Research and prevention priorities for alcohol carcinogenesis

Research conducted during the last four decades has established that consumption of alcoholic beverages causes cancer. Etiologic research questions that remain relate to increases in risk at specific sites, the effects of various types of alcoholic beverages, the effect of various concentrations of alcohol, and the mechanism(s) of action, including possible interactions with other agents such as tobacco smoke. Prevention priorities for alcohol-related cancer depend on whether alcohol causes only the upper aerodigestive cancers or whether it also causes breast and possibly colon cancers. If alcohol causes aerodigestive cancers only, existing prevention programs to prevent alcohol abuse by heavy drinkers are sufficient. The possible small cancer risk faced by moderate drinkers may be more than offset by a decrease in the risk of cardiovascular death. On the other hand, if alcohol consumption increases the occurrence of breast cancer, a prevention program aimed at women who are at high risk for breast cancer is worth considering, but the risks must be weighed against the cardiovascular benefits for moderate drinkers.