1. DiGiulio, Sarah

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ASCO recently issued the organization's first statement on alcohol and cancer, which was published in the Journal of Clinical Oncology (2017;36:83-93).

Noelle Loconte, MD. ... - Click to enlarge in new windowNoelle Loconte, MD. Noelle Loconte, MD

"Alcohol can increase your cancer risk," the statement's lead author Noelle LoConte, MD, Associate Professor of Medicine in the Division of Hematology/Oncology at University of Wisconsin, told Oncology Times. "We aren't saying 'don't drink,' but we are saying know your risks and talk to your health team about what amount of alcohol makes sense for you given your medical history and family history.


"And even cutting back without quitting will decrease your risk," she added.


According to the statement, between 5 and 6 percent of new cancers and cancer deaths globally can directly be attributed to alcohol.


The new statement includes a review of the most recent evidence on the link between drinking alcohol and cancer incidence. It also includes relevant findings from ASCO's recent National Cancer Opinion Survey about public perception on the link between drinking and cancer. And the statement includes several evidence-based policy recommendations to reduce excessive alcohol consumption.


Here's what else LoConte said was important to know about the new statement.


1 This is ASCO's first statement on the link between alcohol use and cancer. Why now?

"Yes, this is the first statement from ASCO on alcohol and cancer. This came to my attention while talking to my peers about what cancers were caused by alcohol (most did not know for sure). And then in reviewing our policy statements, the ASCO Prevention Committee realized we did not have a statement on alcohol, so I offered to help to write it.


"Around the same time, ASCO did a large survey which showed only 30 percent of people surveyed were aware of the link. So we also viewed this as an opportunity to raise awareness for both providers and the lay public."


2 Alcohol is widely consumed and many (even health-focused) organizations support drinking alcohol in moderation. Is ASCO calling for a sea change?

"We (myself and the statement coauthors) could not find substantial scientific evidence that there are 'heart health' benefits to alcohol. We also consulted with preventive cardiologists, who agreed. In fact, the American Heart Association (AHA) no longer recommends red wine for heart health. We are supporting the recommendations of the American Cancer Society and the AHA for women to drink no more than one drink per day, and for men no more than two per day. Also, if you don't drink, don't start.


"Do I think people ought to abstain completely? No, absolutely not. I liken it to skin cancer. We know sun exposure increases risk of skin cancer, but I don't tell people to not go outside in the sun. Rather, think about whether you can use sunscreen and shade and long sleeves when you can.


"It has been interesting to see people fight back against the science supporting alcohol as a carcinogen. I thought I might get push back, but I was not anticipating that people would question that alcohol is a carcinogen. (The Lancet wrote a really nice editorial supporting our statement that says this much [2017;390:2215-2218].)"


3 What would you say is the bottom line message that practicing oncologists and cancer care providers should know about this statement-and about the link between drinking alcohol and cancer?

"One of the areas of needed research that we feel is urgent is what ongoing alcohol use does for current oncology patients. Should they stop drinking? Cut down? Continue? Increase? There is a bit of data (cited in the statement) that alcohol use increases the rate of head and neck cancer recurrence, as well as overall mortality-but there is also data saying it may reduce or increase breast cancer recurrence. We really need better studies to answer this question for oncologists to know how to counsel their patients.


"The role of the oncologist now is to be vocal in their community about the risk of alcohol and cancer and support local policy strategies aimed at reducing high-risk alcohol consumption to decrease the number of patients diagnosed with cancer.


"For those that do prevention work, addressing alcohol use may be a strategy that can be applied in your clinic to reduce someone's risk of developing cancer."