Alcohol causes cancer: more awareness and action needed in Aotearoa – Report

A new factsheet 'Ka Hua Mai Te Mate Pukupuku I Te Inu Waipiro – Alcohol Causes Cancer' by Royal Society Te Apārangi compiles the evidence of alcohol causing cancer from an Aotearoa New Zealand perspective and is calling for greater awareness and action to address the issue.

The factsheet aims to inform choices about drinking – for people and communities.

It follows the release of an assessment of the health burden caused by alcohol consumption published in August 2024 by Health New Zealand | Te Whatu Ora. This report had found that the greatest proportion of the 901 deaths attributable to alcohol in the year studied were from cancer at 42 percent or just over 4 in 10.

How alcohol causes cancer
“Alcohol causes cancer through several mechanisms,” explains Emeritus Professor Jennie Connor, University of Otago Ōtākou Whakaihu Waka, the lead expert advisor on the factsheet.

“Alcohol and its breakdown products can cause mutations. It can also aid other carcinogens accessing our cells, and can disrupt hormones. In addition, alcohol can increase the chance of metastasis, the spreading of cancer to other parts of the body,” she says.

Types of cancer
The factsheet outlines that drinking alcohol causes cancer of the mouth and throat, breast cancer (female), liver cancer and bowel cancer in particular.

Alcohol contributes to Aotearoa New Zealand’s high rate of bowel cancer – amongst the worst in the world. Every year 1,250 Kiwis die from it.

Breast cancer is the most common cancer in women living in Aotearoa New Zealand. Every year 3,400 people are diagnosed with breast cancer and more than 650 die from it.

“Breast cancer is the leading cause of death from alcohol in New Zealand women. The risk is higher the more we drink, but even one drink a day increases a woman’s risk. Drinking less is one of the few things we can do to reduce our risk of breast cancer,” Professor Connor says.

“While both alcohol and smoking cause cancer in the mouth and throat, drinking and smoking together multiplies the risk because alcohol can help the toxins from tobacco get into the cells.”

Low awareness that alcohol causes cancer
New Zealanders are big drinkers – four out of five adults in this country drink. Yet awareness about alcohol causing cancer is low, despite the link between drinking alcohol and cancer having been known for over a hundred years. Research published last year found that most New Zealanders do not know that alcohol causes cancer (more than four in five people didn’t know this). However, most Kiwis know that smoking and sun exposure cause cancer.

Even moderate drinking carries risks
“It’s not just heavy drinking that is a problem. Even drinking one or two standard drinks a week increases our risk of getting cancer,” says Professor Sue Crengle, a GP and Māori health researcher, who was also an expert advisor on the factsheet.

“There is no safe minimum, and the type of alcoholic drink (such as wine, beer, cider or spirits) does not affect the risk, including red wine. It’s the alcohol in the drink that increases cancer risk.”

Manatū Hauora Ministry of Health currently recommends a limit of two standard drinks (containing 10 grams of alcohol) per day for women and three for men (with a maximum of 10 and 15 per week, respectively) to reduce long-term health risks. These guidelines, however, are under review. International guidelines are much more conservative, recommending below four standard drinks per week to minimise health risks.

Inequitable health burden
Despite the fact that Māori did not produce or drink waipiro (alcohol) until the arrival of Europeans, they are more likely to die from alcohol-linked cancers because they are less well served by the health system, says Professor Crengle.

“Alcohol has many harmful impacts for all, including cancer, but the burden is greater for Māori,” she says.

Professor Connor’s research has shown that Māori with alcohol-related cancers die an average of two years earlier than non-Māori.

Recommended actions
According to the factsheet, the World Health Organization’s top evidence-based solutions for reducing cancer harm from alcohol are to:

regulate the price of alcohol to make it less affordable
put suitable restrictions on availability
limit alcohol marketing.

Professor Connor says the government and health authorities in New Zealand need to be taking the recommendations of the WHO seriously to reduce the cancer harm from alcohol in Aotearoa.