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Alcohol at oncology events: Dr. Noelle LoConte on cancer risks and ethics

DALL·E 2024-07-10 13.47.16 - A high-quality, lifelike image illustrating the topic of alco

10.07.2024—Dr. Noelle LoConte, Associate Professor of Medicine at the University of Wisconsin and a leading expert in gastrointestinal oncology, sheds light on the complex relationship between alcohol consumption and cancer risk. As a co-author of the widely read 2017 ASCO policy statement on alcohol and cancer, Dr LoConte provides insights into the ethical implications of serving alcohol at oncology events. She discusses the importance of balancing cultural norms with health advocacy, practical steps for policy changes, and the crucial role of awareness and education in reducing alcohol-related cancer risks.

Noelle LoConte

Interview Could you explain the current scientific understanding of the link between alcohol consumption and cancer, and highlight the key findings from the 2017 ASCO policy statement on this issue?

Noelle LoConte: Alcohol is a carcinogen and is associated with increased risk of at least 7 types of cancer and is estimated to cause about 5% of cancers worldwide. From a cancer risk perspective, there is no safe amount of consumption. Our policy statement highlighted support for various policy approaches to decrease the amount of alcohol consumption as a way of reducing the amount of cancer. We also highlighted some high needs areas for further research.


You have raised concerns about the ethical implications of serving alcohol at oncology events. Given that alcohol is a known carcinogen, how does this practice align with the mission to reduce the burden of cancer?

I did a podcast called Healthcare Unfiltered about this very question with my colleague Dr. Shalaan Beg. We also wrote an opinion piece about this for ASCO Connection

In short, serving alcohol (particularly if it is free) is not in alignment with the mission to reduce the burden of cancer, but may be in line with networking and other goals, like philanthropy, so it is complicated. A middle ground may be to limit the amount of alcohol to stay below the guideline recommended amounts, for example with drink tickets. Offering appealing non-alcoholic options is also critically important. Lastly, we would like to see an equal amount of effort put in to supporting our colleagues and community members in recovery.


What practical steps do you recommend oncology organizations take regarding the provision of alcohol at conferences and events?

It would set a bold message to stop serving alcohol at ASCO and AACR and ESMO - people would likely pay more attention to the data around alcohol as a carcinogen. Short of that, we can limit amount or free distribution, and seek to normalize not drinking. 

How can increased awareness and education about the link between alcohol and cancer among both medical professionals and the public lead to changes in behavior and policy? What strategies could be most effective in this regard?

Multiple studies have known that increased awareness of alcohol as a carcinogen corresponds to increased support for policy changes. When we know better, we do better. So, we believe education is a key step in successfully moving policy forward. Only about 33% of the American population is even aware that alcohol is a carcinogen. (This is based on the ASCO National Opinion Survey as well as the NCI HINTS survey results). There is also the persistent misinformation that a little bit of alcohol is "heart healthy" that we need to combat to increase support for policy change. 


The reduction in smoking rates has been attributed to strong public health policies and changing social norms. What lessons can be drawn from tobacco control efforts that could be applied to addressing alcohol consumption in the context of cancer prevention?

I am reluctant to draw too many parallels here because alcohol and tobacco are quite different, but I think we can borrow from the tobacco control efforts that the process is long, but success can compound on itself, as well as some lessons learned about messaging and coalition building.

Doctors are often seen as role models for healthy behaviour. How does the high rate of alcohol consumption among doctors influence their willingness to counsel patients about the risks of alcohol? What can be done to encourage doctors to lead by example in this area?

We know that doctors that drink are less likely to counsel their patients about alcohol. I think we need to normalize asking every patient about alcohol as a place to start. Providers need rapid access to excellent substance use teams for patients that are interested in cutting down. We need to support physician colleagues in recovery. We need to push back on the belief that "everyone" drinks or that you have to drink alcohol in great amounts to be successful. 

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