Alcohol has long been associated with several health concerns, ranging from liver diseases to cardiovascular issues. But did you know that its consumption can also increase the risk of cancer?
While some believe moderate drinking has health benefits, mounting research rubbishes this claim, pointing to alcohol as a significant risk factor for several types of cancer. The World Health Organization (WHO) and leading oncologists worldwide have said that alcohol is a carcinogen, meaning it has the potential to cause cancer.
“Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a group 1 carcinogen by the International Agency for Research on Cancer (IARC) decades ago. This is the highest risk group, which also includes asbestos, radiation and tobacco,” notes WHO, adding, “When it comes to alcohol consumption, there is no safe amount.”
Despite this classification, awareness about its carcinogenic properties remains low. Dr Tejinder Kataria, chairperson of radiation oncology & cancer centre at Medanta: The Medicity, emphasises the gravity of this: “Alcohol is placed in the highest risk category for causing cancer. This means that consuming alcohol can directly lead to the development of cancer.” It’s clear that alcohol is not just a lifestyle choice — it’s a significant health risk.
Crucial connection
The connection between alcohol and cancer is not based on mere speculation but on extensive research. “Alcohol is a major risk factor for cancers of the oral cavity, pharynx, larynx, oesophagus, liver, breast, and colorectum,” says Dr Rajat Saha, senior consultant and unit head, medical oncology at Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), Delhi. “When alcohol is metabolised in the body, it turns into acetaldehyde, a toxic substance that damages DNA and proteins, leading to mutations and, ultimately, cancer.”
Dr Kataria of Medanta further elaborates on the biological mechanisms that make alcohol a potent carcinogen. “Alcohol impairs the body’s ability to absorb essential nutrients like folate and vitamins A, C, D, and E, which are crucial for maintaining healthy cells and preventing cancer. Additionally, alcohol increases obesity, thereby raising levels of certain hormones, such as oestrogen, which can contribute to the development of breast cancer.”
The carcinogenic potential of alcohol increases with the quantity consumed. However, even moderate drinking is not free of risk. “People assume that only heavy drinking is dangerous, but even moderate consumption has been linked to breast and oesophageal cancer,” explains Dr Madan Maitre, consultant, radiation oncology, at Kokilaben Dhirubhai Ambani Hospital, Mumbai. “The cumulative effect over years of drinking is what significantly raises cancer risk.”
Alcohol consumption was associated with 62,100 or 5% of newly diagnosed cancer cases in 2020 in India, according to a 2021 study published in The Lancet Oncology journal, which shows alcohol use is on the rise in the country. Globally, the researchers found that more than 740,000 or 4% of new cancer cases in 2020 may be attributed to alcohol drinking.
“From a clinical perspective, I have encountered patients with advanced liver disease and oral cancers who had a history of heavy alcohol consumption. These cases are particularly concerning because they often present at later stages, making treatment more complex and outcomes less favourable. The interplay of alcohol with other risk factors, such as tobacco and diet, complicates both the prevention and management of alcohol-related cancers,” says Dr Maitre.
No drink is less harmful
Several myths surround alcohol consumption, many of which downplay its risks. One prevalent belief is that certain types of alcohol—such as wine—are less harmful than others. “There is a misconception that red wine is safe or even beneficial due to its antioxidant content,” Dr Kataria notes. “But the reality is that the carcinogenic effects of alcohol come from ethanol itself, regardless of the source or production method or whether it comes from beer, wine, or spirits.”
Another widespread myth is that occasional drinking does not contribute to cancer risk. However, Dr Saha of RGCIRC emphasises, “There is no completely safe level of alcohol consumption when it comes to cancer risk. Even light drinking has been associated with an increased likelihood of developing certain cancers. Alcohol taken in binge amounts, like approximately in excess of 60 to 70 ml per day, and people going up to 150 ml per day, that amount of alcohol is still carcinogenic.”
Another common myth is that alcohol aids digestion, points out Dr Maitre. “There is no scientific evidence supporting this claim. In reality, alcohol irritates the digestive tract and can contribute to gastrointestinal cancers,” he explains.
In fact, a 2023 study published in JAMA Network Open found that moderate alcohol intake did not confer health benefits for older adults, instead it was associated with an increased risk of disease-related mortality.
Are we doing enough?
Given the evidence, one would expect strict regulations and widespread awareness campaigns about alcohol’s carcinogenic effects. Alcohol consumption is a growing public health concern in India, with its carcinogenic risks often downplayed due to cultural acceptance and commercial influence. While regulations exist, enforcement remains inconsistent, and awareness campaigns struggle to compete with the influence of celebrity endorsements.
Dr Piyush Kumar Agrawal, clinical director and head of surgical oncology at Marengo Asia Hospitals, Gurugram, stresses the importance of early intervention. “Regulations alone aren’t enough to make people take up a healthy lifestyle. More important is awareness, which has to start at the primary school level to inculcate healthy habits in the young population.”
Dr Saha of RGCIRC highlights the shortcomings of India’s awareness efforts. “There are certain awareness campaigns which are routinely run on television as well as in cinema halls. But they are not so effective. More and more influential people, like our film stars, are promoting these kinds of activities, and for the common public, that is more influential than running an alcohol-related ad.”
Dr Maitre believes that economic measures can help curb alcohol consumption. “We should probably increase taxation to such an extent that it becomes slightly unaffordable. Education of the public should also be intensified in whatever form possible.”
Dr Kataria of Medanta emphasises the need for “comprehensive educational programmes highlighting the risks of alcohol consumption and its link to cancer.”
The fragmented nature of India’s alcohol policies further weakens their impact. Experts stress the need for a unified, evidence-based national policy to standardise regulations and improve awareness.
Recognising the power of celebrity influence, the Central Consumer Protection Authority (CCPA) introduced stricter penalties for surrogate advertising last year. Under the new rules, celebrities and influencers face fines of `10 lakh for a first-time violation and `50 lakh for repeat offenses.
Despite these efforts, alcohol-related cancer risks remain widely overlooked. Stronger regulations, increased public education, and strict penalties for misleading endorsements are crucial to reducing alcohol-related harm in India.
Lesser-known carcinogens
While alcohol is a major but under-recognised carcinogen, several other everyday substances also pose significant cancer risks.
“Processed meats, for example, are classified as group 1 carcinogens,” says Dr Saha of RGCIRC. “Consumption of processed meats like bacon, sausages, and salami has been linked to colorectal cancer. Yet, public awareness about this risk is minimal.”
Dr Kataria of Medanta adds that environmental pollutants also play a significant role. “Air pollution, particularly fine particulate matter (PM2.5), has been linked to lung cancer. In urban areas with high pollution levels, even non-smokers face substantial risks.”
She also highlights other common carcinogens found in daily life. “Plastics containing bisphenol A (BPA) and phthalates have raised concerns due to their potential to disrupt hormones and increase cancer risk. Similarly, high-temperature cooking methods, like frying or grilling meats, produce carcinogenic compounds.”
Dr Agrawal of Marengo Asia Hospitals stresses the dangers of tobacco-related carcinogens beyond just smoking. “Chewing tobacco, commonly used in India, is directly linked to oral and oesophageal cancers. The combination of tobacco and alcohol further exacerbates cancer risk.”
Dr Maitre too points to occupational and environmental exposures. “Certain industrial chemicals, pesticides, and prolonged exposure to UV radiation are often overlooked but contribute significantly to cancer cases. Workers in industries dealing with asbestos, benzene, and formaldehyde face higher cancer risks.”