DEAR DR. ROACH: I am 76 years old and in excellent health, according to all my test results and doctors’ reports. I am very physically active, including playing tennis and golf, working out and fast walking. I also enjoy eating, in moderation, and drinking. I typically have a glass of wine with lunch and during cocktail hour, and a glass or two of red wine with my evening meal.

What surprises me is that when I divulge my candid drinking information on the standard questionnaires for various doctors, I frequently am given a lecture on the health risks that I am subjecting myself to by drinking three or four glasses of wine or beer over the course of a day. Now, I understand that some individuals are unable to control their alcohol consumption, and consequently, doctors and medical advisers shy away from saying anything that would encourage those people to drink any alcohol. However, my own life experiences would indicate that drinking may have a beneficial effect; not just one or two drinks a day, but three or four drinks, with meals, a day. Do you feel there is any validity to what I am saying? — W.C.

ANSWER: It is true that moderate use of alcohol is associated with a lowered risk of death, mostly through decreased rates of heart disease. However, it is far from clear that drinking is beneficial to your health. People who drink moderately tend to have many other healthy behaviors, and it’s not definitive that the drinking itself reduces risk. As a result, I do not tell people to drink for their health, but do advise people who drink to stay within moderate limits. For men, that’s two drinks a day; one drink for women. A drink is a 5-ounce glass of wine, 12 ounces of beer or 1.5 ounces of hard alcohol. However, these are rough estimates, because all of those drinks can vary somewhat in alcohol content, and individuals vary widely in body size and the ability of their stomachs and livers to metabolize alcohol.

If moderate drinking is associated with lowered risk, it is absolutely clear that more than moderate use is not only associated with but causative of increased risk of death. At three or more drinks per day for men and two or more for women, the risks start increasing.

While it is possible that an individual person may not experience harm from alcohol above these guidelines, many more people will be harmed rather than get any benefit from alcohol at more than moderate levels. I have seen too many people with problem drinking (which I don’t assert you have) justify their drinking with purported health benefits.

DEAR DR. ROACH: I have a 65-year-old friend who has never had a colonoscopy. She says that a doctor told her that she doesn’t have a particular marker in her blood and that if a person doesn’t have this marker, they will never get colon cancer, so she has no need for a screening procedure. I have never heard of this. Is this true? — K.

ANSWER: It would be great if it were, but as of today, there are no blood tests for colon cancer that are reliable enough to use for screening. Colonoscopy remains the most frequently used and probably the best tool for colon cancer screening. For people who can’t or won’t get a colonoscopy, there are other screening tests, including stool tests looking for gene products and CT colonography. However, a colonoscopy allows for immediate biopsy of suspicious lesions, which is partly why I recommend it as the first option.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.