Scientific Article
Addressing Alcohol Consumption as a Modifiable Risk Factor for Breast Cancer

Julia Sinclair (email:, Mark McCann, Ellena Sheldon, Isabel Gordon, Lyn Brierley-Jones and Ellen Copson
Sinclair J, McCann M, Sheldon E, et al The acceptability of addressing alcohol consumption as a modifiable risk factor for breast cancer: a mixed method study within breast screening services and symptomatic breast clinics BMJ Open 2019;9:e027371. doi: 10.1136/bmjopen-2018-027371
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    BMJ Open
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The Acceptability of Addressing Alcohol Consumption as a Modifiable Risk Factor for Breast Cancer: A Mixed Method Study Within Breast Screening Services and Symptomatic Breast Clinics

Research article



Potentially modifiable risk factors account for approximately 23% of breast cancers, with obesity and alcohol being the two greatest. Breast screening and symptomatic clinical attendances provide opportunities (‘teachable moments’) to link health promotion and breast cancer-prevention advice within established clinical pathways.

This study explored knowledge and attitudes towards alcohol as a risk factor for breast cancer, and potential challenges inherent in incorporating advice about alcohol health risks into breast clinics and screening appointments.


A mixed-method study including a survey on risk factors for breast cancer and understanding of alcohol content. Survey results were explored in a series of five focus groups with women and eight semi-structured interviews with health professionals.


Women attending NHS Breast Screening Programme (NHSBSP) mammograms, symptomatic breast clinics and healthcare professionals in those settings.


205 women were recruited (102 NHSBSP attenders and 103 symptomatic breast clinic attenders) and 33 NHS Staff.


Alcohol was identified as a breast cancer risk factor by 40/205 (19.5%) of attenders and 16/33 (48.5%) of staff.

Overall 66.5% of attenders consumed alcohol, and 56.6% could not estimate correctly the alcohol content of any of four commonly consumed alcoholic drinks. All women agreed that including a prevention-focussed intervention would not reduce the likelihood of their attendance at screening mammograms or breast clinics.

Qualitative data highlighted concerns in both women and staff of how to talk about alcohol and risk factors for breast cancer in a non-stigmatising way, as well as ambivalence from specialist staff as to their role in health promotion.


Levels of alcohol health literacy and numeracy were low.

Adding prevention interventions to screening and/ or symptomatic clinics appears acceptable to attendees, highlighting the potential for using these opportunities as ‘teachable moments’. However, there are substantial cultural and systemic challenges to overcome if this is to be implemented successfully.

Implications of the study

Over 20% of women aged 45 to 64 reportedly consume more alcohol than 14 units per week, so any intervention to reduce population level consumption could have a significant influence on breast cancer rates, as well as help to manage the side effects of treatment and improve the overall health of survivors,” wrote the researchers of the study as per, MedicalXpress.

Source Website: The British Medical Journal Open