For some people, this post today may ruin your day. We’ve always been told, even in medical school, that alcohol in moderation, especially red wine, may actually be beneficial to your health. There’s even a scripture in the Bible where the Apostle Paul tells his young protégé, Timothy, “No longer drink water exclusively, but use a little wine for the sake of your stomach and your frequent ailments.” (I Tim. 5:23)

But keep in mind the quality of the water in those days was poor and the alcoholic content of the wine was low. And the best medical practices of the day was the anointing of the head with oil!

Unfortunately, the latest medical research challenges our previous conceptions about alcohol use in moderation. Zena le Roux, writing in The Epoch Times, tells us “Lighting a cigarette in a crowded room might earn you glares, but pouring a glass of wine? That’s still seen as relatively harmless—even healthy by some. Yet few people realize that alcohol is a Group 1 carcinogen, in the same category as tobacco and asbestos. According to the International Agency for Research on Cancer, Group I carcinogens can result in cancer in humans.”

Today, alcohol is linked to at least seven types of cancer: oral cavity, pharynx, larynx, esophagus, colorectal, liver, and female breast. Globally, alcohol consumption is associated with about 740,000 new cancer cases each year. Breast, esophageal (food pipe), and liver cancers are the three most strongly linked to alcohol use.

The main culprit is ethanol—the pure form of alcohol found in all alcoholic drinks. When the body breaks down ethanol, it produces acetaldehyde, a toxic substance, which can damage DNA. The effect of ethanol and acetaldehyde on our cells and DNA may change how cells replicate and stop the body from repairing the damage.

“All types of alcoholic beverages contain ethanol—beers, wine, and spirits all pose a risk,” Carina Ferreira-Borges, a public health specialist and World Health Organization regional adviser for alcohol, told The Epoch Times. Alcohol also promotes oxidative stress and inflammation, which can further harm DNA. It may also affect hormone levels, particularly estrogen, which can raise the risk of breast cancer.

No Safe Levels

Research has established that alcohol is a cause of cancer, even at low levels of intake. For instance, it has been shown that women who have less than one drink per day still have a higher risk of breast cancer than those who don’t drink at all. Light to moderate drinking—defined as fewer than 20 grams of pure alcohol per day—was linked to approximately 23,000 new cancer cases in the European Union in 2017. That’s roughly equivalent to less than 1.5 liters of wine, 3.5 liters of beer, or 450 ml of spirits per week. More than one-third of these cases were tied to light drinking of less than 10 grams per day.

In the United States, awareness that alcohol increases cancer risk was highest for liquor, at about 31 percent, followed by beer and wine. Some believe that alcohol might be protective—or at least pose no harm. To address this critical gap in public awareness, one key strategy, Ferreira-Borges said, is making health warnings on alcoholic products more visible and explicit, similar to tobacco labels.

“Labels should clearly state the cancer risk and other health dangers associated with drinking,” she said. Ferreira-Borges also emphasized the need for stronger regulation to curb the alcohol industry’s influence on policy and research. “Governments must prioritize public health over profits,” she said. Finally, health care professionals should educate patients about the dangers of even moderate alcohol use, Ferreira-Borges said, but they need clear guidance and support to do so effectively.

We all know alcoholic drinking can lead to cirrhosis of the liver as well as social and emotional decline. Now we know it can also lead to cancer. It’s time to take drinking seriously.

The U.S. has the greatest healthcare in the world. The U.S. has the worst life expectancy statistics among developed nations. Can both of these statements be true? Unfortunately, the answer is yes. Many of the leading doctors and medical institutions are found in the U.S. and people from all over the world come here for the latest and greatest medical treatments. But you might live longer if you live in another country.

The graphic below shows life expectancy for the U.S. compared to other developed countries:

Brianna Abbott, writing in The Wall Street Journal, tells us much of the gap in life expectancy is due to deaths among working-age adults, according to Dr. Steven Woolf, a life-expectancy researcher at the Virginia Commonwealth University. “Americans die earlier and are sicker than people in other high-income countries,” he said. “This has been true for a long time, and the trend is getting worse.” Drug overdoses from opioids, alcohol, suicide and chronic diseases drive most of those early deaths, researchers said. The U.S. also took a bigger hit from Covid-19, even among younger adults who were at lower risk.

That was in part because Americans were already in worse health and more vulnerable to the virus’s toll. The U.S. obesity rate is nearly double the average of peer nations, disrupting prior decades of progress against heart disease. Around a third of U.S. adults have had multiple chronic conditions, the highest rate among our peers, according to the Commonwealth Fund.

Rates for conditions including hypertension and chronic obstructive pulmonary disease have held relatively steady in recent decades, and the rising prevalence of diabetes is in part because people are living longer with the disease, researchers say. But the U.S. still has higher rates of these conditions compared with peer nations.

Many preventable chronic diseases are related to four major risk factors: cigarette smoking, excessive alcohol use, physical inactivity and poor nutrition. In the U.S., people get less exercise, moving less than some European counterparts, studies have shown. The nation’s Western-style diet is heavy in sugars, processed meat and unhealthy fats. Americans also consume more ultra-processed foods, surveys suggest, and such diets have been linked to increased risks of obesity, Type 2 diabetes and some cancers.

The U.S. is arguably the best in the world at treating complex diseases, says Dr. Philip Landrigan, director of the global public health program at Boston College. But it is worse at providing access to care and services that help manage or prevent illness, he says.

Wealthy Americans have lower rates of chronic diseases and live longer than their low-income counterparts. The U.S. also has a wider gap in death rates between wealthy and poor Americans than European countries, a recent study found. But the wealthiest Americans still had mortality rates comparable to the poorest Northern and Western Europeans.

If you’re over the age of fifty, you’ve probably had a colonoscopy. Most doctors recommend routine colonoscopy every ten years to screen for colon cancer. Colon cancer is the second leading cause of cancer-related deaths in the U.S. Approximately one in 23 men and one in 25 women will be diagnosed with colorectal cancer in their lifetime according to the American Cancer Society.

Cologuard is a non-invasive test to screen for colon cancer that only requires providing a stool sample in a specially prepared container for laboratory analysis. This test looks for abnormal cell DNA shed in the stool, which can be an indication of cancer. Cologuard is advertised frequently in the media as an alternative to colonoscopy for low-risk patients. Barium enema is also done as an alternative to colonoscopy in some patients, particularly those who have abdominal adhesions that impair the ability to safely perform colonoscopy.

What other alternatives are available?

Amy Denney, writing in The Epoch Times, tells us of another option. She says, “Offering patients options to test for colorectal cancer may be a good strategy, according to the results of a study by Kaiser Permanente researchers presented at Digestive Disease Week. Investigators in this 20-year population-based study sent at-home kits for fecal immunochemical testing (FIT) and colonoscopy reminders to patients overdue for colonoscopies.”

“If you offer people more than one option for screening—such as colonoscopy or FIT—they’re more likely to get screened than if you offer either option by itself,” Dr. Douglas Corley, researcher and gastroenterologist, said in a news release. “To get above an 80 [percent] screening rate, you almost always have to offer people multiple options.”

What is FIT?

FIT tests are a noninvasive way to determine whether people have blood in their stool. People with positive tests should then follow up with a colonoscopy. FIT tests in particular are a great way to reach both patients who live in rural areas and young adults, who are experiencing more incidents of colorectal cancer even as the overall incidence declines, Corley said in an American Medical Association update.

“So there are a lot of positives about it,” he said. “And that’s one of the reasons why the U.S. Preventive Services Task Force kind of equally recommends colonoscopy and FIT for benefit in terms of decreasing the risk of death from colorectal cancer.

I first learned about FIT testing from my gastroenterologist. He expressed no confidence in the accuracy of Cologuard testing but was much more impressed with the results of FIT testing. He uses FIT when colonoscopy cannot be performed safely.

Screening rates—via colonoscopy, sigmoidoscopy, or FIT—grew from 37.4 percent in 2000 to 79.8 percent in 2019 across all racial and ethnic groups, according to the researchers. Giving patients more options in the type of colorectal cancer screening they received—including a FIT test mailed to their home—reduced the number of those who got cancer by one-third; reduced deaths by one-half; and eliminated nearly all the racial differences in screenings, diagnoses, and deaths.

Colorectal cancer deaths decreased by about 50 percent in the Kaiser Permanente study with the largest reductions seen in black patients who have historically had worse outcomes from colorectal cancer. Deaths among black patients declined from 52.2 per 100,000 to 23.5 per 100,000.

Colonoscopy is still the gold standard for detecting colon cancer. But FIT is a suitable alternative when colonoscopy cannot be performed, especially in low-risk patients. Ask your doctor about FIT instead of Cologuard next visit.