Alcohol and cancer risk
Cancer is now the leading cause of death in Ireland. It is responsible for almost 1/3 of all deaths each year.[i] We have known for almost 40 years that alcohol causes cancer and the more we drink the greater our risk of alcohol-related cancer. It was first classified as a Group 1 carcinogen by the World Health Organization’s (WHO) International Agency for Research on Cancer (IARC) in 1988.[ii]
Research in the decades since has only strengthened the conclusion, including for breast, liver, colorectal and esophageal cancers. While in 2023, the WHO and the IARC declared in a joint statement: “No safe amount of alcohol consumption for cancers can be established.”.[iii] This means that there is conclusive evidence that alcohol causes cancer and places it in the same category as tobacco, asbestos and radiation3.
Alcohol causes at least 7 types of cancer: mouth, throat (pharynx), voice box (larynx), oesophagus, breast, bowel and liver cancer. Despite this significant risk, public awareness remains alarmingly low. In the 2022 National Survey on Cancer Awareness and Attitudes less than half (42%) of people living in Ireland identified alcohol as a risk factor for cancer.”.[iv]
Risk is the same whether it's beer, wine or spirits
All alcohol-related cancers show a dose-response relationship with alcohol use on an exponential scale, i.e. the risk of developing cancer increases with increasing volume of alcohol consumed. The cancer risks from alcohol are the same, regardless of the type of alcoholic beverage consumed (e.g. wine, beer or spirits).
It has been established that ethanol, and not any other ingredients of alcoholic beverages, is the ingredient that mainly causes cancer, with acetaldehyde (a toxic chemical produced when our bodies break down alcohol) likely to be the most important biological carcinogen.
How many alcohol-related cancer cases per year?
A global Lancet study found that in 2020 there were approximately 1,000 alcohol related cancer cases in Ireland – 670 in men and 380 in women.[v] This included approximately 260 breast cancers and 320 bowel cancers.[vi]
According to the Health Research Board, between 2012 and 2017, there were 55,097 discharges from Irish hospitals due to alcohol-related cancers.[vii] The magnitude of the risk varies by cancer site. There is evidence that alcohol may increase risk of cancer even at very low levels of consumption. For example, women are at greater risk of developing breast cancer from consuming <21 g of pure alcohol (approximately two standard drinks or more) per day.[viii]
Economic impact
The impact of the loss of anyone to premature death from cancer attributable to alcohol goes far beyond economics but research, published in 2023, provides some stark facts across 27 countries in the European Union plus Iceland, Norway, Switzerland, and Britain.[ix] Ireland has one of the largest costs per death at €374,000 with an estimated 140 such deaths in 2018. This equates to a productivity cost per capita of €11, again one of the highest in the countries examined.
Public awareness
Despite all of the scientific evidence regarding the negative health consequences of drinking alcohol, research demonstrates poor public knowledge of the association between alcohol and a range of alcohol-related health conditions, including cancer.[x] Findings from a Healthy Ireland Survey demonstrate that current public knowledge of the link between cancer and alcohol in Ireland is low.[xi] Just one-quarter of Irish women are aware of the direct link between alcohol and breast cancer, despite this being the most common type of cancer among women in Ireland.
This, coupled with the very real health dangers posed by alcohol, supports the need for the urgent implementation of health warning labels on alcohol products as set out in the Public Health (Alcohol) Act 2018.
Section 12 of the Act stipulates that all alcohol products to be sold in Ireland will be required to display, among other things, a warning informing the public of the direct link between alcohol and fatal cancers. Additionally, details of a website, to be established and maintained by the HSE, will provide public health information in relation to alcohol consumption.
Unfortunately, the public are unlikely to be made aware of the link between alcohol and cancer any time soon given that the government acquiesced to the demands of the alcohol industry to delay alcohol health information labelling until 2028.
Such health warning labels would have ensured that the public was fully informed of the health risks associated with alcohol consumption. However, government decided that the interests of the alcohol industry were more important than public health.
[i] https://www.cso.ie/en/releasesandpublications/ep/p-vsys/vitalstatisticsyearlysummary2024/
[ii] https://www.iarc.who.int/wp-content/uploads/2023/12/QA_HB20A_web.pdf
[iii] https://www.who.int/europe/news/item/06-11-2023-joint-statement-by-who-europe-and-iarc-to-the-european-parliament—raising-awareness-of-the-link-between-alcohol-and-cancer
[iv] https://www.hse.ie/eng/services/list/5/cancer/prevention/nccp-national-survey-on-cancer-awareness-and-attitudes-report.pdf
[v] https://www.thelancet.com/article/S1470-2045(21)00279-5/fulltext
[vi] https://www.thelancet.com/article/S1470-2045(21)00279-5/fulltext
[vii] https://www.hrb.ie/wp-content/uploads/2024/06/HRB_Alcohol_Overview_Series_11.pdf
[viii] https://pmc.ncbi.nlm.nih.gov/articles/PMC3832299/
[ix] https://www.sciencedirect.com/science/article/abs/pii/S1877782123000450
[x] https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3855-6
[xi] https://assets.gov.ie/7643/4b369846e8ed41f7beb688e3b48ffaae.pdf
