Exhaustive Review of the Literature Reveals Even Moderate Alcohol Intake Increases Risk of Cancer

The Cancer Institute of New South Wales, Australia, has released a comprehensive analysis of current evidence for the association between alcohol consumption and risk of cancer. Limited to systematic reviews and meta-analyses of the highest methodological quality, the 194-page monograph, entitled Alcohol as a Cause of Cancer, revealed that even moderate alcohol consumption is associated with an often dramatic increase in the risk of several types of cancer.

Key findings are as follows:

Alcohol intake of approximately 2 drinks per day increases the risk of

• cancer of the oral cavity and pharynx by 75 percent,
• the risk of esophageal cancer by 50 percent, and
• the risk of laryngeal cancer by 40 percent.

Moderate intake also significantly increases the risk of colorectal cancer, liver cancer, and stomach cancer.

• Intake of approximately 4 drinks per day increases the risk of any cancer by 22 percent, while
• 8 drinks per day increases the risk by 90 percent.

The risk of breast cancer is 11 to 22 percent higher in women who drink alcohol than in women who do not.

Comments: The authors were unable to identify levels of consumption associated with no risk of cancer. Although the World Health Organization lists alcohol as a Group-1 carcinogen, as noted in the introduction to this study, few people are aware that even moderate consumption can cause cancer. These findings may be limited by possible underreporting of alcohol use or misclassification of exposure (e.g., light or ex-drinkers classified as nondrinkers).

Nonetheless, information about the association between alcohol and cancer needs to be more widely available so that the public can make informed choices about their behavior.

Richard Saitz, MD, MPH. Research Reference; Lewis S, Campbell S, Proudfoot E, et al. Alcohol as a Cause of Cancer. Sydney, Cancer Institute NSW, May 2008.

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Counselling for Alcohol Problems (Counselling in Practice series) by Richard D B Velleman Read more about this title…

Women Can Inherit Drinking Problem Too, Study Finds

In the first major twin study to compare genetic and environmental factors that contribute to the risk of alcoholism in both sexes, researchers have found that genetics plays an important role in determining alcohol dependence in women as well as in men. The study contradicts the long-held assumption that a woman’s environment is more likely to influence whether she becomes dependent on alcohol.

The study was conducted by scientists at Washington University School of Medicine in St. Louis and Australian collaborators at the Queensland Institute of Medical Research. It was funded by the U.S. National Institute of Alcoholism and Alcohol Abuse, and the findings were published in a recent issue of the journal Psychological Medicine.

While there is ample evidence for an important genetic influence on alcoholism risk in men, the tie between genetics and alcoholism in women has been uncertain, said the paper’s lead author, Andrew Heath, Ph.D., a professor of psychiatry at Washington University.

The study sought to address this shortcoming. It involved 2,685 pairs of twins, all participants in an adult twin study started in Australia in 1978 and maintained by the Australian National Health and Medical Research Council. The two members of each pair were raised in the same home environment. The study included — for the first time — twins of opposite sex as well as twins that were either both male or both female.

Telephone interviews with the twins were conducted to assess whether the participants had lost control over their drinking, were unable to cut back on drinking or had similar problems with alcohol.

Twins who had an alcoholic identical twin were much more likely to be alcoholic themselves than were twins who had an alcoholic fraternal twin, and this was equally true in women and in men. More surprisingly, men who had an alcoholic twin sister had very high rates of alcoholism.

“If shared environmental factors are of predominant importance in women but genetic influences predominate in men — a commonly held belief — then we would have expected to see very low concordance for alcoholism of unlike-sex twin pairs,” Heath said. “That wasn’t the case.”

The study also found that women with an alcoholic identical (monozygotic) twin sister were six times more likely to be alcohol dependent than other women. Monozygotic twins share the same genetic makeup. Dizygotic, or nonidentical, twins, who are not more alike genetically than ordinary sisters, were only three times more likely to be alcohol dependent if their twin had a drinking problem.

The study also examined whether psychiatric disorders that commonly precede or coexist with alcoholism, such as childhood behavior problems like lying and stealing or depression, were as strongly associated with risk of alcoholism in women as in men.

“It used to be believed that depression predicted increased risk of alcohol problems in women, whereas a history of childhood behavior problems predicted alcoholism risk in men. We found that depression is a potent predictor for alcohol dependence in both men and women,” said Heath. “A history of behavior problems also is as strong a predictor in women than in men — slightly more powerful in women, in fact.”

Heath AC, Bucholz KK, Madden PAF, Dinwiddie SH, Slutske WS, Bierut LJ, Statham DJ, Dunne MP, Whitfield JB, Martin NG. “Genetic and Environmental Contributions to Alcohol Dependence Risk in a National Twin Sample — Consistency of Findings in Women and Men”. Psychological Medicine. 27(6):1381-1396, 1997 November.

The more alcohol an individual drinks, the more the risk of suicide grows, according to a researcher at Canada’s Center for Addiction and Mental Health (CAMH).

All Headline News reported Sept. 8 that CAMH senior researcher Robert Mann found that while suicide risk rose with alcohol consumption, as well as other factors like unemployment, the risk of suicide decreased when heavy drinkers joined Alcoholics Anonymous.

“These results suggest that a 1-liter increase in alcohol consumption led to an increase of 11 percent to 39 percent in suicides,” said Mann. “This observation is consistent with individual-level studies that show that heavy drinking, alcohol abuse and alcohol dependence increase a person’s risk of suicide substantially … However, it was heartening to see that increasing AA membership was related to reduced suicide mortality rates.”

The link between drinking and suicide was stronger among women than men, Mann noted.

Night Falls Fast: Understanding Suicide by Kay Redfield Jamison Read more about this title…

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ACOA Mutual help groups, perceived status benefits, and well-being: A test with adult children of alcoholics with personal substance abuse problems.

A field experiment was conducted to examine the potential effects of mutual help group participation on perceived status benefits, depression, and substance use among 82 adult children of alcoholics (ACOA’s; aged 22-60 yrs) with personal substance abuse problems.

Participants were randomly assigned to attend either ACOA-specific mutual help group meetings or substance abuse education classes during the initial month that they were enrolled in a residential treatment program for low-income substance abusers.

Analyses were based on assessments made at baseline, a 1-month posttest, and a 6-month follow-up.

Results indicate that participation in the mutual help group promoted perceived status benefits, which in turn led to reductions in depression and substance use.

These findings have clear implications for consumers of ACOA groups and can inform research on the social psychological underpinnings of different types of mutual help groups.

Kingree, J. B; Thompson, Martie. Mutual help groups, perceived status benefits, and well-being: A test with adult children of alcoholics with personal substance abuse problems. American Journal of Community Psychology. Vol 28(3), Jun 2000, 325-342.

The Complete ACOA Sourcebook: Adult Children of Alcoholics at Home, at Work and in Love by Janet Woititz Read more about this title…

Women and the Twelve Steps of Alcoholics Anonymous: A Gendered Narrative

This paper examines how women “work” the twelve steps of Alcoholics Anonymous (AA) from a gendered perspective.

Feminist critics of AA have

• challenged the language of AA’s Twelve Steps,
• the spiritual nature of the steps, and
• the male-dominated culture of the Twelve-Step program.

This paper offers insight into how women in AA approach, interpret, and utilize the Twelve Steps to recover from alcoholism.

Through survey and narrative data, findings suggests

• that women working AA’s Twelve Steps become empowered and
• change for the better in spite of the male-dominated culture and language of the Twelve Steps and
• regardless of the difficulty they may have encountered in completing these steps.

In particular, the first three steps-the “surrender steps”-

• encourage women to let go of their alcoholic obsession and
• begin a spiritual path of recovery.

Steps Four through Nine require

• women to “clean house” and
• get rid of old self-destructive ways so that they may develop a new and stronger sense of self.

Finally, on completing Steps Ten through Twelve, women

• experience a spiritual awakening and
• then, in turn, “pass on” what they have learned from the Twelve Steps to other women in the program.

Woven throughout these women’s experiences is

• an acknowledgment of gender and
• the role it plays in how they work the Twelve Steps.

In the end, these women express a sense of personal empowerment that is particular to a gender-specific orientation to the Twelve Steps of AA.

Research; Jolene M. Sanders, Women and the Twelve Steps of Alcoholics Anonymous: A Gendered Narrative. Alcoholism Treatment Quarterly, Volume: 24 Issue: 3, 2006

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Difference in medical history classified by ICD-10 between male and female alcoholics.

The drinking history and current medical history of patients with alcohol dependence were surveyed in Japan and they were analyzed by demographics; gender, age and changes with time (2 stages).

The results showed that in the course of continued habitual drinking by patients with alcohol dependence, a wide range of physical complications occurred.

The main complications

• in men were gastrointestinal diseases and
• in women were mental and behavioral disorders, showing a gender difference in the medical history.

This result suggested that there is a high possibility that this will contribute to early discovery and early measures against alcohol related problems in women, which are difficult to bring out into the open.

Better alcohol education including mental health is important from an early age.

Nihon Arukoru Yakubutsu Igakkai Zasshi. 2008 Feb;43(1):25-34. Difference in medical history classified by ICD-10 between male and female alcoholics. Shinoda R, Mizukami Y, Nakagawa Y, Maruyama K.

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Patterns of alcohol consumption and blood alcohol levels in emergency room patients.

The study was conducted in a public hospital of the province of Jujuy, Argentina.

A survey was conducted among all patients during the 24 hours of 4 consecutive days (N = 500) using the Alcohol Use Disorders Identification Test, short version (AUDIT-C). Blood samples were collected in 84% of participants.

Results showed that;

• 37% were hazardous drinkers (men 50% vs. women 23%),
• 29% had symptoms of dependence (men 48% vs. women 11%);
• 17% of men and 3% of women had high blood alcohol levels, equal or greater than 50 mg/dl.

In multivariate logistic regression models men had;

• increased likelihood of hazardous drinking (Adjusted OR 3.2; 95% CI 2.1-5.0),
• symptoms of dependence (Adjusted OR 7.5; 95% CI 4.4-12.7) and
• increased blood alcohol levels (Adjusted OR 8.0; 95% CI 2.2-28.8), compared with women.

Patients admitted due to accidents, violence, or drug use, had;

• increased likelihood of hazardous drinking (Adjusted OR 2.4; 95% CI 1.5-3.9),
• dependence symptoms (Adjusted OR 2.0; 95% CI 1.2-3.3) and
• increased blood alcohol levels (Adjusted OR 7.7; 95% CI 3.0-19.8), compared with those admitted for other reasons.

Alcoholism has a significant impact on the occurrence of injuries and on the demand imposed on health services.

Prevention programs can potentially reduce the negative health and social impact of alcoholism.

Research; Medicina (B Aires). 2008;68(1):31-6. Alcohol consumption in the emergency room. Alderete E, Bianchini P.

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Understanding and Counseling: Persons With Alcohol, Drug, and Behavioral Addictions by Howard Clinebell Read more about this title…

Research Summary; Women and men appear to have different genetic and environmental risk factors for alcoholism, Reuters reported Jan. 24/2006.

A quartet of new family studies on alcoholism show, for example, that while both sexes are more likely to develop alcoholism if they have a history of aggressive behavior in childhood, women who experienced severe physical punishment in childhood were also at elevated risk, while men were not.

“Clearly, there are some common antecedents (to alcoholism), such as conduct disorder or symptoms, but there are also predictors unique to each gender,” said researcher Aruna Gogineni of the Johns Hopkins University School of Medicine. “These are the kinds of findings that call out for many more studies on women in order to determine how the mechanisms of alcoholic parental risk may differ in men and women.”

Researchers affirmed that children of alcoholics were generally more likely to have alcohol problems themselves, but said that genetic makeup may be more important for men, while environmental factors may have more of an impact on women. For example, one study comparing children of biological and adopted parents with alcoholism found that male children of alcoholics related by blood were more likely to be alcoholics themselves.

The research appears in the February 2006 issue of the journal Alcoholism: Clinical & Experimental Research.

From; Join Together Online

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Understanding and Counseling: Persons With Alcohol, Drug, and Behavioral Addictions : Counseling for Recovery and Prevention Using Psychology and Religion by Howard Clinebell Read more about this title…

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