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What can we learn from the association between adolescent alcohol consumption and breast cancer risk?

Growing evidence points to the importance of early life exposures in later adult cancer risk. For example, studies have found obesity and physical inactivity in childhood and adolescence to be important drivers of risk for numerous adult onset cancers [1]. This includes many of those classified by the IARC as caused by adult weight gain (esophagus, gastric cardia, colon and rectum, liver, gallbladder, pancreas, postmenopausal breast, uterine, ovary, kidney (renal cell), meningioma, thyroid cancers, and multiple myeloma). Importantly, evidence shows that obesity in late adolescence and early adult years increases the risk of pancreatic cancer, colon cancer, and hematologic malignancies [2]. Alcohol is an established risk factor for multiple cancers, including breast, esophageal, liver, colorectal, and aerodigestive cancers [3,4]. Alcohol use is also common in youth, with around 30% of high school students drinking alcohol in the past month [5]. Does such exposure in this developmental stage result in unique cancer risks similar to those associated with obesity and physical inactivity?