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. 1979 Sep;25:1081–1085.

The Role of Alcohol as a Co-Carcinogen

Saul Cohen
PMCID: PMC2383124  PMID: 21297757

Abstract

If cancer occurs because of what we eat, what we drink, what we smoke, and to some extent where we live and work, it follows that over 80% of cancers in human beings are related to environmental causes and therefore preventable.

Since virtually every major chemical is under investigation for its carcinogenic effect, it is high time that the biological impact of alcohol received more than scant attention from the health professions as a lifestyle chemical which may be a factor in the commencement or promotion of modern man's most deadly disease.

Clinical and epidemiological studies have implicated the excessive use of alcohol with the risk of developing certain cancers, especially when combined with heavy smoking. Other factors associated with drinking and increased risk of cancer consist of geographic, racial, sex and organ specificity, variations of which must be borne in mind in any study of potential environmental hazards.

Research is currently under way to determine whether certain alcohol beverages may contain carcinogens, which may focus attention on the role of heavy drinking as one additional environmental factor in the spectrum of exogenous agents related to cancer production.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bradshaw E., Schonland M. Oesophageal and lung cancers in Natal African males in relation to certain socio-economic factors. An analysis of 484 interviews. Br J Cancer. 1969 Jun;23(2):275–284. doi: 10.1038/bjc.1969.37. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Collis C. H., Cook P. J., Foreman J. K., Palframan J. F. A search for nitrosamines in East African spirit samples from areas of varying oesophageal cancer frequency. Gut. 1971 Dec;12(12):1015–1018. doi: 10.1136/gut.12.12.1015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cook P. Cancer of the oesophagus in Africa. A summary and evaluation of the evidence for the frequency of occurrence, and a preliminary indication of the possible association with the consumption of alcoholic drinks made from maize. Br J Cancer. 1971 Dec;25(4):853–880. doi: 10.1038/bjc.1971.99. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. DAVIDSON C. S., SUMMERSKILL W. H., WOLFE S. J. Thickening and contraction of the palmar fascia (Dupuytren's contracture) associated with alcoholism and hepatic cirrhosis. N Engl J Med. 1956 Sep 20;255(12):559–563. doi: 10.1056/NEJM195609202551204. [DOI] [PubMed] [Google Scholar]
  5. Davidson C. S. Nutrition, geography, and liver diseases. Am J Clin Nutr. 1970 Apr;23(4):427–436. doi: 10.1093/ajcn/23.4.427. [DOI] [PubMed] [Google Scholar]
  6. De Jong U. W., Breslow N., Hong J. G., Sridharan M., Shanmugaratnam K. Aetiological factors in oesophageal cancer in Singapore Chinese. Int J Cancer. 1974 Mar 15;13(3):291–303. doi: 10.1002/ijc.2910130304. [DOI] [PubMed] [Google Scholar]
  7. HOU P. C. The relationship between primary carcinoma of the liver and infestation with Clonorchis sinensis. J Pathol Bacteriol. 1956 Jul;72(1):239–246. doi: 10.1002/path.1700720130. [DOI] [PubMed] [Google Scholar]
  8. Higginson J. Etiological factors in gastrointestinal cancer in man. J Natl Cancer Inst. 1966 Oct;37(4):527–545. [PubMed] [Google Scholar]
  9. Higginson J. The geographical pathology of liver disease in man. Gastroenterology. 1969 Nov;57(5):587–598. [PubMed] [Google Scholar]
  10. KAMIONKOWSKI M. D., FLESHLER B. THE ROLE OF ALCOHOLIC INTAKE IN ESOPHAGEAL CARCINOMA. Am J Med Sci. 1965 Jun;249:696–700. doi: 10.1097/00000441-196506000-00011. [DOI] [PubMed] [Google Scholar]
  11. Kissin B., Kaley M. M., Su W. H., Lerner R. Head and neck cancer in alcoholics. The relationship to drinking, smoking, and dietary patterns. JAMA. 1973 May 21;224(8):1174–1175. [PubMed] [Google Scholar]
  12. Kissin B., Kaley M. M., Su W. H., Lerner R. Letter: Cancer in alcoholics (corrected table). JAMA. 1973 Dec 10;226(11):1360–1360. doi: 10.1001/jama.1973.03230110048023. [DOI] [PubMed] [Google Scholar]
  13. Kmet J., Mahboubi E. Esophageal cancer in the Caspian littoral of Iran: initial studies. Science. 1972 Feb 25;175(4024):846–853. doi: 10.1126/science.175.4024.846. [DOI] [PubMed] [Google Scholar]
  14. Krain L. S. Crossing of the mortality curves for stomach and pancreatic carcinoma. Int Surg. 1972 Apr;57(4):307–310. [PubMed] [Google Scholar]
  15. Lee F. I. Cirrhosis and hepatoma in alcoholics. Gut. 1966 Feb;7(1):77–85. doi: 10.1136/gut.7.1.77. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Lowenfels A. B. Alcohol and cancer. N Y State J Med. 1974 Jan;74(1):56–59. [PubMed] [Google Scholar]
  17. Lynch H. T., Kwers D. D., Krush A. J., Sharp E. A., Swartz M. J. Esophageal cancer in a midwestern community. Am J Gastroenterol. 1971 May;55(5):437–442. [PubMed] [Google Scholar]
  18. MacDonald W. C. Clinical and pathologic features of adenocarcinoma of the gastric cardia. Cancer. 1972 Mar;29(3):724–732. doi: 10.1002/1097-0142(197203)29:3<724::aid-cncr2820290328>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  19. Martinez I. Factors associated with ccer of the esophagus, mouth, and pharynx in Puerto Rico. J Natl Cancer Inst. 1969 Jun;42(6):1069–1094. [PubMed] [Google Scholar]
  20. Martínez I. Retrospective and prospective study of carcinoma of the esophagus, mouth, and pharynx in Puerto Rico. Bol Asoc Med P R. 1970 Jun;62(6):170–178. [PubMed] [Google Scholar]
  21. PERNU J. An epidemiological study of cancer of the digestive organs and respiratory system. A study based on 7078 cases. Ann Med Intern Fenn Suppl. 1960;49(Suppl 33):1–117. [PubMed] [Google Scholar]
  22. Pell S., D'Alonzo C. A. A five-year mortality study of alcoholics. J Occup Med. 1973 Feb;15(2):120–125. [PubMed] [Google Scholar]
  23. Pindborg J. J., Jolst O., Renstrup G., Roed-Petersen B. Studies in oral leukoplakia: a preliminary report on the period pervalence of malignant transformation in leukoplakia based on a follow-up study of 248 patients. J Am Dent Assoc. 1968 Apr;76(4):767–771. doi: 10.14219/jada.archive.1968.0127. [DOI] [PubMed] [Google Scholar]
  24. Prince A. M., Leblanc L., Krohn K., Masseyeff R., Alpert M. E. S.H. antigen and chronic liver disease. Lancet. 1970 Oct 3;2(7675):717–718. doi: 10.1016/s0140-6736(70)91981-1. [DOI] [PubMed] [Google Scholar]
  25. Rothman K., Keller A. The effect of joint exposure to alcohol and tobacco on risk of cancer of the mouth and pharynx. J Chronic Dis. 1972 Dec;25(12):711–716. doi: 10.1016/0021-9681(72)90006-9. [DOI] [PubMed] [Google Scholar]
  26. SCHWARTZ D., LELLOUCH J., FLAMANT R., DENOIX P. F. [Alcohol and cancer. Results of a retrospective investigation]. Rev Fr Etud Clin Biol. 1962 Jun-Jul;7:590–604. [PubMed] [Google Scholar]
  27. Sakurai M. A histopathologic study on the effect of alcohol on cirrhosis and hepatoma of autopsy cases in Japan. Acta Pathol Jpn. 1969 Aug;19(3):283–314. doi: 10.1111/j.1440-1827.1969.tb00709.x. [DOI] [PubMed] [Google Scholar]
  28. Schmidt W., De Lint J. Causes of death of alcoholics. Q J Stud Alcohol. 1972 Mar;33(1):171–185. [PubMed] [Google Scholar]
  29. Schoenberg B. S., Bailar J. C., 3rd, Fraumeni J. F., Jr Certain mortality patterns of esophageal cancer in the United States, 1930-67. J Natl Cancer Inst. 1971 Jan;46(1):63–73. [PubMed] [Google Scholar]
  30. Schottenfeld D. Alcohol as a co-factor in the etiology of cancer. Cancer. 1979 May;43(5 Suppl):1962–1966. doi: 10.1002/1097-0142(197905)43:5+<1962::aid-cncr2820430703>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  31. Schrauzer G. N., McGinness J. E., Ishmael D., Bell L. J. Alcoholism and cancer. I. Effects of long-term exposure to alcohol on spontaneous mammary adenocarcinoma and prolactin levels in C3H/St mice. J Stud Alcohol. 1979 Mar;40(3):240–246. doi: 10.15288/jsa.1979.40.240. [DOI] [PubMed] [Google Scholar]
  32. Tuyns A. J. Cancer of the oesophagus: further evidence of the relation to drinking habits in France. Int J Cancer. 1970 Jan 15;5(1):152–156. doi: 10.1002/ijc.2910050120. [DOI] [PubMed] [Google Scholar]
  33. Tuyns A. J., Massé L. M. Mortality from cancer of the oesophagus in Brittany. Int J Epidemiol. 1973 Autumn;2(3):241–245. doi: 10.1093/ije/2.3.241. [DOI] [PubMed] [Google Scholar]
  34. VINCENT R. G., MARCHETTA F. THE RELATIONSHIP OF THE USE OF TOBACCO AND ALCOHOL TO CANCER OF THE ORAL CAVITY, PHARYNX OR LARYNX. Am J Surg. 1963 Sep;106:501–505. doi: 10.1016/0002-9610(63)90137-5. [DOI] [PubMed] [Google Scholar]
  35. WYNDER E. L., BROSS I. J. A study of etiological factors in cancer of the esophagus. Cancer. 1961 Mar-Apr;14:389–413. doi: 10.1002/1097-0142(196103/04)14:2<389::aid-cncr2820140220>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  36. WYNDER E. L., BROSS I. J. Aetiological factors in mouth cancer; an approach to its prevention. Br Med J. 1957 May 18;1(5028):1137–1143. doi: 10.1136/bmj.1.5028.1137. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. WYNDER E. L., BROSS I. J., DAY E. A study of environmental factors in cancer of the larynx. Cancer. 1956 Jan-Feb;9(1):86–110. doi: 10.1002/1097-0142(195601/02)9:1<86::aid-cncr2820090108>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  38. WYNDER E. L., BROSS I. J., DAY E. Epidemiological approach to the etiology of cancer of the larynx. J Am Med Assoc. 1956 Apr 21;160(16):1384–1391. doi: 10.1001/jama.1956.02960510010003. [DOI] [PubMed] [Google Scholar]
  39. WYNDER E. L., BROSS I. J., FELDMAN R. M. A study of the etiological factors in cancer of the mouth. Cancer. 1957 Nov-Dec;10(6):1300–1323. doi: 10.1002/1097-0142(195711/12)10:6<1300::aid-cncr2820100628>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  40. WYNDER E. L., BROSS I. J., FELDMAN R. M. A study of the etiological factors in cancer of the mouth. Cancer. 1957 Nov-Dec;10(6):1300–1323. doi: 10.1002/1097-0142(195711/12)10:6<1300::aid-cncr2820100628>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  41. WYNDER E. L., FRYER J. H. Etiologic considerations of Plummer-Vinson (Patterson-Kelly) syndrome. Ann Intern Med. 1958 Nov;49(5):1106–1128. doi: 10.7326/0003-4819-49-5-1106. [DOI] [PubMed] [Google Scholar]
  42. WYNDER E. L., HULTBERG S., JACOBSSON F., BROSS I. J. Environmental factors in cancer of the upper alimentary tract; a Swedish study with special reference to Plummer-Vinson (Paterson-Kelly) syndrome. Cancer. 1957 May-Jun;10(3):470–487. doi: 10.1002/1097-0142(195705/06)10:3<470::aid-cncr2820100309>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  43. Williams R. R. Breast and thyroid cancer and malignant melanoma promoted by alcohol-induced pituitary secretion of prolactin, T.S.H. and M.S.H. Lancet. 1976 May 8;1(7967):996–999. doi: 10.1016/s0140-6736(76)91865-1. [DOI] [PubMed] [Google Scholar]

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