Alcohol consumption is a major cause of disease and death. In a previous study, we reported that in 2002, 3.6% of all cases of cancer and a similar proportion of cancer deaths were attributable to the consumption of alcohol. We aimed to update these figures to 2012 using global estimates of cancer cases and cancer deaths, data on the prevalence of drinkers from the World Health Organization (WHO) global survey on alcohol and health, and relative risks for alcohol-related neoplasms from a recent meta-analysis. Over the 10-year period considered, the total number of alcohol-attributable cancer cases increased to approximately 770,000 worldwide (5.5% of the total number of cancer cases) - 540,000 men (7.2%) and 230,000 women (3.5%). Corresponding figures for cancer deaths attributable to alcohol consumption increased to approximately 480,000 (5.8% of the total number of cancer deaths) in both sexes combined - 360,000 (7.8%) men and 115,000 (3.3%) women. These proportions were particularly high in the WHO Western Pacific region, the WHO European Region and the WHO South-East Asia region. A high burden of cancer mortality and morbidity is attributable to alcohol, and public health measures should be adopted in order to limit excessive alcohol consumption.

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Published in Cancer

BACKGROUND: There is limited research examining beverage habits, one of the most habitual dietary behaviors, with mortality risk.

OBJECTIVE: This study examined the association between coffee, black and green tea, sugar-sweetened beverages (soft drinks and juice), and alcohol and all-cause and cause-specific mortality.

METHODS: A prospective data analysis was conducted with the use of the Singapore Chinese Health Study, including 52,584 Chinese men and women (aged 45-74 y) free of diabetes, cardiovascular disease (CVD), and cancer at baseline (1993-1998) and followed through 2011 with 10,029 deaths. Beverages were examined with all-cause and cause-specific (cancer, CVD, and respiratory disease) mortality risk with the use of Cox proportional hazards regression.

RESULTS: The associations between coffee, black tea, and alcohol intake and all-cause mortality were modified by smoking status. Among never-smokers there was an inverse dose-response association between higher amounts of coffee and black tea intake and all-cause, respiratory-related, and CVD mortality (black tea only). The fully adjusted HRs for all-cause mortality for coffee for <1/d, 1/d, and >/=2/d relative to no coffee intake were 0.89, 0.86, and 0.83, respectively (P-trend = 0.0003). For the same black tea categories the HRs were 0.95, 0.90, and 0.72, respectively (P-trend = 0.0005). Among ever-smokers there was no association between coffee or black tea and the outcomes. Relative to no alcohol, light to moderate intake was inversely associated with all-cause mortality (HR: 0.87; 95% CI: 0.79, 0.96) in never-smokers with a similar magnitude of association in ever-smokers. There was no association between heavy alcohol intake and all-cause mortality in never-smokers and a strong positive association in ever-smokers (HR: 1.56; 95% CI: 1.40, 1.74). Green tea and sugar-sweetened beverages were not associated with all-cause or cause-specific mortality.

CONCLUSIONS: Higher coffee and black tea intake was inversely associated with mortality in never-smokers, light to moderate alcohol intake was inversely associated with mortality regardless of smoking status, heavy alcohol intake was positively associated with mortality in ever-smokers, and there was no association between sugar-sweetened beverages and green tea and mortality.

Published in Drinking Patterns

Background: Alcohol is a risk factor for cancer of the oral cavity, pharynx, oesophagus, colorectum, liver, larynx and female breast, whereas its impact on other cancers remains controversial.

Methods: We investigated the effect of alcohol on 23 cancer types through a meta-analytic approach. We used dose-response meta-regression models and investigated potential sources of heterogeneity.

Results: A total of 572 studies, including 486 538 cancer cases, were identified. Relative risks (RRs) for heavy drinkers compared with nondrinkers and occasional drinkers were 5.13 for oral and pharyngeal cancer, 4.95 for oesophageal squamous cell carcinoma, 1.44 for colorectal, 2.65 for laryngeal and 1.61 for breast cancer; for those neoplasms there was a clear dose-risk relationship. Heavy drinkers also had a significantly higher risk of cancer of the stomach (RR 1.21), liver (2.07), gallbladder (2.64), pancreas (1.19) and lung (1.15). There was indication of a positive association between alcohol consumption and risk of melanoma and prostate cancer. Alcohol consumption and risk of Hodgkin's and Non-Hodgkin's lymphomas were inversely associated.

Conclusions: Alcohol increases risk of cancer of oral cavity and pharynx, oesophagus, colorectum, liver, larynx and female breast. There is accumulating evidence that alcohol drinking is associated with some other cancers such as pancreas and prostate cancer and melanoma.

Published in Cancer

Resveratrol, which may occur in wine, was suggested to act as a chemopreventive agent against the carcinogenic effects of ethanol. The assumption was based on data from experimental animals, which have shown that resveratrol above certain thresholds may reduce the incidence of tumours in several of the alcohol-related cancer sites (colon, liver and female breast). Using a probabilistic Monte Carlo type methodology, we estimated daily intake based on chemical analysis of resveratrol (n = 672) and ethanol (n = 867). Benchmark dose (BMD)-response modelling was conducted for resveratrol based on eight animal experiments, whereas BMD data for ethanol were taken from the literature. The margin of exposure (MOE) was calculated for both substances as an indicator if the intake may reach effective dosages. For intake of one 100-mL glass of wine, the average MOE was found to be 4.1 for ethanol and 459,937 for resveratrol. In the best-case scenario for resveratrol (e.g., very high contents and assuming a low effective dosage), the minimum MOE would be 111, which means that 111 glasses of wine need to be consumed daily to reach the BMD. The MOE ratio between resveratrol and ethanol is 166,128 on average, meaning that per glass of wine, ethanol is more than 100,000 times more potent than resveratrol. As resveratrol intake may not optimally reach the effective dosage, our study excludes a preventive effect of this substance on alcohol-related cancer. Commercial information about cancer-preventive or -protective effects of resveratrol in wine is misleading and must be prohibited.

Published in Phenolic compounds
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