While current research is largely consistent as to the harms of heavy drinking in terms of both cancer incidence and mortality, there are disparate messages regarding the safety of light-moderate alcohol consumption which may confuse public health messages.Introduction
We aimed to evaluate the association between average lifetime alcohol intakes and risk of both cancer incidence and mortality.Methods
Population-based cohort study using data from 99 654 adults, aged 55–74 years participating in the U. S. Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Cox proportional hazards models assessed the risk of overall and cause-specific mortality, cancer incidence (excluding non-melanoma skin cancer), and combined risk of cancer and death across categories of self-reported average lifetime alcohol intakes, with adjustment for potential confounders.Results
During 8 36 740 person-years of follow-up, 9599 deaths and 12 763 primary cancers occurred. Positive linear associations were observed between lifetime alcohol consumption and cancer-related mortality and total cancer incidence. J-shape associations were observed between average lifetime alcohol consumption and overall mortality, cardiovascular-related mortality and combined risk of death or cancer. In comparison to lifetime light alcohol drinkers (1–3 drinks per week), lifetime never or infrequent drinkers (<1 drink/week) as well as heavy (2-<3 drinks/day) and very heavy drinkers (3+drinks/day) had increased overall mortality and combined risk of cancer or death. Corresponding hazard ratios and 95% confidence intervals for combined risk of cancer or death, respectively, were 1.09 (1.00 to 1.12) for never drinkers, 1.07 (1.03 to 1.12) for infrequent drinkers, 1.08 (1.01 to 1.16) for heavy drinkers, 1.20 (1.12–1.29) for very heavy drinkers.Conclusions
The study supports a J-shaped association between alcohol and mortality, which remains after adjustment for cancer risk. The results indicate that intakes between 1–5 drinks per week were associated with the lowest combined risk of cancer or death.