Population-level decreases in alcohol, tobacco use could reduce cancer mortality

Population-level reductions in tobacco and alcohol consumption could lower cancer mortality, according to findings from a population-based cohort study conducted in Australia.

Systematic literature reviews published by the World Cancer Research Fund and International Agency for Research on Cancer found long-term alcohol and tobacco consumption increases risk for cancer of the lips, oral cavity, pharynx, larynx, lung, stomach, colorectum, breast, pancreas and liver.

“There is significant epidemiological evidence linking cancer on set to alcohol consumption and tobacco smoking and confirming a strong dose-response and risk association, with a higher amount of alcohol and tobacco consumption in the long-term associated with a greater risk [for] cancer,” Heng Jiang, PhD, research fellow at Centre for Alcohol Policy Research at School of Psychology and Public Health of La Trobe University in Melbourne, and colleagues wrote. “However, understanding whether the population-level consumption of alcohol and tobacco is associated with cancer mortality is a crucial question for public health policy that is not answered by case-control, prospective or retrospective studies of particular samples.”

The researchers performed a population-based cohort study of alcohol and tobacco consumption and cancer mortality in Australia, using the Australian Bureau of Statistics and Cancer Council of Victoria to collect data on per capita tobacco and alcohol consumption among Australians aged 15 years and older between 1935 and 2014. Researchers also retrieved information on age- and sex-specific cancer mortality from 1968 to 2014 from the Australian Institute of Health and Welfare.

Slightly more than half (50.5%) of the population in the study were women.

The annual cancer death rate increased steadily from 1968 to 1989, rising from a rate of 199 per 100,000 to 214 per 100,000. Beginning in 1989, cancer death rates fell, declining to 162 per 100,000 in 2014.

Over a 20-year period, 1-liter decreases in per capita alcohol consumption were associated with a 3.9% decrease in overall cancer mortality, while 1-kg decreases in tobacco consumption were associated with a 16% reduction in cancer mortality.

Consumption of alcohol was significantly associated with cancer mortality among men aged 50 to 69 years and women aged 50 years and older, whereas tobacco consumption was significantly associated with cancer mortality only among men aged 50 years and older.

The researchers suggested “caution in the interpretation of the age- and sex-specific findings” because of limited information on temporal trends in alcohol and tobacco use by age and sex.

“Future research on associations between alcohol and tobacco consumption and specific types of cancer mortalities is needed,” Jiang and colleagues wrote. “In a more global perspective, future studies using multicountry cancer mortality data from the WHO cancer database could help to better understand the associations in different socioeconomic status and health policy environments and identify effective policy or clinical interventions to reduce alcohol- and tobacco-related cancer diseases.” – by Andy Polhamus

Disclosures: Jiang reports grants from the Australian National Health and Medical Research Council during the conduct of the study. Please see the study for all other authors’ relevant financial disclosures.