Increased Risk of Skin Cancer Related to Alcohol Intake

Skin cancer is common in areas of the world with extreme sun exposure and among individuals reporting excessive tanning; its association with alcohol consumption is not well understood. This study, based on combined data from 3 large US cohorts, examined the association between alcohol consumption and the risk of cutaneous squamous cell carcinoma (cSCC). The authors found:

• An increased risk of cSCC with alcohol intake. Among women, there was a steep increase in risk of cancer for lower levels of intake (< 5 g/day, slightly less than one half of a typical drink), with a gradual increase in risk thereafter; among men there was more of a gradual increase in risk with greater reported alcohol intake.
• A 22% increase in risk per typical drink in a day for invasive cSCC and 14% for in situ cSCC. In beverage-specific analyses, white wine consumption of ≥ 5 times in a week was associated with an increased risk of cSCC (relative risk, 1.31), but the increased risk was not found for other alcoholic beverages.
• The population-attributable risk associated with alcohol intake of < 20 g/day (about 1.5 typical drinks) was estimated as 3% of all cSCCs.

Comments:

The results of the study are consistent with increases in risk associated with alcohol consumption for other types of skin cancer. Given that sun exposure is by far the primary risk factor for skin cancer, and consumers of alcohol tend to have a higher number of sunburns compared with abstainers, it is difficult to determine whether residual confounding by sun exposure is playing a role. While the authors recommend that physicians offer counseling to patients concerning the risks associated with alcohol consumption and cSCC, they should also focus on the much greater protection provided by avoiding exposure to ultraviolet radiation.

R. Curtis Ellison, MD

Reference:

Siiskonen S, Han J, Li T, et al. Alcohol intake is associated with increased risk of squamous cell carcinoma of the skin: three US prospective cohort studies. Nutr Cancer. 2016;68(4):545–553.