Incident cancers attributable to alcohol consumption in Germany, 2010
- 369 Downloads
Germany lacks an up-to-date assessment of the cancer burden attributable to alcohol. Therefore, cancer incidence attributable to this exposure was estimated for colorectal, liver, breast, and upper aerodigestive tract (UADT) cancer. Additionally, the impact of alcohol on UADT cancer was analyzed by smoking status, to account for synergistic interactions between these two risk factors.
Alcohol consumption and smoking prevalence from a nationwide survey in Germany 2008–2011 were combined with relative risks of incident cancer from meta-analyses to obtain population attributable risks (PARs), indicating the proportion of cancers that could be avoided by eliminating a risk factor. Each PAR was multiplied with the respective cancer incidence for 2010 to calculate the absolute number of attributable cases.
In Germany, for the year 2010, approximately 13,000 incident cancer cases could be attributed to alcohol consumption (3 % of total cases). PAR was highest for esophageal cancer (men: 47.6 % and women: 35.8 %) and lowest for colorectal cancer in men (9.7 %) and breast cancer in women (6.6 %). Among women, moderate consumption levels account for the greatest PAR overall, whereas heavy drinking contributes considerably to overall PAR among men. Additionally, moderate-to-heavy drinking among smokers substantially contributes to the overall PAR of UADT cancers compared to drinking among non-smokers.
In Germany, a substantial proportion of cases of common cancers can be attributed to alcohol consumption, even when consumed at moderate levels. Alcohol consumption with concurrent tobacco smoking is especially important for cancers of the UADT. These findings strengthen the rationale for prevention measures that address exposure at all levels.
KeywordsAlcohol drinking Alcohol-related cancers Tobacco smoking Population attributable risks Germany
Assessment of multiple systematic reviews
German Health Interview and Examination Survey for Adults (2008–2011)
Food frequency questionnaire
International Agency for Research on Cancer
Population attributable risk
Robert Koch Institute
Upper aerodigestive tract
The authors thank all the German cancer registries as well as the teams of the German health survey at the Robert Koch Institute for providing the comprehensive data sets.
Conflict of interest
The authors declare that they have no conflicts of interest.
- 1.IARC (2012) A review of human carcinogens. Part E: personal habits and indoor combustions. In: World Health Organization, International Agency for Research on Cancer (eds) IARC monographs on the evaluation of carcinogenic risks to humans. World Health Organization, LyonGoogle Scholar
- 10.Gaertner B, Meyer C, John U, Freyer-Adam J (2013) Alkohol - Zahlen und Fakten zum Konsum. In: Deutsche Hauptstelle für Suchtfragen e.V. (ed) Jahrbuch Sucht 2013. Pabst, HammGoogle Scholar
- 16.Ridolfo B, Stevenson C (2001) The quantification of drug-caused mortality and morbidity in Australia, 1998. In: Australian Institute of Health and Welfare (ed) Drug statistics series. Australian Institute of Health and Welfare, CanberraGoogle Scholar
- 18.Shea BJ, Grimshaw JM, Wells GA et al (2007) Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol 7Google Scholar
- 23.Lumley T (2009) Analysis of complex survey samples. R-package “survey”, 3.30-3 edn. R Foundation, ViennaGoogle Scholar
- 24.RKI (2013) Cancer in Germany 2009/2010. Robert Koch Institute and the Association of Population-based Cancer Registries in Germany, BerlinGoogle Scholar
- 28.Ferraroni M, Decarli A, Franceschi S et al (1996) Validity and reproducibility of alcohol consumption in Italy. Int J Epidemiol 25:775–782Google Scholar
- 35.Singer MV, Teyssen S (2001) Alkoholassoziierte Organschäden. Befunde in der Inneren Medizin, Neurologie und Geburtshilfe/Neonatologie. Dtsch Ärztebl 98:A2109–A2120Google Scholar