The headlines were everywhere:
"Surgeon General's report warns even moderate alcohol use increases cancer risk." --Tallahassee Democrat.
"Moderate drinking raises cancer risks while offering few benefits." --The New York Times.
"US surgeon general sounds alarm about link between alcohol and cancer." --CNN.
Those in the insurance and reinsurance industries calmly sipped their coffee and said some version of, "This is news?"
Inside the Surgeon General's Report
As he prepared to leave office after serving for presidents Obama, Trump, and Biden, U.S. Surgeon General Dr. Vivek Murthy issued a report titled, "Alcohol and Cancer Risk." The 22-page general advisory identified alcohol consumption as a leading preventable cause of cancer, stating that 741,300 cancer cases worldwide were attributable to alcohol in 2020. A quarter of those cases afflicted people who consumed two or fewer drinks per day.
Even more alarming to some, that percentage did not vary significantly as consumption increased. Just more than 28% of cases were linked to those who consumed around two to four drinks a day. Roughly 21% affected those who consumed four to six, and 26% for those with six or more. The report considered one drink comparable to a five-ounce glass of wine, a 12-ounce beer, or 1.5 ounces of liquor.
In concluding his report, Murthy called for warning labels to be placed on alcoholic beverage containers similar to those on cigarette packs.
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What This Means for Insurers
Whether such labels are appropriate is a matter for politicians and regulators to decide. For insurers, alcohol's link to cancer is nothing new. The connection has been well established through multiple studies dating back to the 1980s and long factored into insurance risk assessment.
The headline-grabbing message that sparked so much public attention has been understood in the life insurance industry for decades: There is no completely safe level of alcohol consumption. Cancer is just one of the danger areas, layered on top of increased risk of liver disease and accidental death.
Alcohol consumption trails only tobacco and obesity as a leading preventable cause of cancer in the U.S. Research has demonstrated a causal relationship between alcohol use and an increased risk for seven types of cancer – breast, colorectum, esophagus, liver, mouth, throat, and voice box. And, as the surgeon general correctly points out, that risk starts increasing for some of those cancers – such as breast, mouth, and throat – with as little as one drink a day or less.
Scientifically, the call for warning labels makes sense. Alcohol metabolism occurs mainly in the liver and produces acetaldehyde, a metabolite from ethanol that can cause DNA damage that ultimately leads to cancer development. The International Agency for Research on Cancer (IARC) classifies alcoholic beverages, ethanol in alcoholic beverages, and acetaldehyde as carcinogenic to humans (Group 1).
The recent headlines led many who have heard from their doctors for years that a nightly glass of red wine might actually be good for them to scratch their heads. Then again, there was a time when doctors (not to mention the beloved children's cartoon Flintstone characters) endorsed cigarettes on television commercials.
While tobacco's link to cancer has been the subject of massive awareness campaigns for decades, alcohol's connection has largely flown under the public radar. In fact, only 45% of Americans surveyed in 2019 by the American Institute of Cancer Research said they believed alcohol causes cancer. More than 40% believed smoking was a major cause of cancer – in 1966. That number rose to 71% by 2001. While the percentage today varies depending on the type of cancer, a National Institutes of Health study found 97% of U.S. adults believe smoking causes lung cancer.
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What to Do Now
That discrepancy – more than 97% for smoking's link to lung cancer compared with just 45% for alcohol's connection to cancer overall – justifies the surgeon general's warning. But Dr. Murthy is ringing a bell the insurance industry has been sounding for years.
That said, this added attention presents life and health insurers – along with all those in the health and wellness space – a timely opportunity to reinforce that there is no completely safe level of alcohol consumption. As insurers continue to account for alcohol use in risk assessment, they can also take steps to educate consumers about its contributing role to a variety of cancers and other conditions, further establishing themselves as policyholders' wellness partners.
