A study by researchers at Harvard Medical School, Indiana University and Brown University reports an association between higher alcohol intake and incidence of invasive melanoma in white men and women. White wine carried the most significant association, and the increased risk was greater for UV-protected parts of the body.
Andrew Rivera et al found that alcohol intake is associated with a modest increase in the risk of melanoma. Image credit: Skitterphoto.
Approximately 3.6% of cancer cases worldwide have been attributed to alcohol, most typically cancers of the aerodigestive tract, liver, pancreas, colon, rectum, and breast.
Previous research has suggested that alcohol can cause carcinogenesis as the ethanol in alcohol metabolizes into acetaldehyde, which damages DNA and prevents DNA repair.
Dr. Eunyoung Cho, an associate professor of dermatology and epidemiology at Brown University’s Warren Alpert Medical School and co-authors sought to determine whether alcohol consumption increased melanoma risk.
The team used data from three large prospective cohort studies in which 210,252 participants were followed for a mean of 18.3 years, using food-frequency questionnaires to determine their alcohol consumption. A standard drink was defined as 12.8 grams of alcohol.
“A total of 1,374 cases of invasive melanoma were documented during 3,855,706 person-years of follow-up,” the researchers said.
“There was an association between higher alcohol intake and incidence of invasive melanoma.”
Overall alcohol intake was associated with a 14% higher risk of melanoma per drink per day.
Each drink per day of white wine was associated with a 13% increased risk of melanoma.
Other forms of alcohol — beer, red wine, and liquor — did not significantly affect melanoma risk.
The association between alcohol and melanoma was strongest for parts of the body that typically receive less sun exposure.
“Compared with nondrinkers, those who consumed 20 grams or more of alcohol per day were 2% more likely to be diagnosed with melanomas of the head, neck, or extremities, but 73% more likely to be diagnosed with melanomas of the trunk,” Dr. Cho said.
“This finding was novel and further research would be required to explain the results.”
She added: “it was surprising that white wine was the only drink independently associated with increased risk of melanoma. The reason for the association is unknown.”
“However, research has shown that some wine has somewhat higher levels of pre-existing acetaldehyde than beer or spirits.”
“While red and white wine may have similar amounts of pre-existing acetaldehyde, the antioxidants in red wine may offset the risks.”
The study adds melanoma to the list of cancers associated with alcohol, and the findings support existing recommendations by organizations including the American Cancer Society to limit alcohol intake.
“The clinical and biological significance of these findings remains to be determined, but for motivated individuals with other strong risk factors for melanoma, counseling regarding alcohol use may be an appropriate risk-reduction strategy to reduce risks of melanoma as well as other cancers,” Dr. Cho said.
However, she pointed out that modest alcohol intake has been connected with reduced risk of cardiovascular disease.
“For drinkers, risks and benefits of alcohol consumption have to be considered individually, including the risk related to skin cancer,” she said.
The findings were published in the December 2016 issue of the journal Cancer Epidemiology, Biomarkers & Prevention.
“The study’s chief limitation was the homogeneity of the study population,” Dr. Cho noted.
“Non-whites were excluded, as there were too few non-white participants to draw statistically valid conclusions. Therefore, the study’s findings cannot be generalized for other racial or ethnic groups.”
“Also, few study participants reported heavy drinking, and the study did not account for some potential risk factors of melanoma, such as sun-protection behaviors. Participants were excluded if they reported a personal history of cancer at baseline of the follow-up in order to avoid bias due to closer physician follow-up of cancer patients,” she said.
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Andrew Rivera et al. 2016. Alcohol Intake and Risk of Incident Melanoma: A Pooled Analysis of Three Prospective Studies in the United States. Cancer Epidemiology, Biomarkers & Prevention 25 (12): 1550-1558; doi: 10.1158/1055-9965.EPI-16-0303
