Press release – Alcohol consumption contributes to cancer, even in moderate drinkers: Otago study
The University of Otago released the following press report based on Prof Jennie Connor’s work on Monday, 27 June 2016.
Drinking alcohol increases the risk of several types of cancer, and was responsible for 236 cancer deaths under 80 years of age in New Zealand in 2012, according to a new study at the University of Otago.
The research, in collaboration with the Global Burden of Disease Alcohol Group, and just published in the international journal Drug and Alcohol Review, builds on previous work that identified 30 per cent of all alcohol-attributable deaths in New Zealand to be due to cancer, more than all other chronic diseases combined.
The study uses evidence that alcohol causes some types of cancer after combining dozens of large studies conducted internationally over several decades. The cancers that are known to be causally related to alcohol include two of the most common causes of cancer death in New Zealand, breast and bowel cancer, but also cancer of the mouth, pharynx, oesophagus, larynx and liver. This New Zealand study estimated mortality for 2007 and 2012.
Lead author, Professor Jennie Connor of the Department of Preventive and Social Medicine at Otago Medical School, said the findings about breast cancer were particularly sobering.
“About 60 per cent of all alcohol-attributable cancer deaths in New Zealand women are from breast cancer. We estimated 71 breast cancer deaths in 2007 and 65 in 2012 were due to drinking, and about a third of these were associated with drinking less than two drinks a day on average. Although risk of cancer is much higher in heavy drinkers there are fewer of them, and many alcohol-related breast cancers occur in women who are drinking at levels that are currently considered acceptable,” Professor Connor says.
“There was little difference between men and women in the number of cancer deaths due to alcohol, even though men drink much more heavily than women, because breast cancer deaths balanced higher numbers of deaths in men from other cancer types.”
She adds: “These premature deaths from cancer resulted in an average 10.4 years of life lost per person affected, with more loss of life among Māori than non-Māori, and for breast cancer compared with other cancers.”
“While these alcohol-attributable cancer deaths are only 4.2 per cent of all cancer deaths under 80, what makes them so significant is that we know how to avoid them,” explains Professor Connor.
“Individual decisions to reduce alcohol consumption will reduce risk in those people, but reduction in alcohol consumption across the population will bring down the incidence of these cancers much more substantially, and provide many other health benefits as well.
“Our findings strongly support the use of population-level strategies to reduce consumption because, apart from the heaviest drinkers, people likely to develop cancer from their exposure to alcohol cannot be identified, and there is no level of drinking under which an increased risk of cancer can be avoided.
“We hope that better understanding of the relationship of alcohol with cancer will help drinkers accept that the current unrestrained patterns of drinking need to change.”
Connor JL, Kydd R, Maclennan B, Shield K, Rehm J. Alcohol-attributable cancer deaths under 80 years of age in New Zealand. Drug and Alcohol Review 2016 DOI: 10.1111/dar.12443
12 KEY POINTS FROM ALCOHOL & CANCER CONFERENCE
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.
Regional Meetings 2016
Meeting presentation:
AANZ – Regional Meetings Powerpoint Show – Prof Jennie Connor, Dunedin & Prof Doug Sellman, Christchurch
Posters advertising meetings (three versions for each region):
Alcohol & Cancer Conference 2015
Hosted by Alcohol Action NZ and Cancer Society of NZ, Te Papa 17 June 2015
Conference Presentations:
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
Alcohol & Cancer Conference Programme
Flaunting it on Facebook: Young adults, drinking cultures and the cult of celebrity – research report March 2014
This final report is the result of a three year research project funded by the Royal Society of New Zealand on young adults’ drinking cultures and social networking in Aotearoa/New Zealand. The team is made up of an international multidisciplinary team of primary researchers, PhD and postgraduate students. The report can be easily downloaded from the Massey University website.
Action on Alcohol: Change is Coming Conference 2014
Presentations from Action on Alcohol: Change is Coming the 5th annual Alcohol Action conference held at Te Papa, Wellington, on Thursday 20 March 2014:
Opening Address -Sir Geoffrey Palmer
Change is Coming – But Not One Person at a Time – Professor Kypros Kypri, New South Wales
Change is Coming – Stocktake of Change So Far – Professor Jennie Connor, Dunedin
Change is Coming – Culture Change Comes From Policy Change –Dr Peter Miller, Victoria
Change is Coming – Will Local Alcohol Policies be Part of It –Rebecca Williams, Alcohol Healthwatch, New Zealand
Change is Coming – Call for Action –Professor Jennie Connor, Dunedin
Change is Coming – How to Make it Happen –Professor Mike Daube, Western Australia
Further information on the keynote speakers is available from the conference booklet.
The Perils of Alcohol Marketing Conference 2013
Held at Te Papa on 7 March 2013, this 4th Alcohol Action annual conference specifically addressed concerns regarding alcohol marketing. Conference presentations can be viewed via the Alcohol Healthwatch website as follows:
Video 1 – Introductory Comments – Dr Geoff Robinson, Alcohol Action NZ
Video 2 – Alcohol Harms – Prof Jennie Connor, University of Otago
Video 3 – Responsible Alcohol Marketing: A Public Health Oxymoron? – Prof Janet Hoek, University of Otago
Video 4 – Where Would Alcohol Companies be without Alcohol Marketing? – Prof Sally Casswell, Massey University
Video 5 – Alcohol Advertising and Sponsorship: Young People Need a Sporting Chance – Dr Kerry O’Brien, Monash University, Australia
Video 6 – The Culture of Intoxication: Young Adults, Social Networking and Alcohol Marketing – Assoc Prof Antonia Lyons, Massey University
Presentations Available for Downloading
• Alcohol Harms (7MB)
• Responsible Alcohol Marketing: A Public Health Oxymoron? (0.8MB)
• The Culture of Intoxication: Young Adults, Social Networking and Alcohol Marketing (3.6MB)
Babies, Children & Alcohol Conference 2012
Slide presentations from the third annual Alcohol Action NZ conference Babies, Children and Alcohol:
- The Extent of the Problem: Alcohol-related Harm to Children – Jennie Connor, Professor of Preventive and Social Medicine, University of Otago, Dunedin
- How to Maim or Kill your Child Using Alcohol – Dr Nick Baker, Community Paediatrician NMDHB, Chair CYMRC
- Fetal Alcohol Spectrum Disorder and Youth Justice in NZ – Dr Craig Immelman, Psychiatrist, Auckland
- Babies, Children and Alcohol: Child Advocacy – Dawn Elder, Associate Professor, Dept of Paediatrics and Child Health, University of Otago, Wellington
- Families Commission: What We Do – Dr Kathie Irwin, Chief Advisor Maori
- How Might a Child Rights Approach Help in Reducing Alcohol-related Harm? – Dr Russell Wills, Children’s Commisioner with YPRG members: Prashan Casinader, Jessica Palairet, Alex Kroch and Kieran Denton
- Evidence-based Solutions – Doug Sellman, Professor of Psychiatry and Addiction Medicine, National Addiction Centre, University of Otago, Christchurch
Downloads
- A summary of the law commission’s report “Curbing the Harm”
- Who is the biggest drug pusher in New Zealand?
- An historic opportunity to change New Zealand’s heavy drinking culture: A public statement by the Doctors and Nurses of New Zealand
- Initial Signatories for the public statement by the Doctors and Nurses of New Zealand
- Alcohol Action Pamphlet – Ten Things the Alcohol Industry Won’t Tell You About Alcohol (32 references cited below)
- Powerpoint Slideshow for the national series of public meetings “Ten things the alcohol industry won’t tell you about alcohol”
- Article: A Triumph of Reason
- Article: Facts from Fallacy
- 21 shot questionairre
- 10 facts the alcohol industry don’t want advertised
- Alcohol is a drug poster
- Alcohol is a drug Postcards to send to MPs
- “Big Booze Are Not Bad Blokes…”
Useful links
- Law Commission: Review of Regulatory Framework for the Sale and Supply of Liquor.
- Law Commission: The law commission’s full report “Curbing the Harm”
References to information cited on this website
- Anderson P, Chisholm D, Fuhr D. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet 2009;373:2234-2246.
- Attwood AS, Ataya AF, Benton CP, Penton-Voak IS, Munafo MR. Effects of alcohol consumption and alcohol expectancy on the categorisation of perceptual cues of emotional expression. Psychopharmacology 2009; 204:327-34.
- Babor T, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K, Grube J, Gruenewald P, Hill L, Holder H, Homel R, Osterberg E, Rehm J, Room R, Rossow I. Alcohol: No Ordinary Commodity. Research and Public Policy. Oxford Medical Publications, Oxford University Press, Oxford, 2003.
- Bond L, Daube M, Chikritzhs T. Access to confidential alcohol industry documents: From Big Tobacco to Big Booze. Australasian Medical Journal 2009; 1: 1-26.
- Chikritzhs T, Catalano P, Stockwell T, Donath S, Ngo H, Young D, Matthews S. Australian Alcohol Indicators, 1990-2001: Patterns of alcohol use and related harms for Australian states and territories. National Drug Research Institute, Perth, 2003.
- Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen K. Alcohol and coronary heart disease: A meta-analysis. Addiction 2000;95:1505-1523.
- Connor J, Broad J, Rehm J, Vander Hoorn S, Jackson R. The burden of death, disease and disability due to alcohol in New Zealand. New Zealand Medical Journal 15 April 2005;118(1213): http://www.nzma.org.nz/journal/118-1213/1412/
- Corrao G, Bagnardi V, Zambon C, La Vecchia C. A meta-analysis of alcohol consumption and the risk of 15 diseases. Preventive Medicine 2004;38:613-619.
- Erasmus D. Alcohol and Traffic Safety. New Zealand Police, 2009.
- Fillmore KM, Chikritzhs T, Stockwell T, Bostrom A, Pascal R. Alcohol use and prostate cancer: A meta-analysis. Molecular Nutrition & Food Research 2009;53:240-255.
- Foster SE, Vaughan RD, Foster WH, Califano JA. Alcohol consumption and expenditures for underage drinking and adult excessive drinking. Journal of the American Medical Association 2003; 289: 989-995.
- Gable RS. Comparison of acute lethal toxicity of commonly abused psychoactive substances. Addiction 2004;99:686-696.
- Habgood R, Casswell S, Pledger M, Bhatta K. Drinking in New Zealand. National Surveys Comparison 1995 and 2000. Alcohol and Public Health Research Unit, University of Auckland, 2001.
- Harper C. The neuropathology of alcohol-related brain damage. Alcohol & Alcoholism 2009; 44: 136–140.
- Hawkes DV. What would a friendly alcohol industry look like? Addiction 1993; 88: 22-23.
- Hilts PJ. The relative addictiveness of drugs. New York Times August 2, 1994. Available http://www.tfy.drugsense.org/tfy/addictvn.htm (cited 25 March 2009).
- Jackson MC, Hastings G, Wheeler C, Eadie D, MacKintosh AM. Marketing alcohol to young people: Implications for industry regulation and research policy. Addiction 2000;95(Suppl 4):S597-S608.
- Jackson R, Broad J, Connor J, Wells S. Alcohol and ischaemic heart disease: Probably no free lunch. Lancet 2005;366:1911-1912.
- May PA, Gossage JP. Estimating the prevalence of fetal alcohol syndrome: a summary. National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIAAA), 2001 http://pubs.niaaa.nih.gov/publications/arh25-3/159-167.htm
- National Health and Medical Research Council. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Australian Government, February 2009.
- Neiman J. Alcohol as a risk factor for brain damage: neurologic aspects. Alcoholism: Clinical and Experimental Research 1998;22(7 Suppl):346S–251S.
- Niccols A. Fetal alcohol syndrome and the developing socio-emotional brain. Brain & Cognition 2007;65:135-142.
- Nutristrategy 2005. Caloric content of fat, protein, carbohydrates and alcohol. http://www.nutristrategy.com/nutrition/calories.htm (cited 25 March 2009).
- O’Hagan J, Robinson G, Whiteside E. Alcohol and Drug Problems: Handbook for Health Professionals, Alcohol Advisory Council of New Zealand, Wellington: New Zealand, 1993.
- Parrott DJ, Zeichner A. Effects of alcohol and trait anger on physical aggression in men. Journal of Studies on Alcohol 2002; 63: 196-204.
- Quigley P. Emergency Department Specialist. Capital and Coast District Health Board (personal correspondence).
- Sellman D, Robinson GM, Beasley R. Should ethanol be scheduled as a drug of high risk to public health? Journal of Psychopharmacology 2009;23:94-100.
- Suter PM. Is alcohol consumption a risk factor for weight gain and obesity? Critical Reviews in Clinical Laboratory Sciences 2005; 42: 197-227.
- Stevenson R. National Alcohol Assessment, New Zealand Police, April 2009.
- Wells JE, Baxter J, Schaaf D. Substance use disorders in Te Rau Hinengaro: The New Zealand Mental Health Survey. Final Report. Alcohol Advisory Council of New Zealand, 23 November 2006.
- World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. AICR, Washington DC, 2007.
- World Health Organisation. International Agency for Research on Cancer (IARC) monographs on the evaluation of carcinogenic risks to humans. Volume 44: Alcohol Drinking – Summary of data reported and evaluation. Available at: http://monographs.iarc.fr/ENG/Monographs/vol44/volume44.pdf (last updated 1 December 1998, cited 26 May 2009).
- Yeomans MR. Effects of alcohol on food and energy intake in human subjects: Evidence for passive and active over-consumption of energy. British Journal of Nutrition 2004;92(Suppl 1):S31-34.
32 References to information cited in the Pamphlet Ten Things the Alcohol Industry Won’t Tell You About Alcohol
- Wells JE, Baxter J, Schaaf D. Substance use disorders in Te Rau Hinengaro: The New Zealand Mental Health Survey. Final Report. Alcohol Advisory Council of New Zealand, 23 November 2006.
- Stevenson R. National Alcohol Assessment, New Zealand Police, April 2009.
- O’Hagan J, Robinson G, Whiteside E. Alcohol and Drug Problems: Handbook for Health Professionals , Alcohol Advisory Council of New Zealand, Wellington: New Zealand, 1993.
- Quigley P. Emergency Department Specialist. Capital and Coast District Health Board (personal correspondence).
- Erasmus D. Alcohol and Traffic Safety. New Zealand Police, 2009.
- May PA, Gossage JP. Estimating the prevalence of fetal alcohol syndrome: a summary. National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIAAA), 2001 http://pubs.niaaa.nih.gov/publications/arh25-3/159-167.htm
- Connor J, Broad J, Rehm J, Vander Hoorn S, Jackson R. The burden of death, disease and disability due to alcohol in New Zealand. New Zealand Medical Journal 15 April 2005;118(1213): http://www.nzma.org.nz/journal/118-1213/1412/
- Bond L, Daube M, Chikritzhs T. Access to confidential alcohol industry documents: From Big Tobacco to Big Booze. Australasian Medical Journal 2009; 1: 1-26.
- Hilts PJ. The relative addictiveness of drugs. New York Times August 2, 1994. Available http://www.tfy.drugsense.org/tfy/addictvn.htm (cited 25 March 2009).
- Gable RS. Comparison of acute lethal toxicity of commonly abused psychoactive substances. Addiction 2004;99:686-696.
- Sellman JD, Robinson GM, Beasley R. Should ethanol be scheduled as a drug of high risk to public health? Journal of Psychopharmacology 2009;23:94-100.
- Neiman J. Alcohol as a risk factor for brain damage: neurologic aspects. Alcoholism: Clinical and Experimental Research 1998;22(7 Suppl):346S–251S.
- Niccols A. Fetal alcohol syndrome and the developing socio-emotional brain. Brain & Cognition 2007;65:135-142.
- Harper C. The neuropathology of alcohol-related brain damage. Alcohol & Alcoholism 2009 ; 44: 136–140.
- Parrott DJ, Zeichner A. Effects of alcohol and trait anger on physical aggression in men. Journal of Studies on Alcohol 2002; 63: 196-204.
- Attwood AS, Ataya AF, Benton CP, Penton-Voak IS, Munafo MR. Effects of alcohol consumption and alcohol expectancy on the categorisation of perceptual cues of emotional expression. Psychopharmacology 2009; 204:327-34.
- Yeomans MR. Effects of alcohol on food and energy intake in human subjects: Evidence for passive and active over-consumption of energy. British Journal of Nutrition 2004;92(Suppl 1):S31-34.
- Nutristrategy 2005. Caloric content of fat, protein, carbohydrates and alcohol. http://www.nutristrategy.com/nutrition/calories.htm (cited 25 March 2009).
- Suter PM. Is alcohol consumption a risk factor for weight gain and obesity? Critical Reviews in Clinical Laboratory Sciences 2005; 42: 197-227.
- Corrao G, Bagnardi V, Zambon C, La Vecchia C. A meta-analysis of alcohol consumption and the risk of 15 diseases. Preventive Medicine 2004;38:613-619.
- World Health Organisation. International Agency for Research on Cancer (IARC) monographs on the evaluation of carcinogenic risks to humans. Volume 44: Alcohol Drinking – Summary of data reported and evaluation. Available at: http://monographs.iarc.fr/ENG/Monographs/vol44/volume44.pdf (last updated 1 December 1998, cited 26 May 2009).
- World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. AICR, Washington DC, 2007.
- Fillmore KM, Chikritzhs T, Stockwell T, Bostrom A, Pascal R. Alcohol use and prostate cancer: A meta-analysis. Molecular Nutrition & Food Research 2009;53:240-255.
- Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen K. Alcohol and coronary heart disease: A meta-analysis. Addiction 2000;95:1505-1523.
- Jackson R, Broad J, Connor J, Wells S. Alcohol and ischaemic heart disease: Probably no free lunch. Lancet 2005;366:1911-1912.
- Jackson MC, Hastings G, Wheeler C, Eadie D, MacKintosh AM. Marketing alcohol to young people: Implications for industry regulation and research policy. Addiction 2000;95(Suppl 4):S597-S608.
- National Health and Medical Research Council. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Australian Government, February 2009.
- Habgood R, Casswell S, Pledger M, Bhatta K. Drinking in New Zealand. National Surveys Comparison 1995 and 2000. Alcohol and Public Health Research Unit, University of Auckland, 2001.
- Chikritzhs T, Catalano P, Stockwell T, Donath S, Ngo H, Young D, Matthews S. Australian Alcohol Indicators, 1990-2001: Patterns of alcohol use and related harms for Australian states and territories. National Drug Research Institute, Perth, 2003.
- Foster SE, Vaughan RD, Foster WH, Califano JA. Alcohol consumption and expenditures for underage drinking and adult excessive drinking. Journal of the American Medical Association 2003; 289: 989-995.
- Babor T, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K, Grube J, Gruenewald P, Hill L, Holder H, Homel R, Osterberg E, Rehm J, Room R, Rossow I. Alcohol: No Ordinary Commodity. Research and Public Policy . Oxford Medical Publications, Oxford University Press, Oxford, 2003.
- Anderson P, Chisholm D, Fuhr D. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet 2009;373:2234-2246.