Alcohol consumption and mortality from four alcohol-related cancers in Australia 1950-2018: a time series analysis

BACKGROUND: Long-term alcohol use is a recognised risk factor for liver, upper aerodigestive tract (UADT), colorectal, and female breast cancers, yet aggregate-level evidence linking alcohol consumption to mortality from these cancers remains limited. This study examined the potential preventive impact of reducing population drinking on cancer mortality in Australia, accounting for tobacco use and health expenditure. METHODS: Annual per capita alcohol and tobacco consumption data (aged 15+) from 1910-2018, and mortality data for UADT, liver, breast, and colorectal cancers from the 1950s-2018, were collected from national registries. Time series models were used to estimate sex- and age-specific associations and long-term lagged effects of alcohol and tobacco consumption. RESULTS: A one-litre per capita annual reduction in alcohol consumption was significantly associated with decreases in mortality: 3.6% (95% CI: 1.0-6.2%) in male and 3.4% (1.8-4.9%) in female UADT cancer; 3.9% (0.2-7.7%) in male liver cancer; 1.2% (0.7-1.7%) in male and 0.7% (0.2-1.4%) in female colorectal cancer; and 2.3% (1.7-3.0%) in female breast cancer over a 20-year period. CONCLUSION: Reducing population-level alcohol consumption in Australia could substantially lower mortality from UADT, colorectal, male liver, and female breast cancers, particularly among older adults.