Reducing alcohol consumption could ease Australia’s cancer burden

By Dr. Sanchari Sinha Dutta, Ph.D.Reviewed by Lauren HardakerJan 27 2026

Long-term national data reveal that even modest reductions in alcohol consumption across the whole population could prevent thousands of cancer deaths, especially among older Australians.

Study: Alcohol consumption and mortality from four alcohol-related cancers in Australia 1950-2018: a time series analysis. Image credit: metodej/Shutterstock.com

Population-level reduction of alcohol consumption in Australia could, over the long term, significantly decrease the mortality caused by major alcohol-related cancers, according to a study published in the British Journal of Cancer.

Alcohol and tobacco jointly influence cancer outcomes

Excessive alcohol intake is a major risk factor for several cancers, including upper aerodigestive tract (oral cavity, pharynx, larynx, esophagus), liver, colorectal, and breast cancers. Tobacco smoking further influences the association between alcohol intake and cancer risk, especially for upper aerodigestive tract cancer.

The overall drinking level as well as the population-level distribution of alcohol intake are two important factors that need to be considered while determining the association between alcohol intake and cancer mortality. According to the collectivity theory of drinking culture, the changes in per capita (the mean value per person) alcohol intake are associated with shifts in drinking patterns across the entire population.

It has also been documented in the literature that the prevalence of heavy drinking reduces with the reduction in average alcohol intake across a population. This is particularly important from a public health perspective, as the risk of cancer mortality is disproportionately high for the heaviest drinkers.

Given the significant impact of population-level drinking patterns on cancer mortality, researchers explored the potential preventive impact of reducing population drinking on cancer mortality in Australia, while controlling for changes in tobacco smoking and per capita health expenditure. Existing evidence indicates that higher health expenditure is associated with better cancer outcomes.

National time-series links alcohol trends to cancer deaths

The researchers analyzed annual per capita alcohol intake data (1910–2018) and cancer mortality data (1950s–2018) collected from national registries. The primary focus was on four types of alcohol-related cancers, including upper aerodigestive tract, liver, colorectal, and breast cancers.

The researchers also collected annual per capita tobacco smoking data and per capita health expenditure from national databases and included these variables in the analysis as potential confounders. They used time-series statistical models to estimate sex- and age-specific associations and long-term effects of alcohol intake and tobacco smoking on cancer mortality.

Cancer mortality patterns differ by sex and cancer type

The study analysis revealed a significant increase in per capita alcohol intake between 1950 and 1970 and tobacco smoking between 1950 and 1966, followed by a steady reduction. However, per capita health expenditure increased steadily from 1935 to 2018.

Regarding mortality, the study found an increase in upper aerodigestive tract cancer mortality among males and females until the mid-1980s, followed by a reduction afterwards. Regarding liver cancer mortality, a steady increase was observed between 1968 and 2018.

Female breast cancer mortality mostly remained at the same level between 1950 and 1995 and decreased slightly after 1995. Colorectal cancer mortality increased from 1955 to 1986 and reduced afterwards for males, while female colorectal cancer mortality declined gradually since 1955.

Association between alcohol intake and cancer mortality

The analysis controlling for tobacco smoking and health expenditure revealed that a one-litre decrease in annual per capita alcohol intake is associated with approximately 3.6 % reduction in upper aerodigestive tract cancer mortality among males and 3.4 % among females over a period of 20 years. However, this association is significant only for the 50–69-year age group.

Regarding liver cancer, a 3.8 % reduction in mortality was observed with a one-litre decrease in annual per capita alcohol intake among males. This association was significant only among people aged 50 years and over. However, no significant impact of alcohol intake on liver cancer mortality was observed among females.

Similarly, a significant positive association between alcohol intake and colorectal cancer mortality was observed among males and females aged 50 years and over. However, the estimated effects were smaller than those observed for upper aerodigestive tract and male liver cancers. Regarding female breast cancer mortality, a significant positive association with alcohol intake was observed across all adult age groups (30 years and older).

Considering the average alcohol intake from 1930 to 2018, the study found that about 45 % of male deaths and around 21 % of female deaths due to upper aerodigestive tract cancer, and approximately 48 % of male deaths due to liver cancer were associated with alcohol intake.

Policy-driven drinking reductions could save lives nationwide

The study findings reveal that a population-level decrease in alcohol intake can lead to significant reductions in alcohol-related cancer mortality rates in Australia, particularly among people aged 50–69 years. However, estimates are sensitive to assumptions about long-term exposure lags that determine how past alcohol consumption is weighted over time.

Specifically, the findings suggest that the population-level reduction in alcohol intake may have more pronounced benefits among males than females, reflecting that males consume substantially more alcohol than females.

Among males, the highest benefits of restricted alcohol intake were observed among those aged 50 years and older, reflecting the long-term cumulative effects of alcohol intake on cancer development.

Regarding breast cancer mortality, the findings suggest that female breast cancer mortality risk can be reduced or prevented across adult age groups by reducing alcohol intake.

The authors note that the results come from an aggregate (ecological) time-series analysis and that effect estimates vary depending on the assumed lag between alcohol exposure and cancer outcomes. Under alternative lag assumptions, associations were weaker or not statistically significant, indicating that the findings should be interpreted cautiously rather than as definitive causal estimates.

Overall, the study findings highlight the need for large-scale implementation of public health policies that aim to reduce alcohol intake at the population level, such as increasing alcohol price or tax, reducing alcohol availability, developing drinking-preventive interventions, and controlling alcohol-related advertising.

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