title: Incident cancers attributable to alcohol consumption in Germany, 2010.
abstract: OBJECTIVE
  Germany lacks an up-to-date assessment of the cancer burden attributable to alcohol. Therefore, cancer incidence attributable to this exposure was estimated for colorectal, liver, breast, and upper aerodigestive tract (UADT) cancer. Additionally, the impact of alcohol on UADT cancer was analyzed by smoking status, to account for synergistic interactions between these two risk factors.
  
  
  METHODS
  Alcohol consumption and smoking prevalence from a nationwide survey in Germany 2008-2011 were combined with relative risks of incident cancer from meta-analyses to obtain population attributable risks (PARs), indicating the proportion of cancers that could be avoided by eliminating a risk factor. Each PAR was multiplied with the respective cancer incidence for 2010 to calculate the absolute number of attributable cases.
  
  
  RESULTS
  In Germany, for the year 2010, approximately 13,000 incident cancer cases could be attributed to alcohol consumption (3% of total cases). PAR was highest for esophageal cancer (men: 47.6% and women: 35.8%) and lowest for colorectal cancer in men (9.7%) and breast cancer in women (6.6%). Among women, moderate consumption levels account for the greatest PAR overall, whereas heavy drinking contributes considerably to overall PAR among men. Additionally, moderate-to-heavy drinking among smokers substantially contributes to the overall PAR of UADT cancers compared to drinking among non-smokers.
  
  
  CONCLUSIONS
  In Germany, a substantial proportion of cases of common cancers can be attributed to alcohol consumption, even when consumed at moderate levels. Alcohol consumption with concurrent tobacco smoking is especially important for cancers of the UADT. These findings strengthen the rationale for prevention measures that address exposure at all levels.
authors: Department of Epidemiology and Health Monitoring, German Centre for Cancer Registry Data, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany, WieneckeA@rki.de.
authors: Antje
authors: A
authors: Wienecke
authors: Benjamin
authors: B
authors: Barnes
authors: Hannelore
authors: H
authors: Neuhauser
authors: Klaus
authors: K
authors: Kraywinkel
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000209:etiology; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005858:Germany; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D011795:Surveys and Questionnaires