Attributable fraction of alcohol consumption on cancer using population-based nationwide cancer incidence and mortality data in the Republic of Korea.

Sohee Park,Duk-Hee Lee,Paolo Boffetta,Boram Lee,Mathieu Boniol,Sung-Il Cho,Sue Kyung Park,Kyu-Won Jung,Elisabete Weiderpass,Aesun Shin,Hai-Rim Shin,Sun Ha Jee

doi:10.1186/1471-2407-14-420

Abstract

BackgroundIn the Republic of Korea, cancer is the most common cause of death, and cancer incidence and mortality rates are the highest in East Asia. As alcoholic beverages are carcinogenic to humans, we estimated the burden of cancer related to alcohol consumption in the Korean population.MethodsThe cancer sites studied were those for which there is convincing evidence of a positive association with alcohol consumption: oral cavity, pharynx, esophagus, colon, rectum, liver, larynx and female breast. Sex- and cancer-specific population attributable fractions (PAF) were calculated based on: 1) the prevalence of alcohol drinkers among adults ≥20 years of age in 1989; 2) the average daily alcohol consumption (g/day) among drinkers in 1998; 3) relative risk (RR) estimates for the association between alcohol consumption and site-specific cancer incidence obtained either from a large Korean cohort study or, when more than one Korean study was available for a specific cancer site, meta-analyses were performed and the resulting meta-RRs were used; 4) national cancer incidence and mortality data from 2009.ResultsAmong men, 3% (2,866 cases) of incident cancer cases and 2.8% (1,234 deaths) of cancer deaths were attributable to alcohol consumption. Among women, 0.5% (464 cancer cases) of incident cancers and 0.1% (32 deaths) of cancer deaths were attributable to alcohol consumption. In particular, the PAF for alcohol consumption in relation to oral cavity cancer incidence among Korean men was 29.3%, and the PAFs for pharyngeal and laryngeal cancer incidence were 43.3% and 25.8%, respectively. Among Korean women, the PAF for colorectal cancer incidence was the highest (4.2%) and that for breast cancer incidence was only 0.2%. Avoiding alcohol consumption, or reducing it from the median of the highest 4th quartile of consumption (56.0 g/day for men, 28.0 g/day for women) to the median of the lowest quartile (2.80 g/day for men, 0.80 g/day for women), would reduce the burden of alcohol-related cancers in Korea.ConclusionsA reduction in alcohol consumption would decrease the cancer burden and a significant impact is anticipated specifically for the cancers oral cavity, pharynx, and larynx among men in the Republic of Korea.

Highlights

In the Republic of Korea, cancer is the most common cause of death, and cancer incidence and mortality rates are the highest in East Asia
Relative risks estimates of cancer according to alcohol consumption in Korea The estimated RRs of cancer for the studies included in the present report are shown in Table 1, and a complete summary of these studies is shown in Additional file 1: Table S3
For all cancer sites included in this report, alcohol consumption was considered among individuals aged 20 years or older

Summary

Introduction

In the Republic of Korea, cancer is the most common cause of death, and cancer incidence and mortality rates are the highest in East Asia. As alcoholic beverages are carcinogenic to humans, we estimated the burden of cancer related to alcohol consumption in the Korean population. Cancer is the main cause of death in the Republic of Korea, and cancer incidence rates in Korea are the highest in all of East Asia [1,2]. The human, social and economic aspects of the cancer burden are major concerns for the Korean society and its government [4]. Understanding how cancer morbidity and mortality can be prevented, and thereby controlled, would contribute to the country’s public health agenda [5]. About half of the world’s population abstains from alcohol consumption, nearly 2 billion adults consume an average of 13 g/day of ethanol (about one drink) [7]

Methods

Results

Discussion

Conclusion