Cancer

Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems.


Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start. There is evidence that excessive consumption of alcoholic beverages or binge drinking is associated with increased morbidity and mortality from
several forms of cancer.  Low amounts of wine on the other hand, are not associated with the risk of any cancer site with the possible exception of breast cancer for women and cancers of upper gastrointestinal tract (GIT) such as the mouth and throat as well as the liver.  An increased risk for the GIT cancers is observed with all alcoholic beverages, which is a linear relationship (the greater the amount, the higher the risk), and especially in combination with smoking.

 

With regards to breast cancer and alcoholic beverages, the research results vary widely since not only the amount of alcohol but also other co-factors as well as drinking pattern play an important role and have to be taken into consideration. 

 

The majority of epidemiological studies, however, show a linear increase in the relative risk of breast cancer with an increasing dose of alcohol but the magnitude of the effect is small. An increased breast cancer risk is observed in women with additional co-factors such as genetic disposition, hormone replacement therapy (HRT), low folate intake, overweight and smoking.

 

A meta-analysis for example, examined the influence of hormones on breast cancer risk and found that alcoholic beverages (> 20g/d) might increase the breast cancer risk only among women who were concurrently using menopausal hormone therapy (HT) and /or having estrogen receptors positive tumors. These findings indicate that a hormone-related mechanism may mediate the relation between alcohol drinking and an increased breast cancer risk. Among women who had ceased using HT, the risk associated with 2 or more drinks per day was not apparent.

Another factor to be considered is folate intake. Several studies have shown an inverse relation between folate intake and cancer. Accordingly, some research results found a significant interaction between the consumption of alcoholic beverages and folate intake where alcohol seems to increase the risk significantly only for those individuals with low folate intake.


All the studies show that the knowledge about the causes of breast cancer is still very incomplete and as scientists from the National Institute on Alcohol Abuse and Alcoholism in the USA, recently pointed out, some other (possible confounding) factors have not been considered in the research relating the consumption of alcoholic beverages to breast cancer:

  1. In the epidemiological data provided, the intake of alcoholic beverages is usually under-reported by subjects (which could exaggerate the harm associated with light drinking).
  2. In most studies, the pattern of drinking (regularly and moderately vs. binge drinking with a similar total weekly alcohol consumption) as well as beverage type have generally not been taken into account. However, this aspect of drinking pattern is important given that binge drinking is associated with much higher blood alcohol concentrations and acetaldehyde accumulation (a known carcinogen) and production of free radicals (reactive oxygen species). Considering that the blood alcohol level may be the most important mechanism for effects on cancer risk, the pattern by which a woman consumes a given amount of alcohol is particularly relevant in interpreting associations.
  3. In addition, epidemiological studies usually provide data only for a short period of time, while the development of cancer may relate to exposures over many decades.


The authors concluded that based on scientific evidence, in post menopausal women, the increase in the risk of breast cancer, if there is any at all, is small..

 

The relationship between wine consumption and cancer is even more complex. It is not yet completely proven that wine drinkers have a lower risk for cancer than drinkers of other alcoholic beverages. However, epidemiological studies indicate a lower cancer risk for wine drinkers for most cancer sites compared to drinkers of other alcoholic beverages. Moderate wine intake may actually reduce the risk of oesophagus, thyroid, lung, kidney and colorectal cancers as well as Non-Hodgkin’s Lyphoma. To what extent differences in drinking pattern or certain beverage-specific ingredients are responsible still needs to be determined. Concerning breast cancer, there may also be a protective role for wine.

What might be a possible mechanism for the protective effect of wine? Damage to the DNA of cells by chemicals in the environment and food as well as by the physical environment can lead to cancer. Various experimental studies suggest that the phenolic compounds in wine may protect the DNA of cells of body tissues from damage or may stop the growth of cells with damaged DNA. Complete sequencing of the grapevine genome has revealed genes that are responsible for the synthesis of health-promoting compounds (resveratrol and other polyphenols). 
Another potential explanation for the observation that in some studies  red wine does not appear to increase breast cancer risk, may be the fact that red wine is a nutritional aromatase inhibitor (AI).  Aromatase inhibitors (AI) prevent the conversion of androgens to estrogens, thus a hormone-related mechanism might be involved. 

 

In summary, the cancer risk should not be evaluated in isolation, one particular food factor (like wine consumption) should not be analysed out of context with its cultural and culinary habits. The effect of wine on cancer risk also depends on whether it is consumed with or without a meal and the  nature of other foods consumed. There needs to be a distinction between different types of cancer and the influence of lifestyle (according to the World Cancer Research Fund, more than 1/3 of the cancers could be prevented by a healthy diet, regular physical activity and no weight gain) and genetic factors needs to be assessed.  

 

In future studies, the focus should be more on the pattern of drinking, not just the average weekly amount of alcohol, and thus, have a better understanding of how moderate drinking impacts cancer risk. This will allow consumers to make better informed decisions about the risks and benefits of moderate wine consumption in the context of their overall health and at different stages of their life.

 

The above summary provide an overview of the topic, for more details and specific questions, please refer to the articles in the database.

 

 

 

 

BACKGROUND: Although cancer has become one of the leading health burdens, to the authors' knowledge, evidence regarding its relationship with a healthy lifestyle in the Chinese population remains limited. METHODS: The authors evaluated the association between clustering of healthy lifestyle factors and cancer risk using 3 prospective cohort studies with 101,208 Chinese adults from the general population. Hazard ratios (HRs) and corresponding 95% confidential intervals (95% CIs) related to healthy lifestyle factors were calculated using Cox proportional hazard models, and population-attributable risk percentages were estimated further. RESULTS: The results demonstrated that each additional healthy lifestyle factor was associated with a 6% (range, 3%-9%) lower risk of overall cancer. Compared with having none to 3 healthy lifestyle factors, HRs related to…
PURPOSE: Breast cancer (BC) risk prediction allows systematic identification of individuals at highest and lowest risk. We extend the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) risk model to incorporate the effects of polygenic risk scores (PRS) and other risk factors (RFs). METHODS: BOADICEA incorporates the effects of truncating variants in BRCA1, BRCA2, PALB2, CHEK2, and ATM; a PRS based on 313 single-nucleotide polymorphisms (SNPs) explaining 20% of BC polygenic variance; a residual polygenic component accounting for other genetic/familial effects; known lifestyle/hormonal/reproductive RFs; and mammographic density, while allowing for missing information. RESULTS: Among all factors considered, the predicted UK BC risk distribution is widest for the PRS, followed by mammographic density. The highest BC risk…
Background and aims: Cancer has emerged as the leading cause of death in human populations. The contribution of alcohol has been highly suspected. The purpose of this paper was to analyze the time trend of digestive cancers in Romania, in terms of mortality rates (1955-2012), and incidence rates (2008-2012), and the alcohol consumption data (1961-2010), aiming to find out if there is any association. Methods: The data on six more common digestive cancers mortality rates (1955-2012) and incidence rates (2008-2012) were obtained from the historical and recent country statistics and publications of International Agency for Research on Cancer (IARC)/World Health Organisation (WHO), as age-standardized rate expressed per 100,000 population (ASRw). Data on alcohol consumption were obtained from the statistics and…
BACKGROUND: We aimed to understand the factors shaping alcohol consumption patterns in middle-aged women (45-64), and to identify participant-driven population- and policy-level strategies that may be used to addresses alcohol consumption and reduce breast cancer risk. METHODS: Semi-structured interviews (n = 35) were conducted with 'middle-aged' women conversant in English and living in South Australia with no history of breast cancer diagnosis. Data were deductively coded using a co-developed framework including variables relevant to our study objectives. Women were asked about their current level of awareness of the association between alcohol and breast cancer risk, and their personal recommendations for how to decrease consumption in middle-aged Australian women. RESULTS: Women discussed their previous efforts to decrease consumption, which we drew…
PURPOSE: Breast cancer (BC) risk prediction allows systematic identification of individuals at highest and lowest risk. We extend the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) risk model to incorporate the effects of polygenic risk scores (PRS) and other risk factors (RFs). METHODS: BOADICEA incorporates the effects of truncating variants in BRCA1, BRCA2, PALB2, CHEK2, and ATM; a PRS based on 313 single-nucleotide polymorphisms (SNPs) explaining 20% of BC polygenic variance; a residual polygenic component accounting for other genetic/familial effects; known lifestyle/hormonal/reproductive RFs; and mammographic density, while allowing for missing information. RESULTS: Among all factors considered, the predicted UK BC risk distribution is widest for the PRS, followed by mammographic density. The highest BC risk…
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