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Alcohol consumption guidelines 'inadequate for cancer prevention': "No level of alcohol consumption without risk"

Current alcohol consumption guidelines are inadequate for the prevention of cancer and new international guidelines are needed, according to an analysis by French researchers published in the Canadian Medical Association Journal.

The analysis in the Canadian journal follows on from research on alcohol and cancer in Europe, and a position statement on the subject published by the Cancer Council of Australia, which also advised that there is no safe threshold of alcohol consumption for avoiding cancer (See The Globe Issue 2 2011).

The Canadian analysis argues that guidelines on ‘safe’ or ‘sensible’ drinking in some countries are not currently based on evidence for long-term harm. Most guidelines, it claims, are based on studies that assessed the short term effects of alcohol, such as social and psychological issues and hospital admissions, and were not designed to prevent chronic diseases. As well, in some countries, “alcohol producers were either part of working groups defining sensible drinking or instrumental in dissemination of the guidelines”.

The analysis continues:

“There is increasing evidence that links alcohol consumption to cancer.” The WHO International Agency of Research on Cancer has stated, based on evidence, that alcohol is carcinogenic in both animals and humans. Several evaluations of this agency as well as the joint 2007 report of the World Cancer Research Fund and the American Institute for Cancer Research warned of the link between alcohol and cancers in the mouth, throat, esophagus, liver, colorectum and breast. Based on the evidence, “there is no level of alcohol consumption for which cancer risk is null”.

“On the whole, alcohol is considered an avoidable risk factor for cancer incidence and, more generally, for the global burden of disease,” stated Dr. Paule Latino-Martel, French National Institute for Agricultural Research (INRA), with coauthors from the French Institute for Prevention and Health Education (INPES) and the French National Cancer Institute (INCa). “Although drinking guidelines used in the context of a brief intervention have proven effective” to help people who have problems, due to their drinking habits, to reduce their alcohol consumption, they are inadequate to prevent all types of risks including cancer risk. Therefore, “their application to the general population should be revisited,” write the authors. Canadian guidelines for “lowrisk” consumption, set in 1997 at 9 drinks per week for women and 14 per week for men, may be modified when Canada releases its first national guidelines later in 2011.

“Although guidelines are currently practical for health professionals and health authorities, the time has come to reconsider them using a scientific basis independent of any cultural and economic considerations and to discuss the eventuality of abandoning them,” conclude the authors. “Considering our current knowledge of the relationship between alcohol consumption and cancer risk, national health authorities should be aware of the possible legal consequences of promoting drinking guidelines that allow consumers to believe that drinking at low or moderate levels is without risk.”

The full analysis can be downloaded from:
http://www.cmaj.ca/site/embargo/cmaj110363.pdf.