Deciphering the Relationship Between Alcohol Consumption, Oropharyngeal Cancers, and Socioeconomic Determinants

Alcohol drinking is a major risk factor for oropharyngeal cancer, yet the nature of risk differences across drinking patterns remains unclear.

We leveraged data from large-scale genome-wide association studies to conduct Mendelian randomization analyses, assessing the effects of alcohol intake with meals, intake frequency, maximum habitual intake, and drinks per week on risks of oral cavity cancer, pharyngeal cancer, stomatitis, lichen planus, and oral leucoplakia. Multiple Mendelian randomization methods were applied to model pleiotropic effects, and multivariable analysis was performed to evaluate the interplay between alcohol consumption and household income.

Alcohol intake frequency was associated with increased risk of oral and pharyngeal cancer. In contrast, alcohol intake with meals showed an apparent protective association with these outcomes, which was nullified after adjusting for household income in the multivariable analysis-indicating that the observed benefit was explained by higher socioeconomic status. The frequency-risk relationship remained significant after adjustment, highlighting intake frequency as an independent risk factor under MR assumptions. The number of drinks per week was linked to increased stomatitis risk, and this association remained significant after accounting for household income, suggesting an independent effect of alcohol consumption on stomatitis risk under MR assumptions.

Cancer prevention strategies should target harmful alcohol consumption patterns with attention to drinking frequency and socioeconomic context, rather than treating alcohol exposure as monolithic.