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British Journal of Cancer logoLink to British Journal of Cancer
. 1994 Feb;69(2):327–332. doi: 10.1038/bjc.1994.59

Cancer morbidity in alcohol abusers.

H Tønnesen 1, H Møller 1, J R Andersen 1, E Jensen 1, K Juel 1
PMCID: PMC1968677  PMID: 8297729

Abstract

Data on the association between alcohol abuse and cancer morbidity are scarce in large cohorts of non-hospitalised alcoholic men and women. Of 18,368 alcohol abusers who entered an outpatient clinic in Copenhagen during 1954-87, 18,307 were followed and their cancer incidence was compared with that of the total Danish population. On average the 15,214 men were observed for 12.9 years and the 3,093 women for 9.4 years. The overall morbidity of cancer was increased significantly. Of the men, 1,441 developed cancer [relative risk (RR) = 1.6; 95% confidence interval (CI) = 1.5-1.7], while 182 women did (RR = 1.5; 95% CI 1.3-1.8). Significantly increased incidences were found of cancer in the tongue, mouth, pharynx, oesophagus, liver, larynx, lung and pleura and secondary cancer. The women had significantly increased risk of cervical cancer (RR = 2.0; 95% CI 1.2-3.0). The men developed prostatic cancer significantly more frequently than expected (RR = 1.4; 95% CI 1.2-1.8). The risk of melanomas (RR = 0.5; 95% CI 0.2-0.8) was significantly lower than expected. The relative risks of cancer of the stomach, pancreas, kidney and endocrine system were only slightly increased. The study group did not develop more colonic (RR = 1.0; 95% CI 0.8-1.3) or rectal cancer (RR = 1.0; CI 0.7-1.3) than expected. The risk of breast cancer in women was slightly increased (RR = 1.3; 95% CI 0.9-1.7), but not statistically significant. Thus, the associations between alcohol and cancer of the upper digestive and respiratory tract and the liver are confirmed. In addition, this study indicates an increased occurrence of cancer of the prostate gland, pleura and uterine cervix in alcohol abusers.

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Selected References

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  1. Begg C. B., Walker A. M., Wessen B., Zelen M. Alcohol consumption and breast cancer. Lancet. 1983 Feb 5;1(8319):293–294. doi: 10.1016/s0140-6736(83)91703-8. [DOI] [PubMed] [Google Scholar]
  2. Brinton L. A., Tashima K. T., Lehman H. F., Levine R. S., Mallin K., Savitz D. A., Stolley P. D., Fraumeni J. F., Jr Epidemiology of cervical cancer by cell type. Cancer Res. 1987 Mar 15;47(6):1706–1711. [PubMed] [Google Scholar]
  3. Brock K. E., Berry G., Mock P. A., MacLennan R., Truswell A. S., Brinton L. A. Nutrients in diet and plasma and risk of in situ cervical cancer. J Natl Cancer Inst. 1988 Jun 15;80(8):580–585. doi: 10.1093/jnci/80.8.580. [DOI] [PubMed] [Google Scholar]
  4. Byers T., Funch D. P. Alcohol and breast cancer. Lancet. 1982 Apr 3;1(8275):799–800. doi: 10.1016/s0140-6736(82)91841-4. [DOI] [PubMed] [Google Scholar]
  5. Carstensen J. M., Bygren L. O., Hatschek T. Cancer incidence among Swedish brewery workers. Int J Cancer. 1990 Mar 15;45(3):393–396. doi: 10.1002/ijc.2910450302. [DOI] [PubMed] [Google Scholar]
  6. Coleman M., Douglas A., Hermon C., Peto J. Cohort study analysis with a FORTRAN computer program. Int J Epidemiol. 1986 Mar;15(1):134–137. doi: 10.1093/ije/15.1.134. [DOI] [PubMed] [Google Scholar]
  7. Cuzick J., Babiker A. G. Pancreatic cancer, alcohol, diabetes mellitus and gall-bladder disease. Int J Cancer. 1989 Mar 15;43(3):415–421. doi: 10.1002/ijc.2910430312. [DOI] [PubMed] [Google Scholar]
  8. Dean G., MacLennan R., McLoughlin H., Shelley E. Causes of death of blue-collar workers at a Dublin brewery, 1954--73. Br J Cancer. 1979 Oct;40(4):581–589. doi: 10.1038/bjc.1979.223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Durbec J. P., Chevillotte G., Bidart J. M., Berthezene P., Sarles H. Diet, alcohol, tobacco and risk of cancer of the pancreas: a case-control study. Br J Cancer. 1983 Apr;47(4):463–470. doi: 10.1038/bjc.1983.75. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Freudenheim J. L., Graham S., Marshall J. R., Haughey B. P., Wilkinson G. Lifetime alcohol intake and risk of rectal cancer in western New York. Nutr Cancer. 1990;13(1-2):101–109. doi: 10.1080/01635589009514050. [DOI] [PubMed] [Google Scholar]
  11. Gordon T., Kannel W. B. Drinking and mortality. The Framingham Study. Am J Epidemiol. 1984 Jul;120(1):97–107. doi: 10.1093/oxfordjournals.aje.a113879. [DOI] [PubMed] [Google Scholar]
  12. Graham S., Dayal H., Swanson M., Mittelman A., Wilkinson G. Diet in the epidemiology of cancer of the colon and rectum. J Natl Cancer Inst. 1978 Sep;61(3):709–714. [PubMed] [Google Scholar]
  13. Graham S., Haughey B., Marshall J., Priore R., Byers T., Rzepka T., Mettlin C., Pontes J. E. Diet in the epidemiology of carcinoma of the prostate gland. J Natl Cancer Inst. 1983 Apr;70(4):687–692. [PubMed] [Google Scholar]
  14. Hakulinen T., Lehtimäki L., Lehtonen M., Teppo L. Cancer morbidity among two male cohorts with increased alcohol consumption in Finland. J Natl Cancer Inst. 1974 Jun;52(6):1711–1714. doi: 10.1093/jnci/52.6.1711. [DOI] [PubMed] [Google Scholar]
  15. Harris R. W., Forman D., Doll R., Vessey M. P., Wald N. J. Cancer of the cervix uteri and vitamin A. Br J Cancer. 1986 May;53(5):653–659. doi: 10.1038/bjc.1986.109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Harvey E. B., Schairer C., Brinton L. A., Hoover R. N., Fraumeni J. F., Jr Alcohol consumption and breast cancer. J Natl Cancer Inst. 1987 Apr;78(4):657–661. [PubMed] [Google Scholar]
  17. Heuch I., Kvåle G., Jacobsen B. K., Bjelke E. Use of alcohol, tobacco and coffee, and risk of pancreatic cancer. Br J Cancer. 1983 Nov;48(5):637–643. doi: 10.1038/bjc.1983.245. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Hiatt R. A., Bawol R. D. Alcoholic beverage consumption and breast cancer incidence. Am J Epidemiol. 1984 Nov;120(5):676–683. doi: 10.1093/oxfordjournals.aje.a113934. [DOI] [PubMed] [Google Scholar]
  19. Hiatt R. A., Klatsky A. L., Armstrong M. A. Pancreatic cancer, blood glucose and beverage consumption. Int J Cancer. 1988 Jun 15;41(6):794–797. doi: 10.1002/ijc.2910410603. [DOI] [PubMed] [Google Scholar]
  20. Hirayama T. Association between alcohol consumption and cancer of the sigmoid colon: observations from a Japanese cohort study. Lancet. 1989 Sep 23;2(8665):725–727. doi: 10.1016/s0140-6736(89)90782-4. [DOI] [PubMed] [Google Scholar]
  21. Jensen O. M. Cancer morbidity and causes of death among Danish brewery workers. Int J Cancer. 1979 Apr 15;23(4):454–463. doi: 10.1002/ijc.2910230404. [DOI] [PubMed] [Google Scholar]
  22. Kabat G. C., Howson C. P., Wynder E. L. Beer consumption and rectal cancer. Int J Epidemiol. 1986 Dec;15(4):494–501. doi: 10.1093/ije/15.4.494. [DOI] [PubMed] [Google Scholar]
  23. Klatsky A. L., Armstrong M. A., Friedman G. D., Hiatt R. A. The relations of alcoholic beverage use to colon and rectal cancer. Am J Epidemiol. 1988 Nov;128(5):1007–1015. doi: 10.1093/oxfordjournals.aje.a115045. [DOI] [PubMed] [Google Scholar]
  24. Klatsky A. L., Friedman G. D., Siegelaub A. B. Alcohol and mortality. A ten-year Kaiser-Permanente experience. Ann Intern Med. 1981 Aug;95(2):139–145. doi: 10.7326/0003-4819-95-2-139. [DOI] [PubMed] [Google Scholar]
  25. Kolonel L. N., Yoshizawa C. N., Hankin J. H. Diet and prostatic cancer: a case-control study in Hawaii. Am J Epidemiol. 1988 May;127(5):999–1012. doi: 10.1093/oxfordjournals.aje.a114903. [DOI] [PubMed] [Google Scholar]
  26. Kono S., Ikeda M., Tokudome S., Nishizumi M., Kuratsune M. Alcohol and mortality: a cohort study of male Japanese physicians. Int J Epidemiol. 1986 Dec;15(4):527–532. doi: 10.1093/ije/15.4.527. [DOI] [PubMed] [Google Scholar]
  27. Kune S., Kune G. A., Watson L. F. Case-control study of alcoholic beverages as etiological factors: the Melbourne Colorectal Cancer Study. Nutr Cancer. 1987;9(1):43–56. doi: 10.1080/01635588709513909. [DOI] [PubMed] [Google Scholar]
  28. Kyle R. A. Multiple myeloma. An update on diagnosis and management. Acta Oncol. 1990;29(1):1–8. doi: 10.3109/02841869009089984. [DOI] [PubMed] [Google Scholar]
  29. La Vecchia C., Decarli A., Franceschi S., Pampallona S., Tognoni G. Alcohol consumption and the risk of breast cancer in women. J Natl Cancer Inst. 1985 Jul;75(1):61–65. [PubMed] [Google Scholar]
  30. La Vecchia C., Franceschi S., Decarli A., Gentile A., Fasoli M., Pampallona S., Tognoni G. Dietary vitamin A and the risk of invasive cervical cancer. Int J Cancer. 1984 Sep 15;34(3):319–322. doi: 10.1002/ijc.2910340306. [DOI] [PubMed] [Google Scholar]
  31. Longnecker M. P. A case-control study of alcoholic beverage consumption in relation to risk of cancer of the right colon and rectum in men. Cancer Causes Control. 1990 Jul;1(1):5–14. doi: 10.1007/BF00053178. [DOI] [PubMed] [Google Scholar]
  32. Longnecker M. P., Berlin J. A., Orza M. J., Chalmers T. C. A meta-analysis of alcohol consumption in relation to risk of breast cancer. JAMA. 1988 Aug 5;260(5):652–656. [PubMed] [Google Scholar]
  33. Longnecker M. P., Orza M. J., Adams M. E., Vioque J., Chalmers T. C. A meta-analysis of alcoholic beverage consumption in relation to risk of colorectal cancer. Cancer Causes Control. 1990 Jul;1(1):59–68. doi: 10.1007/BF00053184. [DOI] [PubMed] [Google Scholar]
  34. Lê M. G., Hill C., Kramar A., Flamanti R. Alcoholic beverage consumption and breast cancer in a French case-control study. Am J Epidemiol. 1984 Sep;120(3):350–357. doi: 10.1093/oxfordjournals.aje.a113899. [DOI] [PubMed] [Google Scholar]
  35. Manousos O., Day N. E., Trichopoulos D., Gerovassilis F., Tzonou A., Polychronopoulou A. Diet and colorectal cancer: a case-control study in Greece. Int J Cancer. 1983 Jul 15;32(1):1–5. doi: 10.1002/ijc.2910320102. [DOI] [PubMed] [Google Scholar]
  36. Martin P. M., Hill G. B. Cervical cancer in relation to tobacco and alcohol consumption in Lesotho, southern Africa. Cancer Detect Prev. 1984;7(2):109–115. [PubMed] [Google Scholar]
  37. Meara J., McPherson K., Roberts M., Jones L., Vessey M. Alcohol, cigarette smoking and breast cancer. Br J Cancer. 1989 Jul;60(1):70–73. doi: 10.1038/bjc.1989.222. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Mettlin C., Selenskas S., Natarajan N., Huben R. Beta-carotene and animal fats and their relationship to prostate cancer risk. A case-control study. Cancer. 1989 Aug 1;64(3):605–612. doi: 10.1002/1097-0142(19890801)64:3<605::aid-cncr2820640307>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  39. Miller A. B., Howe G. R., Jain M., Craib K. J., Harrison L. Food items and food groups as risk factors in a case-control study of diet and colo-rectal cancer. Int J Cancer. 1983 Aug 15;32(2):155–161. doi: 10.1002/ijc.2910320204. [DOI] [PubMed] [Google Scholar]
  40. Mommsen S., Aagaard J., Sell A. An epidemiological case-control study of bladder cancer in males from a predominantly rural district. Eur J Cancer Clin Oncol. 1982 Nov;18(11):1205–1210. doi: 10.1016/0277-5379(82)90103-1. [DOI] [PubMed] [Google Scholar]
  41. Monson R. R., Lyon J. L. Proportional mortality among alcoholics. Cancer. 1975 Sep;36(3):1077–1079. doi: 10.1002/1097-0142(197509)36:3<1077::aid-cncr2820360335>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  42. Morgan R. W., Jain M. G. Bladder cancer: smoking, beverages and artificial sweeteners. Can Med Assoc J. 1974 Nov 16;111(10):1067–1070. [PMC free article] [PubMed] [Google Scholar]
  43. Newell G. R., Fueger J. J., Spitz M. R., Babaian R. J. A case-control study of prostate cancer. Am J Epidemiol. 1989 Aug;130(2):395–398. doi: 10.1093/oxfordjournals.aje.a115346. [DOI] [PubMed] [Google Scholar]
  44. Nicholls P., Edwards G., Kyle E. Alcoholics admitted to four hospitals in England. II. General and cause-specific mortality. Q J Stud Alcohol. 1974 Sep;35(3):841–855. [PubMed] [Google Scholar]
  45. O'Connell D. L., Hulka B. S., Chambless L. E., Wilkinson W. E., Deubner D. C. Cigarette smoking, alcohol consumption, and breast cancer risk. J Natl Cancer Inst. 1987 Feb;78(2):229–234. [PubMed] [Google Scholar]
  46. Osterlind A., Jensen O. M. Evaluering af cancerregistreringen i Danmark 1977. En praeliminaer evaluering af cancerregisterets og landspatientregisterets registrering af cancertilfaelde. Ugeskr Laeger. 1985 Jul 29;147(31):2483–2488. [PubMed] [Google Scholar]
  47. Paganini-Hill A., Ross R. K. Breast cancer and alcohol consumption. Lancet. 1983 Sep 10;2(8350):626–627. doi: 10.1016/s0140-6736(83)90711-0. [DOI] [PubMed] [Google Scholar]
  48. Pickle L. W., Greene M. H., Ziegler R. G., Toledo A., Hoover R., Lynch H. T., Fraumeni J. F., Jr Colorectal cancer in rural Nebraska. Cancer Res. 1984 Jan;44(1):363–369. [PubMed] [Google Scholar]
  49. Pollack E. S., Nomura A. M., Heilbrun L. K., Stemmermann G. N., Green S. B. Prospective study of alcohol consumption and cancer. N Engl J Med. 1984 Mar 8;310(10):617–621. doi: 10.1056/NEJM198403083101003. [DOI] [PubMed] [Google Scholar]
  50. Potter J. D., McMichael A. J. Diet and cancer of the colon and rectum: a case-control study. J Natl Cancer Inst. 1986 Apr;76(4):557–569. doi: 10.1093/jnci/76.4.557. [DOI] [PubMed] [Google Scholar]
  51. Raymond L., Infante F., Tuyns A. J., Voirol M., Lowenfels A. B. Alimentation et cancer du pancréas. Gastroenterol Clin Biol. 1987 Jun-Jul;11(6-7):488–492. [PubMed] [Google Scholar]
  52. Robinette C. D., Hrubec Z., Fraumeni J. F., Jr Chronic alcoholism and subsequent mortality in World War II veterans. Am J Epidemiol. 1979 Jun;109(6):687–700. doi: 10.1093/oxfordjournals.aje.a112732. [DOI] [PubMed] [Google Scholar]
  53. Rohan T. E., McMichael A. J. Alcohol consumption and risk of breast cancer. Int J Cancer. 1988 May 15;41(5):695–699. doi: 10.1002/ijc.2910410510. [DOI] [PubMed] [Google Scholar]
  54. Rosenberg L., Palmer J. R., Miller D. R., Clarke E. A., Shapiro S. A case-control study of alcoholic beverage consumption and breast cancer. Am J Epidemiol. 1990 Jan;131(1):6–14. doi: 10.1093/oxfordjournals.aje.a115486. [DOI] [PubMed] [Google Scholar]
  55. Ross R. K., Shimizu H., Paganini-Hill A., Honda G., Henderson B. E. Case-control studies of prostate cancer in blacks and whites in southern California. J Natl Cancer Inst. 1987 May;78(5):869–874. [PubMed] [Google Scholar]
  56. Schatzkin A., Jones D. Y., Hoover R. N., Taylor P. R., Brinton L. A., Ziegler R. G., Harvey E. B., Carter C. L., Licitra L. M., Dufour M. C. Alcohol consumption and breast cancer in the epidemiologic follow-up study of the first National Health and Nutrition Examination Survey. N Engl J Med. 1987 May 7;316(19):1169–1173. doi: 10.1056/NEJM198705073161901. [DOI] [PubMed] [Google Scholar]
  57. Schmidt W., Popham R. E. The role of drinking and smoking in mortality from cancer and other causes in male alcoholics. Cancer. 1981 Mar 1;47(5):1031–1041. doi: 10.1002/1097-0142(19810301)47:5<1031::aid-cncr2820470534>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  58. Snowdon D. A., Phillips R. L., Choi W. Diet, obesity, and risk of fatal prostate cancer. Am J Epidemiol. 1984 Aug;120(2):244–250. doi: 10.1093/oxfordjournals.aje.a113886. [DOI] [PubMed] [Google Scholar]
  59. Stemmermann G. N., Nomura A. M., Chyou P. H., Yoshizawa C. Prospective study of alcohol intake and large bowel cancer. Dig Dis Sci. 1990 Nov;35(11):1414–1420. doi: 10.1007/BF01536750. [DOI] [PubMed] [Google Scholar]
  60. Talamini R., La Vecchia C., Decarli A., Franceschi S., Grattoni E., Grigoletto E., Liberati A., Tognoni G. Social factors, diet and breast cancer in a northern Italian population. Br J Cancer. 1984 Jun;49(6):723–729. doi: 10.1038/bjc.1984.114. [DOI] [PMC free article] [PubMed] [Google Scholar]
  61. Talamini R., La Vecchia C., Decarli A., Negri E., Franceschi S. Nutrition, social factors and prostatic cancer in a Northern Italian population. Br J Cancer. 1986 Jun;53(6):817–821. doi: 10.1038/bjc.1986.138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Thomas D. B., Uhl C. N., Hartge P. Bladder cancer and alcoholic beverage consumption. Am J Epidemiol. 1983 Nov;118(5):720–727. doi: 10.1093/oxfordjournals.aje.a113682. [DOI] [PubMed] [Google Scholar]
  63. Tuyns A. J. Beer consumption and rectal cancer. Rev Epidemiol Sante Publique. 1988;36(2):144–145. [PubMed] [Google Scholar]
  64. Webster L. A., Layde P. M., Wingo P. A., Ory H. W. Alcohol consumption and risk of breast cancer. Lancet. 1983 Sep 24;2(8352):724–726. doi: 10.1016/s0140-6736(83)92258-4. [DOI] [PubMed] [Google Scholar]
  65. Willett W. C., Stampfer M. J., Colditz G. A., Rosner B. A., Hennekens C. H., Speizer F. E. Moderate alcohol consumption and the risk of breast cancer. N Engl J Med. 1987 May 7;316(19):1174–1180. doi: 10.1056/NEJM198705073161902. [DOI] [PubMed] [Google Scholar]
  66. Williams R. R. Breast and thyroid cancer and malignant melanoma promoted by alcohol-induced pituitary secretion of prolactin, T.S.H. and M.S.H. Lancet. 1976 May 8;1(7967):996–999. doi: 10.1016/s0140-6736(76)91865-1. [DOI] [PubMed] [Google Scholar]
  67. Wynder E. L., Shigematsu T. Environmental factors of cancer of the colon and rectum. Cancer. 1967 Sep;20(9):1520–1561. doi: 10.1002/1097-0142(196709)20:9<1520::aid-cncr2820200920>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]

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