酒精会致癌吗？

本视频由MichaelGreger医生于2018年3月28日制作，来自NutritionFacts.org。

前言：译文中没有包括视频中全部幻灯片，请观看完整视频。老玉米学会了制作字幕，从现在开始每个小视频都有中英双语字幕啦。

摘要：如果少量饮酒也会导致癌症的话，为什么医生不警告他们的病人？

https://v.qq.com/txp/iframe/player.html?vid=z0635b3qatb&width=500&height=375&auto=0

饮酒和过高的癌症死亡率之间有可能有关联这件事我们已经知道100多年了。

We’ve known about the possible association between the consumption of alcohol and excessive mortality from cancer for more than a hundred years. 

证明饮酒与胰腺癌、前列腺癌和黑色素瘤之间有关联的证据目前还在逐步累积中，但是我们已相当确定饮酒会增加口腔癌、咽喉癌、食道癌、结肠直肠癌、肝癌、喉头癌和乳腺癌的患病几率。

Though the evidence is accumulating that alcohol drinking is also associated with pancreatic cancer, prostate cancer, and melanoma, we’re pretty certain that alcohol increases risk of mouth cancer, throat cancer, esophageal cancer, colorectal cancer, liver cancer, voice-box cancer, and breast cancer.

当前统计表明，在全世界，饮酒造成了上述癌症致死中大约5.8％的病例。

Current estimates suggest that alcohol causes about 5.8% of all cancer deaths in these organs worldwide.

男性和女性受其影响有所不同。在男性中，饮酒主要导致头颈癌和胃肠癌，在女性中，饮酒主要导致乳腺癌。

Here’s how that breaks down for men and women. In men, alcohol causes mostly head and neck cancers, and gastrointestinal cancers, whereas it’s mostly breast cancer in women.

每年，饮酒似乎会导致10万件以上的乳腺癌病例。

Alcohol appears to cause more than 100,000 cases of breast cancer every year.

也许这些病例都源于长期酗酒？

Yeah, but is that just among heavy drinkers?

不，所有证据都表明，即使是对于少量饮酒者，饮酒也会增加乳腺癌患病风险。

No. “All levels of evidence show…a risk relationship between alcohol consumption and the risk of breast cancer, even at low levels of consumption.”

但是，健康的饮食可能会帮助缓解这个风险。

Now, eating a healthy diet may help modulate that risk.

的确，饮酒会增加得乳腺癌的几率，但高纤维的饮食可能会具有相反的正面效果。

Yeah, alcohol increases the risk of breast cancer, but “a fiber-rich diet may have the opposite effect.”

因此，更多地摄入未经加工处理的植物类食物可能可以缓解饮酒导致的不良健康后果。

So, eating more whole plant foods may be able to “ease the adverse effects” of alcohol.

证据表明，饮酒会提高性激素水平，如雌激素，这可能会增加得乳腺癌的风险。但当多吃高纤维的食物时我们观察到截然相反的影响。

“Alcohol has been shown to increase sex hormone levels,” like estrogen, which may increase breast cancer risk. But, you see the opposite happen eating fiber-rich foods.

纤维可以在大肠中和雌激素结合在一起，由此帮助人体把雌激素排出体外。

“Fiber appears to bind estrogen in the colon” and help flush it out of the body.

但尽管多吃高纤维食物，只要依旧摄入酒精，就无法完全避免得癌症的风险。

But, even so, there does not appear to be any level of alcohol consumption that is completely safe from a cancer standpoint.

也正是因此，在医学文献里，经常可以看到打着感叹号的语句向读者强调：摄入使人上瘾的致癌物（指酒精）无论如何也不能被认为是一种健康的生活选择。

So, that’s why you see commentaries like this in the medical literature, exclamation point and all: the “consumption of…an addictive carcinogen, cannot be considered a healthy lifestyle choice!”

因此，关于饮酒的结论应该无比清楚：酒精有毒、致癌、导致婴儿先天缺陷，而且可能让人上瘾。

Thus, the final message on alcohol should be clear: It is toxic, carcinogenic, birth defect-causing, and potentially addictive.

当科学家支持相反的观点时，可能会帮助酒精产业的说客和广告商扭曲科学证据，并由此捞取利益，而不顾群众的健康。

By arguing otherwise, scientists can give the alcohol lobby and advertisers the opportunity to manipulate the scientific evidence to place profits over public health.

他们否认、并歪曲科学证据，还试图转移群众的注意力。

They do this through denying the evidence, distorting the evidence, and trying to distract the public’s attention.

就像烟草业巨商隐瞒烟草危害的行为一样，酒业巨商似乎同样在广泛误传关于酒精的科学信息。

“The alcohol industry, Big Booze, appears to be engaged in the same kind of extensive misrepresentation of the evidence” for which Big Tobacco is best known.

然而与此同时，他们却能向大众保持一种正直的伪善形象。

Yet, they are able to maintain this illusion of righteousness.

酒精、烟草和垃圾食品公司越来越多地企图说服消费者：他们可以公正客观地提供关于自家的产品的健康信息。

Alcohol, tobacco, and junk food companies “increasingly seek to present themselves…as objective providers of health information about their products.”

但是事实上，我们应该从医学权威那里听取关于人体健康的信息，而不是盲信21世纪最成功的有毒物品贩卖商。

But, “ health information…should come from health authorities, not the 21st century’s most successful drug peddlers.”

因为群众的盲信，制酒业从而获取巨大的利润。有时，他们甚至会用预防癌症的公益活动来宣传他们致癌的酒品。

“Alcohol industries profit hugely from this disconnect though and sometimes even appropriate the cause of cancer prevention in order to promote their carcinogenic product.”

举个例子：Mike'sHard公司推出的粉色柠檬酒。（粉丝带是全球乳腺癌防治活动的公认标识）

Case in point: Mike’s Hard Pink Lemonade.

为纪念一个患乳腺癌去世的员工，该公司推出包装上贴着粉丝带的粉色酒，以防癌的公益名义售卖致癌物多么荒谬！

“Join The Fight & Drink Pink” carcinogens, associating “the creation of their pink-ribboned alcohol with the death of one of their employees from breast cancer,” ironically, “contributing to risk in the name of prevention.” 

同样荒谬的还有肯德基的“吃炸鸡，齐治病”活动（炸鸡桶做成粉色的，捐钱给防乳腺癌组织，然而炸鸡本身就致癌。）

Who, after all, can forget Kentucky Fried Chicken’s “Buckets for the Cure” campaign?

显然，制酒业不会告诉你喝酒会增加得癌症的风险这件事。

Cancer risk is one of the things the alcohol industry won’t tell you.

但是你的医生怎么不告诉你呢？

But, why doesn’t your doctor tell you?

群众对这件事的了解相对较少，然而医学界总体来说并没有传播这个知识。

There’s relatively little public awareness of the link, and the medical community has largely remained silent.

可能医学界越来越多地意识到有些产品虽然危害顾客却能给企业带来巨大的利益。但我们为什么要完全忽略制酒业呢？

The medical profession may be getting more hip to corporate conflicts of interest in general, but “why are we ignoring the alcohol industry?”

换句话说，喝酒增加得癌几率这件事为什么成了个秘密？

In other words: “Why is alcohol cancer’s best-kept secret?” 

也许是因为医生们自己也喝酒，并因此想继续否认这整件事。

Maybe it’s because the doctors are drinkers themselves. And so, they want to remain in denial over the whole thing.

其实，大多数医生不仅喝酒，相当一部分医生还承认他们在工作的时候也喝酒，并遇到过其他医生在明显喝醉了的状态下继续上岗工作。

Not only do most doctors drink; a significant proportion admit to drinking while on call and report encountering fellow physicians on call while apparently impaired.

尽管大部分医生觉得如果喝了酒，状态不适合看诊，他们有义务把这个情况告诉病人，可是事实上有多少医生真的会坦言呢？

Even though most doctors feel they have an obligation to tell their patients should such a situation arise, guess how many actually do?

只有12％的医生表示他们会告诉病人自己喝了酒。

Only 12% reported that they inform their patients when they’ve been drinking.

制酒业已经认定，“喝酒致癌”这个信息是他们卖酒的一个极大的商业威胁。

“The…industry…has identified the alcohol-causes-cancer message as a considerable threat.”

为了自己的利益，制酒商会竭力维持现状：让一般群众和其信任的健康顾问都对酒精的危害相对无知、充满困惑、并倾向于否定。

They have a “vested interest in maintaining the status quo of relative ignorance, uncertainty and denial among the general population and their trusted health advisers.

面对这种情况，医学界人士应该不受自己饮酒习惯的影响，毫无保留地把“喝酒致癌”这个信息传达给他们的病人和社会群众。

“In the face of this, it is time that health professionals set aside any leanings that might stem from their own drinking…and convey unreservedly to their patients and the communities they serve that alcohol-causes-cancer.”

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