Does Alcohol Affect Gastrointestinal Cancer Risk: A Review Updating the Briefings of Related Factors?

Review Article

Austin J Pharmacol Ther. 2022; 10(2).1166.

Does Alcohol Affect Gastrointestinal Cancer Risk: A Review Updating the Briefings of Related Factors?

Niharika¹*, Singh S² and Kumar P³

¹Department of Pharmacy, Metro College of Health Sciences and Research, Greater Noida, India

²Department of Pharmacy, IEC Group of Institutions, Greater Noida, India

³Department of Pharmacy, IFTM University, Moradabad, India

*Corresponding author: Niharika Lal, Department of Pharmacy, Metro College of Health Sciences and Research, Greater Noida, Uttar Pradesh 201308, India

Received: October 31, 2022; Accepted: November 30, 2022; Published: December 07, 2022


Alcohol consumption is a significant risk factor for gastrointestinal cancers that may be controlled. The risk of cancer increases with the amount and duration of drinking. Even occasional drinking can raise cancer risk; 100 g or less per week is presently thought to be the upper limit for low-risk consumption. Alcohol is causally linked to colorectal cancer, hepatocellular carcinoma, gastric cancer, oesophageal squamous cell cancer, and most likely also pancreatic cancer. Alcohol can have a multiplicative effect on the development of gastrointestinal cancer when paired with tobacco usage or being overweight. The recent rises in the incidence of early-onset gastrointestinal cancers in various Western nations may have been influenced by alcohol use. It is important to encourage those who use alcohol in a harmful way to enroll in cancer screening programmes. Eliminating alcohol consumption seems to be effective in lowering the elevated cancer risk that alcohol causes.

Keywords: Cancer; Alcohol; Gastrointestinal cancer; Causes; Risk


Alcoholic beverages rank among the most significant products of the global addiction demand. Alcohol drinking frequently poses a serious issue in emerging nations like India because of the diverse socio-cultural traditions that exist there. The World Health Organization (WHO) claims that alcohol drinking causes more than 200 diseases, including suicide and accidents [1]. Alcohol kills 2.6 lakh Indians annually, either directly or indirectly through liver cirrhosis, cancer, or accidents on the roads. The most frequent alcohol-attributable fractions for specific causes of death are 22% for esophageal cancer, 25% for pancreatitis, and 50% for liver cirrhosis [2].

Alcoholism is a serious health problem that affects people all over the world. It can cause addiction and harm to practically all of the body's organs. The WHO Global Burden of Disease Project, which came to the conclusion that alcohol is responsible for about 1.8 million fatalities annually (3.2% of all deaths), provides the most thorough estimates of the death rates caused by alcohol. Cancer is one of the most significant diseases brought on by long-term alcohol usage [3].

An worldwide team of epidemiologists and experts on alcohol gathered in February 2007 at the International Agency for Research on Cancer (IARC) in Lyon, France, to discuss the potential carcinogenic effects of alcohol and its primary metabolite, acetaldehyde, in both experimental animals and humans. Based on the epidemiological information available, this Working Group has determined that drinking alcohol is causally connected to the development of malignant tumours of the mouth, pharynx, larynx, oesophagus, liver, colorectum, and female breast [4]. Alcohol is therefore regarded as a carcinogen for these organ locations.

The gastrointestinal (GI) tract, as the first line of contact with anything ingested into the body, is at particular risk for damage by toxins. Additionally, a growing body of studies indicates that the body's general health is significantly impacted by poor gastrointestinal health. Making the connection, anything that could harm the GI system could have effects that extend far beyond the intestines [5]. In fact, studies have shown that alcohol consumption, especially when done repeatedly and in higher amounts, triggers a process that starts in the gut and encourages inflammation all over the body. The three most significant diseases brought on by alcohol usage are cancer, pancreatitis, and Alcoholic Liver Disease (ALD). This review therefore focuses on how chronic alcohol consumption could lead development of cancers of the upper gastrointestinal tract, the liver, the colorectum and the female breast. It has been demonstrated over the past few decades that risk factors for disease—genetic and nongenetic— as well as alcohol susceptibility rely not only on the amount of alcohol ingested but also on the target organ [6].

Metabolism of Alcohol

General Overview

In addition to the liver, alcohol is also oxidised in the digestive system. The first pass metabolism of alcohol and alcohol-induced tissue toxicity are both affected by this alcohol metabolism, even though it is less than that of the liver. Alcohol Dehydrogenase (ADH) and the microsomal alcoholoxidising system (MEOS), as well as a wide range of microorganisms, can all metabolisealcohol in the gastrointestinal tract [7]. One or the other metabolic pathway for alcohol may be predominate depending on the digestive region. The so-called first pass metabolism of alcohol by stomach ADH affects alcohol blood concentrations not only in the portal vein and consequently in the liver, but also in the systemic circulation [8]. Increased blood alcohol concentrations after oral ingestion of alcohol may happen in these circumstances because stomach ADH activity is lowered in younger women, the elderly, alcoholics, people who are fasting, and those who have been treated with specific H-2-receptor antagonists. However, the rate of stomach emptying also has an impact on the first pass metabolism of alcohol in addition to ADH activity (e.g. slow gastric emptying leads to increased first pass metabolism) [9]. Finally, first pass metabolism is also influenced by gastric morphology. Gastric ADH activity declines due to chronic atrophic gastritis and Helicobacter pylori-related gastric damage, which may result in a slower first-pass alcohol metabolism. Additionally, the well-known alcohol linked oesophageal cancer growth may be facilitated by the local generation of acetaldehyde from alcohol in the oesophagus, where much more sigma-ADH is present. The colorectum contains several isoenzymes of ADH, and these enzymes can also produce acetaldehyde in high enough concentrations to harm the mucosa. The mixed function oxidase MEOS also metabolises alcohol in addition to ADH[10]. Chronic alcohol use can induce this system, which is involved in the metabolism of several xenobiotics, including procarcinogens and pharmaceuticals. So, this enzyme system's increased activation of dietary procarcinogens could possibly aid in the development of cancer in alcoholics. Additionally, a wide range of bacteria in the digestive tract can convert alcohol to acetaldehyde. In the colorectum, where faecal bacteria, particularly anaerobes in the rectum, can produce high levels of acetaldehyde and this correlates with mucosal hyperregeneration suggesting an acetaldehydemediated mucosal injury, this may be of particular significance [10]. (Figure 1) shows general mechanism of alcohol metabolism.

Citation: Niharika, Singh S and Kumar P. Does Alcohol Affect Gastrointestinal Cancer Risk: A Review Updating the Briefings of Related Factors?. Austin J Pharmacol Ther. 2022; 10(2).1166.