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Aussie Health Group Says No to Alcohol, Even in Moderation

A new report points to cancer risk; many claim the findings are alarmist

Posted: May 13, 2011

An Australian health organization has issued an eyebrow-raising report urging people to abstain from alcohol completely in order to reduce their risk of cancer. On May 1, the Cancer Council of Australia (CCA) released a position statement that claims 5 percent of all cancers in that country are attributable to long-term alcohol use. While past research has shown evidence of a link between alcohol and cancer, particularly breast cancer, many in the medical community believe the jury is still out on a conclusive link. Some studies have even suggested wine may decrease the risk of some cancers. Some experts and wine professionals are criticizing the CCA's report as misleading.

The CCA argues in its statement that any amount of alcohol will increase one’s risk of developing certain cancers, including those of the throat and mouth, as well as colorectal cancer in men and breast cancer in women. The report also noted that combined use of alcohol and tobacco can further elevate cancer risk and even singled out extra calories from ethanol that could increase body weight as another alcohol-related risk factor for cancer.

The CCA suggests people avoid alcohol entirely or, barring that, limit drinking to nationally recommended maximums to reduce risk. As for long-reported links between moderate alcohol consumption and better heart health, the CCA dismissed those, claiming the current research is likely flawed due to errors in methodology. The statement is severe, considering that even the World Cancer Research Fund, which the CCA cites heavily in the statement, has said in a report that, “Modest amounts of alcoholic drinks are likely to protect against coronary heart disease."

To reach their estimate that 5 percent of Australian cancer cases have an alcohol link, the CCA authors used data developed by the WCRF and the American Insititute for Cancer Research (AICR). The data analyzed multiple studies to calculate what percentage of certain cancers were likely attributable to alcohol use in the United Kingdom. The CCA then applied those findings to Australia's population.

Though similar data had been compiled for other countries, the CCA chose the U.K., as it has similar national rates of alcohol consumption. It is a high total compared to other studies, over 5,000 cancer cases, largely because of the recent inclusion of bowel cancer in men and breast cancer in women as cancers where alcohol may be a factor. The CCA posits that 7 percent of male bowel cancer cases and a whopping 22 percent of breast cancer cases in women are attributable to alcohol use.

Several researchers are questioning that 22 percent figure. In 2009, a research paper based on 1.5 million women in the U.K. as part of the Million Women Study estimated that alcohol played a role in 11 percent of breast cancer cases, half of what CCA is claiming. Colorectal cancer was left out of previous estimates, since convincing evidence linking colorectal cancer in men to alcohol has only been published in the past five years.

Alcohol always offers a conundrum for health professionals: Do the potential benefits outweigh the risks? While several studies have found links between consumption and increased risk of some cancers, others have found evidence wine or other drinks in moderation can actually reduce the risk of other cancers. The CCA's report marks a shift from current literature, which says moderate drinking can have benefits. Roger Corder, professor of experimental therapeutics at London’s William Harvey Research Institute, has long advocated the benefits of red wine for cardiovascular health. “This appraisal of risk of cancer in moderate drinkers versus potential benefit in terms of reduction of heart disease appears very superficial and selective,” Corder told Wine Spectator.

Just days after the paper was made public, the Winemaker’s Federation of Australia issued a quick response, saying, “There is currently no research to show a positive relationship between moderate alcohol consumption and cancer risk.”

Dr. Bernard Levin, author of the comprehensive book The American Cancer Society: Colorectal Cancer, says the links are more complex than the CCA report implies. “Moderate drinking [2 drinks per day for men and 1 drink per day for women] is moderately safe, but no intake of alcohol is safest," he told Wine Spectator. "On the other hand, there are social and cardiovascular benefits for low doses. Some individuals, by virtue of genes, are probably susceptible to any dose of alcohol while others may not be.”

The CCA ignores individuality of risk. Dr. Corder called the tone of the paper, “alarmist, perhaps because too many Australians drink in excess, and so perhaps the message is actually one of moderation to avoid adverse consequences." Statistics do suggest that Australia has a strong social drinking culture. In 2007, the country's National Preventative Health Taskforce found that Australians drank 10 liters of alcohol per capita (20 percent more than Americans drank that year), and that 10 percent of Australians drink at “risky” levels (7 or more drinks per day for men and 5 or more for women).

It is unclear if the CCA declaration will alter Australian public policy, but the position statement comes as the government's national alcohol strategy, which tries to reduce alcohol related harm in the country, comes up for revision. Some regional health organizations are not waiting to take action, however. The Cancer Council of Victoria recently launched a graphic set of TV commercials highlighting the dangers of drinking. One spot shows red wine spilling onto a white tablecloth and spreading to form the explosive organs and veins of a female cancer victim.

The CCA's position may not shift popular Australian opinion at the bar, but it will likely add fire to the controversy surrounding medical research on alcohol.

Thomas D Nichols
Houston, TX —  May 14, 2011 7:02pm ET
Margaret Raber, A very good, honest review of a complex, important subject. Thanks. Tom Nichols MD
Howard Kaman
Vancouver, BC, Canada —  May 16, 2011 2:22pm ET
Indeed, this piece has been exceptionally well written, in that it provides some context for the report in light of Australia's drinking culture...
John Crockett
NYC —  August 10, 2011 11:20am ET
From an American perspective, honestly, out of all the things we put into our body that are FDA approved and jam-packed into everything we eat, from high fructose corn syrup to processed foods to antibiotic and hormone-laden meats to Red Dye # whatever, I think a little wine in moderation is probalby not the thing that's making 50% of Americans overweight or even obese and also causing incredibly high rates of cancer and diabetes....

(I say that with an obvious pro-wine bent!)

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