THE ESSENTIAL
- In people who drink alcohol, the risk of developing oral cancer is 68% higher.
- The highest risk is associated with frequent consumption of craft alcohol.
- The cumulative effect of chewing tobacco is believed to be responsible for more than 60% of cases in India, where the study was conducted.
“If a large proportion of oral cavity cancers are attributed to smoking, the role of alcohol remains poorly understood,” said researchers at the Homi Bhabha National Institute in India, where alcoholic beverages include internationally branded and locally produced alcohols, which may vary in their contribution to the risk of oral cancers. As part of a study, published in the journal BMJ Global Healththe team evaluated the link between the consumption of local and imported alcoholic beverages and the risk of developing oral cancer (lips, movable tongue, floor of the mouth, gums, palate, inner side of the cheeks, etc.).
To carry out this work, it compared 1,803 people with confirmed oral cavity cancer, almost half of whom were between 25 and 45 years old, to 1,903 healthy adults, randomly selected in five different centers between 2010 and 2021. Participants completed a questionnaire on the quantity, frequency of consumption (daily or weekly) and total duration of consumption of 11 internationally recognized drinks (beer, whiskey, vodka, rum and flavored alcoholic drinks) and 30 local drinks (apong, bangla, chulli, desi daru and mahua). Volunteers were also asked about the duration and type of tobacco use to examine the interaction between alcohol and tobacco on oral cancer risk.
Oral cancer: local alcoholic drinks linked to higher risk
The results showed that among the cases, 1,019 reported not consuming alcohol compared to 1,420 in the control group and 781 cases reported consuming alcohol compared to 481 healthy adults. The average duration of tobacco consumption was higher among cancer people (around 21 years) than in the control group (around 18 years). Oral cancer patients were also more likely to live in rural areas and consume more alcohol daily: almost 37 g compared to around 29 g.
According to the authors, the risk of developing a tumor was 68% higher among alcohol consumers, reaching 72% for consumers of international brands and 87% for those who opted for local alcoholic drinks. “Consumption of 9 grams of alcohol per day increases the risk of oral cancer by approximately 50% and 62% of cases could be attributed to the consumption of alcohol and chewing tobacco, with a fraction attributable to the overall population of 11.3% for India”we can read in the research.
“There is no threshold for alcohol consumption without risk of oral cancer”
According to scientists, ethanol may change the lipid composition of the oral cavity, thereby increasing its permeability and, therefore, its sensitivity to other potentially carcinogenic substances present in chewing tobacco products. Another explanation: “Possible contamination by toxins, such as methanol and acetaldehyde, in locally produced alcohol could explain the increased risk associated with these drinks, the manufacture of which is largely unregulated. (…) Our study demonstrates that there is no threshold for alcohol consumption without risk of oral cancer. Our results suggest that public health measures aimed at preventing the consumption of alcohol and tobacco could largely eliminate this cancer in India.”
