Findings from a Population-Based Study on Cancers Associated with Alcohol Consumption

Updated worldwide estimates of cancers associated with alcohol consumption stratified by gender, tumour localisation and country indicate causal relation of alcohol with a substantial number of cancer cases that could potentially be avoided. Among all new cancers in 2020, 4.1% were related to alcohol consumption. The numbers were higher among males and also in case of risky and heavy alcohol consumption. Among tumour types, those most frequently related to alcohol consumption were oesophageal, liver and breast cancers. Population attributable fractions were highest in eastern Asia, and central and eastern Europe. Harriet Rumgay, BSc of the International Agency for Research on Cancer in Lyon, France and colleagues published their findings online on 13 July 2021 in The Lancet Oncology.

Alcohol consumption is causally linked to oral, pharyngeal, laryngeal, oesophageal, colon, rectal, liver, and female breast cancers. Based on the GLOBOCAN 2020 database, those cancers were reported in 6.3 million cases and caused 3.3 million deaths worldwide in 2020.

The study team wrote that patterns of alcohol consumption change over time across regions. It has decreased in many European countries, but it is on the rise in some Asian countries and in sub-Saharan Africa.

The authors updated previous worldwide estimates by using the GLOBOCAN cancer incidence estimates for 2020, recent relative risk estimates from the literature and information on patterns of alcohol consumption across the world. They quantified the contribution of moderate drinking defined as consumption of less than 20 g of alcohol per day, risky drinking as consumption of 20 to 60 g of alcohol per day and heavy drinking as consumption of more than 60 g of alcohol per day.  

Estimated population attributable fraction in this report was lower than the previous worldwide estimates. The authors commented that this difference could be due to decreases in alcohol consumption in several world regions, e.g. in southern Europe and central and eastern Europe.

Three quarters of cancers associated with alcohol consumption were recorded in males, in particular 76.7% in males versus 23.3% in females. The worldwide age-standardised incidence rate was 8.4 cancer cases associated with alcohol consumption per 100 000 people; 13.4 cancer cases per 100 000 males and 3.7 cancer cases per 100 000 females. There were also considerable differences in cancer sites in terms of sex.

Population attributable fractions in this report were lowest in northern Africa (0.3%) and western Asia (0.7%), and highest in eastern Asia (5.7%) and central and eastern Europe (5.6%). 

Risky and heavy drinking contributed most, but it is worthy to say that moderate drinking contributed one in seven cancer cases associated with alcohol consumption and caused more than 100 000 cancer cases worldwide.

The study team advocates in their report for a range of public policy-oriented interventions to increase awareness of the cancer risk and decrease alcohol consumption. They predict increase in alcohol consumption until at least 2030 in several world regions. Therefore, the policy actions could reduce such avoidable risk of cancer.

Reference

Rumgay H, Shield K, Charvat H, et al. Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study. The Lancet Oncology; Published online 13 July 2021. DOI: https://doi.org/10.1016/S1470-2045(21)00279-5

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