Half of US Cancer Survivors Drink Alcohol

Are One Fifth Binge Drinkers?

Nick Mulcahy

January 10, 2020

About half of Americans with a cancer diagnosis are current alcohol drinkers, which is less than the general population, and about one third exceed moderate consumption levels, new research from a large national database indicates.

It also found that about one fifth of cancer survivors engage in "binge" drinking, although an expert not involved the study suggested this figure may be inflated.

The large study, derived from data on 30,000-plus men and women with a history of cancer in the National Health Interview Survey from 2000 to 2017, is the first of its kind.

It was published in the January 2020 issue of the Journal of the National Comprehensive Cancer Network.

Current alcohol use is associated with worse cancer outcomes among patients, and drinking is potentially modifiable, say the authors, led by Nina Sanford, MD, UT Southwestern Medical Center, Dallas.

However, the new study has no intention of chastising people with a history of cancer, said Sanford. "We wanted to establish a benchmark [for alcohol consumption] in the cancer population," she told Medscape Medical News.

Among the 34,080 survey participants with a known cancer diagnosis, 56.5% were current drinkers. That's lower than the 70% of current drinkers in the general population, she acknowledged when asked.

The study also found that 34.9% exceeded moderate drinking, defined as more than 1 drink per day for women and 2 drinks per day for men, per the Dietary Guidelines for Americans.

The finding on binge drinking is controversial.

This study defined binge drinking as having ≥ 5 drinks/day for at least 1 day in the past year.

However, the US Substance Abuse and Mental Health Services Administration says the term is reserved for having ≥ 5 drinks/day at least 1 day in the past month — not year.

"It feels like they are talking up the drinking a little bit," said Tim Stockwell, PhD, University of Victoria, British Columbia, Canada, an expert in alcohol addiction, who was asked for comment.

"The study reveals that people with cancer are drinking less than the general population," he said, observing the article does not mention that fact.

However, drinking — either heavily or not at all — is a "good issue" to raise among people recovering from or being treated for cancer, he commented.

"When you have cancer, there is evidence that alcohol is not a good thing in general because it...appears to facilitate the further growth of cancers," he said.

In general, there is a lack of awareness about alcohol being a cancer risk, said Stockwell, adding that only one in three Canadian adults know of the association. He noted that the International Agency for Research on Cancer has alcohol as a class 1 carcinogen, like tobacco and asbestos.

The American Cancer Society recommends cancer survivors limit alcohol to 1 drink a day or less.

More on Binge Drinking

The survey population consisted of all adults in the National Health Interview Survey over a 17-year period who reported a cancer diagnosis. However, similar associations to those above persisted, say the researchers, when the cohort was limited to 20,828 cancer survivors diagnosed ≥ 5 years before survey administration.

A multivariate analysis showed that younger age, smoking history, and more recent survey period were all associated with higher odds of current, exceeding moderate, and binge drinking (P < .001 for all, except P = .008 for excess drinking).

Melanoma, cervical, head and neck, and testicular cancers were associated with higher odds of binge drinking compared with other cancer diagnoses (P < .05 for all). Sanford noted that the demographics of these cancer types, especially younger age, likely explain this association.

Binge drinking rates were much higher for younger study participants. Among 18- to 34-year-olds, 23.6% were binge drinkers (per study definition). In contrast, only 2.6% of those aged 75 years and older were classified as such.

"We recommend that providers screen for alcohol use at regular intervals and provide resources to assist in cutting down use for those who may engage in excessive drinking behaviors," said Sanford in a press statement.

The study authors and Stockwell have reported no financial disclosures.

J Natl Compr Canc Netw. 2020;18:69-79. Full text

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