1. Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study
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Antonio Agudo, Carla H. van Gils, Naomi E. Allen, Miren Dorronsoro, Tobias Pischon, Christina C. Dahm, Antonia Trichopoulou, Madlen Schütze, Sabine Rohrmann, Tara Kehoe, Nadia Slimani, Nicholas J. Wareham, Aurelio Barricarte, Paolo Boffetta, Kim Overvad, Rudolf Kaaks, Petra H.M. Peeters, María José Sánchez, Jürgen Rehm, Anja Olsen, Gerrit Gmel, Laudina Rodríguez, Manuela M. Bergmann, Françoise Clavel-Chapelon, Heiner Boeing, Franco Berrino, Petra A. Wark, Mazda Jenab, Elio Riboli, María Dolores Chirlaque, Vasiliki Benetou, Anne Tjønneland, Dora Romaguera, Kay-Tee Khaw, Rosario Tumino, Paolo Vineis, Marie-Christine Boutron-Ruault, Dimosthenis Zylis, Domenico Palli, Timothy J. Key, Schütze, M., Boeing, H., Pischon, T., Rehm, J., Kehoe, T., Gmel, G., Olsen, A., Tjønneland, A.M., Dahm, C.C., Overvad, K., Clavel-Chapelon, F., Boutron-Ruault, M.C., Trichopoulou, A., Benetou, V., Zylis, D., Kaaks, R., Rohrmann, S., Palli, D., Berrino, F., Tumino, R., Vineis, P., Rodríguez, L., Agudo, A., Sánchez, M.J., Dorronsoro, M., Chirlaque, M.D., Barricarte, A., Peeters, P.H., van Gils, C.H., Khaw, K.T., Wareham, N., Allen, N.E., Key, T.J., Boffetta, P., Slimani, N., Jenab, M., Romaguera, D., Wark, P.A., Riboli, E., Bergmann, M.M., [Schuetze,M, Boeing,H, Pischon,T, Bergmann,MM.] German Inst Human Nutr Potsdam Rehbrucke, Dept Epidemiol, Nuthetal, Germany. [Rehm,J, Kehoe,T, Gmel,G] CAMH, Toronto, ON, Canada. [Rehm, J] Tech Univ Dresden, Inst Clin Psychol & Psychotherapy, Dresden, Germany. [Olsen,A, Tjonneland,AM.] Danish Canc Soc, Inst Canc Epidemiol, Copenhagen, Denmark. [Dahm,CC] Aarhus Univ Hosp, Dept Clin Epidemiol, Aalborg, Denmark. [Overvad,K] Aarhus Univ, Sch Publ Hlth, Dept Epidemiol, Aarhus, Denmark. [Clavel-Chapelon,F, Boutron-Ruault,M-C] Inst Gustave Roussy, Ctr Res Epidemiol & Populat Hlth,Villejuif, France. [Clavel-Chapelon,F, Boutron-Ruault,MC] Paris S Univ, UMRS 1018, Villejuif, France. [Trichopoulou, A, Benetou,V, Zylis,D] Univ Athens, Sch Med, Dept Hyg Epidemiol & Med Stat, WHO Collaborating Ctr Food & Nutr Policies, Athens, Greece. [Kaaks,R, Rohrmann,S] German Canc Res Ctr, Div Canc Epidemiol, Heidelberg, Germany. [Palli,D] Canc Res & Prevent Inst, Mol & Nutr Epidemiol Unit, Florence, Italy. [Berrino, Franco] Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, Epidemiol Unit, Milan, Italy. [Tumino,R] Civile MP Arezzo Hosp, Canc Registry, Ragusa, Italy. [Vineis, Paolo] Inst Sci Interchange Fdn, Turin, Italy. [Rodriguez,L] Hlth & Hlth Care Serv Council, Publ Hlth & Participat Directorate, Asturias, Spain. [Tumino,R] Civile MP Arezzo Hosp, Histopathol Unit, Ragusa, Italy. [Agudo,A] Catalan Inst Oncol IDIBELL, Canc Epidemiol Res Programme, Unit Nutr Environm & Canc, Barcelona, Spain. [Sanchez,MJ] Andalusian Sch Publ Hlth, Granada, Spain. [Sanchez,MJ, Dorronsoro,M, Chirlaque,MD, Barricarte,A] CIBERESP, San Sebastian, Spain. [Dorronsoro, Miren] Publ Hlth Dept Gipuzkoa, San Sebastian, Spain. [Chirlaque,MD] Murcia Reg Hlth Council, Dept Epidemiol, Murcia, Spain. [Peeters,PH., van Gils,CH.] Univ Med Ctr, Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. [Khaw,K_T] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England. [Wareham,N] MRC, Epidemiol Unit, Cambridge, England. [Allen,NE., Key,TJ.] Univ Oxford, Nuffield Dept Clin Med, Canc Epidemiol Unit, England. [Boffetta, P, Slimani,N, Jenab,M] Int Agcy Res Canc, Lyon, France. [Boffetta,P] Mt Sinai Sch Med, Tisch Canc Inst, New York, NY USA. [Vineis,P, Romaguera,D, Wark,PA., Riboli,E] Univ London Imperial Coll Sci Technol & Med, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England., The work was performed (partly) within the coordinated action EPIC (SP23-CT-2005-006438), which has received research funding from the Community’s Sixth Framework Programme, as well as by the 'Europe Against Cancer' Programme of the European Commission (SANCO), Deutsche Krebshilfe, German Cancer Research Center, German Federal Ministry of Education and Research, Danish Cancer Society, Health Research Fund (FIS) of the Spanish Ministry of Health (grant No: Network RCESP C03/09), Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, ISCIII, Red de Centros RETIC(RD06/0020) (grant No: C03/09), Cancer Research UK, Medical Research Council, UK, Stroke Association, UK, British Heart Foundation, Department of Health, UK, Food Standards Agency, UK, Wellcome Trust, UK, Italian Association for Research on Cancer (AIRC), Compagnia di San Paolo, Progetto Integrato Oncologia-PIO, Regione Toscana, Dutch Ministry of Public Health, Welfare and Sports, National Cancer Registry of the Netherlands, Greek Ministry of Health and Social Solidarity, and Hellenic Health Foundation and Stavros Niarchos Foundation
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Male ,Alcohol drinking ,Alcohol use disorder ,burden ,0302 clinical medicine ,Breast cancer ,Cost of Illness ,Neoplasms ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Health Education ,General Environmental Science ,Colon Cancer ,Incidence (epidemiology) ,Hazard ratio ,General Engineering ,General Medicine ,cohort ,Middle Aged ,Diseases::Neoplasms [Medical Subject Headings] ,Consumo de bebidas alcohólicas ,3. Good health ,European Prospective Investigation into Cancer and Nutrition ,Colon cancer ,Europe ,Oncology ,030220 oncology & carcinogenesis ,Female ,Incidencia ,Alcohol ,Cohort study ,Adult ,medicine.medical_specialty ,Alcohol Drinking ,Health Promotion ,03 medical and health sciences ,Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings] ,Breast Cancer ,Humans ,cancer ,Sex Distribution ,Aged ,Health Care::Health Care Facilities, Manpower, and Services::Health Services::Preventive Health Services::Health Education [Medical Subject Headings] ,business.industry ,Research ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques [Medical Subject Headings] ,prospective ,medicine.disease ,Surgery ,Epidemiologic Studies ,Cardiovascular and Metabolic Diseases ,Relative risk ,attributable ,Attributable risk ,Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Drinking Behavior::Alcohol Drinking [Medical Subject Headings] ,incidence ,General Earth and Planetary Sciences ,Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Incidence [Medical Subject Headings] ,business ,Quantitative research ,Demography - Abstract
Objective To compute the burden of cancer attributable to current and former alcohol consumption in eight European countries based on direct relative risk estimates from a cohort study. Design Combination of prospective cohort study with representative population based data on alcohol exposure. Setting Eight countries (France, Italy, Spain, United Kingdom, the Netherlands, Greece, Germany, Denmark) participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Participants 109 118 men and 254 870 women, mainly aged 37-70. Main outcome measures Hazard rate ratios expressing the relative risk of cancer incidence for former and current alcohol consumption among EPIC participants. Hazard rate ratios combined with representative information on alcohol consumption to calculate alcohol attributable fractions of causally related cancers by country and sex. Partial alcohol attributable fractions for consumption higher than the recommended upper limit (two drinks a day for men with about 24 g alcohol, one for women with about 12 g alcohol) and the estimated total annual number of cases of alcohol attributable cancer. Results If we assume causality, among men and women, 10% (95% confidence interval 7 to 13%) and 3% (1 to 5%) of the incidence of total cancer was attributable to former and current alcohol consumption in the selected European countries. For selected cancers the figures were 44% (31 to 56%) and 25% (5 to 46%) for upper aerodigestive tract, 33% (11 to 54%) and 18% (−3 to 38%) for liver, 17% (10 to 25%) and 4% (−1 to 10%) for colorectal cancer for men and women, respectively, and 5.0% (2 to 8%) for female breast cancer. A substantial part of the alcohol attributable fraction in 2008 was associated with alcohol consumption higher than the recommended upper limit: 33 037 of 178 578 alcohol related cancer cases in men and 17 470 of 397 043 alcohol related cases in women. Conclusions In western Europe, an important proportion of cases of cancer can be attributable to alcohol consumption, especially consumption higher than the recommended upper limits. These data support current political efforts to reduce or to abstain from alcohol consumption to reduce the incidence of cancer.
- Published
- 2011
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