Alcohol Consumption Associated With Increased Cancer Risk in Countries at Different Economic Levels
In a study reported in The Lancet, Smyth et al found that alcohol consumption was associated with increased risk of cancer at sites known to be related to alcohol consumption, with evidence of increased risk being found in both higher- and lower-income countries. The study examined associations between alcohol consumption and several health outcomes (cardiovascular disease, cancer, injury, admission to hospital, and mortality) in addition to cancer.
Study Details
The study included information from 114,970 individuals aged 35 to 70 years from 12 countries participating in the Prospective Urban Rural Epidemiological (PURE) study, including 11% from high-income countries (Sweden, Canada), 21% from upper-middle-income countries (Argentina, Brazil, Chile, Poland, South Africa, and Turkey), 43% from lower-middle-income countries (China, Columbia), and 25% from low-income countries (India, Zimbabwe).
Cancer Risk
Median follow-up was 4.3 years. Alcohol-related cancers, defined as mouth, esophagus, stomach, colorectal, liver, breast, ovary, and head and neck cancers, were identified in 764 individuals. Both current drinkers (31% of population; hazard ratio [HR] = 1.51, 95% confidence interval [CI] = 1.22–1.89) and former drinkers (4% of population; HR = 1.93, 95% CI = 1.32–2.80) had increased risk of alcohol-related cancers vs never-drinkers.
Hazard ratios vs never-drinkers were 1.54 (95% CI = 1.21–1.89) for current drinkers without heavy episodic drinking and 1.06 (95% CI = 0.68–1.66) for those with heavy episodic drinking and 1.58 (95% CI =1.25-2.00), 1.61 (95% CI = 1.10–2.34), and 1.38 (0.88–2.16) for low, moderate, and high intake among current drinkers. Compared with never-drinkers, Hazard ratios for current drinkers were 1.24 (95% CI = 0.97–1.59) in high income and upper-middle-income countries and 1.45 (1.03–2.04) in lower-income and lower-middle-income countries; interaction by income level was not significant (P =.20).
The investigators noted : “Current drinking was associated with increased risk of alcohol-related cancers [consistent with previously reported data]. However, our study was underpowered to detect a significant association and dose response, owing to the low proportion of high-intake consumers and heavy episodic drinkers, the fairly small number of events in these groups, and the short duration of follow-up….”
Andrew Smyth, PhD, of McMaster University and Hamilton Health Sciences, is the corresponding author for the Lancet article.
The study was funded by the Population Health Research Institute, Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, GlaxoSmithKline, Novartis, King Pharma, and national or local organizations in participating countries.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
