We estimated the number of cancer cases and deaths attributable to alcohol drinking in 2002 by sex and WHO subregion, based on relative risks of cancers of the oral cavity, pharynx, esophagus, liver, colon, rectum, larynx and female breast obtained from recent meta-and pooled analyses and data on prevalence of drinkers obtained from the WHO Global Burden of Disease project. A total of 389,100 cases of cancer are attributable to alcohol drinking worldwide, representing 3.6% of all cancers (5.2% in men, 1.7% in women). The corresponding figure for mortality is 232,900 deaths (3.5% of all cancer deaths). This proportion is particularly high among men in Central and Eastern Europe. Among women, breast cancer comprises 60% of alcohol-attributable cancers. Although our estimates are based on simplified assumptions, the burden of alcohol-associated cancer appears to be substantial and needs to be considered when making public health recommendations on alcohol drinking. ' 2006 Wiley-Liss, Inc.Key words: alcohol; neoplasms; epidemiology A causal link has been established between alcohol drinking and cancers of the oral cavity, pharynx, esophagus, colon, rectum, liver, larynx and breast. 1 For other cancers, a causal association is suspected. 1 Despite the importance of alcohol as a human carcinogen, 2,3 a detailed estimate of the global burden of alcohol-related cancers is lacking. We aimed to estimate the worldwide burden of alcoholrelated cancer by combining the relative risk of cancer with the distribution of drinkers and the number of incident cases of cancer and of deaths from cancer. Although cancer incidence is a more relevant measure to estimate the burden of cancer, we have also included mortality in our estimates because of the higher quality of this type of data in many low-and medium-resources countries. 4 MethodsWe calculated the number of cases of cancer of the oral cavity and pharynx, esophagus, colorectal, liver and larynx for both sexes and for breast cancer for women. For each cancer site and each WHO subregion (Table I), we obtained the age-specific distribution of drinkers among adults from the Global Burden of Disease project. 2 These distributions are based on surveys conducted in 69 countries. We considered 5 categories of drinkers: abstainers, and drinkers of 1-19, 20-39, 40-59 and 60 and more grams of alcohol/day. We combined the first 2 categories of drinkers for men, and the last 2 categories for women. We obtained relative risks (RR) for all cancers, but female breast cancer from a recent metaanalysis. 5 In this meta-analysis, the authors provided summary RR estimates for intake of 25 g/day (used for the 20-39 g/day category), 50 g/day (used for the 40-59 g/day category) and 75 g/day (used for the 601 g/day category). For the 1-19 g/day category, we estimated the excess risk to be half of that reported for the 25 g/day category (as the midpoint of the 1-19 g/day category lies close to 25/2), and we estimated the excess risk for the 1-39 g/day category in men to be 75% of that reported in the...
Although some problems with the quality of the alcohol samples were found, there is insufficient evidence from this pilot study to conclude that alcohol quality has an influence on health as reflected in alcohol-attributable mortality rates. Given the extent of alcohol-attributable disease burden in central and eastern European countries, future research should focus on collection of large, representative samples, particularly of unrecorded sources, which was the most problematic product group in our study.
BackgroundAlthough alcohol consumption has long been considered as a risk factor for chronic disease, the relationship to cardiovascular disease (CVD) is complex and involves at least two dimensions: average volume of alcohol consumption and patterns of drinking. The objective of this contribution was to estimate the burden of CVD mortality caused by alcohol consumption.MethodsRisk assessment modelling with alcohol-attributable CVD mortality as primary outcome. The mortality burden of ischaemic heart disease (IHD) and ischaemic stroke (IS) attributable to alcohol consumption was estimated using attributable-fraction methodology. Relative Risk (RR) data for IHD and IS were obtained from the most comprehensive meta-analyses (except for Russia and surrounding countries where alcohol RR data were obtained from a large cohort study). Age-group specific RRs were calculated, based on large studies. Data on mortality were obtained from the World Health Organization’s Global Health Estimates and alcohol consumption data were obtained from the Global Information System on Alcohol and Health. Risk of former drinkers was modelled taking into account global differences in the prevalence of sick quitters among former drinkers. Alcohol-attributable mortality estimates for all other CVD causes except IHD and IS were obtained from the 2014 Global Status Report on Alcohol and Health.ResultsAn estimated 780,381 CVD deaths (441,893 and 338,490 CVD deaths among men and women respectively) were attributable to alcohol consumption globally in 2012, accounting for 1.4 % of all deaths and 26.6 % of all alcohol-attributable deaths. This is in contrast to the previously estimated 1,128,273 CVD deaths attributable to alcohol consumption globally, and represents a decrease of 30.8 % in alcohol-attributable CVD mortality and of 10.6 % in the global burden of all alcohol-attributable deaths.ConclusionsWhen the most comprehensive and recent systematic reviews and meta-analyses are taken as bases, the net impact of alcohol consumption on CVD is lower than previously estimated.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3026-9) contains supplementary material, which is available to authorized users.
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