Is there an association between trends in alcohol consumption and cancer mortality? A multi-country analysis

Introduction:  The International Agency on Research on Cancer (IARC), has classified alcohol as a “Group 1” carcinogen. This presentation examines long-term trends in apparent alcohol consumption and associations with lagged data on specific types of cancer mortality.

Methods: Our main variables are: per capita (age 15+) annual alcohol sales of pure alcohol; mortality rate of cancers among those aged 25 and older with highest proportion of alcohol-related cancers -- lip, oral cavity and pharynx, larynx, and oesophageal; and grams per adult per day of all tobacco products. We focus on countries with over three decades of alcohol sales, considered to have reliable data, and several decades of cancer data available from IARC mortality data-base. Analysis focused on 18 countries using a two-step process, with lagged data: tobacco use and specific cancers, and then adding in the alcohol variable, using a UCM time series analysis.

Results: There was a statistically significant association between alcohol sales and cancer mortality eight to twelve years later; this remained after controlling for tobacco use.  For example, in France there has been a long-term decline in alcohol consumption and a lagged parallel decline in cancer mortality. This relationship was significant for larynx and oral cancer mortality among males. Significant associations were also observed in other countries between trends in alcohol consumption and corresponding lagged trends in mortality from specific cancer types.

Conclusions/recommendations:  Trends in consumption appear to be associated with changes in mortality from selected cancers of the upper digestive tract, after controlling for tobacco use.