Did drinking give me breast cancer?
April 13, 2018 9:43 AM   Subscribe

"The breast cancer risk from alcohol isn’t nearly as high as the lung cancer risk from smoking. But alcohol-related breast cancer kills more than twice as many American women as drunk drivers do."
posted by Lycaste (53 comments total) 15 users marked this as a favorite
 
damn...this has been on my mind a lot recently. I just turned 50 and definitely drink more than is strictly necessary. I know as a woman I have an increased risk due to drink and age but some evenings its hard to care when I think about the state of the world...

but breast cancer :(
posted by supermedusa at 10:30 AM on April 13 [5 favorites]


I heard about the new study on the radio, and the science reporter said something that resonated with me (paraphrasing): all these studies are based on self-reporting, and we really don't know if people report honestly.
Because this is the internet, I don't want to write close details and anyway anecdotes, but I had two relative of the same age and I supported both at doctors' appointments. One was a healthy person who followed all health recommendations and worked out, and the other (still alive) is a raging alcoholic who never moved a pinky. Guess who of them told the truth about their alcohol intake, and who died from cancer. It's only a few weeks ago that the still living drinker claimed she didn't drink, even with multiple bottles of empty and half-empty whisky on the kitchen counter.
I hope it is obvious that I won't defend alcoholism. It's just that this type of study has a built-in issue that isn't improved by being multiplied, and which maybe makes more people like my healthy relative feel even more unnecessary guilt about their moderate intake of alcohol (which was only during a short period of time).
posted by mumimor at 10:34 AM on April 13 [15 favorites]


"Sarah Longwell, the managing director of the American Beverage Institute, said in a statement that “a substantial number of well-conducted studies reveal no correlation between cancer and moderate to light alcohol consumption.” Moderate drinking, she noted, has been found to reduce the risk of heart disease, among other benefits. “There has been a concerted effort by some researchers to reverse that knowledge,” she said in an earlier conversation. “I think it is flying in the face of good science.”
This is bullshit in two ways, not only is it indeed pretty clear that moderate drinking has a significant impact on breast cancer rates, but moderate drinking is not the business model of the American Beverage Institute's members.

According to NESARC data, the top decile of drinkers in America consume the equivalent of four and a half bottles of hard alcohol per week, which would seem alarming enough considering how extreme that is. However, those drinkers represent well more than half of all alcohol sales, which means that, while most consumers have a 'healthier' relationship with alcohol, most revenue comes from people who unambiguously don’t. Indeed, if that top decile of drinkers were to simply cut back to join the still pretty heavy drinking 9th decile, then alcohol sales would drop by 60%. Not only can most of their customers indeed expect significant increases in cancer risk, but most of what they sell goes to giving people very high increases in cancer risk that are very much comparable to tobacco. Just like with Big Tobacco, the product they sell isn't bottles or a good time but a habit, and a really shit one.

The beverage industry are some evil fuckers, but every time they've been beaten back or corralled its been Crone Island residents doing it, you'd think they'd learn not to fuck with women.
posted by Blasdelb at 10:34 AM on April 13 [32 favorites]


I mean, fuck cancer. But also, fuck the way the our fear of it being our own fault for getting cancer makes us feel like we're doing life wrong, no matter what we do. I'm so sick of it.
posted by kitcat at 10:38 AM on April 13 [84 favorites]


I don't have any qualms with the fact that alcohol increases cancer risks. But some of this from the article:
Overall, American women have about a 12 percent lifetime risk of getting breast cancer. Walter Willett, an epidemiology professor at the Harvard T.H. Chan School of Public Health who has conducted studies on alcohol and breast cancer, says a woman who consumes two to three drinks a day has a lifetime risk of about 15 percent—a 25 percent increase over teetotalers. By comparison, mammography reduces the death rate from breast cancer by about 25 percent. “Alcohol can undo all of that at about two drinks a day,” Willett says.
...I mean, sheesh. I'm no statistician, but this seems to be a very clumsy attempt to make aggregated data sound scary for individuals. This type of thing makes me side-eye all articles like this. 12-15% is still an acceptable level of risk for something that gives people a lot of enjoyment. If Walter Willett had described a rise from 12% to 40%, on the other hand, that's headline news. But come on.
posted by witchen at 10:47 AM on April 13 [18 favorites]


Someone I know lost a big chunk of his tongue to cancer. We assumed it was HPV-related, but the doctors said drinking had caused it. He drank like he was in a sideshow for maybe 15 or 20 years give or take, but he quit thirty years before the lesions first showed up.

My problem with drinking these days is this shit about what constitutes "moderate," especially for women. One drink a day is "moderate." What's the point, at that point? I want to drink like in Wodehouse, where you have a pub lunch with a couple of pints, then a cocktail at cocktail hour, then wine with dinner, then a couple more cocktails, then a nightcap. As long as you didn't go out with Spinky Worcestershire or whoever and swing from the light fixtures so you had to have the manservant mix you a hangovercure in the morning, you were drinking sensibly. If that's not how we're doing it, then to hell with the whole thing. I'm not sipping on a thimblesized wine serving all night and then licking out the glass.
posted by Don Pepino at 10:53 AM on April 13 [52 favorites]


I'm super weary of risk factor culture generally. Like I feel like by the time I have policed my life to the extent that I reduce all of my cancer risk factors to their lowest possible levels, I will have spent more of my life doing that than I gain at the end, if I even gain anything. Living causes dying. Plus the world is just too fucked up to be sober all the time, at least for me.

That said, industry funded misinformation about anything is also super not cool and I am weary of that too.
posted by Lutoslawski at 11:03 AM on April 13 [20 favorites]


@witchen, that point is very helpful for me and raises a key difficulty in how normal laypeople can assess health risks from scientific data and the way it’s reported. “A 25% greater risk than teetotalers have” seems much more alarming than “teetotalers have a 12% risk and moderate drinkers have a 15% risk” even though they describe the same phenomenon.

I really wish all this stuff was consistently presented as absolute risk. A few years ago I wanted to go back on the pill but my doctor was hung up on how because I get migraine with aura my stroke risk was dramatically increased. I did some googling and as best I could tell, my personal risk, at my age, for the pill I wanted to take, was something like 40% higher than it would have been if I didn’t get migraines. But the absolute risk was still something like 1 in 100,000 in any given year, which was a risk I was personally prepared to take. (My doctor still refused to prescribe).

Of course all this gets even more complicated when you try to balance personal health decisions against public health consequences.
posted by mrmurbles at 11:09 AM on April 13 [17 favorites]


The marketing has definitely had its effect on me. I don’t like wine. Even one glass gives me dry eyes, migraines, makes me feel ill and messes with my sleep. But I definitely have been feeling that there is something wrong with me for feeling that way—that I’m being a drag socially because maybe it means my companion(s) have to order by the glass instead of getting a bottle. This article has made me feel more confident in my preference, though bringing up cancer risk as a reason for declining probably wouldn’t go over well!

Also, interesting point about the “non” drinkers confounding studies. I recently had my health assessed by a new doctor, and when the alcohol question came up, we concluded that I am a light drinker even though I hardly ever drink, just because I don’t fully abstain. I enjoy a night at the bar a couple times a year, but I never drink at home and I generally go for water at restaurants/parties. Yet I’m being binned in with people who have 1 or 2 drinks every day. Maybe it would be better to ask about lifetime consumption, even though that would involve breaking out the calculator.
posted by mantecol at 11:20 AM on April 13 [11 favorites]


This is a bit different from the linked article but there was a different article I read recently -- who the hell knows how accurate it was, it certainly wasn't a medical journal or any kind of venue you'd trust for Medical Advice -- that indicated the current research shows that one to two drinks per day lowers life expectancy by six months and it goes up from there to about 2-5 years for moderate drinking.

For whom is this statistic even useful? I've watched a whole bunch of people die over the last five or so years (both prematurely and, I don't know, on time) and I don't know if this is a distinctly American thing or not but the fact that people should be alive at all costs regardless of the quality of life has gone from baffling to infuriating for me and trying to tell a person they're statistically shaving six months off what could be ninety years is straight-up fearmongering.

You're going to die and they're going to try to keep you alive and all I've seen that do is stretch nothing more than pure suffering out until someone with enough authority and time on their hands yells at the medical staff enough times to actually enforce the DNR you're waving in front of their face. What's six months off that?
posted by griphus at 11:31 AM on April 13 [32 favorites]


This is a bit different from the linked article but there was a different article I read recently -- who the hell knows how accurate it was, it certainly wasn't a medical journal or any kind of venue you'd trust for Medical Advice -- that indicated the current research shows that one to two drinks per day lowers life expectancy by six months and it goes up from there to about 2-5 years for moderate drinking.

Kind of sounds like this recent study in The Lancet.
posted by thelonius at 11:36 AM on April 13 [2 favorites]


I want to drink like in Wodehouse

...who lived to the ripe old age of 96.
posted by briank at 11:43 AM on April 13 [10 favorites]


...Moderate drinking, she noted, has been found to reduce the risk of heart disease, among other benefits. “There has been a concerted effort by some researchers to reverse that knowledge,” she said in an earlier conversation. “I think it is flying in the face of good science.”

The Lancet study I linked discusses this - they say that, when you exclude from comparison ex-drinkers, a lot of whom quit after they already became high-risk persons, and a lot of whom smoke, then the supposed cardiac health benefit among moderate drinkers disappears.
posted by thelonius at 11:49 AM on April 13 [4 favorites]


I also found it very difficult to assess the actual, absolute health risks based on the numbers this article provided. Having it boiled down to 12% versus 15%, is in fact pretty damn illuminating. I appreciate that the misinformation peddled by the alcohol industry is appalling, but my alcohol consumption averages out to 3-4 drinks a week, if that, well below even the "moderate" level given of 2-3 a day. Reading this article, I had no clear sense of what that would mean for my risk level, and whether it even matters. Like, thanks, this is important information surely, but I'm still not turning teetotaler based on the slightly increased risk of breast cancer, and I'd venture to say most people are in my position. It all just feels like fear-mongering, yet another choice to make or not make and thereby avoid cancer, which when taken in aggregate, all just starts to seem like magical thinking, a health ritual whose results are impossible to accurately gauge over the long-term, but which leads to a lot of short to medium term misery thanks to eschewing little pleasures.

All that said, I think the writer has a good point about not being educated about the risks. I think we all get copious education about the risks of smoking, at this point. Those who still choose to smoke can't plead ignorance, and know about the dangers. When it comes to alcohol, most of the education (in America anyway) is focused on drinking and driving and the risks of excessive consumption and binge drinking. I don't recall ever learning anything about cancer risks, apart from the risks of oral/esophageal/stomach cancers from habitual excessive drinking.
posted by yasaman at 11:52 AM on April 13 [15 favorites]


"...I mean, sheesh. I'm no statistician, but this seems to be a very clumsy attempt to make aggregated data sound scary for individuals. This type of thing makes me side-eye all articles like this. 12-15% is still an acceptable level of risk for something that gives people a lot of enjoyment. If Walter Willett had described a rise from 12% to 40%, on the other hand, that's headline news. But come on."
Casinos make so much money from so many unhappy people because we don't tend to be great at judging either risk or the value of momentary pleasure. Just how massive this increase in risk is really blew me a way, pushing up such a huge source of mortality by so much represents a hell of a lot of women dying. For example, just roughly, if we take the 6,600 deaths per year due to the increased risk of breast cancer caused solely by alcohol consumption at face value, and compare it to half of the 2,712,630 deaths that happened in 2015, that is the beverage industry responsible for half a percent of all the women who died in America. That also doesn't include the other huge sources of alcohol related mortality or any of the morbidity. By way of comparison, in 2014, 6,721 deaths were attributed directly to HIV.
posted by Blasdelb at 11:54 AM on April 13 [4 favorites]


I recently cut way back on my alcohol consumption (I now only drink on the 9th of the month, if at all). Nearly everyone in my life has been very supportive. I did talk to one person who asked: if you were a moderate red wine drinker (which I was), aren't you now giving up some heart-protecting benefits? And I said: yes, but I'm willing to give those up in the interest of the health benefit of absolutely ensuring I do not become an alcoholic.

I read this article, and maybe I missed something in it, but I feel like I still don't know what the actual evidence says about the long-term effects on adult women (who were not previously heavy drinkers) of being a light drinker on the order of one to five drinks per month. And the Lancet article, unless I'm missing something, does not break things down within the 0-12 drinks per week bucket.

I'll plug here the awesome "Say Why to Drugs" podcast on the actual harms and benefits of various drugs. SWTD had a recent ep on "Dry January", and has past episodes on hangovers and alcohol in general.
posted by brainwane at 11:58 AM on April 13 [4 favorites]


I don't spend a lot of time in this particular branch of the literature, but most of this evidence seems epidemiologically based, without Koch's postulates actually having been fulfilled in appropriate in vitro or animal studies. I am super skeptical about the correllation/causation trap inherent in epi studies, especially those relying on self-reporting; it is virtually impossible to account for every miniscule (but possibly impactful) facet of human behavior that might complicate a cancer epi study. I understand that there is some mechanistic justification via acetaldehyde formation, but cooked/processed meats also produce narsty things, vegetables contain pesticide residues, etc. and who knows how all these things interact. The US has higher breast cancer rates than France, a country of women who are quite prodigious drinkers of wine. If alcohol was so much more impactful than other risk factors, you would think that the heaviest-drinking countries (looking at you, Belarus) would represent in the breast cancer rankings but they don't.

I'm NOT poo-pooing the evidence completely or saying we should all go funnel a Colt 45, but mayhaps this is a little on the hand-wavy side. It merely reinforces my belief that we should all consider alcohol, processed meat, flour, and sugar to be poisons and dole them out accordingly as dangerous hedonic proclivities demand.
posted by SinAesthetic at 12:09 PM on April 13 [11 favorites]


Oh my goodness, I forgot smoking in my comparison between my two relatives. The healthy person who died from cancer didn't smoke, the other person who is still alive and lying is also lying about her 40 cigs a day smoking habit. I'm not saying you can't do these studies, but I am saying that you need to be able to monitor your patients in a way that literally isn't possible today (and probably shouldn't be).
posted by mumimor at 12:19 PM on April 13 [2 favorites]


For example, just roughly, if we take the 6,600 deaths per year due to the increased risk of breast cancer caused solely by alcohol consumption at face value, and compare it to half of the 2,712,630 deaths that happened in 2015

I think this is kind of the main point - something can be a relatively small risk for individuals but have a large public heath implication.

And while I'd say I've been aware that alcohol is a cancer risk for a long time - it's a Group 1 carcinogen - if you'd asked me what kind of cancer it causes I would have said... oral and throat cancer? Liver cancer, if you drink enough to cause liver damage? Breast cancer would not have been high on the list - though maybe that's because I'm male.
posted by atoxyl at 12:19 PM on April 13 [2 favorites]


The thing that makes my head spin and ultimately not want to continue reading articles like this is that I have yet to see any science-backed consensus on what constitutes a light/medium/heavy/binge drinker. My previous doctor considered it totally fine and, at most, a "medium" amount for me and my husband to share a bottle of wine every night. His only reasoning for cutting back was "think about how many more vacations you could take with the money you saved."

My current doctor is very strict on alcohol and believes that if a woman has more than 3 drinks in a night even ONCE PER YEAR, she is automatically considered a binge drinker. I don't know about the rest of you, but in the tech world from what I've observed in the last 18 years, it is completely normal for a team outing to involve >3 drinks per person and these outings happen at least once a quarter.

This amount of conflict, from two doctors in the same city working at the same practice, makes it impossible for any layperson to really know what is an "okay" amount and how to truly assess risk.
posted by joan_holloway at 12:24 PM on April 13 [34 favorites]


You're going to die and they're going to try to keep you alive and all I've seen that do is stretch nothing more than pure suffering out until someone with enough authority and time on their hands yells at the medical staff enough times to actually enforce the DNR you're waving in front of their face. What's six months off that?
Breast cancer isn't like pneumonia or other causes of death that mostly push people who are already on their way out a little bit faster. It kills an awful lot of otherwise healthy people, even if they're mostly middle aged and older.
I think this is kind of the main point - something can be a relatively small risk for individuals but have a large public heath implication."
But the way in which a small piece of a really big pie can be a really big piece works on an individual level too, even if its easier to see when writ large on a population scale. Pointing a revolver that was loaded in just one of 200 chambers at your head is a lot less safe than might be intuitive because death is a super big pie.
posted by Blasdelb at 12:25 PM on April 13 [3 favorites]


The US has higher breast cancer rates than France, a country of women who are quite prodigious drinkers of wine. If alcohol was so much more impactful than other risk factors, you would think that the heaviest-drinking countries (looking at you, Belarus) would represent in the breast cancer rankings but they don't.

The French apparently also get 2 hours more sleep per *night*, and take way more vacation. Giving their bodies more of a chance to recover from the inflicted damage. There are also significant dietary differences. Etc etc.
posted by mantecol at 12:25 PM on April 13 [13 favorites]


This amount of conflict, from two doctors in the same city working at the same practice, makes it impossible for any layperson to really know what is an "okay" amount and how to truly assess risk.
My grandmother had a close friend who was a specialist in pain management, and he preferred her taking paracetamol combined with cocktails to any forms of morphine or artificial morphine. She lived to 91. But she didn't have more than one cocktail a day AFAIK.
posted by mumimor at 12:32 PM on April 13


The thing that makes my head spin and ultimately not want to continue reading articles like this is that I have yet to see any science-backed consensus on what constitutes a light/medium/heavy/binge drinker

This is, I guess, an advantage I had as a raging alcoholic - there was not any need to agonize over these distinctions. Once you can drink a 750 ml bottle of liquor in a night and not even throw up, it's pretty clear where you stand :)
posted by thelonius at 12:32 PM on April 13 [3 favorites]


@witchen, that point is very helpful for me and raises a key difficulty in how normal laypeople can assess health risks from scientific data and the way it’s reported. “A 25% greater risk than teetotalers have” seems much more alarming than “teetotalers have a 12% risk and moderate drinkers have a 15% risk” even though they describe the same phenomenon

This times 1000.

This misuse of statistics is how statin drugs have been sold to people who have no business taking statin drugs, because they lower the annual heart attack risk from (e.g.) 1.2% to 1.1%.

Yes, in some sense the drugs are "helping", but the raw risk is already very low, and the side effects are non-trivial. But it sounds really good when you take a tiny number to an even tinier number, that is 10% smaller or 20% smaller. And then the pitch is "reduces heart attack risk by 20%" (call the New York Times!).

However, When the NNT value ("number needed to treat") is over 100, and the drugs have significant side effects, who is really benefiting from massive prescription of these medicines? (Answer: pharma companies)
posted by theorique at 12:36 PM on April 13 [7 favorites]


There are plenty of health reasons for alcoholics not to drink besides trying to avoid cancer. I wasn't really dealing with my diabetes when I was drinking; generally, alcohol was my gambit to avoid dealing with any number of things. My doctor was threatening to put me on insulin when I sobered up (he didn't know about my heavy drinking; I lied about my alcohol intake to him, as I did to everybody), and when I quit, my A1C went down almost immediately. Aside from the more obvious alcohol-related diseases--cirrhosis of the liver, Wernicke–Korsakoff syndrome--there's this sort of add-on effect to other diseases, if not a direct physiologic effect then from neglect. (Plus increased risk of accidents of all sorts, of course.)
posted by Halloween Jack at 12:40 PM on April 13 [4 favorites]


With diabetes it really depends what you drink (and if you can still manage the condition while drunk). We found just switching from beer to whiskey (and cutting carbs in other ways) lowered the A1C. Of course, the A1C was also lowered by bacon (if you don't have cholesterol issues I totally suggest bacon as a management tool). My husband went from a (far) >14 to a 5.0 in under 6 months and didn't reduce his alcohol intake at all.
posted by I'm Not Even Supposed To Be Here Today! at 12:47 PM on April 13 [3 favorites]


The French apparently also get 2 hours more sleep per *night*, and take way more vacation.

When contrasting (certain parts of) Europe with America it always seems like the conclusion is that the miserable lifestyle the US impresses on you is killing you earlier, but you may be able to live longer if you just choose to be ...slightly more miserable on top of that.
posted by griphus at 12:47 PM on April 13 [50 favorites]


He drank like he was in a sideshow for maybe 15 or 20 years give or take, but he quit thirty years before the lesions first showed up.

That's the part of the article that really caught my eye -- much like sun damage to your skin, most of this harm is done and dusted before you're even, like, 25. Which means it's too late for me, so I'll see y'all at the bar!

all these studies are based on self-reporting, and we really don't know if people report honestly.

In these United States, where people still remember the bad old days (and the worse days to come, before long) when a family history or preexisting condition could get you kicked off of insurance for the rest of your life, the incentive to lie to your doctors is strong as fuck.
posted by We put our faith in Blast Hardcheese at 1:18 PM on April 13 [32 favorites]


most of this harm is done and dusted before you're even, like, 25.
Heyheeeey! (does tiny sedentary jig) Thanks!!
posted by Don Pepino at 2:16 PM on April 13 [4 favorites]


The French apparently also get 2 hours more sleep per *night*, and take way more vacation.

And Japanese get much less sleep than Americans, work more, and take almost no vacation (despite being legally entitled to it). But live much longer.

It's always tricky to single anything out from a system as complicated as health / our bodies, since there are so many ways things can go wrong/right.

Still, the "positive" evidence for alcohol is not very strong, so its mostly in the neutral-to-probably-not-good-for-you category. But also it seems like for most people, unless you're a heavy drinker, its in the big mess of diet/exercise/sleep/stress/etc where you're not going to be able to single it out as a factor.

(Unlike heavy drinking, or heavy smoking, or anything that has a huge risk/correlation well above normal lifestyle variance)
posted by thefoxgod at 2:37 PM on April 13 [2 favorites]


My overall reaction to every new health study is basically to season it with a giant grain of salt...
posted by PhineasGage at 2:40 PM on April 13


most of this harm is done and dusted before you're even, like, 25.

Exactly - having experienced infancy in middle-class 90s Beijing where my parent could not possibly had the resources to remove environmental carcinogens from my porous young life, I assume a little BPA here and there is a drop in the uncoated plastic bucket, and likewise, with alcohol.
posted by batter_my_heart at 2:46 PM on April 13 [2 favorites]


a different article I read recently... indicated the current research shows that one to two drinks per day lowers life expectancy by six months and it goes up from there to about 2-5 years for moderate drinking. For whom is this statistic even useful? ... You're going to die and they're going to try to keep you alive and all I've seen that do is stretch nothing more than pure suffering.. What's six months off that?

I'd find this pretty persuasive if the actual choices were "drinkers just skip the last six low quality months of life and go straight to dead" vs "non-drinkers get an additional six months full of crappy hospital time, IV, meds and suffffferrringggggg."

I don't think I've seen any evidence that's how it works, though. What seems more likely to me is that you just hit your last low quality-of-life months or years earlier (with an increased probability of 3-x year interstitial periods of battling a life threatening illness with debilitating effects and treatments).

Six months is pretty significant to me. You offer me six months of magic extra time inside this year and there's a lot I'd give up to take it.

Now, not everything. I think there is probably something every person does that they know adds to health or mortality risks, and yet they make the trade. If it's an important part of a life that you truly value, then it isn't doing life wrong. Maybe that's not even going far enough -- maybe a meaningful life all but demands that one decide that something is more important to them than the number of days they get.

It's easy for me to say that something isn't alcohol. YMMV.
posted by wildblueyonder at 3:08 PM on April 13 [1 favorite]


I wish we had a better way to describe light/medium/heavy drinking.

I have shifted from a non-drinker to a "light" drinker, averaging 1-2 drinks per month. In reality, that's 4-6 drinks per convention/festival weekend, 2-3 times per year. Going six months without alcohol is normal for me. Celebrating the winter holidays with a single half-shot of rum in eggnog is also normal.

I really don't think I'm running the same risks as someone who drinks 1-2 glasses of wine almost every day, and a few extra on special occasions. I have a hard time getting useful information out of articles about How Alcohol Can Hurt You, because their level of "low" is 20x or more higher than mine.
posted by ErisLordFreedom at 3:12 PM on April 13 [11 favorites]


When reading pieces like this - if you're a relatively low drinker - i think it's always helpful to remember:

More people drink way more than you think, and people tend to really understate their drinking; the alcohol lobby is very powerful and has been spewing misinformation about the "healthy" benefits of alcohol for literally decades (protip: there is nothing in alcohol, or wine, that you cannot get from something else that doesn't come bundled with the negative effects); these studies are always coming at it from a population level because that's how the health system is funded and managed; take away the moral component, most public health professionals don't care about morals, they only care about health
posted by smoke at 6:02 PM on April 13 [1 favorite]


I have shifted from a non-drinker to a "light" drinker, averaging 1-2 drinks per month. In reality, that's 4-6 drinks per convention/festival weekend, 2-3 times per year. Going six months without alcohol is normal for me. Celebrating the winter holidays with a single half-shot of rum in eggnog is also normal.

I like the metaphor used by the author of "How Not to Die" where he says you can survive hitting yourself with a hammer every once in a while and suffer no real serious long term consequences but if you hit yourself with a hammer every single day....
posted by srboisvert at 8:03 PM on April 13 [1 favorite]


The article mentions this briefly: "Canada recently launched an experiment to test cancer warning labels on alcohol in the Yukon but stopped the project a month later amid intense pressure from alcohol companies"

Here's how it went down

Nov 2017: As part of an ongoing research project Health Canada introduces new labels on all bottles and cans of alcohol sold in the Yukon warning "Alcohol can cause cancer including breast and colon cancers," or advising "To reduce health risks drink no more than 2 [for women] or 3 [for men] standard drinks a day. Plan two or more non-drinking days each week"

Dec 2017: Liquor industry calls halt to cancer warning labels on Yukon booze, citing concerns which include the legislative authority on applying labels post market, the label placement, trademark infringement, and defamation and damages related to the messages on the labels that are affixed to the brand owners's products without consent.

Jan 2018: Yukon seeks 'common ground' with liquor industry over warning labels. The president of the trade association Beer Canada implies that the label suggesting consumers drink no more than 2 or 3 standard drinks a day could lead to an increase in drunk driving and rejects any comparison between alcohol and tobacco, when it comes to warning labels about cancer risk.

Jan 2018: Yukon alcohol producers say they were left in the dark about warning label study. Researcher says it would violate ethical guidelines for researchers to discuss label design with people who have vested commercial interests.

Feb 2018: Cancer warning labels on booze aren't coming back, Yukon says. The research project will continue with two other warning labels that had also been introduced last fall. One offers suggested guidelines for low-risk drinking, the other shows a standard drink size. The cancer stickers have been canned. The compromise was proposed by the researchers as a way for the project to continue.
posted by Secret Sparrow at 8:19 PM on April 13 [5 favorites]


With a first pregnancy at 33, I had a good 20 years of drinking to damage my breasts, and my adolescent binge drinking may have been especially devastating.

If only I'd gotten knocked up at 19, I guess?

I feel like there's a weird metamessage in here in the stuff she cites--alcohol, birth control, having children at an older age--which makes me wonder about her biography and, like, current religious identity but maybe I just feel defensive of the single martini I have about once a week or so (is that moderate drinking? I can't even tell from this.)
posted by PhoBWanKenobi at 8:35 PM on April 13 [9 favorites]


I dialed back my alcohol consumption a few years ago when it was at unhealthy levels, but probably still 2-3 drinks over the weekly recommendation.

And ya know what? Given that in a best case scenario some of the coastal cities I have visited and lived in during important parts of my life will drown in my life time, and a worst case scenario is that we die in a nuclear holocaust before then, I'm going to drink a fucking extra beer or two during my weekly intake over what my doctor would prefer me to. If our global leaders won't get their act together to fix the world, then I am not going to feel guilty for doing something that helps me calm the hell down in this dumpster fire of a historical timeline.

Life is short. Eat the butter, have a glass of wine if you want it. When the fireball lights up the sky, it won't matter how healthy your liver is.
posted by mostly vowels at 8:35 PM on April 13 [6 favorites]


I'm really quite curious to see what they'll be saying about pot in 30 years' time, when it's been widely legalized for about a generation, proper medical research has happened, and the inevitable corporatization and attendant industry lobbying has become fully entrenched. As of now it still feels like the safest recreational drug out there (when was the last time you heard about a pot overdose?) but part of me still wonders. What will the health conversation look like once we're able to actually have it?
posted by Anticipation Of A New Lover's Arrival, The at 8:53 PM on April 13 [5 favorites]


you may be able to live longer if you just choose to be ...slightly more miserable on top of that.

I believe the phrase you may be looking for is "a stubborn cuss".
posted by Greg_Ace at 8:56 PM on April 13 [2 favorites]


i did poorly in statistics, but it cant possibly be that you can do a global study saying the risk of death for a given (self reported) population is X higher per year than another, and extrapolate from that how many hours per day each drink takes off your life, and then add/subtract the number of hours per day that some other behavior (i.e. mammography) causes vis a vis the first number. that cant possibly be statistically sound, can it? because that's how these pseudoscientific news articles make it seem.
posted by wibari at 11:35 PM on April 13 [2 favorites]


@wibari: It's statistically sound, it's basically just giving the statistics in different units. A 1% higher chance of dying from cancer with 2 drinks a day can also be expressed as losing on average 10 months of life (or whatever) at two drinks a day, or 7 hours per drink (again "or whatever", too tired to do real math right now). And yeah, if you add in a risk factor but reduce some other risk by the same amount, they pretty much do cancel out.

I would speculate that the issue that makes you uncomfortable is that this *only* sound statistically. The most likely effect of a drink or two a day on your life is nothing. The most likely benefit of a mammogram is nothing. In fact, a mammogram adding a week to your life or a drink shaving seven hours off of it is almost impossible--there's not really any mechanism by which that could happen. It'd be like a casino winning exactly 2.3 cents on your single dollar bet.
posted by mark k at 12:10 AM on April 14 [2 favorites]


This type of thing makes me side-eye all articles like this. 12-15% is still an acceptable level of risk for something that gives people a lot of enjoyment

I think this may be where the distinction between moderate and heavy drinkers lie. As a recovering alcoholic I found very little enjoyment in drinking.

As a woman in this age group with a child to consider, you can bet I'm taking this information seriously. Of course it may not matter at this point. As a younger person, even having a lot of experience working in epidemiology and having somewhat understanding of causation, I'm certain I would have ignored it
posted by waving at 6:06 AM on April 14 [2 favorites]


I know I would have ignored it. I didn't take to drinking until I took German in college, but that's only because the option wasn't in front of me. Had I been in a drinking set in high school, I'd've been drinking in high school, and I know I was impervious to PSAs because I can remember thumbing my nose at the "Fry now, pay later" billboard on the way to the beach every Saturday to spend 12+ carefree hours making liver spots and cataracts. "Later." Feh. What even is "later" when you're 16?
posted by Don Pepino at 7:25 AM on April 14 [5 favorites]


I found this list of known carcinogens pretty eye-opening. Other things you might be doing/have done to increase your cancer risk:
- Eating low-quality corn or peanuts (aflatoxins)
- Using VHS or cassette tapes (chromium)
- Spending time in or near traffic (engine exhaust)
- Making out with people (Epstein-Barr)
- Taking high school biology (formaldehyde)
- Getting a common infection from family or mate (helicobacter pylori; 50% of people globally are infected)
- Doing carpentry, shining shoes, sweeping chimneys (wood dust, leather dust, soot; basically inhaling any particulate matter)
- Eating processed meat
- Working in factories (exposure to various toxins)
- Frying food, any food (various toxins)
- Drinking hot beverages
posted by mantecol at 7:37 AM on April 14 [2 favorites]


OK fine I'll just go live a joyless existence inside a Faraday cage inside a cleanroom.
posted by fluttering hellfire at 8:32 AM on April 14 [4 favorites]


Overall, American women have about a 12 percent lifetime risk of getting breast cancer. Walter Willett, an epidemiology professor at the Harvard T.H. Chan School of Public Health who has conducted studies on alcohol and breast cancer, says a woman who consumes two to three drinks a day has a lifetime risk of about 15 percent—a 25 percent increase over teetotalers.

Does the 12% risk apply to American women overall, or to teetotallers?
posted by Segundus at 10:01 AM on April 14


Does the 12% risk apply to American women overall, or to teetotallers?

Presumably overall. But because drinking rates are so skewed, it's not that different than for teetotalers. See the chart here, which shows that while the average is 1-2 drinks per day, the median person consumes around 1 drink per week, for whom the average cancer rate is presumably pretty close to that of teetotalers.

While various people are frustrated that "low" vs "moderate" drinking isn't well defined in the article, it does give a number of more precise estimates that allow us to extrapolate to whatever drinking level we like:

The International Agency for Research on Cancer estimates that for every drink consumed daily, the risk of breast cancer goes up 7 percent....

Walter Willett... says a woman who consumes two to three drinks a day has a lifetime risk of about 15 percent—a 25 percent increase over teetotalers.


These two statements don't quite agree, but they're pretty close. If we assume an approximately linear dose-response curve, that means that each additional drink per day increases your absolute risk level by about 1 percentage point. That's a high increase, at least compared to many other carcinogens (apart from cigarettes) that we worry about. But on the other hand, because most people don't actually drink very much, many are worrying about differences relevant to their own behavior -- say, between not drinking at all and having a couple drinks a week or a few a month. But if we use the linear approximation, cutting back from 100 drinks a year to 0 would decrease your odds by only about 0.3 percentage points, from around 12.3% to 12%. So at that scale, by almost any comparative standard for evaluating risk, it's probably not anything to worry about as an individual. The more significant implications of these studies, both for individuals and epidemiologists, is for the 20% of Americans who have multiple drinks per day, and especially the 10% of Americans who have 5, 10, or more drinks a day.
posted by chortly at 1:50 PM on April 14 [3 favorites]


On cancer in general, I am not a doctor, but I do have smart friends who patiently explain things to me. As I understand it, “getting cancer” is not a singular event, as we commonly conceive it. Our body is constantly generating new cells, and a certain percentage of them have cancerous mutations. It is the job of other cells in the body to find these mutated cells and destroy them. So we are all getting and curing cancer (on a small scale) on a daily basis. Problems start when the body’s built-in mechanisms for repairing itself start to break down.

Things we can do to support our bodies in their cancer-fighting efforts:

- Intermittent fasting. There is a connection between diseases like cancer, and damaged mitochondria. Fasting encourages the body to recycle damaged mitochondria. I try to compress all of my eating into a 10-hour window, to give my body a 14-hour fast each day. I don’t always stick to this as I sometimes feel like eating at night, but invariably I feel better on mornings when I’ve gone to bed on an empty stomach. Your body will get used to whatever feeding cycle you choose; I never feel like I’m starving myself. Just take care that you’re getting enough nutrients. And note that fasting starts after your last calorie-containing drink, including alcohol, has been drunk.

- Sleep! Deep sleep during the first half of the night is when the body spends time cleaning itself up. The hormone that promotes sleepiness, melatonin, is also a powerful antioxidant. If you’re like me and have struggled your whole life with getting regular full sleep, I recommend considering supplementing with melatonin. There don’t seem to be many downsides, but going decades without getting decent sleep is almost certain to lead to one disease or another.

- Exercise! Just as rest is important, so is exercise. An hour of intense cardio each day will greatly reduce your risk of developing cancer. And strength training helps ward off aging in other ways. Exercising or not exercising is a choice we all make daily. As Nike says, just do it.

The body is pretty good at healing itself, but there are some things it cannot repair, so avoidance is key:

- Lung damage. The lungs are a giant network of tiny passages. They have mechanisms for cleaning themselves out, but they’re not perfect. A certain amount of the stuff you breathe in is going to stay there and inflict permanent damage. It goes without saying that you should avoid cigarette smoke, but also consider indoor and outdoor air pollution. There are lots of sizes and types of particulates, each with their own associated risks. While you may not be able to control where you’re living or working, you can use air filtration (masks and purifiers) to keep the particulates out of your lungs. This is one of those long-term things where the benefits will only be noticed over decades, and it’s somewhat annoying to have to constantly think about, so discipline is required.

- Skin damage. The outer layer of skin is dead, and it doesn’t much matter what happens to it. It serves as protection for the base layer, which contains stem cells that are responsible for making new skin cells. Skin aging and melanoma happen as this base layer is damaged by UV. The more you’ve been exposed to UV over your lifetime, the greater your risk of melanoma. So cover up if you’re going outside for long periods of time, even if you don’t tend to burn, and for goodness’ sake, don’t use tanning beds. This is another case where damage accumulates slowly over time, and by the time the effects of carelessness start showing up, it will be too late to do anything about it.

It’s impossible to avoid all cancer causing toxins like the ones I listed earlier, and sometimes we even expose ourselves to them by choice, such as drinking or smoking. But there are also steps we can take to actively reduce our cancer risk. I look forward to the day when the science behind cancer is better understood, and we can feel more in control of our own destinies.
posted by mantecol at 7:57 PM on April 14 [4 favorites]


Thank you for posting this. I have never heard that drinking poses an increased risk to breast cancer.

And I've been steeped in breast cancer related information for years - my mother was diagnosed in 2008 and died from it a little less than two years ago. I've spent hundreds/thousands of hours reading about cancer in general and breast cancer specifically.
There are four calculators that are generally used by the health industry to predict future breast cancer risk - they are all pretty similar to this one - but none of them ask for any data on alcohol consumption. A relative of mine had the BRCA mutation testing - which along with the blood tests involves querying extended family history information - but none of those questions were about alcohol intake. My doctor requires that I now get MRI's instead of mammograms due to my family history and my own (exciting but non-cancerous) breast history, but she's never said anything about a correlation between alcohol and breast cancer.

I've seen articles on the benefits of drinking at least one drink a day as recently as a few weeks ago. But I haven't heard shit about drinking and cancer risk. That's appalling.

@ Don Pepino: Here's a question - how can they tell if a cancer is caused by alcohol intake?
posted by 8dot3 at 10:09 AM on April 15


I didn't hear it straight from the doctors' mouths, but I doubt they said, "Your drinking definitely caused this." I think probably they responded to "What caused it?" with "Well, weirdly, not HPV. One risk factor was the swimmingpoolfull of whiskey you drank in the 80s, so could be that. Probably was that. But we don't know for sure." He thrashed through family-sized bottles of Listerine at an astonishing rate after quitting drinking. That may not have been the culprit, either, but it probably didn't help.
posted by Don Pepino at 10:40 AM on April 15


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