Even one drink a day increases oral cancer risk, `there is no safe limit': study

Mumbai, Dec 24 (PTI) There is no safe limit when it comes to the link between alcohol and oral cancer as even one drink a day can lead to 50 per cent heightened risk, according to a study.

All forms of alcohol, be it beer, whisky, wine or the locally produced brews like mahua, toddy, country liqour or tharra, increase the risk of buccal cavity cancer, said the study conducted by the Tata Memorial Centre, Mumbai.

The greatest risk, however, is associated with locally brewed alcohol, said the research report published online in the open access journal BMJ Global Health.

"There is no safe limit for alcohol drinking in the development of oral cancer. Even a low daily intake of alcohol, just around one standard drink, is linked to a 50 per cent heightened risk of mouth (buccal mucosa) cancer in India," it said.

The study, for the first time, also confirmed that tobacco chewing and alcohol drinking jointly increase the risk of oral cavity cancer. The risk is four times higher compared to the absence of both of the habits.

"Alcohol was a contributory factor in increasing the risk of mouth cancer irrespective of how long tobacco had been used, possibly because ethanol might alter the fat content of the inner lining of the mouth, increasing its permeability and therefore its susceptibility to other potential carcinogens in chewing tobacco products.

"As tobacco use and alcohol drinking often go hand in hand, it is imperative to control the use of tobacco as well as alcohol in order to prevent oral cavity cancer," the study said.

Oral cancer is the second most common malignancy in India, with an estimated 1,43,759 new cases and 79,979 deaths every year, the researchers noted. Rates of the disease have risen steadily, with an incidence rate of around 15 for every 1,00,000 Indian men.

The main form of mouth cancer in India is soft pink lining of the cheeks and lips (buccal mucosa). Less than half (43 per cent) of those affected survive five or more years, the report said.

The study compared 1,803 people with confirmed buccal mucosa cancer and 1,903 randomly selected people free of the disease (control group) between 2010 and 2021.

Compared to those who did not drink any alcohol, the risk was 68 per cent higher for those who did. It was observed that any kind of alcohol beverage increases the risk. Both international as well as locally produced liquors almost double the risk of developing buccal mucosa cancer, the study said.

Dr Sudeep Gupta, Director Tata Memorial Centre, said the study for the first time demonstrates the joint effect of alcohol and tobacco chewing.

Dr Pankaj Chaturvedi, Director, ACTREC, suggested it was high time the authorities strengthened alcohol control policies.

The locally-brewed liquor market is mostly unregulated, with some forms used by participants containing up to 90 per cent alcohol content, Chaturvedi noted.

Dr Rajesh Dikshit, Director, Centre for Cancer Epidemiology, pointed out that as per the study, more than 1 in 10 cases (nearly 11.5%) of all buccal mucosa cancers in India are attributable to alcohol, rising to more than 15 per cent in some states with a high prevalence of the disease, such as Arunachal Pradesh, Meghalaya, Assam, Telangana and Madhya Pradesh.

The states like Gujarat which have banned the sale of alcohol show very low attributable risk for alcohol-related oral cancer, Dikshit said.

Dr Sharayu Mhatre, Scientific Officer and lead senior author of the study, said it shows that there is no safe limit of alcohol consumption for buccal mucosa cancer risk.

"Our findings suggest that public health action towards prevention of alcohol and tobacco use could largely eliminate buccal mucosa cancer from India," Mhatre said. PTI PR KRK