Heavy Alcohol Consumption Associated with Risk of Liver Cancer

Heavy alcohol consumption is known to cause hepatic cirrhosis, which frequently precedes the development of liver cancer. Investigators carried out a meta-analysis to evaluate the association of alcohol consumption with liver cancer. They used data from 19 prospectively studied cohorts with a large total number of cases: 4445 incident cases and 5550 deaths from liver cancer.

• Compared with no alcohol consumption, the relative risk for developing liver cancer was 0.91 for “moderate” drinking (defined as < 3 drinks in a day) and 1.16 for heavy drinking (defined as ≥ 3 drinks in a day).
• Increasing alcohol consumption led to a linear increased risk of liver cancer, with an estimated excess risk of 46% for 50 g of ethanol (i.e., ~4 standard drinks) in a day and 66% for 100 g in a day.
• The investigators found no association between “moderate” drinking and the risk of liver cancer.

Comments:

Heavy drinking appears to not only cause cirrhosis but is associated with liver cancer too. These findings are consistent with other studies that support alcohol’s carcinogenicity. Although the studies did not detect associations between “moderate” alcohol use and liver cancer, the data were limited to the average number of drinks per day. Many people who drink the average amounts defined as “moderate” in this study exceed per occasion (daily) limits (they have occasional heavy [“binge”] drinking episodes). Such individuals should not be reassured about their alcohol-related liver cancer risk. On the other hand, if those with occasional heavy drinking were removed, the protective association between “moderate” use and cancer might be greater.

R. Curtis Ellison, MD

Reference:

Turati F, Galeone C, Rota M, et al. Alcohol and liver cancer: a systematic review and meta-analysis of prospective studies. Ann Oncol. 2014;25(8):1526–1535.