Tuesday, July 31, 2012

Heavy Alcohol Drinking and Pancreatic Cancer Risks

Having three or more drinks of liquor a day is associated with an increased risk of dying from pancreatic cancer, shows a well-designed study by American Cancer Society (2011). 

The findings are based on an analysis of the Cancer Prevention Study II, a decades-long study of more than 1 million US adults who reported on various lifestyle factors like drinking, smoking, diet and exercise. Because the study was so large, researchers were able to tease out the relationship of alcohol to pancreatic cancer more clearly than previous studies could, says lead researcher Susan Gapstur, Ph.D., M.P.H, vice president of epidemiology at the American Cancer Society.

In particular, they were able to assess whether alcohol is associated with pancreatic cancer independent of smoking. Smoking is a well-known risk factor for pancreatic cancer, but because many drinkers also smoke, it has been hard to separate the effects of each factor in smaller studies, Gapstur says.

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Elevated Risk with Hard Liquor

Among people who never smoked, those who drank 3 or more drinks of hard liquor daily had a 36% higher risk of dying from pancreatic cancer than nondrinkers. Those who drank only beer or wine did not have a higher risk. The researchers did not assess the risk in people who drank more than one kind of alcohol.

Experts say, that the finding are important for the medical professionals and for the people who have increased risk for the pancreatic cancer development, comparing to the average due to the genetics and hereditary factors. Before, the only two other lifestyle factors that are modifiable -- smoking and obesity --  were known to be associated with the risk for pancreatic cancer, which is one of the leading causes of cancer death.

Yes, these factors are modifiable, so the person may alter its lifestyle to minimize the risks to the certain degree.

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Alcohol and Pancreatic Cancer

So, the study, which included more than 1.2 million Americans in San Francisco Bay Area, California, who were followed for 24 years, found that overall those who reported drinking three or more liquor drinks daily saw their risk of dying of pancreatic cancer go up by about one-third compared to nondrinkers. The same increase in risk wasn’t seen in people who reported drinking the same amount of beer or wine each day. Researchers think that may have something to do with the way these different beverages are packaged and consumed.

Beer, for example, is most often found in single-serving bottles or cans, which helps keep alcohol consumption in check. When it comes to liquor, though, Gapstur says, “People are pouring a little more from the bottle. For any given liquor beverage the average amount of alcohol consumed is probably, on average, higher than an average drink of wine or beer”.

However, some experts think the lack of an association between pancreatic cancer and beer or wine may be a statistical blip. They caution people not to assume those drinks are safer than liquor.

The pancreatic cancer-alcohol associations remained after researchers tried to adjust the numbers for the effects of other things known to influence cancer risk, like obesity, age, and a history of smoking, or diabetes.

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How Alcohol May Harm the Pancreas

The pancreas is gland that sits behind the stomach. It’s responsible for producing the hormones insulin and glucagon as well as enzymes that help to digest food.

Alcohol is partially metabolized in the pancreas, Gapstur says, “and some of the early metabolites of alcohol can be toxic to the cells. They can lead to changes in pathways that are important to cancer like inflammation.”

It’s long been known that heavy drinking can damages the pancreas and that excessive alcohol consumption can contribute to pancreatitis, an inflammation of the pancreas characterized by severe abdominal pain and vomiting. About 7 out of 10 cases of chronic pancreatitis are due to long term heavy drinking. While chronic pancreatitis is a known risk factor for cancer of the pancreas, the alcohol intake related chronic pancreatitis doesn't increase risk as much as other types. Still, the causal link is obvious.

Heavy alcohol use can raise also the risk of diabetes and liver cirrhosis, which are all certain risk factors for pancreatic cancer.

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Safe Drinking Limits

Complicating the picture on alcohol and health is that excess consumption has been linked to a host of cancers including breast, colon, liver, and cancers of the mouth, throat, or larynx. Moderate drinking, at least in middle-aged adults, has been tied to a lower risk of cardiovascular disease.

According to the researchers, the best rule of thumb is to follow the recommendations of the American Cancer Society to “limit consumption to no more than one drink a day if you’re a woman and no more than two drinks a day if you’re a man.”

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