Too Much Sun Is Not the Only Risk Factor at That Tiki Bar

Summary and Comment |
November 15, 2013

Too Much Sun Is Not the Only Risk Factor at That Tiki Bar

  1. Hensin Tsao, MD, PhD

Type of alcohol and the amount consumed were among the risk factors linked to development of melanoma and nonmelanoma skin cancers.

  1. Hensin Tsao, MD, PhD

Some study results have linked alcohol consumption with skin cancer risk. However, many of the prior analyses did not adjust for confounding factors. In Women's Health Initiative Observational Study, researchers recently found an increased risk for both melanoma and nonmelanoma skin cancer among alcohol drinkers, with links to the amount and type of alcohol consumed.

Among 59,575 white, postmenopausal women followed prospectively for a mean of 10.2 years, 532 cases of physician-diagnosed malignant melanoma (MM) and 9593 cases of self-reported nonmelanoma skin cancer (NMSC) were reported. Using Cox proportional hazards models and logistic regression techniques, the researchers found a significant relationship between amount of alcohol consumed and occurrence of both MM and NMSC. Compared with nondrinkers, those who consumed 7 or more drinks per week had a heightened hazard of MM (hazard ratio, 1.64; P=0.0013) and increased risk for NMSC (odds ratio, 1.23; P<0.0001). Higher lifetime alcohol consumption and a preference for white wine or hard liquor were also associated with increased occurrence of MM and NMSC compared with nondrinkers.


This large cohort analysis is the latest in a series of studies that have found a low but increased risk for nonmelanoma skin cancers and melanoma among drinkers. Drinkers may be more apt than nondrinkers to engage in higher-risk behavior, such as tanning and sunscreen neglect. The level of risk is significantly heightened but low enough that it would be hard to show a reduction in skin cancer risk with alcohol cessation. Nevertheless, I would recommend including skin cancer among the health hazards associated with heavy drinking when counseling patients.

Editor Disclosures at Time of Publication

  • Disclosures for Hensin Tsao, MD, PhD at time of publication Consultant / advisory board Genentech; Quest Diagnostics; WorldCare Clinical Grant / research support NIH; Department of Defense; American Skin Association Editorial boards British Journal of Dermatology; Journal of the American Academy of Dermatology; Journal of Investigative Dermatology Leadership positions in professional societies American Academy of Dermatology (Chair, Skin Cancer and Melanoma Committee); American Board of Dermatology (Director)


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