Missing topic during Breast Cancer Awareness Month
October is Breast Cancer Awareness Month in Canada, the US, and around the world. You will likely start to notice pink ribbons popping up everywhere, reminders for regular mammograms, and alarming statistics about the impact of this brutal disease. Statistics like 1 in every 8 women (which is true in both Canada and the US) will develop breast cancer in her lifetime and 1 in every 36 women will die from it. Another concerning statistic: in both Canada and the US (and likely other parts of the globe), there has been a concerning increase in breast cancer rates in younger women.
Despite the popularity and prominence of breast cancer awareness and research, what you might not see as much of this month is information on the causal link between alcohol and breast cancer. While we are starting to see more conversations about alcohol’s carcinogenic nature, what we still aren’t seeing enough of is accurate information on alcohol as a leading risk factor for breast cancer, signaling a noticeable gap in the conversation.
Low levels of awareness but high levels of breast cancer due to alcohol
As someone who works professionally in the recovery space as a sober coach and as someone who has a health- and research-based Master’s degree, I was shocked to learn about the causal link between alcohol and breast cancer.”
Amy C. Willis
This gap in the conversation is reflected clearly in low levels of awareness when it comes to the causal link between alcohol and breast cancer risk. According to this study, which included 14 European countries, women’s awareness levels of the direct link between alcohol and breast cancer are shockingly low, typically hovering around 20%.
This means is approximately 80% of the women in these studies who consume alcohol do not know about the causal link between alcohol and breast cancer, which is a huge and potentially deadly problem.
This is especially concerning for several reasons:
First, in many parts of the world, alcohol is widely available, heavily marketed, often socially expected and its consumption is both glamorized and normalized. In addition, the alcohol industry often misrepresents or downplays the inherent risks and harms of their products so those who are consuming alcohol aren’t fully aware of their risk exposure.
Second, when it comes to breast cancer risk, outside of genetic and hereditary factors, alcohol is one of the leading risk factors for breast cancer and unlike many other risk factors, it can be completely avoided in an effort to lower one’s risk of breast cancer development.
According to the International Agency for Research on Cancer (IARC), in 2020, an estimated 2.26 million new cases of breast cancer were reported globally making it (at the time) the most common type of cancer worldwide. According to these same data, approximately 100,000 of these breast cancer cases are due to alcohol.
In 2022, there were 2.31 million new cases of breast cancer worldwide, making breast cancer both the most common type of cancer diagnosed amongst women and the most common cause of cancer death in women.
I was shocked that the information about the causal link between alcohol and breast cancer wasn’t more readily available or commonplace.”
Amy C. Willis
It is important to remember that these numbers are estimates, based on population data and self-reporting by individuals of their alcohol consumption. When held up to alcohol sales, what becomes clear is that many individuals underreport their alcohol consumption. Therefore it is reasonable to expect that the number of breast cancer cases due to alcohol is even higher. What these numbers indicate is an urgent need for increased education and awareness of the link between alcohol and breast cancer and public policy action to lower levels of alcohol consumption in an effort to prevent and reduce alcohol harms for women.
Breast cancer scare leads to exploration of alcohol and breast cancer topic
As someone who works professionally in the recovery space as a sober coach and as someone who has a health- and research-based Master’s degree, I was shocked to learn about the causal link between alcohol and breast cancer but I was also shocked that the information wasn’t more readily available or commonplace. It was my own breast cancer scare* that began in 2021 that prompted me to explore alcohol’s link to breast cancer risk.
In my own experiences, my doctor hardly inquired about my alcohol consumption and talking about the link between alcohol and breast cancer was not discussed, even after it became clear that my breast health was in question and my history of heavy alcohol consumption was known.”
Amy C. Willis
After experiencing unusual skin irritation and pain in my right breast, I booked an appointment with my doctor for a visual and manual breast exam. Through the manual exam, my doctor found a golf-ball sized mass and I was sent for both a mammogram and ultrasound for additional information. I was 39 years old at the time.
I was both worried and confused about why this was happening to me and in the absence of any history of breast cancer or genetic markers that would increase my risk, I began researching other risk factors that contribute to breast cancer risk. It was at this time that I learned that alcohol is one of the biggest risk factors for breast cancer.
Understanding risk
During my research, I also learned how low and moderate levels of alcohol consumption increase the cancer risk and got a glimpse of how my history of heavy alcohol consumption increased my own risk of breast cancer significantly. What the research shows is that 1 standard alcoholic drink per day/7 alcoholic drinks a week increases risk by 14%, 2 standard alcoholic drinks per day/14 alcoholic drinks per week increase risk by 28%, and if a person is drinking more than 2 standard alcoholic drinks per day or engaging in binge alcohol use , their level of risk is even higher. And these numbers are in addition to the baseline risk of 12%.
The more alcohol a person consumes, the greater their risk of getting cancer. Conversely and powerfully, the less alcohol a person drinks, the less risk they experience. While doing this research, I have never been more grateful for my own sobriety and making that life-changing and saving decision to get sober in 2016.
I was terrified, saddened and furious to learn that this causal relationship between alcohol and breast cancer existed, has been known for years and yet it wasn’t part of the mainstream conversation. In my own experiences, my doctor hardly inquired about my alcohol consumption and talking about the link between alcohol and breast cancer was not discussed, even after it became clear that my breast health was in question and my history of heavy alcohol consumption was known.
Why don’t more women know?
When it comes to the causal link between alcohol and breast cancer risk, why do more women not know the facts?
After spending a considerable amount of time thinking about, researching and analyzing this question, there seem to be several factors contributing to the current climate that lacks important and accurate information.
First, when compared to other types of cancer causally linked to alcohol such as mouth, throat, esophagus, and liver, on an intuitive level, these types of cancer make more sense as alcohol makes contact with these areas of the human body as it moves through the alcohol consumer. This is not the case with breast cancer, which is an area of the body that doesn’t have direct contact with alcohol.
Second, alcohol companies spend huge amounts of money (at least $17 billion in 2017) on marketing not only to sell their products but perhaps more importantly, to control the narrative around alcohol, influence behavior and consumption and create confusion and misinformation through unethical, manipulative and dishonest campaigns.
Alcohol companies, under the guise of corporate social responsibility, have even gone as far as creating entities called social aspects/public relations organizations (SAPROs) which are organizations and websites that masquerade as independent and/or charitable groups that claim to exist to provide information on alcohol and reduce alcohol harms.
On the surface and to the untrained eye, they look like (and state that they are) websites that provide information about alcohol. However, much like their marketing strategies, these organizations use tactics like denial and omission (of the inherent risks and harms of alcohol), distortion (mentioning health concerns but misrepresenting the level of risk) and distraction (instead of clearly name causal relationships, pointing to other factors that might contribute to negative health consequences). These tactics create confusion and misinformation and for anyone who is proactively looking for information on alcohol risks and harms, these types of websites intentionally mislead people with unclear information.
My hope in sharing my own story and writing this piece on alcohol use and breast cancer risk is to inspire candid conversations about alcohol use and to ultimately prevent and reduce alcohol harms moving forward.”
Amy C. Willis
Despite both the World Health Organization and the World Heart Federation clearly stating that no amount of alcohol is safe for human consumption, when it comes to popular messaging about alcohol, we are inundated with subtle and insidious marketing messages (think: product placements, influencer marketing, sponsorships) daily that tell a different story. In a climate of little to no regulation around marketing campaigns in many countries and billion dollar marketing budgets of the alcohol industry (which public health organizations simply don’t have) running roughshod over accurate, public health messaging, it’s no wonder that we, as a collective, lack awareness and understanding of the inherent risks and harms of alcohol consumption. This is by design and is especially true when it comes to alcohol and breast cancer risk.
My hope in sharing my own story and writing this piece on alcohol use and breast cancer risk is not to prompt fear but instead to increase awareness amongst women, to inspire candid conversations about alcohol use and to ultimately prevent and reduce alcohol harms moving forward.
Whether you live in Canada or not, in 2023, Canada introduced groundbreaking new low risk alcohol consumption guidelines. Based on the most recent research and data, these guidelines suggest that in order to stay within the low risk range, no more than 2 standard alcoholic drinks per week should be consumed. These are great guidelines to follow if you are interested in reducing your risk of breast and other cancers and negative health outcomes.
When it comes to breast cancer risk, there are numerous risk factors that can’t be avoided but alcohol absolutely can. By reducing or eliminating alcohol intake, women are reducing or eliminating the additional breast cancer risk alcohol exposes them to. This risk can be avoided and my hope is that with accurate information, this risk will be avoided by more women moving forward. I also hope that for the women who read this piece, that they pass it along to the women in their lives in an effort to combat the misinformation and lack of awareness.
Women deserve more. Women deserve better.
*After 2.5+ years of regular screenings and imaging for breast cancer, the identified masses were recently deemed benign by my doctors.
For further reading
WHO Europe: Shouldn’t we know this already? The link between alcohol and breast cancer
An article answering the questions of How alcohol causes breast cancer, how many breast cancer cases in Europe there are and which role alcohol plays, and which role alcohol policy plays in breast cancer prevention and promoting women’s health and future well-being.
