Impact of alcohol drinking on total cancer risk: data from a large-scale population-based cohort study in Japan

We conducted a cohort study of alcohol consumption and total cancer incidence and mortality in 73 281 subjects ( 35 007 men and 38 274 women) aged 40 - 59 years old at baseline over a 10-year follow-up period. During 1990 - 2001, a total of 3403 cases of newly diagnosed cancer and 1208 cancer deaths were identified. In men, the lowest risk of developing cancer was observed among occasional drinkers, and a linear positive association with increased ethanol intake was noted ( hazard ratio 1.18 for 1 - 149 g per week, 1.17 for 150 - 299 g per week, 1.43 for 300 - 449 g per week, 1.61 for greater than or equal to450 g per week, P for trend <0.001). The positive relation was similar for cancer incidence and mortality, but was more striking among current smokers and alcohol-related cancers. Relatively few women were regular drinkers. Our results suggest that increased ethanol intake linearly elevates the risk of cancer, and that nearly 13% of cancers among males in this study were due to heavy drinking (>= 300 g per week of ethanol), to which smoking substantially contributed. The simultaneous reduction of smoking is therefore important for reducing the effect of alcohol on cancer risk.