Moderate Alcohol Intake and Cancer Incidence in Women
With the exception of breast cancer, little is known about the effect of low-risk intakes of alcohol, or of particular types of alcohol, on cancer risk in women.
A total of 1 ,280,296 middle-aged women in the United Kingdom enrolled in the Million Women Study were routinely followed for incident cancer. Cox regression models were used to calculate adjusted relative risks and 95% confidence intervals (CIs) for 21 site-specific cancers according to amount and type of alcoholic beverage consumed. All statistical tests were two-sided.
A quarter of the cohort reported having no alcohol; 98% of users consumed fewer than 21 alcoholic beverages per week, with users consuming an average of 10 g alcohol (1 alcoholic beverage) per day. During an average 7.2 years of follow-up per woman 68,775 invasive cancers occurred. Increasing alcohol consumption was associated with increased risks of cancers of the oral cavity and pharynx (increase per 10 g/d = 29%, 95% CI = 14% to 45%, Ptrend < .001), esophagus (22%, 95% CI = 8% to 38%, Ptrend = .002), larynx (44%, 95% CI = 10% to 88%, Ptrend = .008), rectum (10%, 95% CI = 2% to 18%, Ptrend = .02), liver (24%, 95% CI = 2% to 51%, Ptrend = .03), breast (12%, 95% CI = 9% to 14%, Ptrend < .001), and total cancer (6%, 95% CI = 4% to 7%, Ptrend < .001). The trends were similar in women who had wine exclusively and other consumers of alcohol. For cancers of the upper aerodigestive tract, the alcohol-associated risk was confined to current smokers, with little or no effect of alcohol among never and past smokers ( Pheterogeneity < .001). Increasing levels of alcohol consumption were associated with a decreased risk of thyroid cancer ( Ptrend = .005), non–Hodgkin lymphoma ( Ptrend = .001), and renal cell carcinoma ( Ptrend = .03).
Low-risk alcohol consumption in women increases the risk of certain cancers. For every additional alcoholic beverage regularly consumed per day, the increase in incidence up to age 75 years per 1000 for women in developed countries is estimated to be about 11 for breast cancer, 1 for cancers of the oral cavity and pharynx, 1 for cancer of the rectum, and 0.7 each for cancers of the esophagus, larynx and liver, giving a total excess of about 15 cancers per 1000 women up to age 75.