Grundy Anne, Poirier Abbey E, Khandwala Farah, McFadden Alison, Friedenreich Christine M, Brenner Darren R
Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, McFadden, Friedenreich, Brenner), CancerControl Alberta; Department of Oncology (Friedenreich, Brenner); Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta.
CMAJ Open. 2016 Sep 21;4(3):E507-E514. doi: 10.9778/cmajo.20160070. eCollection 2016 Jul-Sep.
Alcohol consumption has been associated with risk of oral cavity/pharyngeal, laryngeal, esophageal, liver, colorectal and breast cancers. The purpose of this study was to estimate the proportion and total number of these cancers in Alberta in 2012 attributable to alcohol consumption.
We estimated cancers attributable to alcohol consumption in adults in Alberta using population attributable risk calculations. Relative risks were obtained from recent meta-analyses, and alcohol consumption in Alberta was quantified with the use of data from the Canadian Community Health Survey. We obtained age-, site- and sex-specific cancer incidence data for 2012 from the Alberta Cancer Registry. The impact of potential underestimation of alcohol consumption in Canadian Community Health Survey data was evaluated with the use of per-capita alcohol sales data from Statistics Canada.
Proportions of cancers attributable to alcohol consumption at individual cancer sites were estimated to be as low as 5.1% (liver) and as high as 19.9% (oral cavity/pharynx) among men and as low as 2.1% (liver) and as high as 7.6% (oral cavity/pharynx) among women in Alberta. The total number of alcohol-attributable cancer cases was highest for common cancers (colorectal, female breast), whereas at individual cancer sites, population attributable risks were highest for upper aerodigestive tract cancers. A total of 4.8% of alcohol-associated cancers (1.6% of all cancers) in Alberta could be attributed to alcohol consumption. After adjustment for recorded alcohol consumption, our estimates of population attributable risk increased to 10.7% of alcohol-associated cancers and 3.5% of all cancers.
Alcohol consumption is estimated to account for 1.6%-3.5% of total cancer cases in Alberta. Given that no level of alcohol consumption is considered safe with respect to cancer risk, strategies to reduce alcohol consumption have the potential to reduce Alberta's cancer burden.
饮酒与口腔/咽、喉、食管、肝脏、结肠直肠和乳腺癌的发病风险相关。本研究的目的是估算2012年艾伯塔省因饮酒导致的这些癌症的比例和总数。
我们使用人群归因风险计算方法估算了艾伯塔省成年人中因饮酒导致的癌症。相对风险来自近期的荟萃分析，艾伯塔省的饮酒情况通过加拿大社区健康调查的数据进行量化。我们从艾伯塔癌症登记处获得了2012年按年龄、部位和性别分类的癌症发病率数据。利用加拿大统计局的人均酒精销售数据评估了加拿大社区健康调查数据中饮酒量可能被低估的影响。
在艾伯塔省，男性中个别癌症部位因饮酒导致的癌症比例估计低至5.1%（肝脏），高至19.9%（口腔/咽）；女性中低至2.1%（肝脏），高至7.6%（口腔/咽）。酒精所致癌症病例总数在常见癌症（结肠直肠癌、女性乳腺癌）中最高，而在个别癌症部位，上消化道癌症的人群归因风险最高。艾伯塔省共有4.8%的与酒精相关的癌症（占所有癌症的1.6%）可归因于饮酒。在对记录的饮酒量进行调整后，我们对人群归因风险的估计增加到与酒精相关癌症的10.7%和所有癌症的3.5%。
据估计，饮酒在艾伯塔省所有癌症病例中占1.6%-3.5%。鉴于就癌症风险而言，没有任何饮酒水平被认为是安全的，减少饮酒的策略有可能减轻艾伯塔省的癌症负担。
