Alcohol, young women and breast cancer

I'm a firm believer that if you want to get messages across to young people they must be credible and resonate with them in some way. If you start talking about risks that aren't important to them at their time of life, it's unlikely that they will take notice of them. What is the point of talking about drink driving with 15 year olds? They've got a while to go until they're driving themselves and realistically, as much as many of them can't wait to get behind the wheel of a car, trying to give them messages about driving safely is just not going to work until they are just about to drive or have just started driving.

As much as I think it is important to talk about the impact of alcohol on the brain and the liver to young people - you really have to pick the right time. Too early, and honestly, most of them couldn't care less. Potential liver damage is frightening (and very real, particularly for young women) but it's an alien concept for many and certainly isn't a message that is likely to be heeded by teens totally embedded in the party culture - it's just not going to happen to them!

The one thing that does appear to have some traction with young women is the link between alcohol and breast cancer. I'm not sure why it has the impact - could it be that so many young women are actually touched by the disease (i.e., they know someone who has been diagnosed with the condition) or is simply due to the fact that we talk about breast cancer so much and that so many famous women have come forward to talk about their personal experiences? Whatever the reason, this is one alcohol issue that does seem to make young females sit up and take notice.

So what do we know about the link between alcohol and breast cancer? The Cancer Council has a Position Statement on the issue of alcohol and cancer risk that is a great summary of the evidence in the area. One of its key messages is as follows:

"Alcohol use is a cause of cancer. Any level of alcohol consumption increases the risk of devloping an alcohol-related cancer; the level of risk increases in line with the level of consumption."

When it comes to breast cancer in women, according to the Cancer Council, there were 12,170 cases diagnosed in 2005 in Australia. Frighteningly, 2,677 of these were attributable to alcohol use. The actual role alcohol plays in causing breast cancer is not completely clear but it appears it could be due to excessive alcohol use (particularly in the late teens and early 20s) mutating the breast cells (possibly by increasing oestrogen levels) in some way. Then when the woman enters menopause later in life, these mutated cells become cancerous. Most of the evidence in this area focuses on those women who drink to excess, however, more recent research is now suggesting that even light drinking could cause problems. A recent study from the International Agency for Research on Cancer found that there could be as many 5,000 breast cancer deaths a year attributable to just light drinking (up to one drink a day). Based on this evidence an editorial in the medical journal Breast concluded "women who consume alcohol chronically have an increased risk for breast cancer that is dose dependent but without threshold". 'No threshold' means there is apparently no level of alcohol consumption that doesn't raise breast cancer at least a little.

But it is those who have a family history of breast cancer that are most at risk from drinking alcohol. One study suggests that women who are frequent drinkers who have a close relative who had had breast cancer are more than twice as likely to develop the disease themselves than those who do not drink. It is therefore important to get a message to young women to be aware of this risk and drink as responsibly as possible if they have a family history of the disease. It's important not to try to terrify young women in this area but certainly they need to be told about these risk factors so they can make informed decisions.

I had just finished presenting at a Parent Information Evening and three women came up to me and wanted to thank me for the talks I had given to their daughters through the day. One of the women said that she had been trying to communicate with her daughter about alcohol risks but this was the first time that she believed something had got through. Two of the women were wearing headscarves and I should have realized at that point what they were referring to but it wasn't until they told me that all three of them were breast cancer survivors that it finally sank in! They all had teenage daughters who were into the party scene and they had tried to tell them that due to their family history they were at greater risk and needed to be more careful with their alcohol intake, but it was to no avail. Their daughters believed that their mothers were trying to control them and it wasn't until an 'outsider' (me) had come to the school and discussed the link between alcohol and breast cancer that they finally realized that the risk was real and that they needed to moderate their drinking because of their family history.

I don't think for one minute that providing this information is going to stop young women drinking (and that's certainly not what I'm going for!) but the evidence is now stronger than ever before that there is a link between alcohol and breast cancer. When you think that almost 3,000 of the breast cancer cases diagnosed in Australia each year are attributable to alcohol use, if we can prevent even one woman from going through this experience by reducing the amount she drinks in her late teens and 20s simply by providing some simple information on the risks it certainly is worth the effort!