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Cancer Epidemiol. 2016 Dec;45:181-188. doi: 10.1016/j.canep.2016.09.011. Epub 2016 Nov 2.

European Code against Cancer 4th Edition: Alcohol drinking and cancer.

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International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
Health Policy Analyst OECD, 2 rue André Pascal, 75775 Paris Cedex 16, France.
Centre for Research into Cancer Prevention & Screening, Level 7, Mailbox 7, Ninewells Hospital & Medical School, Dundee, DD1 9SY, Scotland, United Kingdom.
Fondazione IRCSS Istituto Nazionale dei Tumori, 1 via Venezian, 20133 Milan, Italy.
Institut Gustave Roussy, 114 rue Edouard Vaillant, 94805 Villejuif, France.
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom.
Department of Epidemiology and Preventive Medicine, University of Regensburg, 93042 Regensburg, Germany.
Department of Epidemiology and Biostatistics, School of Public Health Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom.
Human Nutrition Unit, The Medical School, Beech Hill Road, Sheffield S10 2RX, United Kingdom.
World Cancer Research Fund International, Second Floor, 22 Bedford Square, London WC1 B 3HH, United Kingdom.
International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France. Electronic address:


Alcohol consumption is the third leading risk factor for disease and mortality in Europe. As evaluated by the International Agency for Research on Cancer (IARC) Monographs, a causal relationship is established for consumption of alcoholic beverages and cancers of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum and female breast, even at low and moderate alcohol intakes. The higher the amount of alcohol consumed, the higher the risk of developing cancer. In Europe, an estimated 10% (95% CI: 7%-13%) of all cancer cases in men and 3% (95% CI: 1%-5%) of all cancer cases in women are attributable to alcohol consumption. Several biological mechanisms explain the carcinogenicity of alcohol; among them, ethanol and its genotoxic metabolite, acetaldehyde, play a major role. Taking all this evidence into account, a recommendation of the 4th edition of European Code against Cancer is: "If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention."


Acetaldehyde; Alcohol drinking; Cancer; Disease; Ethanol; Europe; Primary prevention

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