I agree with Mark on this one. As a matter of statistics (God are we really going here again!!) 75% of OC's are tobacco related, and that is well documented. However the number that were exclusively alcohol related is unknown. The vast majority of the time alcohol is a co-factor and not the mutanogenic agent. The method of action has been discussed here before and is also discussed in the main body of the site. High alcohol consumption has the ability to thin the cell wall membrane, in this case the oral mucosal tissues. In smokers, this makes the transference of tobacco combustion carcinogens readily able to access the cell. The relationship of HPV to oral cancer is a far more prevalent CAUSATIVE agent as well as a facilitator and co factor in many cancers (not only oral but even uterine and breast) than alcohol is according to new data. The issues of lifestyle in relationship to disease in general are a touchy subject - but it has been clearly defined that individuals that have poor lifestyle habits, which include poor eating habits (high fat, few vegetables), obesity as a result of those habits to excess, smoking, excessive drinking, little exercise and more, all contribute to higher disease of all types in that population of people in general - not just in cancer. It is also well known in the dental community that people that have two or more of the poor lifestyle choices also don't take care of other parts of their body like their teeth and gums.

The secret to all this is everything in moderation in my opinion. Just as exercise is vital to good health, obsessive, excessive exercise is destructive. Balance in all things......

As an aside, no one here has mentioned the medically reported health benefits (cardiac) related to a small regular consumption of alcohol.

Abstinence from alcohol for those that are unable to drink in moderation is, as many who have let it take over their lives to the point of destruction, self evident that that person needs to find a mechanism to bring things in line. Addictive behaviors are a separate issue from what we define as precipitating factors in recurrence, which regular readers here know I think is a misnomer in too many cases. Surgical only solutions to oral cancers leaving micro-mets which blossom 18 months later are too frequently named recurrences rather that incomplete treatment as they should be. There are legal ramifications to this which often end up in court. The bottom line is that we cannot with certainty TODAY state how many are actual recurrences, how many are incomplete treatment results, and how many are secondary primaries, and lastly how many are the consequence of continued cancerization via patients who continue down a bad path, or field cancerization from original causes. I brought this study to several of the OCF science advisors, and the common statement was that from a methodology perspective the study has flaws.

Lastly, one of the authors is a personal friend, Terry Day. The authors acknowledge that ALL studies (that includes those with small populations or from small institutions etc.) were included in this overview of the literature format paper. We all know that small population studies are not worth the paper they are written on. Remember the 19 person study on dental tooth whiteners causing oral cancer (19 people in total)? Please note that if you did (before June of 05) a retrospective literature search and published a paper on whether oral cancer screening works or not in reducing the death rate, (something that we all know works because disease found in early stages has better long-term outcomes), would have found that there was no scientific evidence that opportunistic oral screenings would produce any positive benefits. A POINT WHICH UNTIL JUST RECENTLY THE CDC HAS USED TO AVOID PUTTING ANY MONEY OR EFFORT INTO ORAL CANCER SCREENINGS IN THE US. There just are not a lot of studies on alcohol consumption by post treatment oral cancer patients to draw from. Personally I think drawing conclusions from an area in which there is little published peer reviewed data is a problem. Also this study offers no concrete recommenedations...like what is acceptable (in these doctors opinions), or what is moderate, excessive, etc. It leaves way too much to be desired, and with all due respect to my friend, I believe that the drive to publish in the medical community often leads to preliminary and often contradictory publications. Also please note that this was not published in Lancet , NEJM, or JAMA, it was published in a small alcohol specific journal. It is unlikely that it would have met the requirements to be published in one of the major journals. When you evaluate the many, many articles that are published, there is much to consider in the weight that you place on the statements and conclusions made in them.