A freshly tapped beer in the pub, a glass of red wine with dinner, champagne at a birthday party - alcohol is part of everyday life in our society. Health risks? Most people wave it off. But even small amounts of alcohol can cause cancer.

The Federal Government Commissioner on Narcotic Drugs complains that 9.5 million Germans "consume alcohol in a form that is risky to their health". On average, every German citizen consumes nearly 10 liters of of pure alcohol per year. Almost 90 percent of adults drink alcohol, one of the seven drinks too much, and almost 1.8 million people are considered alcohol-dependent. Experts are certain: the consumption of alcohol and the development of cancer are interrelated.

The more alcohol, the higher the risk of cancer

Alcohol is said to be a direct trigger for seven types of cancer - in the liver, breast, throat, oral cavity, esophagus, larynx, as well as in colon and rectum. There is a clear dose-effect relationship: the more alcohol is drunk, the higher the risk of developing cancer. The German Cancer Society assumes that the risk of cancer in the oral cavity, pharynx and esophagus increases from just one glass (10 g) per day, and for diseases of the larynx, pancreas and colon and rectum from four glasses per day.

Tobacco has a reinforcing effect

Every German citizen smokes an average of 920 cigarettes per year. For many, a cigarette goes hand in hand with alcohol consumption - but both factors influence the risk of cancer. The individual risks not only add up, they reinforce each other. The result: Statistically, people who drink excessive amounts of alcohol and also smoke have a several times higher risk of developing cancer than those who consume only tobacco or only alcohol. So far, only a far-fetched idea: shock images with cancer motifs not only on cigarette packaging, but also on labels of beer, wine or champagne bottles. Perhaps we will soon have to get used to this?

„gesund!" spoke with Professor Hans Scherübl, head of the Department of Internal Medicine - Gastroenterology, Gastrointestinal Oncology and Infectious Diseases at Vivantes Hospital „Am Urban“, about the connection between alcohol and cancer.

Professor Scherübl, how does excessive alcohol consumption increase the onset of the cancers mentioned in particular?

Alcohol is a good solvent for many carcinogenic substances, such as tobacco ingredients, which, dissolved in alcohol, can penetrate our cells more easily and damage them. Alcohol is metabolized in the body to form the harmful metabolite acetaldehyde - and this has a carcinogenic effect.

Does the risk depend only on the amount of alcohol consumed or is there also a hereditary predisposition?

Hereditary factors also play an important role. Each of us carries a different risk in connection with alcohol consumption. For example, 40 percent of Japanese people cannot metabolize the substance acetaldehyde, which is produced when alcohol is consumed, due to a genetic defect. This hereditary predisposition increases the relative risk of cancer by a factor of 50 to 60 in those who drink. If an individual genetic risk is not known, the general rule is that men should limit themselves to a maximum of two drinks (12 g of alcohol each) per day and women to a maximum of one (12 g).

Why is the combination of alcohol and smoking so dangerous?

People who smoke a lot and drink a lot, for example, increase their personal risk of developing squamous cell cancer of the esophagus by up to 50 times. Giving up alcohol is easier for most people than giving up smoking. If you have already consumed a lot of alcohol (and tobacco) for years, my advice is to now have screening examinations of the colon, the esophagus and, for women, a mammogram.

Dr. Toni Fischer-Medert is a specialist in gynecology and obstetrics at the Vivantes Breast Center at Hospital „Am Urban“. She explains how alcohol consumption affects the risk of developing breast cancer in women.

The exact effect of alcohol on breast tissue has not yet been definitively clarified. However, studies show that there is a clear link between alcohol consumption and the risk of developing breast cancer. Among other things, ethanol increases the level of female sex hormones such as estrogen in the blood and thus leads to a higher risk of breast cancer. Alcohol also causes oxidative stress in the body and thus promotes the body and thus promotes the development of cancer. The fact is that those who drink alcohol regularly have a higher risk of developing breast cancer, regardless of whether they are young women or women in the menopause. The type of drink is irrelevant, so wine is not 'healthier' than beer. The quantity alone makes the difference, and so the risk of breast cancer increases linearly with each glass of alcohol.

Studies show a 7 percent increase in breast cancer risk for every 10 g of alcohol consumed (roughly equivalent to one glass of wine). Half a liter of wine daily (about 40 g of alcohol) thus increases the risk of disease by about 28 percent, with regular (daily) consumption being the decisive factor here. An absolutely risk-free lower limit cannot be defined - the clear rule is: the lower the regular alcohol consumption, the better."

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