Published November 16, 2023
By Timothy Chipp
Whatever you do, avoid heavy drinking of alcohol.
Such was the message of Susan Gapstur, PhD, MPH, the eighth Richard V. Lee, MD, Lecturer, coordinated by UB's Office of Global Health Initiatives.
After all, she said, harmful alcohol consumption is directly linked to several cancers.
That’s right. Alcohol causes cancer. And Gapstur, former senior vice president at the American Cancer Society, knows this because she practically (re)wrote the book on the matter. While serving on a panel for the World Health Organization’s International Agency for Research on Cancer in 2007, she and colleagues studied the link between the popular intoxicant and various cancers.
A link was already established between alcohol and cancers of the mouth/oral cavity, larynx/pharynx, the esophagus and liver, noted by the same agency in a 1988 report. Gapstur’s group both confirmed those results and added two more.
“They began to get a feeling about breast and colon rectum cancer (in 1988), they just weren’t willing to make a conclusion at that point because there was just not enough evidence,” Gapstur said. “By 2010, the evidence was considered sufficient.”
How does alcohol consumption cause cancer? While the ethanol itself is linked to many of these forms of cancer, Gapstur said it’s primarily driven by alcohol being converted to acetaldehyde.
That’s poisonous to the body, she said, and in some cases prevents some people from even being able to take a single drink. In some East Asian populations, for instance, a polymorphism of the DLH2 enzyme causes immediate sickness due to difficulty metabolizing acetaldehyde, calling it “their built-in alcohol prevention tool.”
How at-risk are those who drink? Gapstur said any alcohol consumption at all poses risk for developing some of the cancers studied in 1988. Beyond that, consuming more than two servings per day increases the risk of colorectal cancer, while consuming more than three servings per day may increase the risk of stomach and liver cancers.
What’s most challenging for public health professionals is the lack of awareness around this associated risk, Gapstur said. A 2002 survey, for instance, found that despite knowing and reporting alcohol’s cancer-causing effects 15 years earlier, less than half of the American population understood the situation.
None of this is to say alcohol should be avoided if you wish to consume, Gapstur said. After all, she partook in a glass of wine the night before her address.
It’s the heavy, daily consumption of alcohol that is the most damaging, she added.
The School of Public Health and Health Professions established an annual lectureship focused on aspects of global health to honor Richard V. Lee, MD, former faculty member at the University at Buffalo.
OGHI promotes and coordinates global health opportunities in the School of Public Health and Health Professions.