Alcohol consumption

Increased alcohol consumption associated with increased risk of cancer

August 24, 2022

3 minute read


Disclosures: The researchers do not report any relevant financial information. Abnet and Freedman do not report any relevant financial information.


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According to the results of a Korean population-based cohort study published in Open JAMA Network.

However, those who reduced their alcohol intake or maintained abstinence from alcohol had a lower cancer risk, the researchers wrote.



RRs adjusted for alcohol-related cancer risk with increased (vs. no) alcohol consumption
Data derived from Yoo JE, et al. JAMA Netw Open. 2022;doi:10.1001/jamanetworkopen.2022.28544.

Background

Globally, cancer is the second leading cause of death and accounted for around 9.6 million deaths in 2018. Third after smoking and being overweight, alcohol consumption is a risk factor for cancer key modifiable and established cause of at least seven types of cancer, according to study background.

“Although many studies have shown an association between alcohol consumption and cancer, there is little research on how cancer incidence increases or decreases with changes in drinking habits,” Jung Eun Yoo, MD, PhD, researcher in the Department of Family Medicine at Gangnam Center Health Care Center at Seoul National University Hospital in Seoul, Republic of Korea, and colleagues wrote. “We found only one cohort study reporting an association between reduced alcohol consumption and the risk [for] cancer.”

To address research gaps, Yoo and colleagues examined the association between reducing, stopping, or increasing alcohol consumption and the development of alcohol-related cancers and all types of cancers. cancer in 4,513,746 adult beneficiaries (mean age: 53.6 years; 51.5% male) in the Korean National. Health insurance service database. All study participants underwent national health screenings between 2009 and 2011 and had data on their alcohol consumption.

Researchers asked participants to self-report their level of alcohol consumption as none, light, moderate, or heavy. They then categorized the participants into groups based on changes in alcohol consumption levels between 2009 and 2011, including non-drinkers, supporters, enhancers, dropouts and reducers.

Newly diagnosed alcohol-related cancers, including head and neck, esophageal, colorectal, liver, larynx, and breast cancers in women, served as the primary outcome. All newly diagnosed cancers, except thyroid cancer, served as the secondary outcome.

The researchers followed the participants from one year after the date of the 2011 medical screening until the date of the cancer incident, death, or the end of the study on December 31, 2018 – whichever came first.

The median follow-up was 6.4 years.

Results

Yoo and colleagues reported a cancer incidence rate for the overall study population of 7.7 per 1,000 person-years.

The results showed that between 2009 and 2011, 26.6% of participants with light alcohol levels stopped drinking compared to 9.6% with moderate alcohol levels and 8.6% with high alcohol levels. high alcohol.

Compared to participants who maintained their alcohol level, those who increased their alcohol level had a higher risk of alcohol-related cancers and all cancers. The researchers further found that, compared to those who did not drink, those who changed their drinking level from none to light (HR adjusted [aHR] = 1.03; 95% CI, 1-1.06), moderate (aHR=1.1; 95% CI, 1.02-1.18) or heavy (aHR=1.34; 95% CI, 1.23 -1.45) had a higher risk of alcohol-related cancers and all cancers. Conversely, moderate drinkers who stopped drinking had a lower risk of alcohol-related cancers (aHR = 0.96; 95% CI, 0.92-0.99) compared to those who maintained their alcohol level.

The researchers also observed a higher incidence of all cancers in people with moderate (aHR=1.07; 95% CI, 1.03-1.12) or heavy (aHR=1. 07; 95% CI, 1.02-1.12) who stopped drinking compared to those who continued their drinking levels. However, the increased risk disappeared when participants remained alcohol-free over time.

In addition, heavy drinkers who reduced their drinking to moderate levels also reduced their risk of alcohol-related cancers (aHR = 0.91; 95% CI, 0.86-0.97) and all cancers (aHR = 0.96; 95% CI, 0.92-0.99) compared with those who maintained high levels of alcohol. The researchers observed similar risk reductions in those who reduced their excessive alcohol consumption to moderate levels (alcohol-associated cancer, aHR=0.92; 95% CI, 0.86-0.98; all cancers, aHR = 0.92; 95% CI, 0.89-0.96).

Consequences

Yoo and colleagues reported several limitations to the study, including the likelihood that participants under-reported their alcohol consumption, the unavailability of information about long-term habits, and the lack of relevant information, such as as the reasons for reducing or stopping drinking and the duration of consumption.

“The results of this study suggest that stopping and reducing alcohol consumption should be reinforced for cancer prevention,” the researchers wrote.

Yoo and colleagues’ findings provide important new data on the potential role of changes in alcohol consumption in cancer risk, according to an accompanying editorial in Neal D. Freedman, PhD, MPH, and Christian C. Abnet, PhD, MPH, both researchers in the Metabolic Epidemiology Branch of the Division of Cancer Epidemiology and Genetics at NCI.

“Future studies should follow these authors’ lead and examine the association between alcohol consumption and cancer risk in other populations and using longer intervals between assessments,” they wrote. “Such studies are needed to advance the field and inform public health guidance on cancer prevention.”

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