Talk:Alcohol and cancer

Incorrect and misleading heading

It's incorrect to say no research on alcohol as a potential risk factor has been conducted on the cancers listed. In reality, both alcohol and tobacco are typically investigated. The lists of risk factors are precisely that -- lists of factors that have been identified as increasing risk. The discussions don't list those factors that have not been found to increase risk. If they did, the list of excluded factors would be very long for each cancer. Rblarrimer (talk) 16:17, 19 May 2008 (UTC)

Please note: This entry does not constitute original research according to Wikipedia guidelines:

“Original research that creates primary sources is not allowed. However, research that consists of collecting and organizing information from existing primary and/or secondary sources is strongly encouraged. In fact, all articles on Wikipedia should be based on information collected from primary and secondary sources. This is not ‘original research,’ it is ‘source-based research,’ and it is fundamental to writing an encyclopedia.”

Thank you.David Justin 16:06, 12 January 2006 (UTC)

Definition of 'moderate consumption'

It may be helpful to insert a definition of moderate consumption into this article, as defined by the sources from which this article was developed. --Uthbrian (talk) 20:13, 13 January 2006 (UTC)

Fixed Breast Cancer and Ref sections

Please be careful when adding <ref> tags. Captainj

Duffy query

Reference: Duffy, S.W., and Sharples, L.D. Alcohol and cancer risk. In: Duffy, J.L., ed. Alcohol and Illness: The Epidemiological Viewpoint. Edinburgh: Edinburgh University Press, 1992. pp. 64-127. does not appear to be cited in the article. Anyone know anything about it? Nunquam Dormio 15:37, 7 June 2006 (UTC)

It could be a general reference, or perhaps created when the article was very short. My suggestion is to leave it, it can always serve as an external link if nothing else. CaptainJ ^{(t | c | e)} 16:32, 7 June 2006 (UTC)

It was referenced but with a typo as Dufy. Now corrected.Nunquam Dormio 14:11, 11 June 2006 (UTC)

Ahlgren query

"However, some research finds moderate drinking to reduce the risk of this cancer." (Ahlgren, J. D., et al. Epidemiology and risk factors in pancreatic cancer Seminars in Oncology, 1996, 23(2), 241-250.) When I look at the abstract, it says: "Alcohol and coffee consumption have been reported as possible risks in some (but not in most) studies." which is not quite the same thing. Has anyone got access to the full Ahlgren paper and could summarize what it says about alcohol? Nunquam Dormio 14:11, 11 June 2006 (UTC)

In the absence of any response, I've changed this to a paraphrase of what Ahlgren actually said in the abstract. Nunquam Dormio 10:25, 25 July 2006 (UTC)

LIFE-SAVING INFORMATION It's life-saving information when something as simple as getting enough folic acid can eliminate the effects of alcohol on causing a horrible killer disease.Breast Cancer Survivor 15:26, 1 October 2006 (UTC)

POV

This article isn't confroming to Wikipedia's Neutral point of view policy. I only had to read the first sentence to figure that out. Minipie8 05:18, 11 February 2007 (UTC)

That being "This article does not provide medical advice and none should be inferred." Nunquam Dormio 10:00, 11 February 2007 (UTC)

Bad science

For me the following quote sounds like directly lifted from something like "How To Cheat With Statistics". I mean that to conclude cocarcinogenic activity you must compare not "None" and "Both" columns in your spreadsheet, but those marked "Compound 1", in this case "Tobacco", and "Both".

In humans, the risk for mouth, tracheal, and esophageal cancer is 35 times greater for people who both smoke and drink than for people who neither smoke nor drink,[6] implying a cocarcinogenic interaction between alcohol and tobacco-related carcinogens.

--AgnosticMantis (talk) 04:49, 19 February 2008 (UTC)

Identifying Consensus in Medical Science

It's obvious from the history and discussion pages that people have simply been pulling quotes from studies, putting them in the article and then arguing over what conclusions should be made. Nothing could be farther from the way scientific conclusions are made and it's led to conclusions inconsistent with those reached by science. This is unacceptable in an encyclopedia and a disservice to readers.

The scientific process involves first identifying all published research on the medical issue in question and then systematically and carefully examining each publication in detail to assess its quality and the weight that it should be given in making a scientific judgment.

Major criteria include the research design's strengths and weaknesses, the statistical alalyses used and their appropriateness, the quality of the publication in which the study is reported (usually based on its "impact factor," basically a measure of how often the publication is referenced in other scientific publications), and many, many other considerations. Because of the diffuculties in making valid conclusions about causality, science focuses on research design and other indicators of quality and it's why high quality studies carry so much more weight in making scientific judgments.

Determining if something is a risk factor isn't a matter of simply counting how many studies report positive versus negative findings. Finding some studies inconsistent with most others is to be expected. At the 5% level of statistical confidence, about 5% of studies are expected to yield false positive results. The actual proportion will be much higher because of publication bias that greatly increases the proportion of false positive studies published. This has been recognized for over half a century. Many other things increasing the number of false positive studies are described in textbooks on research methods.

We can't create scientific medical consensus ourselves by arguing over studies. We have to identify any consensus, or lack of consensus, that has been reached among scientists by determining what major medical organizations have concluded.Linda,LCADC (talk) 19:57, 16 July 2008 (UTC)

They're Not Motley or Irrelevant

There's nothing motley or irrelevant about the National Cancer Institute, the American Cancer Society, the Prostate Canceer Foundation, the American Academy of Family Physicians, the Sloan-Kettering Cancer Center, the American Lung Association, the American Society of Clinical Oncology, the American Academy of Dermatology, the Mayo Clinic, the American Thyroid Association or the Pancreatic Cancer Center at Johns Hopkins University Medical School.

They're among the world's more authoritative medical organizations and their conclusions about risk factors are highly relevant, being very objective scientific evaluations of the available reserch evidence. The conclusions of such organizations determine whether or not scientific medical consensus exists on specific risk factors.Linda,LCADC (talk) 19:57, 16 July 2008 (UTC)

For the avoidance of doubt

National Institutes of Health view on Colorectal Cancer Pop-up window if you click on "Diet" on Colorectal Cancer - Step 1: Find Out About Colorectal Cancer Risk reads "Studies suggest that diets high in fat (especially animal fat), high in alcohol, and low in calcium and folate may increase the risk of colorectal cancer."

Sentence Logic

I have an issue with the following sentence:

"In humans, the risk for mouth, tracheal, and esophageal cancer is 35 times greater for people who both smoke and drink than for people who neither smoke nor drink,[7] implying a cocarcinogenic interaction between alcohol and tobacco-related carcinogens."

First let me say that I have not reviewed the citations and am not commenting on the veracity of the claim. However, I do not see how the conclusion "implying a cocarcinogenic interaction between alcohol and tobacco-related carcinogens," logically follows from the assertion that "In humans, the risk for mouth, tracheal, and esophageal cancer is 35 times greater for people who both smoke and drink than for people who neither smoke nor drink." Wouldn't there need to be a comparison of people who only smoke and only drink with people who both/neither smoke and drink to arrive at the stated conclusion? Can this be reworded replaced or removed? unsigned comment by User talk:Mlewko

The sentence is a direct quote so can't be reworded. Nunquam Dormio (talk) 08:17, 25 June 2009 (UTC)

Copy right violations with over-quoting by copying and pasting

It is the other way around. It is a copyright violation, like most of this article and must be reworded. It should be reworded though without distorting what the conclusions of the reference found. If an admin sees this page with all of its copy and pasted quotes, it is likely half of the article will be deleted.--Literaturegeek | T@1k? 09:50, 1 July 2009 (UTC)

Notice the message below edit summary box every time you edit a page says this, "Content that violates any copyrights will be deleted."--Literaturegeek | T@1k? 09:50, 1 July 2009 (UTC)

I don't know what copyright laws, Wikipedia purports to follow (as it happily rips off Lewis Morley's famous photo Christine Keeler – see File:CKeeler1.jpg) where the copyright is clear; however, typical US custom and practice is that up to 10% of a article can be quoted without violating copyright. The cancer article doesn't violate copyright merely by quoting one or two sentences from a paper's conclusion / discussion, though there are stylistic reasons why that might be undesirable.

The sentence mentioned above is from the NIAAA. If you look at the page National Institute on Alcohol Abuse and Alcoholism No. 21, it clearly says "All material contained in the Alcohol Alert is in the public domain and may be used or reproduced without permission from NIAAA. Citation of the source is appreciated." As I argued above, you cannot simply reword the "35 times greater" sentence to something you might prefer. However, on another note, this page is dated 1993 and revised 2000 so it really is rather out-of-date. Nunquam Dormio (talk) 07:28, 2 July 2009 (UTC)

Perhaps it is not a copyright violation but if you look at other pages on wikipedia they don't copy and paste quotes from sources but reword it. What about all of the other refs, do they allow you to copy and paste from it? Why can you not reword it? I just reworded it here. There is even a template which is designed to flag articles such as this one which does too much quoting as it is harmful to the quality of the article. It may also be a form of plagiarism.Wikipedia:Verifiability#Reliable_sources--Literaturegeek | T@1k? 14:58, 2 July 2009 (UTC)

Mlewko originally proposed rewording a direct quote on the ground that a comparison between a smoking/drinking group and a non-smoking/non-drinking group does not in itself prove or imply a co-carcinogenic relationship. Merely doing a précis of the NIAAA sentence does not solve that problem. The only solution is to look at Blot's paper itself Smoking and Drinking in Relation to Oral and Pharyngeal Cancer. Blot says "The strong dose-response relationships leave little doubt that either product alone can induce these cancers, although most cases result from the combined effect of smoking and drinking." So Mlewko's objection is quite valid: alcohol is, in effect, both a carcinogen and a co-carcinogen and the NIAAA sentence as it stands is rather misleading. Nunquam Dormio (talk) 15:31, 2 July 2009 (UTC)

I see that and see that both references are cited. I do think that it would be preferable if we had more recent sources as I am sure research has advanced further since then in this area. We must not distort or change the conclusions of sources, unless we have more recent and updated secondary sources (review articles, meta-analysis etc).--Literaturegeek | T@1k? 18:53, 2 July 2009 (UTC)

Requested help

I have requested help of the wikipedia med project, Wikipedia_talk:WikiProject_Medicine#Alcohol_and_cancer. Hopefully they can help resolve the issues with this article.--Literaturegeek | T@1k? 10:22, 1 July 2009 (UTC)

Biopsy images

I removed the biopsy images, with edit summary "Gory biopsy images are not helpful to describe the role of alcohol in carcinogenesis and their shock value impairs NPOV. Removed." They were replaced by LiteratureGeek, who suggests "Cancer is gory and a not very pleasant disease. What POV are images violating? I can't think of a POV which has a favourable view of cancer" in his/her revert message, so I thought it might be useful to describe my rationale in further detail.

First, this article is about the role of alcohol in carcinogenesis. Excised tissue samples of tumors of unknown etiology and unusual appearance do not meaningfully contribute to or inform any discussion about alcohol's role in cancer -- they do not help a reader understand what the relationship between alcohol and cancer is. They tell you a lot about the gross pathology of cancer, but that's not what the article is about.

My second concern is that the tone of the article in general is presently very alarmist. Throwing gory images behind those claims is sort of akin to putting autopsy images of smoker's lungs on cigarette packs to discourage sales by scaring people straight, so to speak. This could be fine if the claims in the body of the article represented a solid consensus, but I've started digging into the article a little because some of the claims surprised me, and it looks like several sections are supported by references to uncited claims in tertiary literature that don't seem to have good science behind them. As it is, it looks a lot like the article is intended to dissuade alcohol consumption, and the irrelevant gory images contribute to that. "Look what will happen to you if you drink!," etc.

I that's why I think it's important to remove the images -- not only are they unhelpful, but they reinforce the general sense of alarm, which I think it would be helpful to mute until more satisfactory references can be found.

thanks, Mote (talk) 23:54, 11 August 2009 (UTC)

Thank you for your message and explaining your views. I guess my position is how do we find images which "inform the reader of the relationship between alcohol and cancer"? The link between alcohol and cancer is about chronic moderate or most often high consumption of alcohol. There is little if any risk at all from occasional heavy drinking or light drinking with a meal etc. I am not aware of any POV in the medical literature which seems to advocate that excess alcohol consumption has benign effects of health so I disagree with your stance that it is wrong to say we are demonising alcohol similarly to tobacco. Chronic alcohol consumption, particularly high intake can have disasterous effects on health and often very much more quickly than the effects of tobacco. There are many good reviews and meta-analysis on alcohol and cancer, some of which I have added to this article on alcohol and cancer. It does need improving but there really is no recent debate regarding whether alcohol causes an increase in cancer so therefore there is no POV. I am sorry that we are at loggeer heads over this. I am open to suggestions on images which can be used to replace the current images and also other editors opinions.--Literaturegeek | T@1k? 00:06, 12 August 2009 (UTC)

It sounds like we have similar views of the facts, at least, so that's a good start. I agree that there's no dispute that consuming lots of alcohol can contribute to a host of medical ills, including cancer. I think our point of disagreement is that I think it's Wikipedia's place to document that in a coolheaded, rational way, and not to use shocking or gory images or other emotional appeals. I also think that it's possible that a reader could acquire a mistaken impression of the relatively minimal risks of light consumption. I'm sympathetic to wanting to retain some images in the article, but on the other hand it's possible that there aren't good candidates -- I don't have any immediate ideas about what could be helpful. thanks, Mote (talk) 00:35, 12 August 2009 (UTC)

I put the images in a long time ago mainly because it was (and still is) a long article that needs something to break up a mass of text. The images are from the main articles and demonstrate a cancer. If you have suggestions for better images, they're welcome. Nunquam Dormio (talk) 07:41, 12 August 2009 (UTC)

On another note, you say the "tone of the article in general is presently very alarmist". Could you point out any phrases that create an an alarmist tone or aren't justified by the scientific papers? (If you look through the history, this article was originally a cheerleading piece written by an alcohol lobbyist; in my view, the article is now not too bad, but needs attention from editors with specialist medical knowledge.) Nunquam Dormio (talk) 08:11, 12 August 2009 (UTC)

I am not opposed to considering alternative pictures which may be less gory. I think that the removal of images, leaving just a page of text makes the article worse for the reader which was one of the main reasons that I reverted you. I think that the possibility of a reader mistakenly thinking that light or occasional drinking is associated with cancer could be resolved by a good review article added to the lead. I think that the images should stay, at least for now and if alternative relevant images are found then they can be discussed on the talk page.--Literaturegeek | T@1k? 20:31, 12 August 2009 (UTC)

Original Research

Ppl have been drawing their own conclusions instead of reporting the conclusions of scientific organizations. And their conclusions are inconsistent with those of medical bodies. That's the source of the bias. Linda,LCADC (talk) 18:35, 29 September 2009 (UTC)