By Daniel Dunaief

Close to six decades after another surgeon general urged a warning label about the link between cancer and smoking, Dr. Vivek Murthy, the current surgeon general, would like to add cancer warnings to labels for alcohol.

The third leading cause of preventable cancers after tobacco and obesity, alcohol increases the risk for at least seven types of cancer, the surgeon general recently wrote.

At the same time, less than half of the American population recognize alcohol as a risk factor for cancer.

As with the prevailing wisdom about smoking decades ago, several doctors and various studies have, until recently, indicated that moderate drinking such as a single glass of red wine for women each day and two glasses for men, have suggested a medical benefit to consuming alcohol.

“We have been misguided all these years by thinking there’s an acceptable amount of alcohol that’s safe enough to recommend,” said Dr. David Rivadeneira, Director of Northwell Health Cancer Institute at Huntington Hospital. 

Any change in required labels for alcohol would have to come from Congress, which would likely face lobbying pressure from the alcohol industry.

Local doctors, however, suggested that the potential increased risk of cancer from alcohol outweighs any potential reduction in the risk related to any cardiovascular incident or stroke.

Dr. Mark Solomon, medical director of St. Charles’ chemical dependency program, called the benefits of alcohol a “myth.”

“Anything you put in your body affects every cell in your body,” said Solomon. “It’s finally coming to the forefront that we should put labels [on alcohol]. Drinking alcohol is not some benign social activity. There are certain risks associated with that, with cancer being one of them.”

Paolo Boffetta, Associate Director for Population Sciences at the Stony Brook Cancer Center, explained that earlier studies, including one that he participated in, that showed a cardiovascular benefit to drinking had various scientific problems.

Those studies didn’t differentiate between people who quit drinking and those who never consumed alcohol.

“The category of a non drinker had an increased risk” that was above what researchers had understood because that group included a mix of people, Boffetta said.

This sampling problem suggested to Boffetta that the results of some of these studies that suggested a cardiovascular health benefit to drinking “were probably not correct.”

Boffetta, who welcomed Dr. Murthy’s recommendation to add cancer risk to a label that already warns consumers who are pregnant or who are operating a car or heavy machinery, urged researchers to continue to study the link between alcohol and cancer.

Protecting health

Dr. David Rivadeneira, director of Northwell Health Cancer Institute at Huntington who specializes in colorectal cancer, is concerned about the increased incidence of cancer among the younger population.

The current cancer rates are at levels “we’ve never seen before in patients that are less than 50 years old,” said Rivadeneira. “That is very worrisome. The issue of alcohol may have something to do with it.”

Indeed, during the worst of the lockdowns amid the Covid pandemic, some people increased their consumption of alcohol.

“Our current understanding is that alcohol is a chemical that probably has no health benefits whatsoever,” said Rivadeneira. “If anything, it’s detrimental even in small quantities.”

Rivadeneira anticipates the effect of such a discussion of the health consequences of consuming alcohol and of any future labeling on bottles may alter consumer behavior more rapidly than changes in established patterns for smoking decades ago.

“People are more likely to take ownership with regard to their own health,” he said. “They want to be healthier.”

Rivadeneira wants to give patients information that is appropriate and medically sound, giving them the option to decide if they want to incorporate this knowledge into their lifestyle.

Working with their doctors, people can decide on their overall risk profile, based on their family history, other health factors such as their weight and their history through cancer screenings such as mammographies, whether they want to reduce the kind of risk that might tip the scales through alcohol consumption, Rivadeneira said.

“I tell people, ‘You can be proactive or reactive. Here you are, you’ve got to make a decision about what you want to do. Do you want to reduce the chance of cancer and other ailments?’” Rivadeneira said.

A warning and behavior

Doctors believed a warning label on alcoholic products might alter consumer behavior.

“People are more afraid when it’s written down,” said Dr. Jana Deitch, breast surgical oncologist at St. Catherine of Siena Hospital in Smithtown. “If it’s on the bottle, the population will take it more seriously.”

Deitch added that everyone has to decide to what degree they are putting themselves at risk.

“It’s information that’s readily available to the general population” Deitch said.

Solomon suggested that doctors should educate their patients about the dangers of consuming alcohol.

“The medical community and physicians have to be more educated so they can start to relay this to the patient,” said Solomon. “There’ll be some kind of shock to this” because people will indicate that they have been drinking their whole lives. “It’s going to take a long time and it has to start with education from doctors.”