Awareness of the Link between Alcohol Consumption and Cancer across the World: A Review

Cancer Epidemiol Biomarkers Prev. 2018 Apr;27(4):429-437. doi: 10.1158/1055-9965.EPI-17-0645.


Since 1988, the International Agency for Research on Cancer has classified alcohol as a Group 1 carcinogen, the highest level of risk. Growing evidence suggests that alcohol increases the risk of several types of cancer including breast, bowel, prostate, and liver, and accounts for a significant proportion of preventable cancers. Despite ample evidence of this relationship, public awareness is less clear. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we reviewed 32 studies examining lay awareness of alcohol as a risk factor for cancer in 16 countries. Our results show that awareness appears to be low and varies internationally; it is relatively higher in the United Kingdom, Morocco, and Australia. Methodologic differences in assessment obfuscate cross-country and cross-sample comparisons. In general, people are more likely to endorse alcohol as a risk factor when presented with a list of possible risk factors than when asked to list risk factors in an open-ended format. Attempts to increase awareness have been limited and constitute a significant public health need. We provide potential strategies to increase awareness, such as alcohol bottle labeling and fostering patient/physician discussions regarding the link. Cancer Epidemiol Biomarkers Prev; 27(4); 429-37. ©2018 AACR.

Publication types

  • Review

MeSH terms

  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology*
  • Alcoholic Beverages / adverse effects
  • Alcoholic Beverages / standards
  • Australia / epidemiology
  • Food Labeling / standards
  • Global Burden of Disease*
  • Health Knowledge, Attitudes, Practice*
  • Health Services Needs and Demand
  • Humans
  • Morocco / epidemiology
  • Neoplasms / epidemiology*
  • Neoplasms / etiology
  • Neoplasms / prevention & control
  • Patient Education as Topic
  • Risk Factors
  • United Kingdom / epidemiology