Alcohol and Cancer Risk Reduction

There is convincing evidence that alcohol consumption is a cause of cancers of the mouth, pharynx , larynx, esophagus, colorectum (men) and breast (pre and post-menopausal women).

alcoholchartHP**The World Cancer Research Fund/American Institute for Cancer Research, Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective, 2007.

Ethanol, the active ingredient in alcoholic drinks is classified as carcinogenic to humans by the International Agency for Research on Cancer (IARC). Current evidence does not show any safe limit of consumption. Risk increases with amount consumed. (WCRF/IARC report Chapter 4, Section 4.8)

While a key risk factor for cancer, small amounts of alcohol have been found to have a protective effect against ischemic heart disease and diabetes.

In an effort to communicate a balanced and consistent message to the public, Low Risk Drinking Guidelines were developed in Canada in 2011. Cancer Care Nova Scotia and the Department of Health and Wellness support these guidelines which include zero consumption as an option. From a cancer risk reduction perspective, advising the public to abstain from alcohol consumption aligns with the evidence that alcohol is carcinogenic.

                                Canada’s Low Risk Drinking Guidelines :

Women: 0 to 2 drinks a day, up to 10 drinks a week

Men: 0 to 3 drinks a day, up to 15 drinks a week

Men and Women: Have non-drinking days per week to avoid dependence

Drinking Patterns
Data from a study conducted by Paradis et al. published in the Canadian Journal of Public Health, 2010, provides insight into drinking patterns for Canadians by province and gender. This research collected data through telephone interviews with 14,067 Canadians between the ages of 18 and 76. Data is reported for the Maritime region.

*Maritime men typically drink on 84 occasions over the course of a year.
*Men in the Maritimes consume 486 drinks on average each year.
*Beer is the drink of choice for men in the Maritimes where it accounts for 59% of all alcohol consumed. Wine accounts for 16%; spirits for 24% and coolers for 2% of alcohol consumed by men.
*Maritime men consume a usual daily quantity of 4.1 drinks- higher than all other provinces.
Seventy three percent of Maritime males binge drink at least once a year – higher than the rest of Canada.
*Maritime women typically drink on 45 occasions over the course of a year.
*Women in the Maritimes consume 164 drinks on average each year.
*Wine is the drink of choice for women in the Maritimes where it accounts for 38% of all alcohol consumed. Spirits account for 24%; beer for 19% and coolers for 18% of alcohol consumed by women.
*Maritime women consume a usual daily quantity of 2.5 drinks- higher than all other provinces.
*Forty-three percent of Maritime females reported binge drinking at least once a year – higher than the rest of Canada. 

 Reducing Alcohol Consumption

Changing the culture of alcohol consumption will require a multi-faceted approach that engages many sectors of society including, but not limited to health care. The Guide to Community Preventative Services Taskforce evidence-based recommendations to prevent excessive alcohol consumption include :

Interventions Directed to the General Population
Dram Shop Liability                                                                 Recommended March 2010
Electronic Screening and Brief Interventions (e-SBI)        Recommended August 2012
Increasing Alcohol Taxes                                                       Recommended June 2007
Maintaining Limits on Days of Sale                                      Recommended June 2008
Maintaining Limits on Hours of Sale                                    Recommended February 2009
Privatization of Retail Alcohol Sales                                     Recommended April 2011
Regulation of Alcohol Outlet Density                                    Recommended February 2007

Interventions Directed to Underage Drinkers
Enhanced Enforcement of Laws Prohibiting Sales to Minors        Recommended February 2006

Screening for excessive alcohol consumption and brief interventions is recommended.

Alcohol Screening, Brief Intervention and Referral

The College of Family Physicians of Canada and the Canadian Centre on Substance Abuse have established a clinical guide that supports alcohol screening and assessment, brief intervention and referral and follow-up and support. This resource is intended for family physicians, nurse practitioners and other healthcare professionals.

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