If the ritual of the aperitif in the premises has been drastically reduced by the Covid epidemic, the consumption of alcohol does not seem to have suffered setbacks. Indeed, public health experts have repeatedly raised the alarm in the past year because several investigations have detected a notable increase in sales of beer, wine and spirits. Closed at home due to the restrictions dictated by the pandemic, people eat and drink too much, spending most of their time seated: the very young and over 65 are, even in our country, those most exposed to the greatest damage. A real health time bomb, since overweight, obesity and sedentary lifestyle they are (along with smoking) the main causes of the most widespread and lethal diseases worldwide. So much so that, last October, the American Society for Clinical Oncology (Asco), which represents the leading US experts in the treatment of cancer, together with the American Institute for Cancer Research, the American Public Health Association and other institutions among the more representative in the United States, they have formally requested the Federal Government to add specific information on alcohol-related cancer risk to labels of alcoholic products. Proposal on which also returned in recent days New York Times.
In Italy 17 thousand alcohol-related deaths every year
There is more and more evidence, collected in different studies on large population numbers, which leads to the same conclusion: alcohol consumption can cause cancer and a large percentage of cancer cases can be attributed to what we drink. The mechanisms responsible are different, but alcohol abuse has been scientifically linked with the development of different neoplasms starting from those of mouth, throat, liver, intestine and breast. And the consequences of the excesses are concretely measured: in Italy, the 17 thousand alcohol-related deaths, mainly due to liver cirrhosis, tumors, cardiovascular diseases and road accidents due to drunk driving. In addition, expenses are growing, paid for in health by individuals, but also by the community: according to estimates by the World Health Organization, alcohol costs 25 billion euros every year in our country, in health services and social problems (underestimated), especially related to work (absenteeism and loss of productivity) and acts of violence.
How many cases of cancer in Italy can be linked to alcohol?
According to WHO data, in Italy between 5 and 10 cases per 100 thousand inhabitants each year are attributable to alcohol – he replies Massimo Di Maio, national secretary of the Italian Association of Medical Oncology (Aiom) -. This means, roughly speaking, between 3 thousand and 6 thousand new cases per year. It may seem a relatively small number, but in reality an adequate prevention and information campaign on the risks of alcohol would help save many lives, also taking into account the fact that alcohol not only increases the risk of cancer, but also of other pathologies.
What types of cancer does it cause?
Although we instinctively think about the risk to the liver when we talk about alcohol, there is evidence that alcohol consumption also significantly increases the danger of various other cancers: oral cavity (mouth), pharynx, larynx, esophagus, colon. rectum and breast says Di Maio, who is also director of Oncology at the Mauritian Order Hospital of Turin.
How much does the danger increase in those who exceed?
For some of these cancers (oral cavity, pharynx, esophagus, liver) the “attributable risk” to alcohol is high, ie an important percentage of those cancers is caused by alcohol. For colorectal and breast we speak instead of a low danger, but these are very frequent neoplasms, unfortunately: therefore avoiding even a small part of the cases would mean avoiding many diagnoses and many deaths. Although WHO does not specify risk levels, because it emphasizes that the only safe level is not drinking, categories are identified: moderate consumption (a maximum of 20 grams of alcohol per day), risky consumption (up to 60 grams) , “heavy” consumption (over 60 grams). The Higher Institute of Health reminds us that 39% of cases caused by alcohol are due to risky consumption, 51% to “heavy” consumption, but 11% linked to “moderate” daily use (therefore probably considered safe by those who take them, underestimating the risks) not exceeding a bottle of beer (500 ml), 2 glasses of wine (200 ml) or 60 ml of spirits per day.
What does it mean to drink too much?
The WHO emphasizes that ambiguous communication should be avoided, for example messages that reassure consumers by inviting them to “drink responsibly” – replies the oncologist -. In reality, there is no harmless alcohol threshold, below which there is no risk and in recent years the most important scientific societies (including Asco) have made “mea culpa” recognizing that neglecting adequate information on the dangers of alcohol, such as smoking, much more at the center of prevention campaigns. Of course, the damage to health increases considerably as quantities increase: drinking a beer once a week does not imply the same risks as drinking a bottle of wine or super-alcoholic drinks every day, because as with most cancer risk factors there is a “dose-response” association, ie the danger rises with exposure.
How does alcohol cause cancer?
Several mechanisms have been described – explains Di Maio -. First of all acetaldehyde, a molecule resulting from the conversion of alcohol in our body, can cause damage to the DNA of cells, and therefore favor the onset of mutations. Conversion from alcohol to acetaldehyde occurs mainly in the liver, but also in other cells, such as the gastrointestinal tract and mouth. Even independently of the conversion into acetaldehyde, alcohol causes the so-called “oxidative stress”, Which can induce damage to the DNA and therefore favor the transformation of normal cells into cancer. There are data that also demonstrate the impact of alcohol on the levels of various hormones, including estrogen and insulin, which regulate cell growth in the presence of their respective receptors: therefore cell growth can be indirectly unregulated and stimulated. Finally, alcohol abuse can be associated with unhealthy lifestyles and an unbalanced diet: in particular, the reduced intake of folate it can reduce the efficiency with which, by modifying the DNA, the healthy cell regulates the proliferative activity.
Is there a difference between the various types of alcohol?
The various types of spirits obviously differ in their alcohol content, in the sense that to take the same amount of alcohol you have to drink a greater quantity of beer than wine and much greater than spirits. Beer contains on average 5-6 grams of alcohol per 100 milliliters, wine 13-14 grams, spirits even reach 30-40 grams. Moreover, for the same amount of alcohol consumed, there are no substantial differences between the various drinks. Also be careful not to overdo it with sugary drinks, including fruit juices, which have already been linked to greater chances of developing overweight and obesity, but are also a risk factor for the onset of cancer.
March 31, 2021 (change March 31, 2021 | 20:04)
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