Strategies for Reducing the Risk of Cancers in Patients With Alcohol Dependence

Investigators have uncovered the potential benefit of undergoing alcohol rehabilitation and maintaining abstinence in patients with alcohol dependence at risk of developing alcohol-associated cancers, according to a recent study published by Schwarzinger et al in The Lancet Public Health. The findings provided potential evidence linking reduced or ceased alcohol consumption with a decreased risk of alcohol-associated cancers.

Background

“From a public health standpoint, our research highlights a troubling neglect of alcohol dependence compared to other health issues in both research and policy priorities,” emphasized lead study author Michaël Schwarzinger, MD, in the Department of Prevention at Bordeaux University Hospital in France. “Consequently, alcohol dependence continues to be a silent, dreadful epidemic in countries like France—especially given that the average annual level of adult alcohol consumption per capita in that country is over twice the global average,” he added.

Study Methods and Results

In the recent study, the investigators analyzed the data of more than 24 million adults residing in mainland France who were discharged from the hospital between 2018 and 2021.

The investigators found that 6.3% of the male patients and 1.6% of the female patients had alcohol dependence—which was strongly linked to alcohol-associated cancers such as hepatocellular carcinoma as well as oral, pharyngeal, laryngeal, esophageal, and colorectal cancers in both groups. However, the patients with alcohol dependence who underwent rehabilitation or had a history of abstinence had a significantly lower risk of developing alcohol-associated cancers compared with those who had alcohol dependence without rehabilitation or abstinence.

“The research team was surprised at the size of the treatment intervention effect in this study. We know that alcohol dependence treatment is effective, but the fact that alcohol dependence is a recurring chronic disease often makes us forget that even with relapses, periods of abstinence markedly lower the risk of cancer and other chronic diseases,” detailed senior study author Jürgen Rehm, PhD, a senior scientist at the Institute for Mental Health Policy Research at the Centre for Addiction and Mental Health in France.

Conclusions

The investigators suggested that the findings underscored the effectiveness of treatment strategies that combat cancer risks linked to alcohol dependence.

“We know that the most effective strategy to reduce the overall burden of harms caused by alcohol, including cancer, lies in population-level policies—measures such as increasing alcohol taxes, reducing alcohol availability, and banning or restricting marketing,” stressed co–study author Carina Ferreira-Borges, PhD, Regional Adviser for Alcohol, Illicit Drugs, and Prison Health at the World Health Organization’s (WHO) Regional Office for Europe. “However, this study underscores that health systems’ responses [are] also crucial to lower the risk of alcohol-[associated] cancers. By increasing accessibility to interventions for alcohol rehabilitation and abstinence in health-care settings, countries could do more to protect their populations from preventable cancers. Therefore, we call for more investment in rehabilitation and treatment services for alcohol use disorders in France and other countries of the WHO European Region,” she underlined.

“In Canada, hospital admissions for alcohol-[associated] conditions outnumber those for myocardial infarction, and many [patients] face barriers to evidence-based treatment due to stigma and challenges in accessing in-person care. Innovations such as virtual treatment can overcome these challenges by offering flexible and cost-effective solutions. At [the Centre for Addiction and Mental Health], we’re conducting research on fully-virtual day programs [that] show promise, replicating traditional rehabilitation intensity without the need for physical infrastructure—thereby reducing wait times and making treatment more accessible,” underscored Leslie Buckley, MD, MPH, FRCPC, Chief of Addictions at the Centre for Addiction and Mental Health. “Given the imminent increase to alcohol availability in Ontario, it’s essential to consider how we could make treatment more accessible. Increased alcohol availability is likely to lead to higher consumption, and accessible virtual treatment programs could address this by providing crucial care to those in need,” she concluded.

Disclosure: The research in this study was financially supported by the European Union’s EU4Health program. For full disclosures of the study authors, visit thelancet.com.