A new year of life is celebrated and it is celebrated with alcohol. The beginning of the New Year and religious holidays are celebrated with alcohol. It is taken at home or at meetings with friends in bars and discos. Alcohol is a product that is part of the daily lives of many people in Latin America, the region with the highest per capita consumption in the world. But after decades of research, a new scientific review shows that there is strong evidence that alcohol consumption increases the risk of developing 6 types of cancers: liver, breast, esophagus, colorectal, mouth and pharynx, and larynx.
There are several mechanisms involved in the effect of alcohol consumption on the development of these tumors. One is the direct toxic effect of acetaldehyde, a product of the breakdown of alcohol when consumed in the human body. Alcohol also causes changes in hormone levels and the production of free radicals that accumulate and can damage and kill cells. Some mechanisms are triggered after the consumption of excessive amounts of alcohol, while others are already produced with consumption between light and moderate.
The review of the evidence demonstrating the association between cancer risk and alcohol consumption was conducted by a group of researchers from Conicet and the Institute for Clinical and Health Effectiveness (IECS) in Argentina in collaboration with colleagues from the University of Utrecht and other institutions in the Netherlands.
“Globally, there are large differences between regions in alcohol-attributable cancer burden: most alcohol-attributable cancer deaths are in the Western Pacific region (7.8% of all cancer deaths), while in the Eastern Mediterranean region only 0.7% of all cancer deaths are attributable to alcohol consumption,” they wrote in an article that was published by the specialized journal BMC Public Health.
In America, there are 4% of all cancer deaths attributable to alcohol consumption in the world. Recently, specific work has been carried out in Chile and Brazil. Alcohol consumption was found to be the third preventable cause of cancer incidence and mortality in these countries. It accounts for 3.1% in Chile and 4.5% in Brazil of all cancer deaths. In the specific case of Argentina, it had not yet been quantified.
After reviewing previous studies, researchers Ariel Bardach and Natalia Espinola, together with their colleagues from Holland, focused on finding out what the impact of alcohol consumption was on the development of tumors in Argentina. In 2018, 53% of the country's population consumed alcohol. Using different data such as the results of the National Survey of Risk Factors and the vital statistics of the Ministry of Health of the Nation, the researchers developed a model that allowed them to estimate that 3.7% of all cancer deaths in men were attributable to alcohol consumption. While in the case of women it was 0.8%. That is, these percentages speak of men and women who die prematurely from cancer due to alcohol consumption.
They also analyzed the data, and found the different levels of impact depending on the daily amount consumed. Mild or light consumers are those who drink up to a can of beer or half a glass of wine per day. The “moderates” are those who consume up to a liter and a quarter of beer or half a liter of wine per day. Meanwhile, “heavy” consumers are those who drink more than half a liter of wine or more than a liter and a quarter of beer per day.
Scientists found that if “heavy” drinkers drank less daily, and moved to the moderate consumption category, there would be a 24% reduction in alcohol-attributable cancer deaths in the country. But they also identified that a further reduction in the alcohol-attributable cancer burden would be achieved if the group of moderate drinkers were moved to the category of “light or light consumption”: almost half of all deaths and disability-adjusted life years attributable to the use of alcohol, as Dr. Bardach, who is a doctor of medicine from the University of Buenos Aires and has a Master's Degree in Epidemiology from the School of Hygiene and Tropical Medicine in London, England, explained to Infobae.
According to Dr. Bardach and his colleagues, for different levels of alcohol consumption to drop in the coming years in Argentina, the comprehensive strategy of 5 effective and low-cost measures recommended by the World Health Organization (WHO) should be implemented. It is the technical package called SAFER. One measure is to place restrictions on the availability of alcohol through laws, policies and programmes, especially to prevent easy access by young people and other vulnerable and high-risk groups.
The other four are to enforce measures against the driving of vehicles under the influence of alcohol, facilitating access to testing and brief interventions, as well as medical treatment, enforce prohibition or restriction measures with respect to advertising, sponsorship and promotion of alcohol, and increase alcohol prices through taxes. According to Bardach, “in Argentina there is a current regulation related to the control of alcohol consumption, but it is not enough because it is adequate to international standards.”
Consulted by Infobae, Ricardo Pautassi, principal researcher at the Conicet on the effects of alcohol at the Ferreyra Institute, and professor of the Chair of Neurophysiology and Psychophysiology at the Faculty of Psychology of the National University of Córdoba (UNC), gave his opinion on the work done by Bardach, Espinola and their colleagues from Holland. “The work published by the researchers allows us to know the burden of cancers caused by alcohol consumption in Argentina, and to compare it with countries in the region, such as Chile and Brazil. He's a minor in Argentina. Until now that was unknown,” said Pautassi.
Also most relevant, the researcher Pautassi highlighted, is “the preventive strategy that the authors suggest: if public policy were to target moderate consumers, mortality from alcohol-attributable deaths could be reduced by approximately half. Working on that group could generate significant change on public health indicators of cancer disease, even more than working on the group of heavy or heavy users. Although it is worth clarifying that this does not mean that action should not be taken on heavy consumers.”
Pautassi agreed with the Bardach team that the strategy of the 5 low-cost measures recommended by WHO should be implemented in the country as soon as possible. “These are strategies with a well-known positive effect.” He also noted that there is still a low perception of consumer risk for most alcohol-associated cancers.
“I understand that there is an adequate perception of the impact of alcohol consumption on the liver. But this type of pathology is more associated with heavy users. On the other hand, the perceived risk of alcohol consumption for other cancers, such as breast, lip, esophagus, among others, almost does not exist in the population today. The population should consider that alcohol is a drug that has a very broad effect of toxicity on the human body. It generates oxidative stress in cells and gives rise to different cancers,” explained Dr. Pautassi.
“There is previous work by the same authors that suggests that there would be a slight positive effect of low alcohol consumption on cardiovascular disease and stroke. However, the authors point out that if they take into account the data from that study and the new one they have published now on the risk of developing cancers, the lump sum of the effect of alcohol on health is negative,” Pautassi warned. Like smoking tobacco or exposing yourself to its smoke, drinking alcohol is harmful to your health.
Meanwhile, Marita Pizarro, physician and co-executive director of the Inter-American Heart Foundation Argentina (FIC), agreed that Argentina should implement the measures of the WHO SAFER package to reduce harmful alcohol consumption. “Progress should be made in promoting public policies aimed at delaying the age of onset of alcohol consumption in adolescents (which is now 14 years old). By implementing the measures of the SAFER strategy, alcohol consumption will be reduced and consequently the development of cancers and other diseases,” said Pizarro in dialogue with Infobae.
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