January 13, 2025 from Medscape
For years, red wine was considered the exception to the rule — touted as a heart-healthy option, packed with antioxidants like resveratrol, and even rumored to reduce cancer risk when consumed in moderation. But new research is challenging that narrative, suggesting that all types of alcohol, including red wine, may increase cancer risk.
The science is clear: Alcohol is a group 1 carcinogen, according to the International Agency for Research on Cancer (IARC) and the American Cancer Society (ACS). This classification places alcohol in the same category as tobacco and asbestos.
Dr. Timothy Rebbeck, professor of cancer prevention at the Harvard T.H. Chan School of Public Health, emphasized this point:
“There’s no question that alcohol is a group 1 carcinogen. Alcohol can cause cancer.”
Regular alcohol consumption has been definitively linked to seven types of cancer, including:
- Oral cavity
- Larynx
- Pharynx
- Esophagus (squamous cell carcinoma)
- Liver (hepatocellular carcinoma)
- Breast
- Colon/rectum
How Much Alcohol Increases Cancer Risk?
The risk of developing cancer increases with the amount of alcohol consumed. According to Dr. Noelle LoConte, from the University of Wisconsin School of Medicine and Public Health, heavy drinking is associated with a fivefold increase in the risk for oral cavity, pharyngeal, and esophageal cancers, and a 61% increased risk for breast cancer.
High-Risk Drinking:
- Women: 8 or more standard drinks per week
- Men: 15 or more standard drinks per week
Binge Drinking:
- Women: 4 or more drinks in 2 hours
- Men: 5 or more drinks in 2 hours
Does Moderate Drinking Increase Cancer Risk?
Even moderate drinking — defined as 1 drink per day for women and 2 per day for men — is linked to an increased risk of several cancers, albeit at a lower magnitude. Studies show that moderate drinking raises the risk for:
- Breast cancer
- Oral cavity and pharyngeal cancers
- Esophageal and laryngeal cancers
Is Red Wine Really Different?
For years, red wine was believed to be an outlier due to its anti-inflammatory and antioxidant properties, most notably resveratrol. Early research suggested that resveratrol might protect against heart disease and cancer, but much of this research was conducted in animals or test tubes, not in humans.
More recent research suggests that red wine’s health benefits have been overstated. A recent meta-analysis found that many studies suggesting moderate drinking’s benefits were biased or misleading. Another study found that alcohol consumption, regardless of type, increases cardiovascular risk.
“There’s no clear physiological reason that wine would be less risky than beer or liquor,” said Dr. LoConte.
Ethanol — the key ingredient in all alcoholic beverages — is metabolized into acetaldehyde, a DNA-damaging carcinogen that contributes to cancer risk. Additionally, ethanol can alter estrogen and androgen levels, increasing the risk of hormone-sensitive cancers, particularly breast cancer. Laconte explained further, saying
“It likely doesn’t matter how you choose to get your ethanol. It’s a question of volume.”
New Studies Show Wine May Not Be an Exception
A recent study published in JAMA Network Open in August examined cancer mortality among older adults and found that:
- Light to heavy drinkers had an increased risk of dying from cancer compared to occasional drinkers.
- Wine drinkers who consumed over 80% of their ethanol from wine or drank only with meals had a slight reduction in cancer mortality risk.
However, the protective effects observed in wine drinkers were small and inconsistent. As Dr. Tim Stockwell from the Canadian Institute for Substance Use Research pointed out that
“It’s hard to unpack the confounding that goes along with the type of person who’s a wine drinker versus a beer or spirit drinker. Wine drinkers tend to be higher-income, exercise more, and smoke less — all factors that contribute to better health outcomes.”
Wine May Contain Antioxidants, But Is That Enough?
Some researchers argue that wine’s potential anti-carcinogenic properties could counterbalance the harmful effects of ethanol. Besides resveratrol, red wine also contains anthocyanins, quercetin and tannins
However, the protective effects of these compounds are not enough to offset the cancer risks associated with alcohol consumption. The consensus remains that ethanol’s harmful effects outweigh any potential benefits.
No Safe Level of Alcohol for Cancer Prevention
Groups such as the IARC and ASCO (American Society of Clinical Oncology) maintain that no level of alcohol is entirely safe when it comes to cancer risk.
In Canada, the latest alcohol guidelines suggest that consuming six drinks per week throughout adulthood could reduce life expectancy by 11 weeks. For heavy drinkers (four drinks a day), that figure could increase to 2-3 years.
What Should People Do?
While the safest choice is not to drink alcohol, experts recognize that personal preferences and individual circumstances play a role in decision-making. LoConte advised that
“From a cancer prevention standpoint, it’s probably best not to drink. But people don’t make choices based solely on cancer risk. We don’t want to come out with recommendations saying no one should drink. I don’t think the data support that.”
Dr. Rebbeck echoed this sentiment:
“Everybody’s preferences and choices are going to be different. And that’s all we can really do.”
While red wine’s reputation as a health-boosting beverage persists, new research underscores that all types of alcohol — including wine — increase cancer risk. Moderate drinking may offer minimal benefits for some individuals, but for those concerned about cancer prevention, reducing or eliminating alcohol remains the safest course of action.
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