Alcohol consumption among patients diagnosed with genitourinary cancers

Abstract

Objective: To characterize alcohol consumption and binge-drinking patterns among individuals with GU cancers (prostate, kidney, bladder and testicular) compared to a propensity-matched cohort without cancer in a large, nationally diverse population.

Materials and methods: We conducted a retrospective, cross-sectional study utilizing data from the National Institutes of Health All of Us Research Program. Matching accounted for age, sex assigned at birth, smoking status, comorbidities and education/marital status. The primary outcome was self-reported drinking frequency. The secondary outcomes were self-reported binge-drinking frequency and Alcohol Use Disorders Identification Test (AUDIT-C) scores.

Results: Drinking and binge-drinking among individuals with GU malignancy (N = 11 522) closely resembled those of matched controls (N = 47 747), with the majority (53%) consuming at least 2-4 drinks per month. There was no significant association between GU cancer diagnosis and increased drinking frequency (OR: 0.99; p = 0.65), binge-drinking frequency (OR: 0.85; p: 0.055) or AUDIT-C (OR: 0.99; p =0.65). Individuals diagnosed with kidney cancer had reduced odds of higher alcohol use (OR: 0.76; p < 0.001) and AUDIT-C score (OR: 0.83; p < 0.001) compared to controls.

Conclusion: In this large cohort, including traditionally underrepresented minorities, alcohol use was highly prevalent among those with GU malignancies. Drinking behaviours were similar to individuals without cancer, underscoring the need for integration of lifestyle-focused interventions into survivorship care, as alcohol remains a common and modifiable behaviour with wide-ranging health implications.

Keywords: alcohol; genitourinary cancer; modifiable behaviour.

FIGURE 1

Study inclusion flowchart of All of Us participants diagnosed with a GU malignancy.

FIGURE 2

Distribution of drinking frequency across genitourinary malignancy subtypes compared to propensity‐matched noncancer controls. Bar plots show the proportion of individuals reporting different levels of alcohol consumption within the last year, stratified by A) pan‐GU cancers, B) prostate, C) kidney, D) bladder and E) testis cancer. Ordinal logistic regression models adjusted by demographic and clinical characteristics were used to report odds ratio (OR) and 95% confidence intervals (CIs) of more frequent alcohol consumption. C) A diagnosis of kidney cancer was associated with significantly lower odds of reporting heavier drinking (OR (95% CI): 0.76 (0.65,0.90); p < 0.001).

FIGURE 3

Distribution of binge‐drinking frequency across genitourinary malignancy subtypes compared to propensity‐matched noncancer controls. Bar plots show the proportion of individuals reporting different levels of binge‐drinking within the last year, stratified by A) pan‐GU cancers, B) prostate, C) kidney, D) bladder and E) testis cancer. Ordinal logistic regression models adjusted by demographic and clinical characteristics were used to report odds ratio (OR) and 95% confidence intervals (CIs) more frequent heavy alcohol consumption.