Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study

Schütze, Madlen; Boeing, Heiner; Pischon, Tobias; Rehm, Jürgen; Kehoe, Tara; Gmel, Gerrit; Olsen, Anja; Tjønneland, Anne; Dahm, Christina C.; Overvad, Kim; Clavel‐Chapelon, Françoise; Boutron-Ruault, Marie Christine; Trichopoulou, Antonia; Benetou, Vassiliki; Zylis, Dimosthenis; Kaaks, Rudolf; Rohrmann, Sabine; Palli, Domenico; Berrino, Franco; Tumino, Rosario; Víneis, Paolo; Rodríguez, Laudina; Agudo, Antonio; Sánchez, María José; Dorronsoro, Miren; Chirlaque, María Dolores; Barricarte, Aurelio; Peeters, Petra H.M.; Gils, Carla H. van; Khaw, Kay Tee; Wareham, Nick; Allen, Naomi E.; Key, Timothy J.; Boffetta, Paolo; Slimani, Nadia; Jenab, Mazda; Romaguera, Dora; Wark, Petra A.; Riboli, Elio; Bergmann, Manuela M.

doi:10.1136/bmj.d1584

Cited by 231 publications

(168 citation statements)

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“…Other studies have evaluated the burden of alcohol consumption on cancer in Europe. [22][23][24][25] In eight selected European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, 10% and 3% of the incidence of all cancers was attributable to alcohol consumption among men and women, respectively. 22 Concerning the incidence of cancers in the South-East Asian region, we found an AF of 8.9% among men and 1.8% among women.…”

Section: Discussionmentioning

confidence: 99%

Cancer incidence and mortality attributable to alcohol consumption

Praud

Rota

Rehm

et al. 2015

Intl Journal of Cancer

177

136

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Alcohol consumption is a major cause of disease and death. In a previous study, we reported that in 2002, 3.6% of all cases of cancer and a similar proportion of cancer deaths were attributable to the consumption of alcohol. We aimed to update these figures to 2012 using global estimates of cancer cases and cancer deaths, data on the prevalence of drinkers from the World Health Organization (WHO) global survey on alcohol and health, and relative risks for alcohol-related neoplasms from a recent meta-analysis. Over the 10-year period considered, the total number of alcohol-attributable cancer cases increased to approximately 770,000 worldwide (5.5% of the total number of cancer cases)-540,000 men (7.2%) and 230,000 women (3.5%). Corresponding figures for cancer deaths attributable to alcohol consumption increased to approximately 480,000 (5.8% of the total number of cancer deaths) in both sexes combined-360,000 (7.8%) men and 120,000 (3.3%) women. These proportions were particularly high in the WHO Western Pacific region, the WHO European region and the WHO South-East Asia region. A high burden of cancer mortality and morbidity is attributable to alcohol, and public health measures should be adopted in order to limit excessive alcohol consumption.In 2012, 38.1% of the world's population aged 15 years or older were estimated to be regular drinkers, with an average consumption among drinkers of 38.6 g of pure alcohol per day (approximately 3.2 drinks) (calculations based on http:// www.who.int/gho/alcohol/en/; see also Ref. 1); however, there was considerable variation in the prevalence of drinking across the regions of the world.1 Alcohol is one of the primary risk factors for morbidity, disability and mortality worldwide. 1 The impact of alcohol consumption on head and neck cancers and on esophageal squamous cell carcinoma (SCC) has long been known, 2 even at low levels of consumption, 3 but the number of cancers associated with alcohol consumption has increased in recent years, and currently includes cancers of the colon, rectum, liver, female breast 4 and with limited evidence and for high levels of consumption, pancreas.5 Moreover, a recent meta-analysis suggested a weak positive association between alcohol consumption and cancers of the gallbladder, prostate, lung, stomach and melanoma. 6 In a previous study, we reported that in 2002, 3.6% of all cancer cases and a similar proportion of cancer deaths were attributable to alcohol. 7 We aimed to update these results to 2012 and estimate the worldwide burden of cancer attributable to alcohol by combining up-to-date relative risk (RR) estimates of cancer, the global prevalence of drinkers and global estimates of cancer cases and cancer deaths. MethodsWe computed the overall and sex-specific number of cases and deaths of the main alcohol-related cancers, 6 including oral cavity and pharynx, esophagus (SCC only), colon and

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Section: Discussionmentioning

confidence: 99%

Cancer incidence and mortality attributable to alcohol consumption

Praud

Rota

Rehm

et al. 2015

Intl Journal of Cancer

177

136

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“…6 In contrast, alcohol (mainly in the form of wine) that was habitually drunk in moderation within the traditional MD pattern (particularly by men) is a known BC risk factor 4 even in moderate amounts. 7 Epidemiological research into the effect of an a priori MD pattern on BC remains limited. To our knowledge, three cohort studies (based on the United Kingdom, 8 Greece 9 and the United States 10 ) and two population-based case-control What's new?…”

mentioning

confidence: 99%

Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study

Buckland

Travier

Cottet

et al. 2012

Intl Journal of Cancer

Self Cite

179

185

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Epidemiological evidence suggests that the Mediterranean diet (MD) could reduce the risk of breast cancer (BC). As evidence from the prospective studies remains scarce and conflicting, we investigated the association between adherence to the MD and risk of BC among 335,062 women recruited from 1992 to 2000, in ten European countries, and followed for 11 years on average. Adherence to the MD was estimated through an adapted relative Mediterranean diet (arMED) score excluding alcohol. Cox proportional hazards regression models were used while adjusting for BC risk factors. A total of 9,009 postmenopausal and 1,216 premenopausal first primary incident invasive BC were identified (5,862 estrogen or progesterone receptor positive [ER+/PR+] and 1,018 estrogen and progesterone receptor negative [ER−/PR−]). The arMED was inversely associated with the risk of BC overall and in postmenopausal women (high vs. low arMED score; hazard ratio [HR] = 0.94 [95% confidence interval [CI]: 0.88, 1.00] ptrend = 0.048, and HR = 0.93 [95% CI: 0.87, 0.99] ptrend = 0.037, respectively). The association was more pronounced in ER−/PR− tumors (HR = 0.80 [95% CI: 0.65, 0.99] ptrend = 0.043). The arMED score was not associated with BC in premenopausal women. Our findings show that adherence to a MD excluding alcohol was related to a modest reduced risk of BC in postmenopausal women, and this association was stronger in receptor‐negative tumors. The results support the potential scope for BC prevention through dietary modification.

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“…In a similar way, since positive values of both ECI and NBD measure excess dietary deviations from the international standard guidelines to prevent NCDs, it is reasonable to set the minimum deviation from the correct energy, total fat, and protein intake equal to zero. Finally, despite moderate alcohol consumption seeming to provide mild protection against selected NCDs [21], the minimum value of ALC is also set equal to zero, because several studies suggest that this moderate level is very low [22][23][24], and is associated not with alcohol itself, but to the polyphenols contained only in select alcoholic beverages (especially red wine) [25].…”

Section: Methods and Datamentioning

confidence: 99%

Unhealthy Behaviours: An International Comparison

Ferretti

2015

SSRN Journal

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In the current global economy, chronic non-communicable diseases (NCDs) have become the leading cause of death and a major health concern for both developed and developing countries. Among other factors, the worldwide spread of NCDs is driven by the globalisation of unhealthy habits. The purpose of this paper is to develop a simple statistic to measure, at the national level, the average population's exposure to the main NCDs modifiable risk factors. The approach and methodology followed by the United Nations Development Programme to compute the Human Development Index (HDI) is applied to four basic indicators of NCD-related preventable risk factors (alcohol consumption, excess caloric intake, nonbalanced diet and tobacco use) in 112 countries worldwide in 2012-14. We obtain a summary composite index, which we call the Unhealthy Behaviour Index (UBI), which ranks countries by the average level of the unhealthy habits (drinking, eating and smoking) of their populations. We find that Belarus and Russian federation are the two countries with the unhealthiest NCD-related lifestyle. With the exception of Canada, the first twenty populations more exposed to the main NCDs preventable risk factors all live in European countries, and mainly in countries of Eastern Europe. Overall, the UBI tends to increase along with the level of human development. In medium, high and very high HDI countries, however, the same level of human development may be associated with very different kinds of NCD-related lifestyles. Finally, economic growth may push populations toward either more unhealthy or healthy habits, depending on the countries' level of development; the elasticity of unhealthy habits with respect to income per capita is positive (but less than one: on average 0.6) until $30,000, decreases as income rises, and becomes negative (around -0.3) in very high income countries.

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Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study

Abstract: 07.08.14 KB. Ok to add published version to spiral, OA pape

Cited by 231 publications

References 46 publications

Cancer incidence and mortality attributable to alcohol consumption

Cancer incidence and mortality attributable to alcohol consumption

Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study

Unhealthy Behaviours: An International Comparison

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