Report conducted at the University of Sheffield provides ‘clear and compelling’ new evidence on the effectiveness of minimum unit pricing.

Alcohol consumption will cause 63,000 deaths in England over the next five years according to a new report from the University of Sheffield Alcohol Research Group.

alcoholThe report, published by the Foundation for Liver Research, predicts that 32,475 of the deaths – the equivalent of 35 a day – will be the result of liver cancer and another 22,519 from alcoholic liver disease.

In its new report, Financial case for action on liver disease, endorsed by the independent Lancet Commission on Liver Disease, the Foundation for Liver Research urges the Government to implement a suite of policy measures designed to mitigate the rising health and financial burden of alcohol, including the introduction of minimum unit pricing (MUP), re-institution of alcohol duty escalator and advertising restrictions.

  • Between 2017 and 2022 the total cost to the NHS of alcohol-related illness and deaths will be £17 billion.
  • Study shows introduction of minimum unit pricing for alcohol could significantly reduce the burden.

Providing evidence in support of Government intervention, new modelling shows that within five years of its introduction in England, a 50p MUP alone would result in:

  • ian gilmore quote21,150 fewer alcohol-related deaths
  • 74,500 fewer alcohol-related hospital admissions
  • Savings of £325.7m in healthcare costs
  • Savings of £710.9m in crime costs

The total financial savings to the public purse of MUP is forecast to be £1.1 billion – the equivalent cost of the Government’s recently announced investment package for Northern Ireland.

Colin Angus, Research Fellow at the University of Sheffield and part of the Sheffield Alcohol Research Group who conducted the research, said:

“These new findings show there will be 35 deaths and 2,300 hospital admissions due to alcohol every day in England over the next five years. We estimate this will cost the NHS £17 billion at a time when healthcare resources are already overstretched. Our research also shows that policies such as Minimum Unit Pricing have the potential to significantly reduce this burden.”

Liver disease is one of Britain’s biggest killers, claiming about 12,000 lives a year in England alone. The number of deaths associated with it has risen by 400% since 1970. It is estimated that 62,000 years of working life are lost every year as a result of it. People who develop serious liver problems also suffer some of the worst health outcomes in western Europe.

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Alcohol and breast cancer – How big is the risk? ~ Report from the World Cancer Research Fund

Half a glass of wine a day increases breast cancer‘ was just one of the headlines this WCRF_main-150x150week, which discussed a report that reinforced the evidence that alcohol can increase a woman’s risk of developing breast cancer.

The report from the World Cancer Research Fund outlined the latest evidence on how we can reduce that risk – focusing on weight, physical activity and drinking.

The WCRF studies all the evidence on a potential risk and decides whether it’s strong enough to be a basis for making recommendations to the public.

Breast cancer is the most common cancer in the UK, and 1 in 8 women will be diagnosed with breast cancer at some point in their lives. And since we know that almost a third of breast cancer cases in the UK could be prevented, largely by changes to lifestyle, this is important stuff.

While the cause of an individual’s cancer can never be certain, there are still things you can do to reduce your risk. And evidence like this is the first step to helping women to do just that.

So what exactly does the report say?

Alcohol

The report backs up previous research showing that drinking alcohol can cause 7 types of cancer  including breast cancer. Even though it’s in the headlines, this is nothing new.

While the reports may sound alarming, we also know that the more you cut down, the more you’re reducing your risk.

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Although most women don’t regularly drink very large amounts of alcohol, thousands of cases of cancer – including breast – are linked to alcohol each year.

There are 3 good theories on the link between alcohol and cancer which we’ve written about before.

  • When we drink alcohol, it’s broken down into a toxic chemical called acetaldehyde. Acetaldehyde can damage the DNA inside our cells, and then prevent damage from being repaired. This is important because it allows cancer to develop.
  • Alcohol can increase the levels of certain hormones in the body, including oestrogen. We know that high levels of oestrogen can fuel the development of breast cancer, so this might be particularly important here.
  • Alcohol also makes it easier for cells in the mouth and throat to absorb other cancer-causing chemicals. This is probably more important for other cancer types linked to alcohol rather than breast cancer.

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Physical activity

The evidence on the link between breast cancer risk and both weight and physical activity is a bit more complicated. This is because there is evidence that the causes of breast cancer that occur in women before the menopause, compared to after the menopause, are different.

But overall there is strong evidence that keeping a healthy weight and being physically active, can help prevent breast cancer.

Unlike its previous report, this time WCRF says that some forms of physical activity probably reduce the risk for pre-menopausal breast cancer But the finding is only true for ‘vigorous’ activity – exercise which gets you breathing hard and your heart beating fast, so that you won’t be able to say more than a few words without pausing for breath.

The report also adds to the existing evidence that physical activity at any age is related to a lower risk of breast cancer in women after the menopause. This can be anything that gets you a bit hot and out of breath – from fast walking, to cycling, or even heavy housework. And the more you do the better.

Body weight

The evidence on weight and breast cancer is also complicated: as your risk changes depending on the ages at which you were overweight.

But overall the report agrees with previous work showing that being overweight or obese throughout adulthood causes postmenopausal breast cancer, something that is already well established.

Bringing it all together

Other things that affect a woman’s breast cancer risk are less easy to control. As with most cancers, the risk of developing the disease increases with age. Having a family history of the disease can increase a woman’s risk, and breastfeeding can reduce it.

All the different things that can increase the risk of breast cancer are held together by a common thread: they all affect the hormones circulating around in the body in some way.

Hormones help control what happens inside our bodies by sending messages from one place to another – including instructing cells when to stop and start multiplying.

If this system goes wrong, cells can get too many messages telling them to make more cells. And that can lead to cancer.

Overall the best advice is the same as at the start of the week: to keep active, keep a healthy weight throughout life, and limit alcohol.

Originally posted on CRUK, taken from Cancer Research UK Cambridge Institute

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Women & Alcohol | Edinburgh and London-Based Seminar Series | 2017

The Institute of Alcohol Studies (IAS) and the Scottish Health Action on Alcohol Problems (SHAAP) are co-hosting a four part seminar series to discuss issues relating to women and alcohol.

Each session will be chaired by an eminent academic, who will invite three guest speakers to present their personal responses to three pre-set questions, which are relevant to the topic.

These events will provide an opportunity for policy makers, academics, activists, and media representatives to critically discuss topics related to women and alcohol use. The intention is to stimulate thinking, challenge some attitudes and perceptions, and to think about future research and policy priorities.

Seminar 1: Friday, 10th March 2017

Women, Alcohol, and Globalisation.
Royal College of Physicians, London, 2 – 4pm

Chair: Dr. Cecile Knai, Associate Professor of Public Health Policy, London School of Hygiene and Tropical Medicine.

  • How does alcohol marketing influence women’s behaviours?
  • How does alcohol marketing influence attitudes towards women?
  • How does alcohol affect women in different social and cultural contexts?

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Strong evidence that alcohol causes cancer, but how does the public interpret this information?

“Strong epidemiological evidence concerning the causal role of alcohol consumption in cancer may not fit easily with complex lay understandings of the causes of ill health”

Commentary to: Alcohol consumption as a cause of cancer

Connor [1] argues there is strong epidemiological evidence that alcohol causes cancer but highlights uncertainty about how this message may be understood by the ‘wider public’. We agree that there is public confusion and scepticism about public health advice on drinking, and that alcohol industry actors will seek to exploit this by ‘framing’ the debate in ways which further their commercial interests [2, 3]. However, there is also a pressing need to take into account the wider social context in which any new scientific evidence is introduced [4].

People have multi-factorial understandings of the causes of chronic disease which encompass family history, environmental factors, stress and luck, as well as behavioural factors such as smoking and drinking; these factors are perceived as interconnecting, rather than independent, and may become more or less salient at particular points in the life-course [5, 6]. Davison and colleagues [7, 8] argue that, in an iterative process similar to formal epidemiology, ‘lay’ epidemiologists extract information from mainstream health messages and observe patterns of illness and death among family, friends, acquaintances and those in public life to generate and reformulate hypotheses about ‘candidates’ for particular health problems. Gender, age and socio-economic status are also relevant here [9, 10]. Crucially, uncertainty is a key feature of lay epidemiology; some ‘candidates’ are observed to ‘do all the wrong things’ but live long lives (‘unwarranted survivals’: ‘the fat “Uncle Norman” figure who has survived into a healthy old age, despite extremely heavy smoking and drinking’) ([5], p. 682), while other people lead apparently ‘healthy’ lives but still suffer premature illness or death (‘anomalous deaths’). The ‘anomalous death’ of a relative is particularly important in undermining epidemiological evidence about risk factors for major diseases [11].

There are a number of reasons why the message ‘alcohol causes cancer’ may not fit easily with lay epidemiology. First, candidacy only indicates increased risk—not an inevitable outcome–so a message which emphasizes certainty rather than probability may be disregarded. Research investigating the acceptability of cancer warning messages among Australian drinkers [12] suggests that statements about alcohol leading to an ‘increased risk of cancer’ performed better than those which stated that alcohol ‘can cause cancer’.

Secondly, lay epidemiology encompasses an understanding of the different meaning of risk factors at the population and individual level: ‘most people have notions about what renders a person “a candidate” for a specific disease [incorporating “expert” epidemiological understandings of risk at the population level] whilst simultaneously understanding that life, health and death defy prediction at an individual level’ ([11], p. 445). Thus, simple health messages which focus exclusively upon behavioural risk factors at an individual level draw attention to ‘unwarranted survivals’ and particularly to ‘anomalous deaths’ in people’s social networks. The observation that behavioural change does not guarantee a reduction of risk at an individual level (mirroring epidemiological concerns about the ‘prevention paradox’) [11, 13] may therefore result in public scepticism.

Thirdly, while smokers are currently viewed as ‘candidates’ for cancer, it appears that drinkers are not; lay people struggle to find an explanation for non-smokers who develop cancer and instead emphasize the unpredictability and randomness of the disease [14]. Finally, it is important to explore how terms such ‘drinkers’ and ‘drinking’ might be interpreted by the wider public. While ‘smoking causes cancer’ draws on the commonly understood binary opposition between smokers and non-smokers, ‘drinking causes cancer’ may well be understood as comparing ‘heavy’ drinkers with ‘light’ or ‘moderate’ drinkers, rather than contrasting drinkers with non-drinkers. Qualitative research in the United Kingdom demonstrates that drinking is perceived as a routine activity associated with sociability, pleasure and relaxation and that heavy weekend drinking and drinking to intoxication are normalized; thus, drinking alone or choosing not to drink alcohol are behaviours which require explanation, not excessive drinking in general [13, 15-17]. In addition, people construct themselves as responsible, moderate drinkers and position other groups as the ‘problematic’ drinkers. For example, respondents in mid-life portray themselves as ‘experienced’ drinkers and younger people as irresponsible ‘problem’ drinkers [15], younger adults position older people, especially older women drinking heavily in public, as problematic [18], while younger middle-class women position working class women as vulgar and excessive drinkers [19]. This suggests that ‘drinking causes cancer’ may be interpreted as ‘other people’s excessive drinking causes cancer’.

Connor demonstrates the strength of the evidence for alcohol consumption as a cause of cancer. Further research on how lay people conceptualize drinkers and drinking when assessing candidacy is necessary before this message can be communicated effectively to the public.

Declaration of interests

C.E. is a member of the Alcohol Research UK Grants Advisory Panel and has received research funding from Scottish Health Action on Alcohol Problems. S.M. has no competing interests to declare.

Acknowledgements

Thanks to Kate Hunt, Charlie Davison, Una Macleod and Graham Watt for previous conversations about lay epidemiology, and to Penny Buykx for useful suggestions for literature for this commentary.

Original post with references.

Alcohol consumption as a cause of cancer – Full Study