title: Alcohol as a risk factor for cancer: existing evidence in a global perspective.
abstract: The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization's prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.
authors: Danish Cancer Society Research Center, Copenhagen, Denmark ; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors: Nina
authors: N
authors: Roswall
authors: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors: Elisabete
authors: E
authors: Weiderpass
mesh_terms: D000428:Alcohol Drinking; D001943:Breast Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D008297:Male; D009062:Mouth Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D011634:Public Health; D012307:Risk Factors; D012737:Sex Factors
keywords: Alcohol; Incidence; Mortality; Neoplasms; Population Attributable Fraction; Review
references: Eur Addict Res. 2003 Oct;9(4):157-64
references: 12970584
references: Br J Cancer. 2001 Nov 30;85(11):1700-5
references: 11742491
references: IARC Sci Publ. 1997;(138):251-63
references: 9353668
references: Lancet. 2005 Nov 19;366(9499):1784-93
references: 16298215
references: Int J Cancer. 2006 Aug 15;119(4):884-7
references: 16557583
references: Pediatrics. 2007 Jan;119(1):76-85
references: 17200273
references: World Health Organ Tech Rep Ser. 2007;(944):1-53, 55-7, back cover
references: 17970166
references: Alcohol Alcohol. 2008 May-Jun;43(3):360-70
references: 18230698
references: Lancet. 2009 Jun 27;373(9682):2223-33
references: 19560604
references: Lancet. 2009 Jun 27;373(9682):2234-46
references: 19560605
references: Lancet. 2009 Jun 27;373(9682):2247-57
references: 19560606
references: Alcohol Clin Exp Res. 2009 Dec;33(12):2037-46
references: 19740137
references: BMJ. 2011;342:d1584
references: 21474525
references: Nat Rev Cancer. 2007 Aug;7(8):599-612
references: 17646865
references: BMC Cancer. 2014;14:420
references: 24917392
references: Lancet. 2012 Dec 15;380(9859):2224-60
references: 23245609
references: Ann Oncol. 2011 Nov;22(11):2349-57
references: 21378201
references: Addiction. 2010 May;105(5):817-43
references: 20331573
references: Int J Cancer. 2010 Dec 15;127(12):2893-917
references: 21351269
references: Soc Sci Med. 2004 Jul;59(1):113-27
references: 15087148