Abstract
BackgroundIn contrast to our knowledge about the number of cancers attributed to smoking, the number of cancers attributed to alcohol is poorly understood by the public. We estimate the increase in absolute risk of cancer (number of cases per 1000) attributed to moderate levels of alcohol, and compare these to the absolute risk of cancer attributed to low levels of smoking, creating a ‘cigarette-equivalent of population cancer harm’.MethodsAlcohol and tobacco attributable fractions were subtracted from lifetime general population risks of developing alcohol- and smoking-related cancers, to estimate the lifetime cancer risk in alcohol-abstaining non-smokers. This was multiplied by the relative risk of drinking ten units of alcohol or smoking ten cigarettes per week, and increasing levels of consumption.ResultsOne bottle of wine per week is associated with an increased absolute lifetime cancer risk for non-smokers of 1.0% (men) and 1.4% (women). The overall absolute increase in cancer risk for one bottle of wine per week equals that of five (men) or ten cigarettes per week (women). Gender differences result from levels of moderate drinking leading to a 0.8% absolute risk of breast cancer in female non-smokers.ConclusionsOne bottle of wine per week is associated with an increased absolute lifetime risk of alcohol-related cancers in women, driven by breast cancer, equivalent to the increased absolute cancer risk associated with ten cigarettes per week. These findings can help communicate that moderate levels of drinking are an important public health risk for women. The risks for men, equivalent to five cigarettes per week, are also of note.
Highlights
In contrast to our knowledge about the number of cancers attributed to smoking, the number of cancers attributed to alcohol is poorly understood by the public
In order to calculate the absolute increase in lifetime cancer risk (AR) resulting from consumption of ten units of alcohol or ten cigarettes per week we began by subtracting the sum of the Alcohol Attributable Fraction (FAA) (Alcohol Attributable Fraction for England 2013) [21] for all known alcohol-related cancers and Tobacco Attributable Fractions (FTA) (Tobacco-attributable cancer burden in the United Kingdom (UK)) [22] for all tobacco-related cancers from the overall lifetime risk (R0) of cancer (Cancer Research UK (CRUK) 2010) [23] for the general population (Additional file 1: Table S2)
For non-smoking women this was approximately 50% higher with an increase in absolute cancer risk of 1.4% (Additional file 1: Table S4, Fig. 2). In men this risk is due to cancers of the GI tract, whereas in women breast cancer accounts for 55% of additional cases
Summary
In contrast to our knowledge about the number of cancers attributed to smoking, the number of cancers attributed to alcohol is poorly understood by the public. Tobacco use accounts for 7 million deaths per year globally with an estimated two thirds of smokers expected to die from their habit [1, 2]. Each year approximately 3.3 million deaths occur due to the harmful use of alcohol, corresponding to 5.9% of all deaths globally [9]. Alcohol was the leading cause of death among 15–49 year olds worldwide in 2016 [10]. It is estimated that alcohol use lead to 167,000 years of working life lost (YWLL) in England in 2015, 16% of the total and more than that for the ten
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