IARC’s perspective on alcohol reduction or cessation and cancer risk

The results of an extensive review by the International Agency for Research on Cancer (IARC) are summarised in The New England Journal of Medicine. The IARC’s Working Group, comprising global experts, evaluated literature on the relationship between alcohol consumption and cancers of various organs. This evaluation, a part of the IARC Handbooks series known for its definitive cancer prevention analyses, marks a first-ever comprehensive review of the impact of alcohol reduction or cessation across seven alcohol-related cancer types.
Based on the evidence reviewed, the Working Group concluded that there is sufficient evidence that, compared with continuing consumption, reduction or cessation of alcoholic beverage consumption reduces the incidence of cancers of the oral cavity and the oesophagus. The evidence that reduction or cessation of alcohol consumption reduces risk of the other alcohol-related cancer types was either limited or inadequate.
The Working Group also concluded that there is sufficient evidence from mechanistic studies that cessation of alcohol consumption reduces alcohol-related carcinogenesis. This conclusion is based on strong evidence that three alcohol-related mechanistic pathways are reversible upon cessation of alcohol consumption: those involving acetaldehyde metabolism, genotoxicity (such as DNA damage), and the immune and inflammatory systems (intestinal permeability and microbial translocation).
The report’s conclusions are based on rigorous analysis of various studies, including pooled analyses and meta-analyses, adhering to the IARC’s strict evaluation criteria. The findings hold significant implications for public health, reinforcing the WHO’s stance on alcohol as a major health concern, with no safe level of consumption established
Source: Gapstur SM, Bouvard V, Nethan ST, Freudenheim JL, Abnet CC, English DR, Rehm J, Balbo S, Buykx P, Crabb D, Conway DI, Islami F, Lachenmeier DW, McGlynn KA, Salaspuro M, Sawada N, Terry MB, Toporcov T, Lauby-Secretan B. The IARC Perspective on Alcohol Reduction or Cessation and Cancer Risk. N Engl J Med. 2023 Dec 28;389(26):2486-2494.

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