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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How the alcohol industry mislead the public about alcohol and cancer

Alcohol consumption increases the risk of several types of cancer, including several common cancers | Drug and Alcohol Review

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As part of their corporate social responsibility activities, the alcohol industry (AI) disseminates information about alcohol and cancer. We examined the information on this which the AI disseminates to the public through its ‘social aspects and public relations organizations’ and related bodies. The aim of the study was to determine its comprehensiveness and accuracy.

Most of the organisations were found to disseminate misrepresentations of the evidence about the association between alcohol and cancer. Three main industry strategies were identified:

  1.  denial/omission: denying, omitting or disputing the evidence that alcohol consumption increases cancer risk.
  2. distortion: mentioning cancer, but misrepresenting the risk.
  3. distraction: focussing discussion away from the independent effects of alcohol on common cancers. Breast cancer and colorectal cancer appeared to be a particular focus for this misrepresentation.

Full reference: Petticrew, M. et al. (2017) How alcohol industry organisations mislead the public about alcohol and cancer. Drug and Alcohol Review. Published online: 7 Septmeber 2017

135,000 alcohol-related cancer deaths predicted by 2035

Alcohol will cause around 135,000 cancer deaths over the next 20 years and will cost the NHS an estimated £2 billion in treatments, according to estimates from a new report by Sheffield University, commissioned by Cancer Research UK

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Image source: CRUK

The new figures, published today (Friday), reveal that by 2035 the UK could see around 7,100 cancer deaths every year that are associated with alcohol. Of the cancer types included in the report, oesophageal cancer is set to see the largest increase, followed by bowel cancer, mouth and throat cancer, breast cancer and liver cancer.

The report also forecasts that there will be over 1.2 million hospital admissions for cancer over the 20 year period, which will cost the NHS £100 million, on average, every year.

The results were based on analyses that assume alcohol drinking trends will follow those seen over the last 40 years, and takes recent falls in alcohol consumption, including among young people, into account.

Evidence suggests that the more alcohol you drink, the higher the risk of cancer. UK government guidelines, published earlier this year, advise that both men and women drink no more than 14 units of alcohol a week.

Read the full overview here

Read the full report here

Is alcohol consumption a risk factor for prostate cancer?

Zhao, J. et al. BMC Cancer. Published online: 15 November 2016

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Background: Research on a possible causal association between alcohol consumption and risk of prostate cancer is inconclusive. Recent studies on associations between alcohol consumption and other health outcomes suggest these are influenced by drinker misclassification errors and other study quality characteristics. The influence of these factors on estimates of the relationship between alcohol consumption and prostate cancer has not been previously investigated.

 

Conclusion: Our study finds, for the first time, a significant dose–response relationship between level of alcohol intake and risk of prostate cancer starting with low volume consumption (>1.3, <24 g per day). This relationship is stronger in the relatively few studies free of former drinker misclassification error. Given the high prevalence of prostate cancer in the developed world, the public health implications of these findings are significant. Prostate cancer may need to be incorporated into future estimates of the burden of disease alongside other cancers (e.g. breast, oesophagus, colon, liver) and be integrated into public health strategies for reducing alcohol related disease.

Read the full article here

9 in 10 don’t link alcohol and cancer

Cancer Research UK. Published online: 1st April 2016

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Almost 90 per cent of people in England don’t associate drinking alcohol with an increased risk of cancer, according to a new report commissioned by Cancer Research UK.

Drinking alcohol is linked to an increased risk of seven different cancers – liver, breast, bowel, mouth, throat, oesophageal (food pipe), laryngeal (voice box) – but when people were asked “which, if any, health conditions do you think can result from drinking too much alcohol?” just 13 per cent of adults mentioned cancer.

The survey also highlighted a lack of understanding of the link between drinking alcohol and the risk of developing certain types of cancer. When prompted by asking about seven different cancer types, 80 per cent said they thought alcohol caused liver cancer but only 18 per cent were aware of the link with breast cancer. In contrast alcohol causes 3,200 breast cancer cases each year compared to 400 cases of liver cancer.

The report, produced by researchers at the University of Sheffield, comes ahead of the consultation closing on how well new drinking guidelines proposed by the UK’s Chief Medical Officers in January 2016, are communicated. These drew attention to the link between alcohol and cancer, and highlighted the need for greater public awareness of this risk. The findings are based on a nationally representative online survey of 2,100** people conducted in July 2015.

The study also showed that only one in five people could correctly identify the previous recommended maximum number of units that should not be exceeded in a day, as recommended at that time in 2015. Among drinkers, as few as one in 10 men (10.8 per cent) and one in seven women (15.2 per cent) correctly identified these recommended limits and used them to track their drinking habits.

Read the full commentary here

Cancer incidence and mortality attributable to alcohol consumption

International Journal of Cancer: Published online October 2015

Abstract
Alcohol consumption is a major cause of disease and death. In a previous study, we reported that in 2002, 3.6% of all cases of cancer and a similar proportion of cancer deaths were attributable to the consumption of alcohol. We aimed to update these figures to 2012 using global estimates of cancer cases and cancer deaths, data on the prevalence of drinkers from the World Health Organization (WHO) global survey on alcohol and health, and relative risks for alcohol-related neoplasms from a recent meta-analysis.

Over the 10-year period coCollection of Glassesnsidered, the total number of alcohol-attributable cancer cases increased to approximately 770,000 worldwide (5.5% of the total number of cancer cases) – 540,000 men (7.2%) and 230,000 women (3.5%). Corresponding figures for cancer deaths attributable to alcohol consumption increased to approximately 480,000 (5.8% of the total number of cancer deaths) in both sexes combined – 360,000 (7.8%) men and 115,000 (3.3%) women.

These proportions were particularly high in the WHO Western Pacific region, the WHO European Region and the WHO South-East Asia region. A high burden of cancer mortality and morbidity is attributable to alcohol, and public health measures should be adopted in order to limit excessive alcohol consumption.

via Cancer incidence and mortality attributable to alcohol consumption – Praud – International Journal of Cancer – Wiley Online Library.