Press Release - Immediate Release
Survey finds that 45% of Hongkongers binge drink; many have no idea that alcohol is linked not just to liver damage but also to cancers
Hong Kong Anti-Cancer Society urges drinkers to quit drinking as even one beer per day can raise the risk of breast cancer and esophageal cancer
Nowadays, "getting drunk to escape from problems" is no longer the main reason Hong Kong people go for drinking. With the booming number of beer and wine festivals, drinking has become part of the everyday lifestyle of many people. According to the latest survey conducted by the Hong Kong Anti-Cancer Society (HKACS), among those used to drink in the past 3 months, 45% have engaged in binge drinking. While nearly 70% of respondents know that drinking can cause damage to the liver, less than 30% are aware of the increased risk of cancer caused by alcohol. The Society pointed out that even one beer per day can raise the risk of cancer. In particular, young female drinkers are more susceptible to developing breast cancer.
Alcohol, also known as ethanol, is produced by the fermentation of sugars and starch by yeast. It is found in all alcoholic beverages such as beer, cider, red wine, white wine, champagne, spirits and rice wine. Since 1988, alcohol has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer under the World Health Organisation. Bases on the increasing number of evidences, the Agency further confirm the association of many cancers with alcohol in 2010. To raise public awareness of alcohol as a cancer risk factor, HKACS held the "Hong Kong Cancer Day 2018" at the Piazza in Kowloon Park today (Sunday, 9 December). Dr. Constance CHAN Hon Yee, Director of Health, attended as the Guest of Honor of the kick-off ceremony. During the event, there were an array of booths that educated the public about the link between alcohol and cancer.
In the past, most of the Hong Kong people only had alcohol to celebrate special occasions or to drown their sorrows. "In recent years, drinking has become a common leisure activity in Hong Kong. Many people go for drinks with friends after work; restaurants that embrace craft beer have become top dining spots in town. However, drinking alcohol beverages, which increases the risk of developing cancer, should never be normalized." Dr. Rico LIU King Yin, Chairman, Cancer Education Subcommittee of the HKACS, said.
More than 25% of Hong Kong people drink on a weekly basis
To understand Hong Kong people's risk awareness of alcohol-related cancers, HKACS conducted a survey on "Hong Kong People's Drinking Habits and Awareness of the Alcohol-cancer Link" with a random sample of 1,019 adults from 26 October to 7 November 2018. The results showed that among all the respondents, 69% had their first ever drink when they were 20 or younger: 27% had been drinking on a weekly basis for the past three months, with beer being the most common type of alcohol beverages consumed (86%), followed by red/white wine (66%) and champagne/sparkling wine (44%). Meanwhile, among respondents who used to drink in the past 3 months, 45% are binge drinkers (i.e. consuming at least five cans of beer/five glasses of table wine/five shots (20 ml) of liquor at one time) with an average of two binge drinking sessions per month. Comparing the percentage of people engaged in binge drink among different age groups, respondents aged 18-40 ranked the top with 35% used to binge drink.
In addition, of all the respondents, less than 30% know that drinking is associated with cancer and only 2% realize that it can increase the risk of breast cancer. 40% even believe that partaking of alcohol at a younger age can help one's body to adapt to alcohol consumption better and thus lower the risks of developing alcohol-induced cancers. 20% think that consuming low-alcohol beverages such as beer will not raise the risk of cancer. Furthermore, 17% think that only continuous binge drinking will increase the risk of cancer. Dr. Liu stressed that any type of alcoholic beverages, even beer which contains relatively lower concentration of alcohol, can lead to cancer, and the risk increases with alcohol concentration and increasing amount of alcohol consumed.
Accumulation of acetaldehyde leads to cancer; genetics make East Asians more susceptible to alcohol-induced cancers
Dr. Liu explained the mechanism to metabolize alcohol: At first, ethanol will be converted by an enzyme called alcohol dehydrogenase (ADH) into acetaldehyde, a carcinogen that causes damage to cellular DNA and mutations in body cells which may eventually lead to cancer.
Studies showed that East Asians carry a "superactive" version of the gene for ADH that speeds the conversion of alcohol to toxic acetaldehyde. As a result, these people usually have a higher risk of developing pancreatic cancer. "There is another enzyme called aldehyde dehydrogenase 2 (ALDH2) to metabolize acetaldehyde to non-toxic substances so as to reduce ethanol in the body. Unfortunately, 35-45% of East Asians (including Chinese, Japanese and Koreans) carry a defective form of ALDH2, which fails to convert acetaldehyde into non-toxic substances. Hence, the accumulation of acetaldehyde increases the risk of esophageal cancer as well as head and neck cancer," Dr. Liu said.
Three common myths about drinking in Hong Kong:
- Red wine helps prevent cancer
Fact: Grapes used to make red wine contain a plant secondary compound called resveratrol. Although it was once said to have cancer prevention effect, researchers have found no association between resveratrol and reduction of cancer risk.
- Facial flushing = rapid elimination of alcohol and is good to your body
Fact: ALDH2 is the enzyme that metabolizes ethanol. The alcohol flushing response is an indicator of less active ALDH2. Therefore, people who get flushed easily after drinking should avoid drinking.
- Eating cheese or butter before drinking can prevent cancer
Fact: Eating cheese, butter or other food before drinking can only slow down alcohol enters the bloodstream but not prevent or reduce alcohol absorption of the body. Therefore, it cannot help lower the risk of cancer. On the contrary, people are tempted to drink even more due to the delayed intoxication, thus causing more harm.
Alcohol is linked to six types of cancer
The survey found that most Hong Kong people only know that alcohol is linked to liver cancer. However, alcohol can increase the risk of six types of cancers, including mouth, pharynx and larynx cancer, esophageal cancer, breast cancer, stomach cancer, liver cancer and colorectum cancer. Dr. Liu pointed out that even drinking only one beer each day can increase the risk of cancer.
Alcohol intake significantly increases the risk of breast cancer among young women
In Hong Kong, breast cancer is the most common cancer among women. As alcohol consumption increases blood estrogen levels, female drinkers, especially the young ones, are more prone to developing breast cancer. According to a study of 6,899 females aged between 18 and 27, the average number of drinks these young women had per occasion was only 1.06. However, as compared with the non-drinker group, females who drink 1-2 days per week have a 57% increased risk of benign breast disease while those who drink 3-5 days and 6-7 days per week have 3.01 times and 5.5 times higher risk respectively. Benign breast disease is a risk factor of breast cancer, according to a study followed 9,087 women with benign breast disease for a median of 15 years, the relative risk of breast cancer for them is 1.56.
Binge drinking, smoking together with drinking further increases the risk for certain cancers
According to a study of 17,647 women aged 44 or above, binge drinking of 4-5 drinks at one time increases risk of breast cancer by 55% as compared with consumption of one drink. In another study, when compared with nondrinkers, the risk of colorectal cancer increased by 41% for those who consumed 45g alcohol per day (equivalent to 3.5 cans of beer / 3.8 glasses of red wine). "Many Hong Kong people are both drinkers and smokers. As alcohol makes it easier for the mouth and throat to absorb the cancer-causing chemicals in tobacco, those who smoke and drink possess a higher risk of mouth, pharynx and larynx cancer and esophageal cancer than those who either only smoke or drink. Therefore, it's best to stay away from both." Dr. Liu said.
Even one drink is too much: HKACS urges the public to quit drinking
Cutting out alcohol will help lower the risk of alcohol-related cancer. For instance, it can help reduce the risk of pharynx and larynx cancer by an average of 2% per year. However, Dr. Liu stressed that the risk of cancer will not drop right away even if drinkers are able to cut out alcohol completely at once; time is required to reduce risk to the non-drinker level. He urged Hongkongers to quit drinking as soon as possible. "There is no 'safe' level of alcohol consumption. Drinkers should consider drinking less or even quitting for good while non-drinkers should not pick up the habit. Young women are encouraged to look squarely at the association between drinking and breast cancer. If it is difficult to say no in social occasions, consider drinking alcohol-free beer or mocktails instead.” Dr. Liu said.
