Cancer incidence and mortality attributable to alcohol consumption

Praud, Delphine; Rota, Matteo; Rehm, Jürgen; Shield, Kevin D.; Zatoński, Witold; Hashibe, Mia; Vecchia, Carlo La; Boffetta, Paolo

doi:10.1002/ijc.29890

Cited by 177 publications

(158 citation statements)

References 37 publications

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“…The results reported herein on the incidence of and mortality from alcohol-attributable breast cancer are similar to those reported in other studies (Forouzanfar et al, 2015;Nelson et al, 2013;Praud et al, 2016;World Health Organization, 2014), namely that alcohol consumption leads to a large burden of breast cancer incidence and mortality, causing 8.7 and 7.3% of the total breast cancer incidence and mortality. This study is unique as it is the first to estimate the burden of alcohol-attributable breast cancer incidence and mortality due to light drinking.…”

Section: Discussionsupporting

confidence: 91%

Alcohol Use and Breast Cancer: A Critical Review

Shield

Soerjomataram

Rehm

2016

Alcoholism Clin & Exp Res

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147

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The objective of this study was to outline the biological pathways of alcohol-attributable breast cancer, the epidemiological risk relationship between alcohol consumption and breast cancer, and the global burden of breast cancer incidence and mortality attributable to alcohol consumption, with a focus on light drinking. First, the literature regarding the biological mechanisms of how alcohol affects the risk of breast cancer was reviewed and summarized. Second, a search of meta-analyses that evaluated the risk relationship between alcohol consumption and breast cancer was conducted. Last, the burden of alcohol-attributable breast cancer incidence and mortality was estimated by means of a Population-Attributable Fraction methodology. Data on alcohol consumption were obtained from the Global Information System on Alcohol and Health, and data on cancer incidence and mortality were obtained from the GLOBOCAN database. Alcohol consumption affects breast cancer risk through the alteration in hormone levels and the associated biological pathways, the metabolism of ethanol resulting in carcinogens, and the inhibition of the one carbon metabolism pathway. The systematic review found 15 meta-analyses on the risk relationship between alcohol consumption (also light consumption) and the risk of breast cancer. All but 2 of these analyses showed a dose-response relationship between alcohol consumption and the risk of breast cancer. An estimated 144,000 (95% confidence interval [CI]: 88,000 to 200,000) breast cancer cases and 38,000 (95% CI: 2,400 to 53,000) breast cancer deaths globally in 2012 were attributable to alcohol, with 18.8% of these cases and 17.5% of these deaths affecting women who were light alcohol consumers. All levels of evidence showed a risk relationship between alcohol consumption and the risk of breast cancer, even at low levels of consumption. Due to this strong relationship, and to the amount of alcohol consumed globally, the incidence of and mortality from alcohol-attributable breast cancer is large.

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Section: Discussionsupporting

confidence: 91%

Alcohol Use and Breast Cancer: A Critical Review

Shield

Soerjomataram

Rehm

2016

Alcoholism Clin & Exp Res

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147

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“…Based on this evidence, alcohol has been estimated to have caused 770 thousand new cancer occurrences in the year 2012 [5.5 % of all cancer occurrences: 3.5 % in women and 7.2 % in men (Praud et al 2016)]. In the same year, 480 thousand people were estimated to have died of alcohol-attributable cancer [5.8 % of all cancer deaths: 3.3 % in women and 7.8 % in men (Praud et al 2016)] (Fig. 1).…”

Section: Ethanol and Acetaldehydementioning

confidence: 99%

Carcinogenic compounds in alcoholic beverages: an update

et al. 2016

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The consumption of alcoholic beverages has been classified as carcinogenic to humans by the International Agency for Research on Cancer (IARC) since 1988. More recently, in 2010, ethanol as the major constituent of alcoholic beverages and its metabolite acetaldehyde were also classified as carcinogenic to humans. Alcoholic beverages as multi-component mixtures may additionally contain further known or suspected human carcinogens as constituent or contaminant. This review will discuss the occurrence and toxicology of eighteen carcinogenic compounds (acetaldehyde, acrylamide, aflatoxins, arsenic, benzene, cadmium, ethanol, ethyl carbamate, formaldehyde, furan, glyphosate, lead, 3-MCPD, 4-methylimidazole, N-nitrosodimethylamine, pulegone, ochratoxin A, safrole) occurring in alcoholic beverages as identified based on monograph reviews by the IARC. For most of the compounds of alcoholic beverages, quantitative risk assessment provided evidence for only a very low risk (such as margins of exposure above 10,000). The highest risk was found for ethanol, which may reach exposures in ranges known to increase the cancer risk even at moderate drinking (margin of exposure around 1). Other constituents that could pose a risk to the drinker were inorganic lead, arsenic, acetaldehyde, cadmium and ethyl carbamate, for most of which mitigation by good manufacturing practices is possible. Nevertheless, due to the major effect of ethanol, the cancer burden due to alcohol consumption can only be reduced by reducing alcohol consumption in general or by lowering the alcoholic strength of beverages.

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“…Light alcohol drinking (up to one drink per day) increases the risk of cancer of the oral cavity, pharynx, esophagus and breast, but not of the liver, larynx, colon and rectum [4]. It has been estimated that 5.8% of cancer deaths world-wide are attributable to alcohol use [5]. However, the biological mechanism by which alcohol causes cancer is unclear [1,2,6,7]; this is often raised as an objection to accept the strong epidemiological link between alcohol consumption and cancer [2].…”

Section: Introductionmentioning

confidence: 99%

A local mechanism by which alcohol consumption causes cancer

López‐Lázaro

2016

Oral Oncology

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Epidemiological data indicate that 5.8% of cancer deaths world-wide are attributable to alcohol consumption. The risk of cancer is higher in tissues in closest contact on ingestion of alcohol, such as the oral cavity, pharynx and esophagus. The risk of these cancers is increased even in people who have only one alcoholic drink per day. However, since ethanol is not mutagenic and the carcinogenic metabolite of ethanol (acetaldehyde) is mostly produced in the liver, it is not clear why alcohol use preferentially exerts a local carcinogenic effect. It is well known that ethanol causes cell death at the concentrations present in alcoholic beverages; however, this effect has been overlooked probably because dead cells cannot give rise to cancer. Here I discuss that the cytotoxic effect of ethanol on the cells lining the oral cavity, pharynx and esophagus activates the division of the stem cells located in deeper layers of the mucosa to replace the dead cells. Every time stem cells divide, they become exposed to unavoidable errors associated with cell division (e.g., mutations arising during DNA replication and chromosomal alterations occurring during mitosis) and also become highly vulnerable to the genotoxic activity of endogenous and exogenous DNA-damaging agents (e.g., reactive oxygen species, acetaldehyde and tobacco carcinogens). Alcohol consumption probably increases the risk of developing cancer of the oral cavity, pharynx and esophagus by promoting the accumulation of cell divisions in the stem cells that maintain these tissues in homeostasis. Because the cytotoxic activity of ethanol is concentration-dependent, the risk of these cancers will not only increase with increasing amounts of ethanol, but also with increasing concentrations; an ounce of whisky is probably more carcinogenic when taken undiluted than when taken mixed with non-alcoholic beverages. The local cytotoxic effect of ethanol can also explain the known synergistic effect of alcohol and tobacco use on the risk of these cancers. Understanding the mechanisms of carcinogenicity of alcohol is important to reinforce the epidemiological evidence and to raise public awareness of the strong link between alcohol consumption and cancer.

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Cancer incidence and mortality attributable to alcohol consumption

Cited by 177 publications

References 37 publications

Alcohol Use and Breast Cancer: A Critical Review

Alcohol Use and Breast Cancer: A Critical Review

Carcinogenic compounds in alcoholic beverages: an update

A local mechanism by which alcohol consumption causes cancer

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