Am J Health Syst Pharm. 2007 Mar 1;64(5 Suppl 3):S5-11.

Understanding the health impact of alcohol dependence.

Cargiulo T.

Alcohol dependence is a major cause of mortality and is associated with psychiatric conditions, neurologic impairment, cardiovascular disease, liver disease, and malignant neoplasms. Excessive alcohol consumption causes brain damage, as evidenced by brain imaging, and related neurologic deficits, including impairments in working memory, cognitive processing of emotional signals, executive functions, visuospatial abilities, and gait and balance. Whereas moderate alcohol consumption is cardioprotective, heavy drinking is associated with increased risks of hypertension, coronary heart disease, and ischemic stroke, possibly due to alcohol-induced sympathetic activation. Chronic excessive alcohol consumption is a strong risk factor for various types of cancer, particularly cancers of the aero-respiratory tract, but also cancers of the digestive system, liver, breast, and ovaries. Heavy drinking is associated with various forms of alcoholic liver disease, such as cirrhosis. Alcohol dependence also increases the risk of injury, possibly due to alcohol-related factors such as diminished coordination and balance, increased reaction time, and impaired attention, perception, and judgment.


Addiction. 2009 Dec;104(12):1981-90. Epub 2009 Oct 5.

Alcohol and hypertension: gender differences in dose-response relationships determined through systematic review and meta-analysis.

Taylor B, Irving HM, Baliunas D, Roerecke M, Patra J, Mohapatra S, Rehm J.

The risk for hypertension increases linearly with alcohol consumption, so limiting alcohol intake should be advised for both men and women.


Addiction. 2011 Oct;106(10):1718-24. doi: 10.1111/j.1360-0443.2011.03605.x.

Alcohol consumption and non-communicable diseases: epidemiology and policy implications.

Parry CD, Patra J, Rehm J.

Alcohol is causally linked (to varying degrees) to eight different cancers, with the risk increasing with the volume consumed. Similarly, alcohol use is related detrimentally to many cardiovascular outcomes, including hypertension, haemorrhagic stroke and atrial fibrillation. For other cardiovascular outcomes the relationship is more complex. Alcohol is furthermore linked to various forms of liver disease (particularly with fatty liver, alcoholic hepatitis and cirrhosis) and pancreatitis.





J Natl Cancer Inst. 1995 Jun 21;87(12):923-9.

Risk of breast cancer in relation to lifetime alcohol consumption.

Longnecker MP, Newcomb PA, Mittendorf R, Greenberg ER, Clapp RW, Bogdan GF, Baron J, MacMahon B, Willett WC.

Although an association between alcohol consumption and risk of breast cancer has been observed in many studies, questions of major importance remain, including the nature of the dose-response relationship and the effects of drinking at various periods in life.

In these data, alcohol consumption was clearly related to breast cancer risk. Risk appeared to increase even at moderate levels of consumption. For women of all ages combined, consumption before 30 years of age was not an important determinant of risk.


Ann Epidemiol. 2006 Mar;16(3):230-40. Epub 2005 Oct 17.

Lifetime alcohol intake and breast cancer risk.

Terry MB, Zhang FF, Kabat G, Britton JA, Teitelbaum SL, Neugut AI, Gammon MD.

Moderate alcohol intake of one to two drinks per day has been consistently associated with a 30-50% increase in breast cancer…These data give added support that moderate alcohol consumption over the life course increases breast cancer risk, particularly among women with low BMI and those diagnosed with estrogen receptor positive tumors or with invasive rather than in situ disease.


Int J Cancer. 2008 Apr 15;122(8):1832-41.

Alcohol intake and risk of breast cancer defined by estrogen and progesterone receptor status--a meta-analysis of epidemiological studies.

Suzuki R, Orsini N, Mignone L, Saji S, Wolk A.

The association between alcohol consumption and an increased risk of breast cancer has been established. It is still unclear however, whether this relationship differs across the estrogen receptor (ER) and progesterone receptor (PR) tumors subtypes.


JAMA. 2011 Nov 2;306(17):1884-90.

Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk.

Chen WY, Rosner B, Hankinson SE, Colditz GA, Willett WC.

Multiple studies have linked alcohol consumption to breast cancer risk, but the risk of lower levels of consumption has not been well quantified. In addition, the role of drinking patterns (ie, frequency of drinking and "binge" drinking) and consumption at different times of adult life are not well understood…Low levels of alcohol consumption were associated with a small increase in breast cancer risk, with the most consistent measure being cumulative alcohol intake throughout adult life. Alcohol intake both earlier and later in adult life was independently associated with risk.





Int J Clin Oncol. 2010 Apr;15(2):126-34. Epub 2010 Mar 12.

Alcohol drinking, cigarette smoking, and the development of squamous cell carcinoma of the esophagus: epidemiology, clinical findings, and prevention.

Morita M, Kumashiro R, Kubo N, Nakashima Y, Yoshida R, Yoshinaga K, Saeki H, Emi Y

Both cigarette smoking and alcohol drinking are well-established risk factors for esophageal squamous cell carcinoma (ESCC), and the relationship of dose to cancer risk has already been described. Furthermore, the synergistic effect of these two factors has been reported. Our case-control study revealed the odds ratio of ESCC to be 50.1 for those who were both heavy smokers and heavy drinkers in comparison to people who neither drank nor smoked.




Oral Oncol. 2010 Nov;46(11):802-10. Epub 2010 Sep 15.

Alcohol drinking and laryngeal cancer: overall and dose-risk relation--a systematic review and meta-analysis.

Islami F, Tramacere I, Rota M, Bagnardi V, Fedirko V, Scotti L, Garavello W, Jenab M, Corrao G, Straif K, Negri E, Boffetta P, La Vecchia C.

Alcohol drinking is a known risk factor for laryngeal cancer. Overall, alcohol drinking versus non-drinking was associated with an approximately 2-fold increase in risk of laryngeal cancer (RR=1.90; 95% CI: 1.59-2.28). While light alcohol drinking (≥1 drink/day) did not show any significant association with risk of laryngeal cancer (12 studies. RR=0.88; 95% CI: 0.71-1.08), moderate drinking (>1 to <4drinks/day) was associated with a 1.5-fold increase in risk (35 studies. RR=1.47; 95% CI: 1.25-1.72) and heavy drinking (4drinks/day) was associated with a 2.5-fold increased risk (33 studies. RR=2.62; 95% CI: 2.13-3.23).


Oral Oncol. 2010 Jul;46(7):497-503. Epub 2010 May 4.

A meta-analysis of alcohol drinking and oral and pharyngeal cancers. Part 1: overall results and dose-risk relation.

Tramacere I, Negri E, Bagnardi V, Garavello W, Rota M, Scotti L, Islami F, Corrao G

Alcohol consumption, together with tobacco, is the best recognized risk factor for oral and pharyngeal cancers (OPC), but several important aspects of this association need to be further explored. The pooled relative risk (RR) was 1.21 (95% confidence interval, CI, 1.10-1.33) for <or=1 drink per day, and rose to 5.24 (95% CI, 4.36-6.30) for heavy alcohol drinking (>or=4 drinks per day).





Ann Intern Med. 2004 Apr 20;140(8):603-13.

Alcohol intake and colorectal cancer: a pooled analysis of 8 cohort studies.

Cho E, Smith-Warner SA, Ritz J, van den Brandt PA, Colditz GA, Folsom AR, Freudenheim JL

Epidemiologic studies have generally reported positive associations between alcohol consumption and risk for colorectal cancer…A single determination of alcohol intake correlated with a modest relative elevation in colorectal cancer rate, mainly at the highest levels of alcohol intake.


Lancet Oncol. 2006 Feb;7(2):149-56.

Alcohol and cancer.

Boffetta P, Hashibe M.

A causal association has been established between alcohol consumption and cancers of the oral cavity, pharynx, larynx, esophagus, liver, colon, rectum, and, in women, breast; an association is suspected for cancers of the pancreas and lung… Alcohol consumption is increasing in many countries and is an important cause of cancer worldwide.

Int J Cancer. 2007 Nov 1;121(9):2065-72.

Lifetime and baseline alcohol intake and risk of colon and rectal cancers in the European prospective investigation into cancer and nutrition (EPIC).

Ferrari P, Jenab M, Norat T, Moskal A, Slimani N, Olsen A, Tjønneland A

In this large European cohort, both lifetime and baseline alcohol consumption increase colon and rectum cancer risk, with more apparent risk increases for alcohol intakes greater than 30 g/day.


Ann Oncol. 2011 Sep;22(9):1958-72. Epub 2011 Feb 9.

Alcohol drinking and colorectal cancer risk: an overall and dose-response meta-analysis of published studies.

Fedirko V, Tramacere I, Bagnardi V, Rota M, Scotti L, Islami F, Negri E, Straif K, Romieu I, La Vecchia C, Boffetta P, Jenab M.

The International Agency for Research on Cancer (IARC) concluded that alcohol consumption is related to colorectal cancer (CRC)…This meta-analysis provides strong evidence for an association between alcohol drinking of >1 drink/day and colorectal cancer risk.





Gastroenterology. 2004 Nov;127(5 Suppl 1):S87-96.

Alcohol and hepatocellular carcinoma.

Morgan TR, Mandayam S, Jamal MM.


Chronic alcohol use of greater than 80 g/day for more than 10 years increases the risk for hepatocellular carcinoma (HCC) approximately 5-fold; alcohol use of less than 80 g/day is associated with a nonsignificant increased risk for HCC.


Clin Liver Dis. 2005 Feb;9(1):151-69.

Alcohol in hepatocellular cancer.

Voigt MD.

Alcohol has long been recognized as a major risk factor for cancer of the liver and of other organs including oropharynx, larynx, esophagus, and possibly the breast and colon… Cancer of the liver associated with alcohol usually occurs in the setting of cirrhosis.

J Stud Alcohol Drugs. 2011 Nov;72(6):892-902.

Heavy alcohol use and premature death from hepatocellular carcinoma in the United States, 1999-2006.

Dong C, Yoon YH, Chen CM, Yi HY.

Heavy alcohol use has been widely recognized as one of the major etiological factors of hepatocellular carcinoma. This study provides mortality-based empirical evidence to further establish heavy alcohol consumption as one of the key risk factors contributing to premature deaths from hepatocellular carcinoma in the United States...



Int J Cancer. 2010 Mar 15;126(6):1474-86.

Alcohol drinking and pancreatic cancer risk: a meta-analysis of the dose-risk relation.

Tramacere I, Scotti L, Jenab M, Bagnardi V, Bellocco R, Rota M, Corrao G, Bravi F

The increased risk for heavy drinking was similar in women and men, but apparently stronger in cohort studies (RR=1.29), in studies with high quality index (RR=1.30), and did not appear to be explained by residual confounding by either history of pancreatitis or tobacco smoking.


Cancer Causes Control. 2010 Jul;21(7):1047-59. Epub 2010 Mar 27.

Risk of pancreatic cancer by alcohol dose, duration, and pattern of consumption, including binge drinking: a population-based study.

Gupta S, Wang F, Holly EA, Bracci PM.

Results from our detailed analyses provide support for heavy alcohol consumption (including binge drinking) as a risk factor for PCA in men.





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