After last week's mega-coverage of the reported association of breast cancer and alcohol consumption, we at American Council on Science and Health received many queries -- some from very nervous women. Was the answer to follow an alcohol abstention program? After all, the news reports repeatedly said "any amount" of alcohol of "any type" -- beer, wine, or spirits -- upped breast cancer risk. What is a woman to do?
This question requires some perspective.
First, the claims of an alcohol-breast cancer link are admittedly not your typical "scare du jour" where there the risk is purely hypothetical. For example, when you read that drinking soda causes esophageal cancer or that chemicals in lipstick cause myriad cancers, the claims are based only on laboratory rodent studies or some isolated, preliminary population studies. But in the case of alcohol and breast cancer, there is a significant accumulation of medical literature pointing to an association between drinking and breast cancer risk.
Second, however, the term "risk" here needs to be defined. Most studies point to a 20 to 30 percent increase risk in women who consume alcohol. That is a very small risk in comparison, say, to the one pack a day smoker, who has a l,000 percent increased risk of lung cancer. Interestingly, multiple studies of women who met the criteria of "alcoholic" have not reported a high risk of breast cancer -- and you would think that if indeed this relationship is causal, the most heavily exposed population would have a higher rate of the disease. This issue is complex, in that alcoholic women may die earlier from something else or in some other way face competing risks that might mask a relationship between alcohol and breast cancer.
Third, though, it is important that doctors and scientists spread the word that there are easy ways of mitigating the relatively small increased risk of breast cancer associated with alcohol. Both of the major textbooks on the science of cancer epidemiology point to data showing that daily supplementation with the B-vitamin folic acid (also know as folate) will wipe out entirely any increased risk of breast cancer associate with alcohol intake. Alcohol breakdown products inactivate folic acid, resulting in imperfect production of DNA, which leaves a woman more vulnerable to breast cancer -- thus a supplement (about twice the Recommended Daily Allowance) compensates here and eliminates risk.
So what is a woman to do? That becomes a philosophical question -- one which requires a weighing of benefits and risks. For older women, for example, alcohol consumption can offer cardiovascular benefits. You could always take the middle ground, choosing to drink in moderation and pop a folic acid pill daily to derive the protection it offers.
Dr. Elizabeth M. Whelan is president of the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).