How Does Alcohol Affect A Woman's Risk For Breast Cancer?
Is Alcohol Safe for Women?
A new study says even moderate drinking is associated with an increase in breast cancer risk.
By Allison Takeda
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TUESDAY, Nov. 1, 2011 —You may want to think twice about popping open that bottle of pinot tonight.
Drinking — even in moderation — may raise your risk of breast cancer by a “modest but significant” amount, according to a new study published in theJournal of the American Medical Association(JAMA). Researchers at Brigham and Women’s Hospital and Harvard Medical School in Boston, Mass., reviewed data on more than 100,000 women in the Nurses’ Health Study and found that consumption of just three to six drinks a week was associated with a 15 percent increased risk of cancer; more than 14 drinks a week (two a day) was associated with a 51 percent increased risk.
The findings build on data from other studies linking drinking to cancer risk, which begs the question: Is there such thing as a “safe” amount of alcohol?
The Risks of Drinking for Women
There are currently more than 100 studies linking alcohol consumption to breast cancer risk, many of which span several years and include thousands — even millions — of participants. One such study from Oxford University found that for each drink that was consumed daily, there were 11 additional breast cancer cases per 1,000 women.
It’s not just breast cancer, either — scientists have also discovered ties to cancers of the liver, colon, pancreas, stomach, mouth, throat, larynx, esophagus, and lung. For some of these, the increase in risk is associated specifically with consistent heavy drinking — that is, three to four drinks daily — but for others, such as breast and esophageal cancers, even low levels of consumption can have an effect. Past habits, too, may play a role: TheJAMAstudy found that drinking early in life (say, as a college student) was linked to a higher risk of cancer regardless of whether the women reduced their alcohol consumption as they got older.
“Our results highlight the importance of considering lifetime exposure when evaluating the effect of alcohol,” the researchers write. Indeed, “cancer doesn’t happen overnight,” said Samir Zakhari, director of the division of metabolism and health effects at the National Institute on Alcohol Abuse and Alcoholism, in an interview withThe Wall Street Journal. “It’s the repeated exposure to alcohol over a long period of time that will cause damage, and it has a cumulative effect.”
The Dark Side of Drinking
Cumulative — and deadly. According to a review published in theInternational Journal of Cancer, approximately 3.5 percent of cancer deaths worldwide (about 230,000 a year) are attributable to alcohol. That may not sound like much, but experts estimate that 50 percent of those deaths in women could be avoided if alcohol consumption were reduced to no more than one drink a day.
Other research has found that death rates due to alcohol-related suicides and accidents are twice as high in women as in men, and that women are more susceptible to alcohol-related brain damage and substance abuse problems. And one study presented at the 2011 conference of the American Society of Plastic Surgeons suggested that drinking may even be partly responsible for hair loss among women.
Raising a Glass to Your Health
Given this data, you might wonder why doctors don’t recommend simply eliminating alcohol from your diet altogether. But experts say it’s not that simple.
For one thing, most of the studies linking alcohol consumption to cancer risk have been observational, which is to say that they rely on subjects to accurately recall and report their own drinking habits. Many also don’t take into account other lifestyle habits or risk factors. This means that while the studies can show correlation, they can’t prove cause and effect. Researchers have theories, of course — one is that alcohol raises estrogen levels in women, a known risk factor for breast cancer — but thus far, there’s not enough concrete evidence to prove those theories. Experts can say only that drinking alcohol is linked to increased cancer risk, not that drinking alcoholcausesincreased cancer risk. As such, says breast cancer expert Susan Love, MD, president of the Dr. Susan Love Research Foundation, “we also can't say whether stopping drinking will reduce your risk.”
Additionally, for every report that warns of the health dangers associated with drinking, there’s another that touts its potential benefits. One recent Harvard study found that women who drank one drink a day in middle age were more likely to be in good physical and mental health as they got older than women who didn’t drink. And multiple studies have indicated that moderate alcohol consumption can lower a person’s risk of heart disease — the number-one killer of both men and women in the United States. In fact, researchers at Harvard Medical School published findings just last week suggesting that women who drank as many as three drinks a week in the year leading up to a heart attack had a 35 percent lower chance of dying in the decade after than women who didn’t drink.
So how do you reconcile that potentially lifesaving benefit with the potentially deadly risk of cancer? Does one outweigh the other?
Weighing the Risks Against the Benefits
The answer to that question, experts say, depends on the individual. “If a woman is concerned, she should consider not drinking, especially if she knows that she’s already at increased risk of breast cancer because of other factors,” says Marji McCullough, ScD, RD, strategic director of nutritional epidemiology at the American Cancer Society. Such factors may include a having a family history of breast cancer, testing positive for the breast cancer gene mutation, being overweight, not having children, or having dense breasts.
Other women may decide, however, that the risk of heart disease is a bigger concern — or that they just don’t want to give up that occasional glass of wine. According to one recent survey, 73 percent of women like to unwind with a drink at the end of a long day, compared with only 26 percent of men.
If you’re one of those women, you don’t necessarily need to throw out your favorite vintage — but you do need to be mindful of how much and how often you’re drinking. Try to cap your intake at three glasses a week. There is a small risk with even that amount of alcohol, says Dr. Love, but it’s a change of 2.8 percent to 4.1 percent over 10 years. “It’s an increase, but a modest one,” she notes.
Finally, consult with your physician. “Women should consider their risk of breast cancer, other cancers, and heart disease, and talk with their health care provider to make an informed decision,” says the American Cancer Society’s Dr. McCullough. It’s your body — ultimately, how you treat it is in your hands.
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