Dr. Noelle K. LoConte presented “Alcohol and Cancer: A Review of the ASCO Position Paper” at the meeting. Below is the full transcript of the interview.
LoConte: In January of 2018, ASCO, which is the group that puts on this big meeting, put out a statement about alcohol and cancer that was twofold.
One, we were just trying to raise awareness that alcohol causes some but not all cancers. As it turns out there's very low awareness on both the side of the providers and laypeople about that. Also our statement allowed us to endorse several policy strategies that can be used to reduce high-risk drinking.
Doximity: Has the news media accurately represented the ASCO position paper to the general public?
LoConte: In general yes, although people want to get bogged down in the conversation about whether one drink a day is good or bad. There's conflicting evidence that suggests that might be good for the heart, but might contribute to certain cancer risks.
I think the bigger take-home message ought to be that we need to be targeting these high-risk drinkers, which is defined as binge drinking, heavy alcohol use, drinking while pregnant, or youth drinking. So we need to shift that conversation away from “is one glass of wine at dinner really that harmful”—probably not, right, it might be helpful. But those high-risk drinkers—that's really who we as cancer doctors should be focusing on.
Binge drinking is defined as four or more drinks in one sitting for females; five or more drinks in one sitting for males. Heavy drinking is defined this eight or more in a week for women and 15 or more in a week for men. And a drink is defined as one shot of spirits, five ounces of wine, eight ounces of malt liquor, or 12 of beer.
Doximity: How can providers better educate their patients on the association between alcohol and cancer risk?
LoConte: We’re the the so-called end users of these cancers. We see all of these cancers that are caused by alcohol: it's thought to be about 5% globally of cancer incidents and death. That's a lot of cancer—we need to stand up and say we don't want to see patients with alcohol related cancers anymore.
Ultimately, the work is done on the side of the primary care provider, identifying these patients. But I think oncologists can do a better job about even asking about alcohol use—counseling patients about lifestyle changes that they could potentially undertake.
Once they get the cancer, it's unclear except for head and neck cancer if cutting down really impacts them. It's really kind of more upstream that we need to be addressing this problem.
Doximity: What is pink washing and why is it an issue?
LoConte: ASCO took a formal position against pink washing: this concept of branding or changing the color of your alcoholic beverage pink, usually in the month of October for breast cancer awareness. We think that that just doesn't make sense: to sell a product that's related to cancer causes, potentially, breast cancer and then you're trying to engender goodwill or support at the same time. It's sort of like selling cigarettes to raise lung cancer awareness—it just doesn't make a lot of sense.