Abstract
BackgroundAlthough overall alcohol consumption is known to increase the risk of a number of cancers internationally, evidence for Australia and evidence regarding the pattern of drinking and cancer risk is limited.MethodsAdjusted hazard ratios (HR) and 95% confidence intervals (CI) for cancer risk in relation to overall alcohol consumption (drinks/week) and pattern of drinking were calculated using Cox proportional hazard regressions for 226,162 participants aged ≥45 years (2006–2009) in the 45 and Up Study, an Australian prospective cohort study. Incident primary cancer cases were ascertained by linkage to the New South Wales Cancer Registry to 2013 by the Centre for Health Record Linkage.ResultsOver a median of 5.4 years, 17,332 cancers were diagnosed. Increasing levels of alcohol intake were associated with increased risk of cancers of the upper aerodigestive tract (1.19; 1.10–1.29), mouth and pharynx (1.18; 1.08–1.29), oesophagus (1.22; 1.04–1.43), colorectum (1.09; 1.04–1.15), colon (1.13; 1.06–1.20), liver (1.22; 1.04–1.44) and breast (1.11; 1.02–1.21). Breast cancer risk was marginally associated with drinking pattern, with higher risk when intake was concentrated on 1–3 days/week compared to the same amount spread over 4–7 days (Pinteraction = 0.049).ConclusionsAlcohol consumption confers a significant risk of cancer, and drinking pattern may be independently related to breast cancer risk.
Highlights
Overall alcohol consumption is known to increase the risk of a number of cancers internationally, evidence for Australia and evidence regarding the pattern of drinking and cancer risk is limited
A total of 226,162 of 267,153 participants in the 45 and Up Study (84.7%) were included for analysis after excluding 268 (0.1%) participants who withdrew their consent to participate after baseline, 175 (0.07%) from a pilot study, 5 (0.002%) aged
This finding is likely to be of significant public health importance, given that 16% of Australian adults were estimated to consume more than two standard drinks per day on average in 2017–2018.1 Consistent with the international evidence, cancers of the upper aerodigestive tract, mouth, pharynx and larynx, oesophagus, colorectum, colon, liver and breast, were each positively associated with overall alcohol consumption.[7,8,10,11,20]
Summary
Overall alcohol consumption is known to increase the risk of a number of cancers internationally, evidence for Australia and evidence regarding the pattern of drinking and cancer risk is limited. Increasing levels of alcohol intake were associated with increased risk of cancers of the upper aerodigestive tract (1.19; 1.10–1.29), mouth and pharynx (1.18; 1.08–1.29), oesophagus (1.22; 1.04–1.43), colorectum (1.09; 1.04–1.15), colon (1.13; 1.06–1.20), liver (1.22; 1.04–1.44) and breast (1.11; 1.02–1.21). Alcohol consumption is an important risk factor for cancer and has been estimated to account for 2.8% of cancers in Australia and 5.5% of cancers globally,[3,4] as well as 4.5% of the cancer burden in Australia.[5] Studies first identified a relationship between alcohol and cancer as far back as 1903,6 and in 1988, the International Agency for Research on Cancer classified alcohol as a Group 1 carcinogen (the highest IARC classification) for cancers of the mouth, pharynx, larynx, oesophagus and liver. In 2010–2012, IARC reviewed the evidence and determined that there is a causal relationship between alcohol and colorectal and female breast cancer.[7,8] In addition, the World Cancer Research Fund (WCRF)
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