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Cancer Prevention Action Week Part 2: Alcohol and cancer – we need to stop bottling it

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This year’s Cancer Prevention Action Week (23rd – 29th June 2025) is focused on the link between alcohol and cancer. And for good reason. Because this link has rarely received the attention it deserves. Some causes of cancer are better known than others. Smoking, poor diet and UV radiation would perhaps be top of most people’s list. Most people might associate alcohol harm with liver disease, drink-driving, or addiction. Fewer are aware that alcohol is also classed as a Group 1 carcinogen – in the same category as tobacco – by the World Health Organisation. Alcohol is a risk factor in at least seven different types of cancer, including some of the most common cancers: breast, bowel and oesophageal. And in total, alcohol consumption is responsible for 11,900 cases of cancer a year in the UK, nearly one in 25 cases.

Yet awareness of this risk remains strikingly low. Why is that? It may have something to do with the complications of the relationship British society has with alcohol, and the scope and influence that gives to the alcohol industry.

Many of us have seen some of the harms associated with alcohol. Yet at the same time many of us will also associate alcohol with socialising, relaxation and celebrating. And for those reasons, it may be difficult, even jarring, to bring cancer into the conversation, and into our thinking about alcohol.

But understanding and managing risk is a part of life. It’s something we all have to do every day. If alcohol comes with cancer risk, that’s just something else we need to face. We can’t keep bottling it.

However, we also have an information gap that we need to tackle. Most people have just not been exposed to the facts on alcohol and cancer.

So this Cancer Prevention Action Week, CancerWatch has written to the Secretary of State for Health, Wes Streeting, to call for the government to take action and introduce mandatory health warnings on the labels of alcohol products.

The case for doing so is strong. Consumers deserve the ability to make informed choices. There is good evidence that having this information helps people to moderate consumption. But consumers are currently denied that information. Because, unlike foodstuffs, which have mandatory requirements for nutritional information on labels, there is little or no health information available on alcohol labels. And standards for alcohol labelling are maintained by a voluntary industry-led code.

There is a better standard that we could aspire to. The Irish Government has legislated to introduce mandatory health information, including cancer risk, on all alcohol products from May 2026.

The UK government has placed a lot of emphasis on the importance of prevention in its thinking about the soon-to-arrive 10 Year Health Plan and the National Cancer Plan. This is welcome, but an effective approach to cancer prevention will require us to recognise and address the cancer risks associated with alcohol. That starts with raising awareness of that link. We can do this by following the lead set by the Irish government. The government should stop bottling it and act now.

The CancerWatch Team – June 2025

Cancer Prevention Action Week: Part 1 What’s The Value of a Cancer Prevention Action Week?

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This week (23rd-29th June 2025) is Cancer Prevention Action Week (CPAW). The focus for this year’s CPAW is that tricky subject – the link between alcohol and cancer. But what’s the purpose of CPAW and why this particular focus?

Thinking about and campaigning on cancer prevention is at the heart of what CancerWatch does as a charity and we do this all year round. But for most people, including health professionals and policy makers, that almost certainly isn’t the case.

Most of us think about cancer most intensely when it affects us directly through its impact on us, our friends and family. When this happens, we think about diagnosis, treatment, survival, recovery, fear of mortality, loss, and the preciousness of time. Generally speaking, this is what health professionals and policymakers tend to focus on as well.

For understandable reasons, policymakers are typically focused on how to improve all of these things – how to diagnose earlier, treat sooner and more effectively, so as to maximise people’s chance of survival and minimise deaths. And as for the approximately 60% of cancer cases that are not preventable – cases that as far as we are aware nothing could have prevented – those things are all we can focus on.

But around 40% of cancer cases are preventable. These are cancers caused by factors in our wider social and economic environment, cancers that, if those factors had not been present, would not have happened.

That 40% figure represents an awful lot of pain, fear, loss, and lengthy difficult treatments, all of which could potentially have been avoided. Therefore, it is absolutely right that we should take time to step back and focus on what our response to this should be.

And Cancer Prevention Action Week provides an opportunity to do precisely that – to focus a bit more attention on the 40% of cancer cases that are preventable, what we can do to reduce them, and what a serious strategy to reduce preventable cancers across the board might look like.

This will require us to look again at some of the key causal factors in preventable cancers, not just tobacco and smoking, but the role of diet and obesity, the links between alcohol and cancer, and exposure to UV rays in skin cancer.

CancerWatch exists because we believe this conversation should have much greater prominence, and it’s a conversation we pursue all year round.

We believe it’s time for policymakers to do the same. And there are some good signs here, with the “move from sickness to prevention” being identified in the consultations for both the National Cancer Plan and the 10 Year NHS Health Plan.

But what we need is an approach to cancer prevention that truly lives up to this rhetoric. And now is the time to start.

The CancerWatch Team – June 2025

State of play: alcohol

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Throughout this Cancer Prevention Action Week, we are reviewing the current state of public policy for the major risk factors in causing preventable cancers.

Like poor diet and smoking, alcohol can cause many illnesses. The most widely recognised are probably liver disease and the life-disrupting effects of alcohol addiction, but the causal link to cancer is also clear. Cancer is a known factor in causing seven cancers, and the alcohol itself is the problem: whether you consume it in wine, beer or spirits doesn’t matter. There is a further, secondary effect: alcoholic drinks can often be surprisingly calorific, and consuming excess calories raises the risk of obesity, which is itself a cause of cancer.

Among the main causes of preventable cancers, alcohol is the one where policy has diverged most sharply between the nations of the United Kingdom – or, perhaps more accurately, where English policy is lagging behind the rest of the country. Scotland and Wales have introduced minimum unit pricing (Northern Ireland consulted on it in 2022, with next steps still awaited), which has proved successful in restricting the availability of cheap high-strength alcohol.

More generally, English policy tends not to approach alcohol use as a population health issue in the way that the devolved nations tend to. There has been no new strategy on alcohol harm since 2012, when a bold strategy was published that promised minimum unit pricing, banning multi-buy alcohol promotions in shops, obliging local authorities to consider public health when making alcohol licensing decisions, and other population-level interventions. For the most part, these commitments were simply not implemented, often without any formal announcement or explanation. No further significant action on alcohol has been announced since then.

What action would be useful? As with the other main causes, change needs to be structural in nature. There will be a place for measures to equip individuals to make their own decisions, such as through better labelling of alcoholic drinks, but the interventions that will make the biggest difference will be those that shape our environments to make the healthy choice the easy one. Restrictions on the display of alcohol in shops would be one avenue to explore, as would many of the 2012 proposals, not least tightening the framework for local decision-making about licensing alcohol sales and, of course, minimum unit pricing.

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Image by Chuttersnap on Unsplash.

Labelling: what’s in a bottle of wine?

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In front of me I have a bottle of Australia McGuigan Estate Merlot. Like most people I enjoy a glass of wine and I often glance at the label to read a bit of background information about the wine. But since becoming a campaigner against cancer I increasingly look more closely at the health information given on the label.

Let’s decipher the label. The first piece of information of note is “13% vol”. I think many people might know that this relates to the alcohol content, but how many know its relevance? Is 13% a high content or a low content of alcohol? With some further investigation I suspect it will show that this wine is of medium strength — 5.5% would be a wine with low alcohol, 17% would be high — but for the many who don’t have a specialist interest in wine labels, how would they know?

Reading on, in capital letters we are told that it is a wine of Australia and a smaller comment that it contains sulphites. Sulphites, or sulphur dioxide are a legal preservative to stop wine oxidising or being contaminated. They can have unpleasant side effects so they are mentioned on the label. As we shall see, this is one of the few pieces of health information that are added by law. There is also another piece of mandatory information, the quantity of wine that the bottle contains, in this case expressed as 75cle.

Then in a little box that measures 2.5cm by 1.5cm on the back of the bottle is some crucial health information pertaining to this bottle. It shows the bottle of wine has 9.8 units (of alcohol) and an image of a 125ml glass showing 1.6 units. There is also a comment “UK Chief Medical Officers recommend adults do not regularly exceed 3-4 units (men) and 2-3units a day (women)”. The Australians obvious think there are several Chief Medical Officers in the UK. Finally, there is what I think is a tiny ‘prohibited’ sign with a pregnant women on it. It is all in very, very small font and frankly, pretty well illegible.

Bizarrely, because the labelling on non-alcoholic drinks are more closely regulated, generally, alcohol free wines and beers have considerably more health information on their labels than alcoholic beverages. Additionally, alcohol has considerably lower levels of health information than most foodstuffs, in spite of the fact that alcohol in its purist form is basically a form of poison. How did we reach this point?

Back in 2007, the UK Department of Health reached a wide voluntary agreement with the alcohol industry to include specified unit and health information on alcohol labels. This expectation was then absorbed into the Public Health Responsibility Deal which was designed to ensure that alcoholic products on the shelf would have responsible health information. In practice, that has never happened – the alcohol companies did as little as possible, and then in a font so small that much of the information is illegible. Very little further action has been taken since then, resulting in a situation where most bottles of alcohol will contain less health information than a piece of cheese or a packet of biscuits.

Any form of food labelling is highly complex and is based on legislation that was put in place by the European Union from 2014. It key purpose was to allow consumers to make informed choices and make safe use of food and free movement of food. Typically it includes information on allergens, use by dates, nutritional declarations, ingredients, storage, country of origin, energy (calories) and reference intakes. Font size is also specified.

However, the labelling of alcohol is entirely another matter. The relevant regulations are the European Union regulations 1308/2013, 1169/2011 and 607/2009. They stipulate the information to be put on alcoholic labels: the mandatory information is Alcohol by Volume (ABV, alcoholic strength), provenance, bottler, nominal volume expression eg 75cl, and lot number. Additionally, common allergens, mainly sulphites, are mandatory in specific wine products. There is also provision for minor optional items. The rest of any information remains self regulated mainly by the Portman Group, also known as Drinkaware, an industry funded organisation. Increasingly health information is delivered away from the alcohol by way of a website.

Typically alcoholic strength will not be set in a reference indicator. However, under the voluntary agreement with the drinks industry there will often be information on unit content per product/per serve and, occasionally the Chief Medical Officer’s stipulation not to drink more than 14 units a week. Occasionally there may be calorie content, but only because the supermarkets demanded this information.

Other information that should and could be shown includes information on the dangers of binge drinking; specific health information such as the damage that drinking can do to your liver; nutritional information and mandatory energy ie calorie content; ingredients; drink driving warnings; age restrictions; and use by dates.

This may seem a lot, but it is little more than the information that can be found on most foodstuffs which are considerably less harmful than alcohol. Most foodstuffs have to include traffic light diagrams and background information including, in some cases copious ingredients, which take up a large percentage of the packaging, yet space is found.

Improved labelling will not automatically reduce the damage that alcohol causes. But it is a start on the long haul to reduce the incidence of liver, bowel, and breast cancers that are caused by misuse of alcohol. The start of any public health campaign is education and awareness, a hopeless task if information is not available.