Alcohol consumption is an established risk factor for the development of certain types of cancer. A new systematic review looks into the role of alcohol on the survival prognosis among patients with gastrointestinal cancer. The results, published in the scientific journal Best Practice and Research: Clinical Gastroenterology, show that light alcohol consumption probably does not have a negative effect on the survival prognosis.

What is already known? Most research on the association between alcohol and cancer has focused on cancer development. According to the World Cancer Research Fund (WCRF), there is convincing evidence that alcohol is a risk factor for several cancers in the gastrointestinal (GI) tract. There is however little known about the role of alcohol (and other lifestyle factors) on the survival prognosis after cancer diagnosis.

What does this study add? This systematic review looks into the effect of alcohol consumption (and smoking) on the survival prognosis of patients with different types of cancer in the GI tract. Depending on the available data, different levels of alcohol consumption are compared. Only observational studies were available. Therefore, a causal relationship or underlying mechanism is not investigated. Also confounding factors cannot be ruled out.

Effect of alcohol
The researchers look at patients with different types of cancer of the GI tract and the effect of alcohol on the survival prognosis1. Overall, the results show that light alcohol consumption is not associated with worse survival prognosis. Results of specific types of cancer are highlighted below.

Type of cancer Effect of alcohol
Colorectal cancer Light to moderate alcohol consumption seems related to improved survival.
Oesophageal and liver cancer Mainly heavy alcohol consumption seems to have a negative effect on survival prognosis. Data of former drinkers indicate that reducing alcohol intake could be beneficial.
Stomach and pancreatic cancer Limited data for these types of cancer to find an association between alcohol consumption and survival prognosis.

More research needed
The researchers also looked at the effect of smoking on survival prognosis of different types of GI cancers. For most cancers, studies show that (heavy and former) smokers have worse survival prognosis than non-smokers, especially in colorectal cancer. For liver cancer there is insufficient data available. The researchers state that more research is needed on the role of alcohol (and smoking) in the survival prognosis of different types of GI cancer. Future studies should clearly separate light, moderate and heavy alcohol intakes.

Strengths

  • Systematic review that looks at the role of alcohol on survival prognosis of cancer patients instead of the risk of cancer.

Limitations

  • Limited data available for some types of GI cancers.
  • Alcohol consumption is not separated in specific categories or amounts.
  • The researchers did not look at the combined effect of alcohol and smoking.

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