What a behavioral scientist wants you to know about alcohol and cancer risk

Earlier this month, the U.S. surgeon general called for cancer warning labels on alcohol. Drinking alcohol is linked to several cancers and even small amounts may increase your risk. But believe it or not, 70% of the U.S. population is unaware that drinking causes cancer, and current standard public health messages regarding the cancer harms of alcohol use have not significantly increased population awareness.

That’s where Dr. Jennifer Hay—a researcher currently funded by the Prevent Cancer Foundation—comes in. Her mission? Increase drinkers’ awareness of the cancer risk associated with alcohol use. Following the surgeon general’s announcement, we spoke with Dr. Hay about her research and what everyone should know about the relationship between alcohol and cancer.

Note: This interview has been edited for length and clarity.

What does the U.S. surgeon general’s announcement mean exactly, and what could it mean for the future of alcohol consumption in the U.S.?

It has been quite a couple of weeks! While it has been established for decades that alcohol is the third most important lifestyle risk factor for cancer—responsible for 6% of cancer cases nationwide—this message has unfortunately not fully reached the general population, at least in the U.S.

I think the U.S. surgeon general’s report really raises awareness from a trustworthy source. I also think the report and corresponding press surrounding it will galvanize culture change, making it easier to opt out of drinking, even at events where alcohol currently seems central to celebration and socializing. Culture change will take time, but I think greater awareness of the harms of alcohol use will help these messages move into the mainstream.

Which cancer types have alcohol consumption as a risk factor?

Drinking alcohol is related to very common cancers, including colorectal cancer and breast cancer. There is a clear link between alcohol consumption and increased risk for seven types of cancer. These cancers include colorectal and breast cancers as noted above, as well as head and neck cancers (cancers of the oral cavity, pharynx and larynx), as well as liver and esophageal cancers.

Your research addresses the low awareness U.S. adults have of alcohol and cancer risk. How are you reaching people who drink to expand their awareness of the increased cancer risk from alcohol use?

We are conducting two types of research in order to address this. First, we are conducting survey research with a large sample of individuals from all sectors of the U.S. population to understand the level of awareness of the cancer risks of alcohol in different socioeconomic and geographical groups. We recently collected data on 800 drinkers who do not believe there is a link between alcohol and cancer. The goal is to pinpoint those groups where knowledge and awareness are lowest so we can develop specific messages to reach them with this important information.

Second, we are also conducting small discussion groups, inviting people with very high levels of uncertainty about alcohol and cancer risk from across the U.S. to talk with a trained moderator about their thoughts and feelings about alcohol and cancer, as well as their suggestions for messaging that will generate high knowledge and trust.

With the support of the Prevent Cancer Foundation, these research efforts will result in new messages that we intend to use to address low awareness of the cancer harms of alcohol, so that people can make fully informed decisions about their own and their family’s alcohol use going forward.

What inspired you to undertake this project?

I am passionate about bringing behavioral science to cancer prevention challenges. Much of my career has been very focused on measuring and understanding cancer risk perceptions—how people think about their risk—and the ways in which cancer risk perceptions present opportunities to motivate prevention behaviors. As such, the challenge of alcohol and cancer risk is a perfect fit for my background and research mission. On a more personal level, my family has been challenged by both cancer diagnoses and a strong drinking culture across generations, leading me to be deeply invested in this work.

How does alcohol increase your risk of cancer, and, on the inverse, how does abstaining from alcohol improve your health and well-being?

The carcinogen in all forms of alcohol is acetaldehyde, a Group 1 carcinogen that works by damaging DNA. All forms of alcohol, including beer, liquor and wine, contain acetaldehyde. In the case of breast cancer, alcohol can cause cancer by increasing estrogen levels in the body.

All alcohol affects the body in the same way, in the context of cancer. That goes for wine, beer and liquor. Importantly, it is valuable to pay attention to “ABV,” alcohol by volume. To reduce risk, there are low ABV drinks that one might consider and are widely available.

Abstaining from alcohol can not only reduce your risk of developing cancer, but it can also improve your health in other ways—from making it easier to keep to a balanced diet to getting a good night’s sleep. I see patients in my role as a psycho-oncologist who are recovering from cancer, and many of them tell me that abstaining from alcohol has also improved their ability to think clearly and has improved the quality of their relationships. I have found that cancer survivors are highly receptive to the message about alcohol and cancer risk, and are sometimes the first ones to give up drinking while they are being treated for cancer.

What would you say to someone who drinks but is looking to decrease or completely cut out their consumption? Is it ever “too late” to quit?

It is never too late! Additionally, it is never too late to cut down on consumption. In addition to reducing your risk of cancer, there are multiple quality of life and general health benefits associated with quitting that accrue relatively quickly. It is definitely worth it, and there is plenty of help available to help you accomplish this. Start with your primary care provider, who can direct you to resources to get you started on this healthy lifestyle change.

For more information on Dr. Hay’s research, visit preventcancer.org/research. To find more ways to reduce your risk of cancer, visit Krebsvorbeugung.org.