Twelve Key Points from the Alcohol & Cancer Conference
Hosted by Alcohol Action NZ and Cancer Society of NZ, Te Papa 17 June 2015
1. In 1988, the World Health Organisation’s International Agency for Cancer Research scheduled alcohol (ethyl alcohol, ethanol) as a Group 1 carcinogen – an agent for which there is sufficient evidence to assert it directly causes cancer
2. The degree of public awareness about the link between alcohol and cancer in New Zealanders is not known. In Canada, public awareness of the link between alcohol and cancer has slowly increased from 21% in 1996 to 36% in 2012, and education level did not predict awareness of the link.
3. A key mechanism by which alcohol causes cancer involves the major metabolite of ethanol called acetaldehyde. Ethanol is broken down to acetaldehyde in the body and acetaldehyde reacts with primary amines to produce crotonaldehyde. Crotonaldehyde in turn can directly cause mutations in DNA and thus initiate cancer.
4. There are about 240 cancer deaths in New Zealand every year attributable to alcohol, of which about half are in men and about half in women.
5. The cancers for which the strongest evidence exists of causation from alcohol are cancers of the mouth, throat, voice-box, oesophagus, liver, colon, rectum, and breast. Other cancers for which the evidence is accumulating include prostate, pancreas, skin (melanoma), and stomach. Bowel and breast cancer are two of the most common causes of cancer death in New Zealand.
6. Breast cancer is the leading cause of alcohol-attributable deaths in New Zealand women (both Māori and non-Māori). Increasing alcohol consumption from one to two standard drinks a day increases the risk of developing breast cancer by 10%.
7. Although risk of cancer increases with the average amount of alcohol consumed, alcohol-related cancers also occur in people who do not drink at high levels.
8. The less alcohol consumed, the lower the risk of cancer. There is no safe threshold.
9. A whole of population strategy to reduce alcohol consumption is required to reduce alcohol-related cancers (and other alcohol-related harm).
10. Since 1975, publications sponsored by the World Health Organisation have provided overviews of research into the most effective measures a society can use to reduce its consumption of alcohol and thus reduce alcohol-related problems.
11. This body of research has been summarized as the 5+ Solution, which involves reforms of marketing, pricing, accessibility, age of purchase, and drink-driving counter-measures; plus providing increased treatment opportunities for heavy drinkers.
12. The Trans-Pacific Partnership Agreement (TPPA) is a trade agreement being negotiated in secret which benefits big business including global alcohol corporations. The TPPA would give corporations greater influence over adoption of policies such as the 5+ Solution, as they would be able to take the NZ government to an international tribunal to recoup any lost profit that resulted.
Cancer-deaths-attributable-to-alcohol-in-New-Zealanders-under-80 – Prof Jennie Connor, Dunedin
Biological aspects – Dr Jeff Upton, Christchurch
Clinical aspects – Dr Chris Jackson, Dunedin (currently unavailable)
Epidemiological aspects – Prof Ann Richardson, Christchurch
Community response – Jane Martin, Melbourne
National response – The 5+ Solution: Has It Been Enacted in New Zealand Yet? If Not, Why Not? – Prof Doug Sellman, Christchurch
International response – Implications of the TPPA for Alcohol Policy in Aotearoa NZ – Prof Jane Kelsey, Auckland