Written by Dr Akshat Malik

Princess of Wales Kate Middleton recently declined to taste beer or cider during a visit to a brewer in London, saying, “Since my diagnosis, I haven’t had much alcohol. It’s something I have to be a lot more conscious of now.” The comment was made in reference to her ongoing recovery and health journey following her 2024 cancer diagnosis. In her own way, she also raised awareness on why women need to weigh their cancer risk when they pick up their next drink.

A glass of wine after work or cocktails at a weekend party often feels harmless, a source of relaxation even. Yet growing scientific evidence shows that alcohol carries a significant cancer risk — particularly for women. The World Health Organization (WHO) has emphasised that alcohol is directly linked to several cancers and has said that no minimum amount of alcohol can be considered completely safe for cancer risk.

Similarly, the International Agency for Research on Cancer (IARC), the cancer research arm of WHO, classifies alcohol as a Group 1 carcinogen. This is the highest level of cancer-causing risk and places alcohol in the same category as tobacco and asbestos — substances with strong scientific evidence linking them to cancer.

Alcohol can contribute to the development of multiple cancers. For women, one of the most significant concerns is breast cancer. Even modest alcohol intake has been shown to increase breast cancer risk because alcohol can raise levels of estrogen and other hormones associated with tumour growth.

Beyond breast cancer, alcohol consumption has also been linked to cancers of several organs involved in digestion and metabolism. These include cancers of the mouth and oral cavity, throat, voice box (larynx), food pipe (esophagus), liver and large intestine (colon and rectum).

The mechanism is multifactorial. When alcohol is metabolised in the body, it produces a toxic chemical called acetaldehyde, which can damage DNA and interfere with the body’s ability to repair cells. Alcohol also increases inflammation, generates harmful free radicals and may make tissues more vulnerable to other carcinogens. Alcohol can make it easier for the mouth and throat to absorb other harmful carcinogens, particularly those from cigarette smoke. It also interferes with the body’s ability to absorb vital nutrients, such as folate, which help protect against DNA damage. For women who also smoke, the risk multiplies significantly, particularly for cancers of the mouth and throat.

Women’s bodies process alcohol differently from men’s. On average, women have lower levels of the enzymes that break down alcohol, meaning higher levels circulate in the bloodstream for longer periods. Hormonal differences also play a role. Alcohol can influence estrogen levels, which partly explains its strong association with breast cancer. As a result, even smaller amounts of alcohol may carry a relatively higher risk for women compared to men.

For years, moderate drinking was sometimes portrayed as harmless or even beneficial for heart health. However, newer research suggests that any potential cardiovascular benefit must be weighed against the increased cancer risk. In fact, a growing number of countries are now including cancer warnings in alcohol awareness campaigns.

The safest option for cancer prevention is not drinking alcohol at all. However, for individuals who choose to drink, health guidelines suggest limiting intake as much as possible. Common recommendations include keeping alcohol consumption occasional rather than daily. Limit intake to no more than one standard drink on days when alcohol is consumed. Avoid binge-drinking. Keep several alcohol-free days each week.

In the end, reducing alcohol consumption is one of the simplest lifestyle changes that can contribute to lowering cancer risk. Sometimes, protecting long-term health may begin with reconsidering what’s in the glass.

(The author is senior consultant, Head & Neck Oncology, Apollo Hospital, Delhi)