According to a report by the World Cancer Research Fund (WCRF), there is “strong evidence” that drinking three or more alcoholic drinks per day is a cause of liver cancer. Worldwide, liver cancer is the second most common cause of death from cancer, leading to around 746,000 deaths in 2012. The number of new cases around the world increased by around 25 percent from 2002 to 2012, with over 782,000 cases in 2012. Some may disagree with the specific number of drinks cited in the WCRF report, but the overall message from the report is unchanged: excessive drinking is a significant cause of liver cancer.
Pinpointing the Danger Zone
The WCRF used data from 34 studies for the report, which covered the impact of diet, weight and physical activity on the risk of liver cancer, analyzing evidence from just under 8.2 million participants and 24,600 cases of liver cancer. The studies focused primarily on hepatocellular carcinoma, which is the most common form of liver cancer, responsible for about 90 percent of all cases. The evidence was analyzed by a panel of leading international scientists to draw conclusions about the risk associated with various activities and lifestyles.
According to the WCRF’s Amanda McLean, “Until now we were uncertain about the amount of alcohol likely to lead to liver cancer. But the research reviewed in this report is strong enough, for the first time, to be more specific about this.”
The report found evidence linking a few different factors to liver cancer risk. Being overweight or obese, as measured by body mass index (BMI) is one risk factor, eating foods containing aflatoxins (primarily contained within foods from warmer parts of the world that have been stored inappropriately) is another, and drinking three or more alcoholic drinks a day is another. Finally, the report found strong evidence that drinking coffee reduces the risk of liver cancer.
The report recommends that to reduce the risk of liver cancer, people should maintain a healthy weight, and—if you drink at all—you should limit it to two drinks per day (for men) or one drink per day (for women). The report focused on the U.K. and concluded that cases of liver cancer there would drop by around a quarter if people followed these guidelines.
According to the American Cancer Society, the percentage of Americans developing liver cancer has been on the increase. Current estimates put the lifetime chance of developing liver or intrahepatic bile duct cancer (cancer of the bile ducts inside the liver) at around one in 81 for men and one in 196 for women. Generally speaking, liver cancer becomes more likely the older you get, and risk factors like drinking alcohol can notably increase your odds.
Criticism of the Findings
While nobody questions the link between alcohol consumption and liver cancer, the specific finding that three drinks per day causes liver cancer has been called into question by some. Said Paul Pharoah, a professor of cancer epidemiology at Cambridge: “I do not think that the published data are sufficiently robust to conclude that three drinks a day specifically is associated with an increased risk of primary liver cancer.” He points out that two of the studies included in the report—the ones conducted in Europe—showed that people drinking three alcoholic drinks per day had no increased risk, with the increase in risk instead beginning at four drinks per day. In any case, though, the core point that regular alcohol consumption in excess of recommended daily limits is a cause of liver cancer is unchanged.
Education and Addiction Treatment to Reduce Liver Cancer Deaths
The chairman of the Alcohol Health Alliance, professor Sir Ian Gilmore, cut right to one of the core take-home points from this research, saying, “Alcohol, like tobacco and asbestos, is a class 1 carcinogen and it is totally unacceptable that the public is not provided with such basic information.” He added, “It’s time for the government to take action to minimize the risk of harm, including ensuring that labels carry mandatory health warnings and lists of ingredients to standards that are developed independently from groups with vested interests.”
While most people understand that alcohol does carry an increased risk of some cancers, the gulf between the warnings on a packet of cigarettes and what you see on bottle of hard liquor or a can of beer are striking. If warning labels aren’t added to alcohol, educational ad campaigns would undeniably hold the potential to make some people think again about their drinking.
The biggest issue is for those struggling with alcoholism, who are very likely to consume three, four or many more drinks per day. Helping people recognize when they’re having problems with drinking and getting them into treatment is another essential step for reducing alcohol-related harm.
Unwelcome News, but it Could Help Us Make Better Choices
The truth is that many drinkers who see their own consumption as casual and not a health risk may be taken aback by this finding, which underscores the importance of the recommended maximum daily alcohol intake. As unpleasant as it may be, the news should help casual drinkers make better choices and think carefully before they decide to binge drink. For those struggling with alcoholism, the finding is simply another reminder of the huge health benefits—physical as well as psychological—that you experience by kicking the habit.