The association of lifetime alcohol use with mortality and cancer risk in older adults

The risk of mortality, and of developing a number of cancers, is lowest in light drinkers consuming an average of less than one drink per day across their lifetime, and the risk of some cancers increases with each additional drink per week, according to a new study.

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Abstract

Background
While current research is largely consistent as to the harms of heavy drinking in terms of both cancer incidence and mortality, there are disparate messages regarding the safety of light-moderate alcohol consumption, which may confuse public health messages. We aimed to evaluate the association between average lifetime alcohol intakes and risk of both cancer incidence and mortality.

Methods and findings
We report a population-based cohort study using data from 99,654 adults (68.7% female), aged 55–74 years, participating in the U.S. Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Cox proportional hazards models assessed the risk of overall and cause-specific mortality, cancer incidence (excluding nonmelanoma skin cancer), and combined risk of cancer and death across categories of self-reported average lifetime alcohol intakes, with adjustment for potential confounders.

During 836,740 person-years of follow-up (median 8.9 years), 9,599 deaths and 12,763 primary cancers occurred. Positive linear associations were observed between lifetime alcohol consumption and cancer-related mortality and total cancer incidence. J-shaped associations were observed between average lifetime alcohol consumption and overall mortality, cardiovascular-related mortality, and combined risk of death or cancer.

In comparison to lifetime light alcohol drinkers (1–3 drinks per week), lifetime never or infrequent drinkers (<1 drink/week), as well as heavy (2–<3 drinks/day) and very heavy drinkers (3+ drinks/day) had increased overall mortality and combined risk of cancer or death. This analysis is limited to older adults, and residual confounding by socioeconomic factors is possible.

Conclusions
The study supports a J-shaped association between alcohol and mortality in older adults, which remains after adjustment for cancer risk. The results indicate that intakes below 1 drink per day were associated with the lowest risk of death.

Full reference: Kunzmann, A. T. et al. | The association of lifetime alcohol use with mortality and cancer risk in older adults: A cohort study | PLOS Medicine | June 19, 2018
See also: ScienceDaily | Risks of cancer and mortality by average lifetime alcohol intake

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