Prevention in Oncology is guest edited by Jennifer Ligibel, MD, Chair of ASCO’s Energy Balance Working Group and a member of ASCO’s Cancer Survivorship and Cancer Prevention Committees. Dr. Ligibel is Director of the Leonard P. Zakim Center for Integrative Therapies at Dana-Farber Cancer Institute.
Each Prevention in Oncology column will address one of five areas in cancer prevention— alcohol use, obesity, tobacco use, vaccines to prevent cancer-causing infections, and germline genetics—with the goal of providing strategies to reduce the risk of cancer, as well as preventing cancer recurrence and second malignancy during cancer survivorship.
Among the many surprising findings in ASCO’s National Cancer Opinion Survey, published this past October, is that 30% of the more than 4,000 Americans polled identified alcohol as a risk factor for cancer, and just 38% of respondents said they limit alcohol consumption to prevent cancer.1 The survey results were published a month before ASCO issued its statement on the role alcohol plays in the development of cancer and its recommendations to reduce cancer risk through evidence-based strategies to prevent the excessive use of alcohol and modify behavior.2
The connection between heavy, prolonged alcohol use and the increased risk for certain cancers—mainly those of the upper aerodigestive tract (e.g., oropharyngeal, laryngeal, and esophageal cancers), as well as colon, liver, and female breast cancers—has been well known for at least 3 decades, given the International Agency for Research on Cancer’s determination in 1987 that alcoholic beverages were carcinogenic to humans.3 In fact, it is estimated that 5.5% of all new cancer occurrences and 5.8% of all cancer deaths worldwide4—and 3.5% of all cancer deaths in the United States5—are attributable to alcohol consumption.
On Sunday the Victorian Government announced reforms to the Liquor Control Reform Act.
The Victorian Government media release about the reforms is available here.
In summary the reforms include:
The Alcohol Policy Coalition (APC) has responded to the reforms. The APC media release is available.
Further information about alcohol harm zones is available in the APCs submission to the 2016 review of the Liquor Control Reform Act.
Principal Program Officer, Alcohol and Tobacco (VicHealth)
The Poll is now in its ninth year of publication and explores Australia’s attitudes towards alcohol, drinking behaviours, awareness and experience of alcohol harm, and opinions on alcohol policies.
Key findings this year include:
The report, along with a series of short videos, is available at www.fare.org.au
Alcohol consumption is a ubiquitous and widely accepted part of Australian life. It is commonly consumed at social occasions, during recreational activities, and at cultural ceremonies. In 2014-2015, over 80% of the adult population in Australia reported consuming alcohol in the past year. Drinking in large quantities is seen as a rite of passage to adulthood, and this is reflected in the large increase in alcohol consumption with attainment of the legal age to purchase alcohol. Furthermore, the production and consumption of alcohol are major contributors to the Australian economy (Richardson, 2012). However, alcohol is “no ordinary commodity” and a large body of evidence now demonstrates that alcohol consumption imposes a significant health and social burden on Australian society.
Comments: There is currently no high-quality evidence supporting pharmacological treatment to control drinking in patients with alcohol use disorder. The risks of incomplete outcome data or selective outcome reporting were identified by this report. In addition, no study demonstrated a benefit on health outcomes. More evidence is needed on this topic.
Nicolas Bertholet, MD, MSc
Pharmacologically controlled drinking in the treatment of alcohol dependence or alcohol use disorders: a systematic review with direct and network metaanalyses on nalmefene, naltrexone, acamprosate, baclofen and topiramate. Addiction. 2018;113(2):220–237.