Alcohol-attributable cancer risk and burden estimates for Australia’s updated alcohol consumption guidelines

Abstract

Background: The Australian alcohol health guidelines were revised in 2020 to recommend a maximum of 10 drinks/week. We calculated estimates of cancer caused by alcohol use in Australia for the updated recommended limits. Methods: Cox regression models were used to estimate hazard ratios (HR) for cancer incidence in relation to self-reported alcohol consumption (drinks/week) among 225,805 participants aged ≥45 years (2005–2009) in the New South Wales (NSW) 45 and Up Study, an Australian prospective cohort study (baseline n = 267,357). Cumulative absolute risk of cancer to age 85 years was estimated using 0 to <1 drink/week as the comparator. Population attributable fractions were calculated using Australian national alcohol consumption and cancer incidence data, compared to a theoretical minimum risk exposure of no alcohol consumption. Cancer cases and deaths were ascertained through record linkage to the NSW Cancer Registry and NSW Registry of Births Deaths & Marriages to 2019. Participants diagnosed with cancer pre-baseline were excluded. Results: Over a median 11.4 years, 34,860 cancer cases were recorded. When modelled as a continuous variable, alcohol-related cancer risk increased by 19% for every ten drinks/week increase in consumption (HR: 1.19; 95% confidence interval: 1.15–1.23). By age 85 years, those who consumed >10 drinks/week had an estimated 4.9% higher cumulative absolute risk of an alcohol-related cancer compared to those consuming 0 to <1 drink/week. An estimated 7804 cancer cases (4.6% of all cancer cases) were attributable to alcohol use in 2024. Conclusions: The proportion of alcohol-attributable cancers in Australia is substantial and somewhat higher than previously estimated. Show more