Many people remain unaware, blissfully or otherwise, of long-term risks, which aren’t just restricted to “heavy drinkers”. Alcohol is one of the largest risk factors for avoidable death and illness.
The growing list of alcohol-related diseases includes bowel cancers, mouth and oesophageal cancers, breast cancers, heart disease, respiratory infections and mental health problems. Some evidence is emerging of a link with other diseases such as prostate cancer.
We have also seen the transgenerational impact through fetal alcohol spectrum disorders (FASD). These are lifelong and severe disorders that occur as a result of exposure to alcohol in the womb.
Here are four diseases evidence shows are linked strongly with alcohol consumption.
In total, cancers account for the largest proportion (more than one-third, or around 2,000 Australian deaths a year) of alcohol-attributable deaths. Breast cancer is the leading cause of death for women, followed by liver disease. For men, the leading cause is liver disease, followed by bowel cancer.
Three decades ago, the World Health Organisation identified alcohol as a group one carcinogen, in the same category as tobacco. But many health professionals and others still don’t connect alcohol and cancer.
It has been estimated that alcohol is a leading cause of cancer worldwide, contributing to 770,000 cases.
Cancer risk can increase at relatively low levels of consumption, and rises the more you drink. It’s also influenced by individual vulnerability.
For bowel cancer, risk increases from two standard drinks a day. For every standard drink, breast cancer risk for women increases by around 12%. Cancers of the larynx (voice box) increase from one standard drink a day – daily consumption of ten standard drinks a day increases the risk four-fold compared to not drinking.
Similar evidence exists for mouth, oesophageal and liver cancers. Emerging evidence suggests we also need to consider associations with prostate, pancreatic, lung and gallbladder cancers and malignant melanoma.
2. Heart disease
There are strong claims about the benefits of low doses of alcohol.
But systematic reviews (where multiple studies are analysed) conclude that there is no net benefit, or very limited benefit, of moderate drinking over abstention. Even where protective effects for the heart are identified, these are often at very low levels of consumption (such as one standard drink every other day).
There is evidence alcohol is associated with high blood pressure, ischaemic heart disease and stroke. Heart diseases attributed to alcohol are major contributors to death and hospitalisations in Australia.
Alcohol consumption affects judgment, reaction time and contributes to risk-taking. Alcohol-related injuries from falls, drowning, vehicle accidents and violence contribute to a high proportion of hospitalisationsin Australia and overseas.
Falls and assaults contribute to 21% of alcohol-attributable hospitalisations in Australia. These injuries resonate through the whole community in terms of harm to family members, innocent bystanders and the cost to our policing and health systems.
4. Neuropsychiatric disorders
Neuropsychiatric conditions, which include alcohol dependence and abuse, are the leading causes of alcohol-attributable hospitalisations (37%) in Australia.
Mental health conditions associated with alcohol include depression, self-harm and suicide.
Evidence is emerging of alcohol’s impact on the developing brain and the significant cost of alcohol-acquired brain injury is well established.
Knowing your risk
There are guidelines to help drinkers understand risk.
Individual vulnerability and the context in which you drink are relevant. But, in general, low-risk drinking to avoid alcohol-related death is two standard drinks or less a day. Single-occasion low-risk drinking is four standard drinks or less.
The safest option for those thinking about pregnancy, or who are pregnant, and for those under 18 years old, is not to drink. Exposing an unborn child to alcohol is a dose-dependent risk that can endure across their lifetime.