Alcohol drinking, social class and cancer

Area of Science:

• Epidemiology
• Public Health
• Oncology

Background:

• Social class gradients are observed in the incidence of several cancers.
• Alcohol consumption is a known risk factor for cancers of the upper gastrointestinal tract, respiratory tract, and liver.
• Tobacco smoking is a major determinant of these cancer types.

Purpose of the Study:

• To review data on alcohol-related cancer occurrence in relation to social class.
• To assess the role of alcohol drinking in observed social class gradients for these cancers.
• To evaluate the influence of tobacco smoking as a confounding factor.

Main Methods:

• Review of existing epidemiological data on cancer incidence and social class.
• Analysis of consistency in social class gradients across different alcohol-related cancers.
• Use of lung cancer data to estimate the impact of tobacco smoking.
• Inclusion of data on alcohol consumption levels and other alcohol-related morbidity where available.

Main Results:

• A significant role for alcohol drinking in negative social class gradients for alcohol-related cancers is highly probable in men from France, Italy, and New Zealand.
• Suggestive, though less robust, evidence for alcohol's role was observed in men from Brazil, Switzerland, the United Kingdom, and Denmark.
• Other factors, particularly tobacco smoking and dietary habits, likely contribute to these observed gradients.

Conclusions:

• Alcohol consumption is a likely contributor to social inequalities in specific cancer types.
• Tobacco smoking and dietary factors are also important determinants of these cancer disparities.
• Further research is needed to fully elucidate the complex interplay of factors influencing alcohol-related cancer incidence across social classes.