Cancer risks increase with alcohol use, leading to over 740k cases last year • Hacker News Board

Re: Cancer risks increase with alcohol use, leading to over 740k cases last year

#161

Post by taneq » Sat, Jul 17, 2021, 12:53 PM UTC

schindlabua wrote: post #151

j4yav wrote: post #142

Earlier quoted context omitted.

In my experience, people who quit subsequently taking extreme / absolutist negative positions (I assume it is something for people who actually did have a problem to help them quit?) is much more predictable than concluding that anyone who smokes a joint with friends is certainly a substance abuser or that it is impossible except in theory to be productive or creative if you ever use weed. I rarely smoke weed, maybe…

I've developed a pretty strong aversion it's true. To the point where being high doesn't feel nice anymore. I also know two people with PhDs who smoke, they are the kind that limit themselves to smoking in the evening. But then I also know at least 4 people in their late twenties who prefer weed and gaming over getting a job. Both groups are the exception. Most of my friends still smoke so I'm fine with it, but I'm 1…

> But then I also know at least 4 people in their late twenties who prefer weed and gaming over getting a job.

I find this kind of phrasing confusing. I think most people would prefer their substance and activity of choice over getting a job, most people just don't have that option. I'm guessing these kids are being supported by their parents or partners?

Re: Cancer risks increase with alcohol use, leading to over 740k cases last year

#162

Post by [deleted] » Sat, Jul 17, 2021, 12:53 PM UTC

taneq wrote: post #155

fuzxi wrote: post #54

Earlier quoted context omitted.

The number I see frequently as the threshold of "heavy drinking" is 15 drinks per week, so I certainly agree that it's not accurate to call 14 drinks per week "moderate". 15 drinks per week is actually the limit here for commercial drivers. If you admit to drinking more than that during your annual/semi-annual DMV physical, you have essentially just admitted to alcoholism and can't keep driving class A/B vehicles unl…

What would you call the level below "heavy"? I'd imagine if you asked most people the scale would go something like "nondrinker", "light drinker", "moderate drinker", "heavy drinker", "full blown alcoholic". If so then 14 drinks per week is the upper end of "moderate". I'd expect it also depends on how you drink it. One restaurant-pour glass of wine with dinner every day adds up to 14 drinks a week but no reasonable…

[deleted]

Re: Cancer risks increase with alcohol use, leading to over 740k cases last year

#163

Post by newsyyswen » Sat, Jul 17, 2021, 12:58 PM UTC

TaupeRanger wrote: post #148

yarcob wrote: post #36

Earlier quoted context omitted.

If you live that same life and drink a glass of grape juice instead of wine everyday, you'll live even longer. Alcohol is a poisson and there is no "safe" level. Now, it's a personal decision how much risk is acceptable to you, but don't lie to yourself how "one glass a day is not going to make a difference".

Just plain wrong. Sugar is also "poison", right? For every study that shows a negative effect from wine, you can find one that shows a benefit to mortality. Leave your vendetta against alcohol out of this - epidemiological studies in this area are very low quality and don't show causation in any way.

Yes, sugar is basically poison, especially the large quantities of processed sugars that we regularly comsume. Cutting out candy, soda, sugar-in-coffee, etc. can bring a lot of very noticeable benefits if you were consuming them every day.

Part of the harm caused by alcohol comes from the way that your body metabolizes it...into sugars. The whole "a glass of red wine with dinner is heart-healthy" thing has also been pretty thoroughly debunked.

Re: Cancer risks increase with alcohol use, leading to over 740k cases last year

#164

Post by ImaCake » Sat, Jul 17, 2021, 1:27 PM UTC

There's a lot of people dismmising this study. But I don't think people realise how much history and scholarship is going into this. I am not a cancer biologist, so neither do I. But I can provide a little bit of insight so that people at least know what they are trying to reject.

The data for this study comes from the GLOBOCAN database, which seems to be an aggregator of cancer data [0]. This database must be massive in it's scale. The abstract states an estimated 750,000 cases attributable to alcohol consumption. That's a lot of people. But the actual data they are using contains several million participants at a minimum! You can take a look at some of the numbers here [1]. "19.3 million cases and 10 million cancer deaths in 2020" are huge numbers, even if they are staying with just 2020 registered cancer cases. How do they get these numbers? It looks like they have aggregated together cancer registries from multiple countries. Some of these will be super accurate (e.g Nordic countries, New Zealand etc) and some more sparse and less complete.

The estimates of cancer risk come from about the most authoritative scholary source possible today: "World Cancer Research Fund International’s Continuous Update Project" which appears to be a kind of set of mega systematic reviews on the links between diet/nutrition/exerice on cancer risk. This project has massive amounts of scholarship, data, and experience behind it [2].

You may think the paper is still crap. But maybe think for a moment before rejecting it out of hand. This isn't a single biased study of 30 white college students at Harvard. This is a model based on data from whole nation's cancer registries combined with parameters estimated from the best, hopefully least biased, human trial studies we can manage with the resources available to us.

0. https://www.uicc.org/who-we-are/about-us 1. https://www.uicc.org/news/globocan-2020-new-global-cancer-da... 2. https://www.wcrf.org/dietandcancer/a-summary-of-the-third-ex...

Re: Cancer risks increase with alcohol use, leading to over 740k cases last year

#165

Post by schindlabua » Sat, Jul 17, 2021, 1:29 PM UTC

taneq wrote: post #161

schindlabua wrote: post #151

Earlier quoted context omitted.

I've developed a pretty strong aversion it's true. To the point where being high doesn't feel nice anymore. I also know two people with PhDs who smoke, they are the kind that limit themselves to smoking in the evening. But then I also know at least 4 people in their late twenties who prefer weed and gaming over getting a job. Both groups are the exception. Most of my friends still smoke so I'm fine with it, but I'm 1…

> But then I also know at least 4 people in their late twenties who prefer weed and gaming over getting a job. I find this kind of phrasing confusing. I think most people would prefer their substance and activity of choice over getting a job, most people just don't have that option. I'm guessing these kids are being supported by their parents or partners?

Fourth guy I was thinking of has a job so I guess I know 3. Parents and unemployment money yeah.

I really miss one guy in particular, none of our group ever see him anymore. The only way I can know what's happening in his life is to talk to the dealer who I hang out with occasionally. Hope he wisens up soon. Used to be a pretty smart guy too but all the doing nothing for years made him dumb.

Re: Cancer risks increase with alcohol use, leading to over 740k cases last year

#166

Post by inciampati » Sat, Jul 17, 2021, 1:31 PM UTC

scotty79 wrote: post #138

synquid wrote: post #70

Earlier quoted context omitted.

https://www.jacc.org/doi/10.1016/j.jacc.2017.06.054 What do you make of studies such as this? Their baseline was strictly lifetime abstainers, absolutely no people who stopped drinking for medical reasons. Still, moderate drinking results in lower all-cause mortality.

It might be that people with worse health tend to abstain from alcohol more often because they feel worse after consuming it. Or that some substances consumed with alcohol, like all other compounds present in wine except for alcohol might have some protective function when consumed regularly. There are way more possible explanations better than "some amount of ethyl alcohol is actually a little bit beneficial".

Ethyl alcohol may cause harm to the body, but these findings do suggest that the total effect on health is positive.

Interestingly, (wrt. https://www.jacc.org/doi/10.1016/j.jacc.2017.06.054) the 15 drink-a-week threshold that's often quoted as a kind of limit to safe drinking puts your all-cause-mortality risk right at that of lifetime teetotalers. The utilitarian implication is that, after 15 drinks a week, you really are causing harm relative to not drinking at all. So its costs outweigh any benefits. But that implies that there are benefits. These may be very subtle.

Perhaps alcohol is part of a balanced diet. It arises during digestion. You find it in ripe fruit, a significant part of many primate diets. It also appears to be part of the typical diet in many of the regions of the world that have the highest life expectancy. Would they live even longer if they could shake the habit? Maybe we could study that genetically. Are these cultures just healthier for other reasons, and thus more tolerant of alcohol? It would be like the entire society has shifted along the curve shown here https://www.jacc.org/cms/asset/f6fb55ac-3d9d-4e40-8128-ec785....

Re: Cancer risks increase with alcohol use, leading to over 740k cases last year

#167

Post by ImaCake » Sat, Jul 17, 2021, 1:32 PM UTC

TaupeRanger wrote: post #144

This is complete bunk, like most nutrition epidemiological studies. They start by assuming a causal relationship that we simply don't know actually exists, using biologically "plausible" pathways that are, again, unproven. And even then, they don't seem to account for the reduction of cancer risk that many wine and beer studies have shown (though, again, from equally spurious epi studies). And here again we have news…

>They start by assuming a causal relationship that we simply don't know actually exists

They assume this causal relationship based on decades of randomised controlled trials (the only ethical way to get this information in humans). Their estimate for the risk of cancer based on alcohol consumption comes from previous work which would have carefully summarised the data from these trials and conservatively estimated the risk.

As for the counter that alcohol may reduce cancer risk. Sure, that is true. You can also demonstrate that sunscreen causes cancer. But does the increased cancer risk from sunscreen outweigh the risk of getting too much sun exposure? Probably not (keep wearing sunscreen!). It is easy to imagine a similar equation for alcohol.

Re: Cancer risks increase with alcohol use, leading to over 740k cases last year

#168

Post by maxerickson » Sat, Jul 17, 2021, 1:34 PM UTC

ImaCake wrote: post #167

TaupeRanger wrote: post #144

This is complete bunk, like most nutrition epidemiological studies. They start by assuming a causal relationship that we simply don't know actually exists, using biologically "plausible" pathways that are, again, unproven. And even then, they don't seem to account for the reduction of cancer risk that many wine and beer studies have shown (though, again, from equally spurious epi studies). And here again we have news…

>They start by assuming a causal relationship that we simply don't know actually exists They assume this causal relationship based on decades of randomised controlled trials (the only ethical way to get this information in humans). Their estimate for the risk of cancer based on alcohol consumption comes from previous work which would have carefully summarised the data from these trials and conservatively estimated th…

There are people that drink what the study says to drink, every day?

What else would 'controlled' mean in this context?

Re: Cancer risks increase with alcohol use, leading to over 740k cases last year

#169

Post by ImaCake » Sat, Jul 17, 2021, 1:35 PM UTC

Falkon1313 wrote: post #114

flunhat wrote: post #7

Earlier quoted context omitted.

From the paper, > Globally, an estimated 741 300 (95% UI 558 500–951 200), or 4.1% (3.1–5.3), of all new cases of cancer in 2020 were attributable to alcohol consumption. Males accounted for 568 700 (76.7%; 95% UI 422 500–731 100) of total alcohol-attributable cancer cases, and cancers of the oesophagus (189 700 cases [110 900–274 600]), liver (154 700 cases [43 700–281 500]), and breast (98 300 cases [68 200–130 500…

Well one other way to frame it would be that 96% of the people who got cancer were not regular drinkers. When you consider how many people are regular drinkers (and how low the bar is set - only 2 drinks per day) vs how many people get cancer (39.5%), then if only 4% of cancer occurred in regular drinkers, then you would naturally draw the conclusion that regular drinking appears to prevent cancer. But that goes agai…

The error you are making is that the authors are calculating risk. That is, very broadly, the chance of getting cancer goes up if you drink. The authors do not claim that drinking == cancer. That is ridiculous and would rightly be ignored by cancer researchers.

Lots of people drink and smoke and will not ever get cancer. The authors are not disputing this. They do however suggest that drinking might increase your risk of getting cancer.

Re: Cancer risks increase with alcohol use, leading to over 740k cases last year

#170

Post by schindlabua » Sat, Jul 17, 2021, 1:41 PM UTC

hrh wrote: post #153

schindlabua wrote: post #151

Earlier quoted context omitted.

I've developed a pretty strong aversion it's true. To the point where being high doesn't feel nice anymore. I also know two people with PhDs who smoke, they are the kind that limit themselves to smoking in the evening. But then I also know at least 4 people in their late twenties who prefer weed and gaming over getting a job. Both groups are the exception. Most of my friends still smoke so I'm fine with it, but I'm 1…

Think through your last two paragraphs. Yeah, people that feel good are probably going to be more productive than those feeling bad (assuming you're not feeling too good). I can't do the stuff you're talking about when I'm not high (or couldn't) because I couldn't stop anxiety and other issues from getting in the way. Weed liberates me from that. I have friends that hate weed, friends that become different people whi…

Many drugs feel great but don't make you more productive.

Medical issues are a big exception yeah. I wasn't able to focus at all while high, at least not for a prolonged period of time... I guess it's just different for me. Mostly I stayed up way too late doing nonsense and got very little sleep as a result which impacted my day-to-day activities. It wasn't a good time.