Page last updated: August 15, 2018
Alcohol, cancer, and mortality: Further affirmation of the J-shaped curve for mortality and increase in incidence of cancer with larger intake of alcohol

Scientific studies have shown consistently that that the consumption of small amounts of alcohol on a regular basis is associated with a lower risk of total mortality, while consumption of large amounts is associated with an increased risk of certain cancers and mortality. The present report is from a population-based cohort study of almost 100,000 older subjects who were followed for a median of 8.9 years. There were large numbers of deaths (n=9,599) and incident cancers (n=12,763) diagnosed during follow up, which should lead to more precise estimates of effect.

The authors report that light-to-moderate drinking was associated with lower total mortality, but the risk of incident cancer increased with greater alcohol consumption, especially the intake of beer or spirits. However, the analyses indicate that the slightly increased risk of cancer associated with moderate alcohol consumption was less than the beneficial effect on mortality.

Specifically, in comparison with never drinkers or very light (< 1 drink/week) drinkers, the study shows lower mortality for “light-to-moderate” alcohol consumers (up to 2 drinks/day) but greater mortality among subjects classified as “heavy” (2 to < 3) or “very heavy” (3+ drinks/day) consumers. In beverage-specific analyses, there was a slight increase in total mortality for reported intake of spirits starting at the consumption of about 1 ½ drinks/day and for beer at or above about 2 drinks/day; no significant increase in cancer risk was associated with wine consumption, regardless of the amount. The authors conclude that “there is a J-shaped association between alcohol and mortality in older adults, which remains after adjustment for cancer risk.”

Forum member considered this to be a well-done analysis, and shows, essentially for the first time in a single study, how the beneficial effects of light and moderate drinking on cardiovascular disease and total mortality exceed the slight increase in cancer risk for alcohol consumption at this level. In other words, while even light-to-moderate drinking may be associated with a slight increase in the risk of certain cancers, such drinking still favorably affects the overall risk of mortality.

Reference: Kunzmann AT, Coleman HG, Huang W-Y, Berndt SI. The association of lifetime alcohol use with mortality and cancer risk in older adults: A cohort study. PLoS Med 2018;15:e1002585. https://doi.org/10.1371/journal.pmed.1002585.

For the full critique of this paper by members of the International Scientific Forum on Alcohol Research, please click here.

 

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