer, 2015) and Dry
Creek Valley winemaker John Pedroncelli (cancer, 2015).
Of course, these isolated cases do not document a significantly increased risk of dying from cancer among
wine professionals. In the United States alone in 2016, there is expected to be 595,690 cancer deaths
reflecting the fact that cancer is a prevalent cause of death. However, the increased exposure to alcohol
among wine critics, winemakers and sommeliers compared to many in the general population suggests that
they may be at heightened risk of dying from cancer.
Since I taste wine almost daily, I wondered about the health risk. It has been well established since the 1980s
that alcohol is a carcinogen at high levels of alcohol intake at several sites in the human body including the
mouth, throat, larynx, esophagus, stomach, colon, rectum, pancreas, liver, lung and breast. There is a dose response
curve, meaning that the risk increases the more alcohol people consume on a regular basis with
smoking tobacco greatly adding to the risk for all cancers, particularly throat and mouth cancer. The quantity of
alcohol consumed matters most for men’s cancer risk, the frequency of drinking is more important for women’s
risk according to Dr. Arthur Klatsky, a renowned health and alcohol researcher.
I asked Curtis Ellison, M.D., Professor of Medicine and Public Health at Boston University and one of the
country’s top authorities on the relationship of alcohol and health, if he knew of a study that showed an
increased risk of cancer among wine writers and critics, and he did not. A.H. Finkel, M.D., who has written
about alcohol and health, told me in good humor that assuming judicious spitting, the only two
risks among wine tasters are (1) dissolution of dental enamel, presumably by acidic wine being held in the
mouth for long periods of time (and exacerbated by fastidious individuals brushing their teeth soon after
slurping and swishing), and (2) stained neckties (a declining risk since hardly anyone wears neckties any more).
He also mentioned that like all critics, those of wine share the risk from enraged subjects of their trade.
Research published in 2015 in the Australian Dental Journal has shown that acid in wine can expose teeth to
erosion. This study found that just 10 one-minute episodes of wine tasting normally
experienced by wine tasters was enough to erode tooth enamel, with teeth becoming vulnerable within a few
minutes of wine acid exposure. Dr. Sarbin Ranjitar of the University of Adelaide who conducted the study said,
“With professional wine tasters and winemakers tasting anywhere from 20 to 150 wines per day, and wine
judges tasting up to 200 wines per day during wine competitions, this represents a significant risk to their oral
health. Our results reinforce the need for people working the profession to take early preventive measures, in
consultation with their dentists, to minimize the risks to their teeth.” These measures include not brushing teeth
the morning of a wine tasting or if brushing is required, use chewing gum to stimulate saliva which is naturally
protective. After wine tasting, do not brush the teeth as that may damage the enamel, but rinse with water and
when it is time to clean the teeth, put some toothpaste on a finger and gently clean the teeth.
I tested my own blood alcohol level on several occasions after tasting with spitting a series of 8 to 12 wines with multiple passes
through each wine (my usual tasting regimen). My blood alcohol level was less than 0.08% on every occasion.
However, I believe those critics who taste large numbers of wine at one sitting, even with judicious spitting, will
exceed that blood alcohol level. Spitting does not insulate one from alcohol absorption for it is proven that there
is some absorption of alcohol through the mucous membranes of the mouth (alcohol is soluble in both water
and saliva and moves easily and quickly within 10 to 20 seconds across membranes), and some alcohol is
absorbed as vapor through the lungs. Fortunately, alcohol dries the mucous membranes of the mouth, causing
the secretion of mucous that protects against absorption.
The jury is out since their is no scientific research to implicate an increased risk of cancer among those who do
extensive wine tasting appropriately. One thing is for sure, however, as Dr. Finkel noted, like all critics, those of
wine share the risk from enraged subjects of their trade. This stress is undoubtedly unhealthy.
Did this short discourse pique your interest about the risks of cancer among wine drinkers? Read further if you
There were several major studies published in 2015 regarding the association of alcohol consumption with the
risk of cancer, and the papers were critically reviewed by the International Forum on Alcohol Research.
The first study was published in the British Medical Journal and titled “Light to moderate intake of alcohol,
drinking patterns, and risk of cancer: results from two prospective US cohort studies.” This study involved
88,084 women and 47, 881 men participating in the Nurses’ Health Study and Health Professionals Follow-up
Study, followed until 2010. The Forum considered this a well-done analysis of two very large cohort studies and
felt that this was an important study presenting data that is of relevance to individuals and agencies providing
advice regarding alcohol consumption. That said, the Forum pointed out that all dietary and lifestyle factors
shown to increase the risk of cancer were not included in the report. The authors of the study concluded that
light to moderate drinking (up to two drinks per day) is associated with a minimal increased risk of overall
cancer. For men who have never smoked, risk of alcohol related cancers is not appreciably increased for light
and moderate drinking. For women who have never smoked, risk of alcohol related cancers (mainly breast
cancer) increases even within the range of up to one alcoholic drink a day. For both genders, there seemed to
be a dose-response increase in risk of cancer with larger amounts of alcohol. Heavy drinking markedly
increased the risk of upper airway and digestive tract cancers. Smoking was identified as an even more
important risk factor than alcohol for cancers.
The second study was published in Permanente Journal by chief author Arthur Klatsky, M.D., titled “Alcohol
intake, beverage choice, and cancer: A cohort study in a large Kaiser Permanente population.” The results of
this very large study indicated that heavy drinking (equal to or greater than 3 drinks a day) was associated with
an increased risk of upper airway/digestive tract, lung, female breast, colorectal and melanoma cancers, with light to moderate
drinking related to all but lung cancer. No significantly increased risk was seen for 12 other cancer
sites: stomach, pancreas, liver, brain, thyroid, kidney, bladder, prostate, ovary, uterine body, cervix, and
hematologic system. For all cancers combined there was a progressive relationship with all levels of alcohol
drinking. Alcoholic beverage choice played no major independent role.
A third study was published in the British Medical Journal, titled “Alcohol consumption and site-specific cancer
risk: a comprehensive dose-response meta-analysis.” The authors of the study concluded that heavy drinking
(the study defined one typical drink as 12.5 g or less per day) of >50 g/day of alcohol increased the risk for
cancers of the upper airway/digestive tract, lung, female breast, and colon and rectum; for those neoplasms
there was a clear dose-risk relationship. Significant increases were reported for heavy drinking for cancers of
the stomach, liver, gallbladder, pancreas and lung, but the risk ratio for most of these were lower. There was an
indication of a positive association between alcohol consumption and risk of melanoma and prostate cancer.
A fourth study was published in Cancer Causes Control titled “Incident cancers attributable to alcohol
consumption in Germany, 2010.” The authors found that there was an apparent increase in the population
attributable risk of cancer for men for upper airway/digestive tract and colon and rectum, but decreases from
alcohol for liver cancer. For women, there was a decrease in colon and rectal and liver cancer from alcohol, but
increases for breast and upper airway/digestive tract cancers.
As the Forum points out, all these studies describe an increased risk for many cancers among heavy drinkers,
especially cancers of the upper airway and digestive tract. Even with the data from these studies, we still
cannot state reliable threshold levels of drinking that increase the risk of cancer. Most reports on alcohol and
cancer are flawed because they lack information on confounding, drinking patterns, beverage choice and the
effects of under reporting of alcohol intake. The studies also omit a discussion of total mortality versus cancer
mortality. One additional complicating factor is that published studies offer varying definitions of light,
moderate and heavy drinking making results more difficult to compare and threshold levels to be determined.
One more interesting study bears mention. A report published in 2016 in the British Journal of Sports Medicine
found that drinkers who exercised 150 minutes a week reduced their chances of dying due to any alcohol
related illness. In physically active groups, only harmful levels of drinking (more than 39 standard drinks a week
for men and 11-29 standard drinks a week for women) were associated with an increased risk of cancer death
and death from any cause. So although the drinking of an average of 2.4 standard drinks a day for men and
1.6 standard drinks a day for women was associated with a 36% greater risk of death from cancer, the risk was
substantially lessened or offset by physical activity.
In summary, the words of Dr. Klatsky should be noted, “For most persons older than age 50 years, the overall
benefits of lighter drinking, especially the reduced risk of atherothrombotic disese, outweigh possible cancer
risk. For young persons, the possible increased cancer risk at moderate intake should be part of an individual’s
estimation of the overall risk-benefit equation for alcohol drinking.”