Advertisement

Canadian Journal of Public Health

, Volume 109, Issue 1, pp 70–78 | Cite as

Preventing alcohol-related cancer: what if everyone drank within the guidelines?

  • Stephanie W. Young
  • Elisa Candido
  • Julie Klein-Geltink
  • Norman Giesbrecht
Quantitative Research

Abstract

Objectives

The purpose of this study was to estimate the proportion and number of cancer cases diagnosed in Ontario in 2012 that are attributable to alcohol consumption and to compare the impact of drinking within two sets of guidelines on alcohol-attributable cancer incidence.

Methods

We estimated the proportion of cancers in Ontario attributable to alcohol consumption by calculating population-attributable fractions (PAFs) for six cancer types using drinking prevalence from the 2000/2001 Canadian Community Health Survey and relative risks from a meta-analysis. Each PAF was multiplied by the number of incident cancers in 2012, allowing for a 12-year latency period, to calculate the number of alcohol-attributable cases. We also estimated the number of alcohol-attributable cases under two scenarios: (1) assuming consumption had not exceeded the levels recommended by the Low-Risk Alcohol Drinking Guidelines (LRADG) and (2) assuming consumption had not exceeded the recommended levels by the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines.

Results

One thousand two hundred ninety-five (95% confidence interval 1093–1499) new cases of cancer diagnosed in Ontario during 2012 are estimated to be attributed to alcohol consumption, representing approximately 1.7% (1.4–1.9%) of all new cancer cases. If no Ontario adults had exceeded the LRADG, an estimated 321 fewer cancer cases could have been diagnosed in 2012, whereas an estimated 482 fewer cancer cases could have been diagnosed if no Ontario adults had exceeded the stricter WCRF/AICR guidelines.

Conclusion

Strategies to limit alcohol consumption to the levels recommended by drinking guidelines could potentially reduce the cancer burden in Ontario.

Keywords

Neoplasms Alcoholic beverages Alcohol drinking 

Résumé

Objectifs

Estimer la proportion et le nombre de cas de cancer diagnostiqués en Ontario en 2012 qui étaient attribuables à la consommation d’alcool et comparer les effets de cette consommation selon deux ensembles de directives sur l’incidence des cancers attribuables à la consommation d’alcool.

Méthode

Nous avons estimé la proportion des cancers attribuables à consommation d’alcool en Ontario en calculant les fractions attribuables dans la population (FAP) pour six types de cancer à l’aide de la prévalence de la consommation selon l’Enquête sur la santé dans les collectivités canadiennes de 2000–2001 et les risques relatifs d’une méta-analyse. Chaque FAP a été multipliée par le nombre de nouveaux cas de cancer en 2012, en tenant compte d’une période de latence de 12 ans, pour calculer le nombre de cas attribuables à la consommation d’alcool. Nous avons aussi estimé le nombre de cas attribuables à la consommation d’alcool selon deux scénarios : 1) en supposant une consommation ne dépassant pas les niveaux recommandés dans les Directives de consommation d’alcool à faible risque (DCAFR); et 2) en supposant une consommation ne dépassant pas les niveaux recommandés dans les directives conjointes du World Cancer Research Fund et de l’American Institute for Cancer Research (WCRF/AICR).

Résultats

Il est estimé que 1295 (intervalle de confiance de 95%: 1093–1499) nouveaux cas de cancer diagnostiqués en Ontario en 2012 étaient attribuables à la consommation d’alcool, soit environ 1,7% (1,4%–1,9%) des nouveaux cas de cancer. Si aucun adulte ontarien n’avait dépassé les DCAFR, il est. estimé que 321 cas de cancer en moins auraient été diagnostiqués en 2012, tandis que 482 cas de cancer en moins auraient été diagnostiqués si aucun adulte ontarien n’avait dépassé les directives plus strictes du WCRF et de l’AICR.

Conclusion

Des stratégies visant à limiter la consommation d’alcool aux niveaux recommandés dans les directives de consommation pourraient potentiellement réduire le fardeau du cancer en Ontario.

Mots-clés

Tumeurs Boissons alcoolisées Consommation d’alcool 

Notes

Acknowledgements

The authors thank Sue Greco for assistance in using @RISK.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Bagnardi, V., Rota, M., Botteri, E., Tramacere, I., Islami, F., Fedirko, V., et al. (2015). Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. British Journal of Cancer, 112(3), 580–593.CrossRefPubMedGoogle Scholar
  2. Beland, Y. (2002). Canadian community health survey—methodological overview. Health Reports, 13(3), 9–14.PubMedGoogle Scholar
  3. Boffetta, P., & Hashibe, M. (2006). Alcohol and cancer. The Lancet Oncology, 7(2), 149–156.CrossRefPubMedGoogle Scholar
  4. Canadian Cancer Society. Alcohol [Internet]. 2016 [cited 2016 Dec 20]. Available from: http://www.cancer.ca/en/prevention-and-screening/live-well/alcohol/?region=on.
  5. Canadian Centre on Substance Abuse. Canada’s low-risk alcohol drinking guidelines [Internet]. 2011 [cited 2016 Dec 14]. Available from: http://www.ccsa.ca/Eng/topics/alcohol/drinking-guidelines/Pages/default.aspx.
  6. Cancer Care Ontario. (2014). Cancer risk factors in Ontario: alcohol. Toronto: Queen's Printer for Ontario.Google Scholar
  7. Cancer Care Ontario. Technical Appendix to Cancer Risk Factors in Ontario: Alcohol [Internet]. 2014 [cited 2016 Dec 20]. Available from: https://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=303134.
  8. Grundy, A., Poirier, A. E., Khandwala, F., McFadden, A., Friedenreich, C. M., & Brenner, D. R. (2016). Cancer incidence attributable to alcohol consumption in Alberta in 2012. CMAJ Open, 4(3), E507–EE14.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Hashibe, M., Brennan, P., Chuang, S. C., Boccia, S., Castellsague, X., Chen, C., et al. (2009). Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer epidemiology, Biomarkers & Prevention: A Publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 18(2), 541–550.CrossRefGoogle Scholar
  10. International Agency for Research on Cancer. (2012). IARC monographs on the evaluation of carcinogenic risks to humans. Volume 100E. A review of human carcinogens. Part E: Personal habits and indoor combustions. Lyon: International Agency for Research on Cancer.Google Scholar
  11. Kalinowski, A., & Humphreys, K. (2016). Governmental standard drink definitions and low-risk alcohol consumption guidelines in 37 countries. Addiction (Abingdon, England), 111(7), 1293–1298.CrossRefGoogle Scholar
  12. Pandeya, N., Wilson, L. F., Webb, P. M., Neale, R. E., Bain, C. J., & Whiteman, D. C. (2015). Cancers in Australia in 2010 attributable to the consumption of alcohol. Australian and New Zealand Journal of Public Health, 39(5), 408–413.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Parkin, D. M. (2011). 3. Cancers attributable to consumption of alcohol in the UK in 2010. British Journal of Cancer, 105(Suppl 2), S14–S18.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Praud, D., Rota, M., Rehm, J., Shield, K., Zatonski, W., Hashibe, M., et al. (2016). Cancer incidence and mortality attributable to alcohol consumption. International Journal of Cancer, 138(6), 1380–1387.CrossRefPubMedGoogle Scholar
  15. Rehm, J., Baliunas, D., Borges, G. L., Graham, K., Irving, H., Kehoe, T., et al. (2010). The relation between different dimensions of alcohol consumption and burden of disease: an overview. Addiction (Abingdon, England), 105(5), 817–843.CrossRefGoogle Scholar
  16. Schutze, M., Boeing, H., Pischon, T., Rehm, J., Kehoe, T., Gmel, G., et al. (2011). Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. BMJ (Clinical Research Ed), 342, d1584.CrossRefGoogle Scholar
  17. Shield, K. D., & Rehm, J. (2012). Difficulties with telephone-based surveys on alcohol consumption in high-income countries: the Canadian example. International Journal of Methods in Psychiatric Research, 21(1), 17–28.CrossRefPubMedPubMedCentralGoogle Scholar
  18. Shield, K. D., Parry, C., & Rehm, J. (2013). Chronic diseases and conditions related to alcohol use. Alcohol Research: Current Reviews, 35(2), 155–173.Google Scholar
  19. Stockwell, T., Zhao, J., & Macdonald, S. (2014). Who under-reports their alcohol consumption in telephone surveys and by how much? An application of the ‘yesterday method’ in a national Canadian substance use survey. Addiction (Abingdon, England), 109(10), 1657–1666.CrossRefGoogle Scholar
  20. Stockwell, T., Zhao, J., Greenfield, T., Li, J., Livingston, M., & Meng, Y. (2016). Estimating under- and over-reporting of drinking in national surveys of alcohol consumption: identification of consistent biases across four English-speaking countries. Addiction (Abingdon, England), 111(7), 1203–1213.CrossRefGoogle Scholar
  21. World Cancer Research Fund/American Institute for Cancer Research. (2007). Food, nutrition, physical activity, and the prevention of cancer. Washington, DC: AICR.Google Scholar

Copyright information

© The Canadian Public Health Association 2018

Authors and Affiliations

  • Stephanie W. Young
    • 1
  • Elisa Candido
    • 1
  • Julie Klein-Geltink
    • 1
  • Norman Giesbrecht
    • 2
  1. 1.Prevention and Cancer ControlCancer Care OntarioTorontoCanada
  2. 2.Institute for Mental Health Policy ResearchCentre for Addiction and Mental HealthTorontoCanada

Personalised recommendations