Let’s toast to common sense, moderation with drinking, cancer-risk studies

alcohol-248x300When topics like booze and health flow together, common sense seems to disappear. So let’s give credit to the context-restoring efforts of Aaron Carroll— a pediatrics faculty member at Indiana University medical school, a health policy researcher, and a writer for the New York Times’ “Upshot” column—and healthnewsreview.org, a health information watch dog site.

Both addressed a “panic” in certain quarters generated by a new caution issued by the American Society of Clinical Oncologists. The respected organization of cancer medical specialists said that even light alcohol consumption can add to drinkers’ cancer risks.

As Carroll summarized the cancer experts warning:

There is a reasonable amount of evidence finding an association between some cancers (specifically oropharyngeal and larynx cancer, esophageal cancer, hepatocellular carcinoma, breast cancer and colon cancer) and alcohol. It acknowledges that the greatest risks are with those who drink heavily, but it cautions that even modest drinking may increase the risk of cancer. In the United States, the announcement also notes, 3.5 percent of cancer deaths are attributable to alcohol.

But he went on to note that data can be confusing to ordinary audiences—and reporters seemed a little too casual in throwing around alarming statistic, healthnewsreview.org pointed out. The watchdog site, for example, noted that a network news broadcast talked about a “500 percent increase in risk” for heavy drinkers getting head and neck cancer.

Just what the heck does that mean, really? Throwing around risk percentages like that is about as helpful as telling a lost family in car in Washington, D.C., that they can get to Los Angeles if they’ll just drive left.

Carroll carefully walks his reader through the number jumble that’s common, not just in the oncologists’ caution but also in too many medical-scientific studies. He looks, for example, at what the experts have said about booze and some of the more significant, studied risks for drinkers to get breast cancer. He delves into not just percentage expressions but also what researchers describe as relative and absolute risks.

Most key: He provides the NNH, the Number Needed to Harm, which is the cousin to the NNT aka the Number Needed to Treat.  The NNT is the one medical statistic that most folks need to know, offering a clear, plain view of what works in medicine and what might not. It describes how many people would need to take a drug or undergo a treatment before one benefits. The NNH flips the concept around. It asks how many patients on average need to be exposed to a risk-factor over a specific period to cause harm in an average of one patient who would not otherwise have been harmed.

So the potentially scary link—which got the most attention—between breast cancer and light drinking, the NNH, Carroll says goes thusly:

If 1,667 40-year-old women became light drinkers, one additional [woman] might develop breast cancer. The other 1,666 would see no difference.

Got it?

Before anyone races off to uncork that good Cabernet, there’s more to be said, much more, of course.

Carroll and healthnewsreview.org look at the oncologists’ study and its examination of various cancers and the possible ties to increased risk due to drinking, light and heavy. They emphasize that the data show an association—emphasis, not a cause.

But drinking also can up the cancer ante in other ways worth noting. It adds calories to the diet, which can contribute significantly to weight and obesity woes. The Centers for Disease Control and Prevention has just warned that a growing body of evidence shows that being overweight heightens cancer risks. And, alas, drinking too often occurs with smoking—a proven and awful cause or major contributor to multiple kinds of cancer and cardiopulmonary woes. It also goes without saying that it’s unnerving to see how, in the midst of an opioid drug abuse epidemic, public health officials have expressed alarm about sharp rises in bad boozing by women, seniors, African Americans, Latinos, and Americans of Asian descent.

In my practice, I see the significant harms that patients suffer while seeking medical services and how their lives can be upended by auto, truck, and motorcycle wrecks. Road deaths, after years of declines, have increased measurably in recent years, with distractions (due to texting and e-devices) and impairment (by drugs, lack of sleep—and yes, drinking) serving as killers anew.

Americans will be traveling heavily during the upcoming holiday season, and they will be feasting and drinking, sadly too often to excess. Please don’t drink and drive, turning your happy Thanksgiving into a vehicular nightmare. Eat in moderation over the next few weeks so you don’t pack on pounds that will be detrimental to your health in so many ways. Get some exercise. Try to lower the stress in your life and for your loved ones, too. And, for goodness’ sake, don’t sneak in a smoke. It’s such a nasty, health harming vice that even the Holy See has banned the sale of cigarettes and deeply discounted tobacco products in the Vatican. Blessed be.

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