Although alcohol consumption is associated with increasing the risk of many cancers, including liver, pancreatic, colon, rectal, and breast, the link between alcohol and higher risk of melanoma is equivocal. Now, a large prospective study by Andrew Rivera, MD, of Harvard Medical School, Boston, and colleagues investigating the link between alcohol consumption and increased melanoma risk has found that alcohol intake, especially white wine, was associated with a 14% higher risk of melanoma per drink per day. White wine alone was associated with a 13% increased risk of melanoma. Other forms of alcohol including beer, red wine, and liquor did not significantly affect melanoma risk.
In addition, melanoma risk was greater for parts of the body that received less sun exposure. Counseling patients regarding alcohol use may be an appropriate strategy to reduce the risks of melanoma and other cancers, according to the study findings. The study was published in Cancer Epidemiology, Biomarkers & Prevention.
The researchers analyzed data from 210,252 participants in 3 cohort studies: Nurses’ Health Study, Nurses’ Health Study II, and Health Professionals Follow-Up Study. The study participants were followed for a mean of 18.3 years (3,855,706 person-years). The participants received biennial questionnaires that included questions about alcoholic beverages (regular beer, light beer, red wine, white wine, and liquor) and their level of consumption per week and per month. A standard drink was defined as 12.8 grams of alcohol.
Participants were also asked to report their date of birth, height, current weight, smoking history, physical activity, caffeine intake, family history of melanoma, tanning ability, lifetime number of severe sunburns, number of moles on forearms, hair color at age 18, and place of residence.
The researchers used a Cox proportional hazards model to calculate multivariate-adjusted hazard ratios (HRs).
Key Study Findings
The researchers documented a total of 1,374 cases of invasive melanoma during 3,855,706 person-years of follow-up. There was an association between higher alcohol intake and incidence of invasive melanoma (pooled multivariate HR = 1.14 [95% confidence interval (CI) = 1.00–1.29] per drink/d; P = .04). Among alcoholic beverages, white wine consumption was associated with an increased risk for melanoma (pooled multivariate HR = 1.13 [95% CI = 1.04–1.24] per drink/d; P = < .01) after adjusting for other alcoholic beverages. The association between alcohol consumption and melanoma risk was stronger for melanoma in relatively ultraviolet-spared sites (trunk) vs more ultraviolet-exposed sites (head, neck, or extremities).
Compared with those for nondrinkers, the pooled multivariate-adjusted hazard ratios for ≥ 20 g/d of alcohol were 1.02 (95% CI = 0.64–1.62; P = .25) for melanomas of the head, neck, and extremities and 1.73 (95% CI = 1.25–2.38; P = .02) for melanomas of the trunk.
“The clinical and biologic significance of these findings remains to be determined, but for motivated individuals with other strong risk factors for melanoma, counseling regarding alcohol use may be an appropriate risk reduction strategy to reduce the risks of melanoma as well as other cancers,” concluded the study authors.
Funding for this study was provided by the National Institutes of Health.
Rivera A, et al: Cancer Epidemiol Biomarkers Prev 25:1550-1558, 2016. ■
