Alcohol consumption and cancer risk in South Korea and the UK: prospective cohort studies

Abstract

Background: This study aimed to compare cancer incidence rates between South Korea and the UK, and assess the associated cancer risks due to alcohol consumption.

Methods: Data were pooled from the Korean Cancer Prevention Study-II and the Korean Genome Epidemiology Study Biobank for South Korea, and from UK Biobank (UKB) for the UK, with follow-up until 2020. Age-standardized incidence rates were calculated by using the World Health Organization standard population. Hazard ratios (HRs) for cancer incidence were analysed in relation to alcohol consumption levels.

Results: The overall cancer incidence rates were similar between South Korea and the UK. However, the incidence of liver, stomach, and thyroid cancers was more than five times higher in the Korean cohort. Compared with never drinkers, consuming ≥50 g of alcohol daily increased the overall cancer risk by 24% in the Korean data and by 11% in the UKB data. In Korea, heavy drinking (≥50 g/day) was associated with higher risks of esophageal cancer (HR = 12.59), liver cancer (HR = 1.65), head and neck cancer (HR = 2.06), alcohol-related cancers (HR = 1.60), and stomach cancer (HR = 1.43). In the UKB cohort, it was linked to increased risks of head and neck cancer (HR = 1.95), breast cancer (HR = 1.12), and alcohol-related cancers (HR = 1.18). Both cohorts showed a lower risk of thyroid cancer with increased alcohol consumption.

Conclusion: Alcohol consumption is associated with an increased risk of alcohol-related cancers in both South Korean and UK populations.

Keywords: South Korea; United Kingdom; alcohol drinking; cohort studies; neoplasms; risk.

Figure 1.

Association between drinking amount and incident cancer risk in all participants in the pooled Korean biobank. Adjusted for age, BMI, smoking status, socioeconomic status, family history of cancer; head and neck cancer included oral cavity cancer, pharynx cancer, larynx cancer; alcohol-related cancer included oral cavity cancer, pharynx cancer, larynx cancer, esophagus cancer, liver cancer, colorectal cancer, female breast cancer. ^†The HR in the pooled Korean biobank is different from that in UKB (Z>1.96).

Figure 2.

Association between drinking amount and incident cancer risk in total participants in UKB. Adjusted for age, BMI, smoking status, socioeconomic status, family history of cancer; head and neck cancer included oral cavity cancer, pharynx cancer, larynx cancer; alcohol-related cancer included oral cavity cancer, pharynx cancer, larynx cancer, esophagus cancer, liver cancer, colorectal cancer, female breast cancer. ^†The HR in the pooled Korean biobank is different from that in UKB (Z>1.96).

Figure 3.

Association between drinking amount and incident cancer risk excluding F/U of <3 years in the pooled Korean biobank. Adjusted for age, BMI, smoking status, socioeconomic status, family history of cancer; head and neck cancer included oral cavity cancer, pharynx cancer, larynx cancer; alcohol-related cancer included oral cavity cancer, pharynx cancer, larynx cancer, esophagus cancer, liver cancer, colorectal cancer, female breast cancer.

Figure 4.

Association between drinking amount and incident cancer risk excluding F/U of <3 years in UKB. Adjusted for age, BMI, smoking status, socioeconomic status, family history of cancer; head and neck cancer included oral cavity cancer, pharynx cancer, larynx cancer; alcohol-related cancer included oral cavity cancer, pharynx cancer, larynx cancer, esophagus cancer, liver cancer, colorectal cancer, female breast cancer.