Abstract
American Journal of Public Health
Volume 103 , 4 , Pages 641 -648 , 2013 (doi:10.2105/AJPH.2012.301199)

Alcohol-Attributable Cancer Deaths and Years of Potential Life Lost in the United States

David E. Nelson, MD, MPH, Dwayne W. Jarman, DVM, MPH, Jürgen Rehm, PhD, Thomas K. Greenfield, PhD, Grégoire Rey, PhD, William C. Kerr, PhD, Paige Miller, PhD, MPH, Kevin D. Shield, MHSc, Yu Ye, MA, and Timothy S. Naimi, MD, MPH

David E. Nelson and Paige Miller are with National Cancer Institute, Bethesda, MD. Dwayne W. Jarman is with Food and Drug Administration, Detroit, MI, and US Public Health Service, Rockville, MD. Jürgen Rehm and Kevin D. Shield are with Centre for Addiction and Mental Health, Toronto, Ontario. Thomas K. Greenfield, William C. Kerr, and Yu Ye are with Alcohol Research Group, Public Health Institute, Emeryville, CA. Grégoire Rey is with INSERM, CépiDc, Le Kremlin-Bicêtre, France. Timothy S. Naimi is with Boston University Medical Center, Boston, MA.

Peer Reviewed

Correspondence should be sent to David E. Nelson, 6120 Executive Blvd, Suite 150E, Bethesda, MD 20892-7105 (e-mail: ). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link.

Note. Opinions expressed in this article represent those of the authors and should not be taken as official positions of the US Federal Government or the Department of Health and Human Services.

Contributors

D. E. Nelson directed the study. D. W. Jarman assisted with the study design and conducted data analyses. J. Rehm, T. K. Greenfield, and G. Rey assisted with study design, analysis, and interpretation. W. C. Kerr assisted with data analysis and interpretation. P. Miller, K. D. Shield, and Y. Ye conducted data analyses. T. S. Naimi helped originate, design, and direct the study.


ABSTRACT

Objectives. Our goal was to provide current estimates of alcohol-attributable cancer mortality and years of potential life lost (YPLL) in the United States.

Methods. We used 2 methods to calculate population-attributable fractions. We based relative risks on meta-analyses published since 2000, and adult alcohol consumption on data from the 2009 Alcohol Epidemiologic Data System, 2009 Behavioral Risk Factor Surveillance System, and 2009–2010 National Alcohol Survey.

Results. Alcohol consumption resulted in an estimated 18 200 to 21 300 cancer deaths, or 3.2% to 3.7% of all US cancer deaths. The majority of alcohol-attributable female cancer deaths were from breast cancer (56% to 66%), whereas upper airway and esophageal cancer deaths were more common among men (53% to 71%). Alcohol-attributable cancers resulted in 17.0 to 19.1 YPLL for each death. Daily consumption of up to 20 grams of alcohol (≤ 1.5 drinks) accounted for 26% to 35% of alcohol-attributable cancer deaths.

Conclusions. Alcohol remains a major contributor to cancer mortality and YPLL. Higher consumption increases risk but there is no safe threshold for alcohol and cancer risk. Reducing alcohol consumption is an important and underemphasized cancer prevention strategy.

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