Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study

Harriet Rumgay; Kevin Shield; Hadrien Charvat; Pietro Ferrari; Bundit Sornpaisarn; Isidore Obot; Farhad Islami; Valery E.P.P. Lemmens; Jürgen Rehm; Isabelle Soerjomataram

doi:10.1016/S1470-2045(21)00279-5

Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study

Harriet Rumgay^*
, Kevin Shield
, Hadrien Charvat
, Pietro Ferrari
, Bundit Sornpaisarn
, Isidore Obot
, Farhad Islami
, Valery E.P.P. Lemmens
, Jürgen Rehm
, Isabelle Soerjomataram

^*Corresponding author for this work

Public Health

Centre for Addiction and Mental Health (Toronto)
University of Toronto
International Agency for Research on Cancer
Centre for Research and Information on Substance Abuse
American Cancer Society
Sechenov First Moscow State Medical University
University of Dresden

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Abstract

Background: Alcohol use is causally linked to multiple cancers. We present 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. We also calculated the contribution of moderate (<20 g per day), risky (20–60 g per day), and heavy (>60 g per day) drinking 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 drinking (346 400 [46·7%; 95% UI 227 900–489 400] cases) and risky drinking (291 800 [39·4%; 227 700–333 100] cases), whereas moderate drinking contributed 103 100 (13·9%; 82 600–207 200) cases, and drinking up to 10 g per day contributed 41 300 (35 400–145 800) cases. Interpretation: Our 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. Funding: None.

Original language	English
Pages (from-to)	1071-1080
Number of pages	10
Journal	The Lancet Oncology
Volume	22
Issue number	8
DOIs	https://doi.org/10.1016/S1470-2045(21)00279-5
Publication status	Published - Aug 2021

Bibliographical note

Acknowledgments:
The work by HR reported in this paper was undertaken during a PhD studentship at the International Agency for Research on Cancer (Lyon, France). We thank all population-based cancer registries and their staff who have contributed in sharing the cancer incidence data used to build the estimates used in this study. We also thank Melina Arnold (Cancer Surveillance Branch, International Agency for Research on Cancer) for providing the oesophageal squamous cell carcinoma estimates and Teresa Norat and Doris Chan (both at the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK) for earlier enquiries about the World Cancer Research Fund results. Where authors are identified as personnel of the International Agency for Research on Cancer and WHO, the authors alone are responsible for the views expressed in this Article and they do not necessarily represent the decisions, policy, or views of the International Agency for Research on Cancer and WHO. Editorial note: the Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations.

Publisher Copyright:
© 2021 World Health Organization

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Cite this

@article{b9e51418112e4624b7605da8c5a96a13,

title = "Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study",

abstract = "Background: Alcohol use is causally linked to multiple cancers. We present 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. We also calculated the contribution of moderate (<20 g per day), risky (20–60 g per day), and heavy (>60 g per day) drinking 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 drinking (346 400 [46·7\%; 95\% UI 227 900–489 400] cases) and risky drinking (291 800 [39·4\%; 227 700–333 100] cases), whereas moderate drinking contributed 103 100 (13·9\%; 82 600–207 200) cases, and drinking up to 10 g per day contributed 41 300 (35 400–145 800) cases. Interpretation: Our 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. Funding: None.",

author = "Harriet Rumgay and Kevin Shield and Hadrien Charvat and Pietro Ferrari and Bundit Sornpaisarn and Isidore Obot and Farhad Islami and Lemmens, \{Valery E.P.P.\} and J{\"u}rgen Rehm and Isabelle Soerjomataram",

note = "Acknowledgments: The work by HR reported in this paper was undertaken during a PhD studentship at the International Agency for Research on Cancer (Lyon, France). We thank all population-based cancer registries and their staff who have contributed in sharing the cancer incidence data used to build the estimates used in this study. We also thank Melina Arnold (Cancer Surveillance Branch, International Agency for Research on Cancer) for providing the oesophageal squamous cell carcinoma estimates and Teresa Norat and Doris Chan (both at the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK) for earlier enquiries about the World Cancer Research Fund results. Where authors are identified as personnel of the International Agency for Research on Cancer and WHO, the authors alone are responsible for the views expressed in this Article and they do not necessarily represent the decisions, policy, or views of the International Agency for Research on Cancer and WHO. Editorial note: the Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations. Publisher Copyright: {\textcopyright} 2021 World Health Organization",

year = "2021",

month = aug,

doi = "10.1016/S1470-2045(21)00279-5",

language = "English",

volume = "22",

pages = "1071--1080",

journal = "The Lancet Oncology",

issn = "1470-2045",

publisher = "Elsevier Ltd.",

number = "8",

}

TY - JOUR

T1 - Global burden of cancer in 2020 attributable to alcohol consumption

T2 - a population-based study

AU - Rumgay, Harriet

AU - Shield, Kevin

AU - Charvat, Hadrien

AU - Ferrari, Pietro

AU - Sornpaisarn, Bundit

AU - Obot, Isidore

AU - Islami, Farhad

AU - Lemmens, Valery E.P.P.

AU - Rehm, Jürgen

AU - Soerjomataram, Isabelle

N1 - Acknowledgments: The work by HR reported in this paper was undertaken during a PhD studentship at the International Agency for Research on Cancer (Lyon, France). We thank all population-based cancer registries and their staff who have contributed in sharing the cancer incidence data used to build the estimates used in this study. We also thank Melina Arnold (Cancer Surveillance Branch, International Agency for Research on Cancer) for providing the oesophageal squamous cell carcinoma estimates and Teresa Norat and Doris Chan (both at the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK) for earlier enquiries about the World Cancer Research Fund results. Where authors are identified as personnel of the International Agency for Research on Cancer and WHO, the authors alone are responsible for the views expressed in this Article and they do not necessarily represent the decisions, policy, or views of the International Agency for Research on Cancer and WHO. Editorial note: the Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations. Publisher Copyright: © 2021 World Health Organization

PY - 2021/8

Y1 - 2021/8

N2 - Background: Alcohol use is causally linked to multiple cancers. We present 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. We also calculated the contribution of moderate (<20 g per day), risky (20–60 g per day), and heavy (>60 g per day) drinking 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 drinking (346 400 [46·7%; 95% UI 227 900–489 400] cases) and risky drinking (291 800 [39·4%; 227 700–333 100] cases), whereas moderate drinking contributed 103 100 (13·9%; 82 600–207 200) cases, and drinking up to 10 g per day contributed 41 300 (35 400–145 800) cases. Interpretation: Our 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. Funding: None.

AB - Background: Alcohol use is causally linked to multiple cancers. We present 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. We also calculated the contribution of moderate (<20 g per day), risky (20–60 g per day), and heavy (>60 g per day) drinking 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 drinking (346 400 [46·7%; 95% UI 227 900–489 400] cases) and risky drinking (291 800 [39·4%; 227 700–333 100] cases), whereas moderate drinking contributed 103 100 (13·9%; 82 600–207 200) cases, and drinking up to 10 g per day contributed 41 300 (35 400–145 800) cases. Interpretation: Our 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. Funding: None.

UR - https://www.scopus.com/pages/publications/85111506604

U2 - 10.1016/S1470-2045(21)00279-5

DO - 10.1016/S1470-2045(21)00279-5

M3 - Article

C2 - 34270924

AN - SCOPUS:85111506604

SN - 1470-2045

VL - 22

SP - 1071

EP - 1080

JO - The Lancet Oncology

JF - The Lancet Oncology

IS - 8

ER -

Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study

Abstract

Bibliographical note

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