Global Burden Of Cancer In 2020 Attributable To Alcohol Consumption: A Population-based Study
Abstract
Background
Alcohol use is causally linked to multiple cancers. This study presents global, regional, and national estimates of alcohol-attributable cancer burden in 2020 to inform alcohol policy and cancer control across different settings globally.
Methods
In this population-based study, population attributable fractions (PAFs) calculated using a theoretical minimum-risk exposure of lifetime abstention and 2010 alcohol consumption estimates from the Global Information System on Alcohol and Health (assuming a 10-year latency period between alcohol consumption and cancer diagnosis), combined with corresponding relative risk estimates from systematic literature reviews as part of the WCRF Continuous Update Project, were applied to cancer incidence data from GLOBOCAN 2020 to estimate new cancer cases attributable to alcohol. The study also calculated the contribution of moderate (<20 g per day), risky (20–60 g per day), and heavy (>60 g per day) alcohol use to the total alcohol-attributable cancer burden, as well as the contribution by 10 g per day increment (up to a maximum of 150 g). 95% uncertainty intervals (UIs) were estimated using a Monte Carlo-like approach.
Findings
Globally, an estimated 741 ,300 (95% UI 558,500–951 ,200), or 4.1% (3.1–5.3), of all new cases of cancer in 2020 were attributable to alcohol consumption. Males accounted for 568,700 (76.7%; 95% UI 422,500–731 ,100) of total alcohol-attributable cancer cases, and cancers of the oesophagus (189,700 cases [110,900–274,600]), liver (154,700 cases [43,700–281,500]), and breast (98,300 cases [68,200–130,500]) contributed the most cases. PAFs were lowest in northern Africa (0·3% [95% UI 0.1–3.3]) and western Asia (0.7% [0.5–1.2]), and highest in eastern Asia (5.7% [3.6–7.9]) and central and eastern Europe (5.6% [4.6–6.6]). The largest burden of alcohol-attributable cancers was represented by heavy alcohol use (346,400 [46.7%; 95% UI 227,900–489,400] cases) and risky alcohol use (291,800 [39·4%; 227,700–333,100] cases), whereas low risk alcohol use contributed 103,100 (13·9%; 82,600–207,200) cases, and having up to 10 g alcohol per day contributed 41,300 (35,400–145,800) cases.
Interpretation
The 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.
