Mumbai: As Christmas and New Year festivities approach, a major study by the Centre for Cancer Epidemiology at ACTREC, Kharghar, part of the Tata Memorial Centre, has issued a stark warning: even low and regular consumption of alcohol significantly increases the risk of oral cavity cancer. The study highlights that there is no safe level of alcohol intake when it comes to the development of oral cancer.
Large Multicentre Analysis Tracks Cancer Risk Over a Decade
Published in the open-access journal BMJ Global Health, the comparative study analysed 3,706 men between 2010 and 2021, including 1,803 confirmed cases of buccal mucosa (inner cheek) cancer and 1,903 disease-free individuals. Researchers found that consuming just one standard drink a day increases the risk of buccal mucosa cancer by nearly 50%.
Compared to non-drinkers, individuals who consumed alcohol had a 68% higher risk of developing buccal mucosa cancer. The study examined both international alcoholic beverages—such as beer, whisky, vodka, wine and rum—and locally brewed drinks like Mahua, Toddy, Desi Daru and Tharra. The highest risk was associated with locally brewed country liquors, some of which may contain alcohol concentrations as high as 90%.
“Most existing research comes from Europe and North America. This is the first large-scale multicentre study from India to examine the link between alcohol consumption—especially locally brewed liquor—and the risk of oral cavity cancer. The individual effect of alcohol has not been explored in much depth, particularly in India, where alcohol and tobacco are often used together,” said Dr. Sharayu Mhatre, Scientific Officer and lead senior author of the study.
Alcohol and Tobacco Combination Proves Especially Lethal
Dr. Sudeep Gupta, Director of Tata Memorial Centre, said the study is the first to clearly demonstrate the combined effect of alcohol consumption and tobacco chewing on oral cancer risk. He reiterated that alcohol is classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC) and is linked to at least seven types of cancer. Quoting the World Health Organization, he noted, “Strong alcohol policies are among the smartest investments you can make.”
The risk increases dramatically when alcohol use is combined with tobacco chewing, a common practice in India. Individuals who both drank alcohol and chewed tobacco faced a fourfold increase in cancer risk compared to those who used neither. Researchers explained that alcohol alters the lining of the mouth, increasing its permeability and making it more vulnerable to carcinogens present in chewing tobacco.
Dr. Rajesh Dikshit, Director of the Centre for Cancer Epidemiology, said nearly 11.5% of buccal mucosa cancer cases in India are attributable to alcohol, rising to over 15% in high-burden states such as Arunachal Pradesh, Meghalaya, Assam, Telangana and Madhya Pradesh. In contrast, states like Gujarat, where alcohol sale is banned, show a much lower alcohol-attributable risk.
Highlighting policy gaps, Dr. Pankaj Chaturvedi, Director of ACTREC, stressed the urgent need to strengthen alcohol control measures. “It’s unfortunate that celebrities from Bollywood promote products made by liquor or tobacco manufacturing companies. They promote different products but they resemble the logo similar to liquor or tobacco products,” he said, adding that India needs stronger regulatory policies rather than limited bans in a few states.
Oral Cancer Remains One of India’s Deadliest and Most Common Cancers
Oral cancer is the second most common cancer in India, with an estimated 1.43 lakh new cases and nearly 80,000 deaths annually. Survival remains poor, with fewer than half of patients surviving beyond five years.
Dr. concluded that there is no safe limit of alcohol consumption when it comes to buccal mucosa cancer. She said that effective public health action targeting both alcohol and tobacco use could largely eliminate this cancer from India.
In Numbers:
As per Global Cancer Observatory 2022, Oral cavity cancer (OC) ranks among the top 15 cancers globally
India leads in OC amongst other countries
Global New Cases: 3,89,765 per year
Death: 1,88,415 per year
New cases in India: 143,759 per year
Death in India: 80,000
6 men and 2 women in 100,000 get OC each year globally
15 men and 5 women in 100,000 get OC each year in India
Risk associated with local liquors
Mahua: 59%
Toddy: 73%
Tharra: 209%
Desi Liquor: 84%
Risk associated with internationally- recognized liquors
Beer: 91%
Whisky: 78%
Vodka: 35%
Rum: 31%
Wine: 42%
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