Abstract

Alcohol is a carcinogen, increasing the risk of cancers of the oral cavity, pharynx, larynx, oesophagus, liver, colon, rectum, and female breast with dose response relationships varying from linear to exponential.   Gram for gram, there is no evidence that risk is related to beverage type. Amongst 15-64 year old Europeans, 1 in 5 of all alcohol-related deaths are due to cancer; 8% of all male and 6% of all female cancer deaths are due to alcohol. At 14 grams of alcohol per day, the margin of exposure (MOE, which measures the ratio of the benchmark dose (lowest dose which is 95% certain to cause no more than a 10% cancer incidence in animals) to exposure) is 3.1 and at 54 grams a day is 0.8.  The European Food Standards Authority considers an MOE based on animal studies for low risk to public health to be 10,000. For a voluntarily consumed produce such as ethanol, this can be dropped to 1,000. For Europeans, this would mean a consumption of about 50 mg ethanol a day, compared with an average consumption of 30 grams a day. It is unrealistic for a 600-fold reduction in alcohol consumption by Europeans, but progress can be made in reducing exposure by reducing the alcohol concentration of beverages, by introducing a minimum price per gram of alcohol consumed, and by reducing heavy drinking through primary health care driven advice and treatment programmes.  All beverages should include a warning label stating that alcohol causes cancer.