19.12.2024 - The link between alcohol and cancer is well-established, with a growing body of evidence cementing alcohol's role as a significant risk factor for an array of cancer types. Yet, surprisingly, the question of how changes in population-wide drinking habits impact cancer mortality remains relatively understudied. A new paper published in Drug and Alcohol Review aims to address this gap, meticulously examining the relationship between per capita alcohol consumption and cancer deaths in 19 high-income countries over nearly six decades.
Researchers from Sweden, led by Iman Dadgar, Thor Norström, and Mats Ramstedt, utilized time-series data spanning from 1960 to 2018, analyzing trends in alcohol consumption alongside cancer mortality rates, while also considering cigarette sales and GDP as control variables. Their approach, using first-difference modeling, enabled them to focus on within-country changes over time and mitigating biases. This methodology is critical for isolating the potential causal relationship between alcohol intake and cancer mortality.
A clear link, with notable nuances
The study's findings reveal some sobering statistics. On average, for every one liter increase in per capita alcohol consumption, there is a corresponding increase in overall cancer mortality: 0.9% among women, and a higher 1.1% for men. These are not just marginal fluctuations, but reflect significant changes in population level mortality.
Interestingly, the team also noted distinct patterns across specific cancer types and genders. Among men, the link was more pronounced for cancers that have a strong causal association with alcohol, and unexpectedly for prostate cancer. For women, the impact of alcohol was statistically significant for breast cancer mortality.
Another significant aspect of this research was the consideration of drinking patterns. By analyzing countries’ scores on a scale that quantifies the harm associated with different styles of alcohol consumption (e.g., heavy episodic drinking versus drinking with meals), the researchers discovered that the estimated effects of alcohol on cancer mortality are heightened in countries with more detrimental drinking patterns. This suggests that it's not just how much a society drinks, but how they drink that plays a crucial role.
Implications for public health and prevention
The study's conclusion is straightforward and policy-relevant: decreasing per capita alcohol consumption is likely to reduce cancer mortality. Given that cancer is a major global health crisis, claiming the lives of around 10 million people worldwide in 2019 alone, and further costs an estimated $25.2 trillion globally (between 2020 and 2050) these findings underscore the importance of public health interventions that can reduce population-level drinking.
The research team is careful to acknowledge the study's limitations. Although it is comprehensive, the data primarily represent affluent nations during a relatively prosperous era, and therefore may not fully extrapolate to low-income countries or nations going through economic transition. Furthermore, the reliance on per capita consumption, rather than gender-specific consumption data, may introduce some bias given the gendered nature of alcohol consumption. As the researchers note, the study also cannot entirely rule out bias from unobserved variables, but they have taken steps to mitigate it as much as possible.
The bottom line
For policy makers, the message is clear: interventions targeted at reducing population alcohol consumption have the potential to significantly reduce cancer deaths and associated economic burdens. While other factors like tobacco use and economic development play a role, this work makes a strong case for recognizing alcohol as a key modifiable risk factor for cancer at a population level. For those of us who are already aware of the alcohol-cancer link, these results provide fresh insights that underscore the public health value of reducing overall consumption. It's a compelling reminder that small shifts at a population level can lead to substantial reductions in cancer mortality.
Source: Drug and Alcohol Review
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