In a population-based study reported in The Lancet Oncology, Rumgay et al provided estimates of the global incidence of new cancers attributable to alcohol consumption, including the estimate that 4.1% of all new cases in 2020 were related to alcohol use.
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In the study, population attributable fractions derived using a theoretical minimum-risk exposure of lifetime abstention and estimates of alcohol consumption in 2010 from the Global Information System on Alcohol and Health, together with relative risk estimates from systematic literature reviews from the World Cancer Research Fund Continuous Update Project were applied to GLOBOCAN 2020 cancer incidence data (with the assumption of 10-year latency between alcohol consumption and cancer diagnosis) to estimate new cases of alcohol-attributable cancers in 2020. Intake of < 20 g per day was defined as moderate, 20 g to 60 g per day as risky, and > 60 g per day as heavy drinking.
An estimated 741,300 (95% uncertainty interval [UI] = 558,500–951,200) new cases of cancer worldwide in 2020 were attributable to alcohol consumption, representing an estimated 4.1% (95% UI = 3.1%–5.3%) of all new cases of cancer.
An estimated 76.7% of new cases occurred in males (n = 568,700).
The most common attributable cancers were esophageal cancer (n = 189,700), liver cancer (n = 154,700, and breast cancer (n = 98,300), followed by colon cancer (n = 91,500), and rectal cancer (n = 65,100). The highest estimated population attributable fractions for attributable cancers were for esophageal cancer (31.6%), pharyngeal cancer, (22.0%), and lip and oral cavity cancers (20.2%).
By region, population attributable fractions for attributable cancers were highest in eastern Asia (5.7%, 95% UI = 3.6%–7.9%), including high population attributable fractions in China and Mongolia, and in central and eastern Europe (5.6%, 95% UI = 4.6%–6.6%), including high population attributable fractions in Moldova and Romania. The lowest population attributable fractions were in northern Africa (0.3%, 95% UI = 0.1%–3.3%), including low population attributable fractions in Kuwait, Libya, and Saudi Arabia, and in western Asia (0.7%, 95% UI = 0.5%–1.2%).
Heavy drinking accounted for an estimated 46.7% of attributable cases (n = 346,400), risky drinking for 39.4% (n = 291,800), and moderate drinking for 13.9% (n = 103,100). Drinking up to 10 g per day accounted for an estimated 41,300 cases.
The investigators concluded, “Our findings highlight the need for effective policy and interventions to increase awareness of cancer risks associated with alcohol use and decrease overall alcohol consumption to prevent the burden of alcohol-attributable cancers.”
Harriet Rumgay, BSc, of the Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France, is the corresponding author for The Lancet Oncology article.
Disclosure: For full disclosures of the study authors, visit thelancet.com.