For folks within the realm of public health, that\u2019s no surprise. The World Health Organization has recognized alcoholic beverages as a Group 1 carcinogen since 2012, meaning evidence supports a link between alcohol and increased cancer risk. This past March, Jennie Connor, a preventative and social medicine researcher from New Zealand\u2019s University of Otago, published a review<\/a> of studies looking at the correlation between drinking and cancer, concluding that \u201cthere is strong evidence that alcohol causes cancer at seven sites in the body and probably others.\u201d Her analysis credits alcohol with nearly 6 percent of all cancer deaths worldwide.<\/p>\n
RELATED: Why I Won\u2019t Get The Genetic Test for Breast Cancer<\/a> <\/p>\n
Connor\u2019s use of the word \u201ccause\u201d separates her from most alcohol researchers and cancer advocacy groups in the US, where the conversation revolves around a more delicate term: \u201crisk.\u201d American consumers and researchers are both uncomfortable\u2014or at least unfamiliar\u2014with the idea of alcohol as health threat. When the American Institute for Cancer Research put out a survey<\/a> to measure public perception of various cancer threats, less than half of respondents believed that alcohol was a risk factor for cancer. Which is odd, because 56 percent thought GMOswere<\/em>, even though there\u2019s no scientific proof that they are.<\/p>\n To be fair, the science around how alcohol impacts the body is still nascent. Ellison and Naimi\u2019s debate wasn\u2019t a mock trial: The public health community is split among people who think alcohol has its benefits and those who caution against its risks. The WHO\u2019s designation puts alcohol in the same category as processed meats<\/a> and sunlight: They\u2019re carcinogenic, but that label doesn\u2019t tell you how<\/em> much ishow<\/em> carcinogenic. Consumers are faced with the conflicting message that moderate drinking can actually increase their level of good cholesterol and decrease their risk of heart disease, which kills more people in the US than anything else.<\/p>\n \u201cLots of us drink and we\u2019d really like to believe drinking is good for us,\u201d says Naimi. \u201cBut the research around that has really fallen apart in the last couple years.\u201d Since Ellison made his confident statement into that mic two years ago, Naimi and many of his peers have gone on the offense against the studies that support alcohol\u2019s potential health benefits, saying they may have been grossly oversold by industry-funded research\u2014in the end, distracting consumers from the realities of cancer risk.<\/p>\n Bias in Booze Science <\/strong><\/p>\n In late 1991, Ellison went on 60 Minutes<\/em> to share the good news about red wine and heart health, and the idea took off. Underlying his claim were years of observational studies that compared moderate drinkers to non-drinkers. A handful of studies found that the moderate drinkers were actually healthier than the non-drinkers.<\/p>\n But in recent years, alcohol scholars like Connor and Naimi have criticized those studies for what\u2019s become known as a \u201csick quitters\u201d bias. Some of the groups of non-drinkers that were compared to moderate drinkers were actually groups of former alcoholics or people who were too sick to continue drinking, so they were generally sicker than the healthier moderate drinkers. When Naimi adjusted the results in a meta-analysis that took the bias into account, the study still showed that moderate drinkers were better off than non-drinkers when it came to heart health\u2014but not by nearly as much as originally thought.<\/p>\n RELATED: A Single $249 Test Analyzes 30 Cancer Genes. But Do You Need It?<\/a><\/p>\n Ellison says recent studies have gotten more sophisticated about eliminating those selection problems. But that\u2019s not the only source of bias in the literature. In the summer of 2014, the journal Addiction<\/em> published a scathing editorial<\/a> that outed Ellison for receiving \u201cunrestricted educational donations from the (alcohol) industry.\u201d That money had supported his work at BU, along with his leadership of a peer group that wrote positive reviews about studies highlighting the potential health benefits of drinking.<\/p>\n It wasn\u2019t the first time the journal had called out the often-cozy relationship between alcohol academics and industry. Trade organizations like the Distilled Spirits Council, which represents alcohol companies and is the largest alcohol lobbying arm<\/a>, often work hand in hand with regulators and researchers. Some researchers go on to work for their industry connections, like Samir Zakhari<\/a>, a former director at the US National Institute of Alcohol Abuse and Alcoholism (the National Institutes of Health\u2019s alcohol research division). After he retired from the NIH, he went to work for the Distilled Spirits Council.<\/p>\n The council, for its part, doesn\u2019t buy the newer research that highlights the link between alcohol and cancer. Frank Coleman, a spokesman for the DSC, says that many of those meta-analyses are flawed, skewed by cherry-picking data points.<\/p>\n The Trouble with Analyzing Alcohol<\/strong><\/p>\n Those biases are a direct challenge to the validity of science on alcohol and health. But even if they didn\u2019t exist, the nature of drinking still makes it extraordinarily difficult to come up with reliable results. Health risks, including those for cancer, are based on a complex interplay of variables\u2014lifestyle factors, age, genetic predispositions\u2014and they play out differently in each individual\u2019s body.<\/p>\n People who drink a bit of wine each day, for example, tend to sit down and drink it with meals. And they\u2019re predominantly wealthier, more privileged consumers\u2014making them predisposed to better health, says Ellison. Beer drinkers also tend to be more susceptible to binge drinking, he says.<\/p>\n RELATED: A Social Network for Women Facing Breast Cancer<\/a><\/p>\n Those factors can be difficult to separate from alcohol\u2019s isolated effect on the body. \u201cWe\u2019re not studying beer or wine specifically,\u201d says Ellison. \u201cWe\u2019re studying people who drink them.\u201d Even low calorie beers come with a lot of empty calories, says Kenneth Portier, who directs the statistics and evaluation programs at the American Cancer Society. \u201cDrink enough of it and it can put you in that other risk factor: obesity.\u201d<\/p>\n Ellison doesn\u2019t deny that there is a link between alcohol and cancer\u2014he just thinks it\u2019s only relevant for heavy drinkers. But that starts a whole new debate: What exactly constitutes moderate drinking, and how do you study moderate vs. heavy drinking in study participants with vastly different body sizes, metabolisms, and socioeconomic backgrounds? In order to guide people in making informed decisions, researchers will need resources from somewhere outside the alcohol industry to conduct randomized studies that can isolate alcohol\u2019s impact on the body over the course of decades.<\/p>\n Still, the less-than-perfect current evidence suggests that about 15 percent of breast cancer deaths are alcohol-related<\/a>, says Naimi. Nearly 20,000 cancer deaths are attributable to alcohol every year in the US alone, he says, and we\u2019re not even the world\u2019s biggest drinkers. Simultaneously, the craft beer market has grown into a $22.3 billion industry<\/a> and AB InBev and SAB Miller, the world\u2019s two largest alcohol companies, are in the midst of a mega merger<\/a>. If there was ever a time to come to a consensus about what exactly alcohol does to our bodies, it would be now.<\/p>\n Shaping the Message <\/strong><\/p>\n Connor\u2019s analysis of existing alcohol research was a turning point for the conversation on booze and cancer. But once you\u2019ve decided that alcohol is a substantial public health risk, you still need to convince<\/em> drinkers of that fact. And it\u2019s a lot easier to tell people drinking is good for them than to explain how and why it isn\u2019t.<\/p>\n \u201cThings that are familiar to us are perceived as less risky,\u201d says Portier. \u201cMost of us have been around alcohol our whole lives and we know people who drink and they\u2019re not dead.\u201d<\/p>\n It becomes even more difficult to construct a coherent public health message when consumers hear conflicting information. For each drink a woman has per day, her relative risk for breast cancer alone can increase by about 7 percent, says Susan Brown, who\u2019s in charge of health education programs at Susan G Komen. But \u201cpeople are often surprised and disappointed that there\u2019s an association between alcohol and breast cancer,\u201d she says. Many times, they\u2019ve heard that moderate drinking is good for them. \u201cThat may be confusing or masking the message,\u201d she says.<\/p>\n So right now, health groups like Susan G Komen and the American Cancer Society simply emphasize drinking in \u201cmoderation.\u201d In public-health speak, that\u2019s defined as one drink a day for women and two drinks a day for men (think of a drink more as a glass of wine or a bottle of fairly light beer, rather than a double martini).<\/p>\n But for most consumers, the concept of moderation is most closely tied to the phrase \u201cdrink responsibly,\u201d an alcohol industry catch phrase that reminds customers not to drink too much\u2014without actually defining how much is too much. \u201cI worry sometimes that the breweries are trying to change the perception of risk to benefit their own equation,\u201d says Portier.<\/p>\n That\u2019s where policy comes into play. In the UK, for example, the Department of Health changed its alcohol guidelines<\/a> from saying it was safe to drink moderately to acknowledging that \u201cthere are a number of serious diseases, including certain cancers, that can be caused even when drinking less than 14 units weekly.\u201d While the risk for moderate drinking was low, they write, \u201cthere is no level of regular drinking that can be considered as completely safe.\u201d<\/p>\n Look back at the public health messages around tobacco and you\u2019ll notice they all share a common, simple message: stop smoking. There was no level of moderation that was considered risk-free, so there was no conversation around moderation. Alcohol, on the other hand, has a much more complex message: don\u2019t drink too much, make sure you understand what \u201ctoo much\u201d means for you, and mitigate the risk of drinking by assessing any other risk factors you may have in your life. Not exactly great fodder for a catchy PSA. But in a world where drinking is so closely tied to culture, it may be the best option.<\/p>\n \u201cIt all comes down to perception of risk and how you want to live your life,\u201d says Portier. Someone who is at a higher risk for heart disease than cancer, for example, may feel more inclined to have a glass of red wine each night than someone who has a strong family history of breast cancer. \u201cPeople should make their own decisions about how much they drink,\u201d says Naimi. \u201cBut I certainly think that people deserve to be more aware of this than they are now.\u201d<\/p>\n To get there, Naimi goes back to the idea of conducting long term, comprehensive, randomized studies. That\u2019s something both sides are anxious to see more of. Zakhari, the alcohol expert who works at the Distilled Spirits Council, says it\u2019s crucial to look at alcohol consumption over a long period of time, since cancer usually develops very slowly. \u201cThese studies always ask women, \u2018how much did you drink last week, last month, last year,\u2019\u201d he says. \u201cBut what they were doing last week or last month or last year has nothing to do with the initiation of cancer 20 years earlier. It\u2019s like someone has food poisoning today and the doctor asks them what they ate for Christmas in 1980.\u201d<\/p>\n Not that help isn\u2019t on the way\u2014sort of. According to the Wall Street Journal<\/a>, AB InBev and Diageo (another heavyweight alcohol producer) are planning to work with a handful of other alcohol companies to pay for a randomized study that will look at the health implications of drinking. It\u2019ll be run by the NIAAA, the same government division where Zakhari once worked.<\/p>\n More from<\/strong> Wired<\/em><\/strong>:<\/p>\n A Smarter Way to Compare Birth Control Methods<\/a><\/p>\n Do Carrots Actually Improve Your Eyesight?<\/a><\/p>\n The Smartest Robot You\u2019ve Ever Seen<\/a><\/p>\n New Federal Law Would Sanction Government Hacking<\/a><\/p>\n What Happens When You Talk About Salaries at Google<\/a><\/p>\n Hackers Trick Facial-Recognition Logins With Facebook Photos<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" For folks within the realm of public health, that\u2019s no surprise. The World Health Organization has recognized alcoholic beverages as a Group 1 carcinogen since 2012, meaning evidence supports a link between alcohol and increased cancer risk. This past March, Jennie Connor, a preventative and social medicine researcher from New Zealand\u2019s University of Otago, published Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-122551","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts\/122551","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/comments?post=122551"}],"version-history":[{"count":0,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts\/122551\/revisions"}],"wp:attachment":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/media?parent=122551"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/categories?post=122551"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/tags?post=122551"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}