Alarming Study on Alcohol and Cancer Death Risk Should Not be Alarming

What the Public reads:

A study was published online February 14, 2013, in the American Journal of Public Health by Nelson, DE et al, in advance of print titled, “Alcohol-Attributable Cancer Deaths and Years of Potential Life Lost in the United States.” The lay press picked up this study and a published summary appeared the following day in the San Francisco Chronicle and soon after in The Seattle Times with an alarming title, “Alcohol use raises the risk of cancer deaths.” NBCNews.com released a report on February 18 with the alarming heading, “Even a drink a day boosts cancer death risk, alcohol study finds.”

The research attempted to provide current estimates of alcohol-attributable cancer mortality and years of potential lost (YPL) in the United States. The researchers based their conclusions on relative risks found on meta-analyses published since 2000 and on adult alcohol consumption using the 2009-2010 National Alcohol Survey and other major alcohol epidemiologic databases.

The study concluded that 18,200 to 21,300 cancer deaths (3.2% to 3.7%) of all United States cancer deaths were due to alcohol consumption. Breast cancer deaths were more common in women and upper airway and esophageal cancer deaths were more common in men. Deaths attributable to cancers result in 17.0 to 19.1 YPL for each death. Daily consumption of less than or equal to 1.5 drinks of alcoholic beverages led to 26% to 35% of alcohol-attributable cancer deaths. The authors of the study concluded, “Higher consumption increases the risk but there is no safe threshold for alcohol and cancer risk.

What the Public didn’t read and needs to understand:

R, Curtis Ellison, MD, Professor of Medicine & Public Health at the Boston University School of Medicine and Co-Director, International Scientific Forum on Alcohol Research, is a recognized expert in the science and epidemiology of the relationship between alcohol and health. In his comments on the published research at www.bu.edu/alcohol-forum/reviews, he points out a number of concerns about the analyses and conclusions made by the authors of this paper. Here are his important comments.

“The authors do not clearly separate the effects of truly moderate drinking from heavier drinking in their conclusions. They do not take into account the pattern of drinking. They do not point out the demonstrated effects of alcohol on total mortality. The authors do not put their results into perspective: in other words, statements such as “There is no safe threshold for alcohol and cancer risk” is more of a ‘scare’ statement than a balanced discussion of their results. Given that almost all prospective studies show that regular moderate drinkers have better health as they age and live longer than abstainers, even papers focused on the effects of alcohol on any particular disease should present a balanced view on its net effects on health and disease. Observational data can never reveal the full ‘truth’ about the causation of disease from exposures.”

Ellison emphasizes what the authors failed to mention in their paper, namely, “There has been a huge amount of previous research in this field, but the authors do not put their own results into prospective or discuss the overall health effects of alcohol consumption. Previous data have clearly shown that regular moderate drinkers tend to have lower risk of cardiovascular disease, stroke, diabetes, and many other diseases, and have a lower overall risk of all-cause mortality.

As I have pointed out many times in the PinotFile, there are many challenges to medical research on alcohol in the United States and attempts to spread the correct communiqué to the American public. There are far too many alarming headlines implicating alcohol as evil and deadly, often under the veil of Neo-prohibitionism, resulting in a confusing message to the public.

I believe we need more voices among the wine industry and many wine organizations, promoting the truth about responsible consumption of alcohol and wine and the resulting possible health benefits. Respected wine columnist, Dan Berger, recently wrote an article on “Scare stories about wine” for the Press Democrat (February 20, 2013) and pointed out that Andre Tchelistcheff lived to 92, Ernest Gallo to 97 and Robert Mondavi to 94. What does that tell you?