Although alcohol is an established risk factor for certain cancers, more than half of survivors reported drinking alcohol, with about a third considering themselves moderate drinkers and more than 20% engaging in binge drinking.
The numbers, reported in a new study, came as a surprise to the researchers.
“We recommend that providers screen for alcohol use at regular intervals and provide resources to assist in cutting down use for those who may engage in excessive drinking behaviors,” said study author Nina Niu Sanford, MD, Assistant Professor, Dedman Family Scholar in Clinical Care, UT Southwestern Medical Center, Department of Radiation Oncology, in a press release. “Typically, questions about alcohol use are just asked once when the patient first enters the medical system and then copied into subsequent notes as part of the patient’s social history.”
For the study, published in the Journal of the National Comprehensive Cancer Network, researchers queried the National Health Interview Survey from 2000 to 2017 among adults who had a cancer diagnosis. They explored any correlation between demographic and socioeconomic factors and the likelihood of patients classifying themselves as a current drinker, exceeding moderate drinking limits, and engaging in binge drinking. Additionally, they examined associations based on cancer type.
Lifetime abstainers were defined as consuming fewer than 12 drinks ever, former drinkers were those who had zero drinks in the past year, and current drinkers were defined as having one or more drinks in the past year. Current drinkers further answered the average number of drinks they consumed on days they drank, and how many days in the past year they had consumed five or more drinks. Moderate drinking was defined as more than one drink per day for women and more than two drinks per day for men.
Final analysis included 34,080 patients who had a known cancer diagnosis. Overall, 56.5% said they were current drinkers, 34.9% reported exceeding moderate drinking limits, and 21.0% participated in binge drinking. Factors associated with any amount of alcohol consumption included younger age, smoking history, and more recently responding to the survey (P<0.001 for all, except P-0.008 for excess drinking). Patients with melanoma and cervical, head and neck, and testicular cancers were more likely to be binge drinkers (P<0.05 for all) compared to those diagnosed with other cancers.
“We would hypothesize that individuals with a diagnosis of cancer who self-report poor health status may be those with persistent or recurrent disease who are undergoing active treatment, or experiencing persistent side effects from prior treatment, and therefore may have been advised not to drink or don’t feel well enough to consume alcohol,” said fellow study author Brandon A. Mahal, MD, McGraw/Patterson Center for Population Sciences, Dana-Farber Cancer Institute, in the same release. “However, since causation cannot be established from the NHIS survey, another possibility could be that alcohol use improved the overall self-reported health among cancer survivors, although we think this is less likely. These results point to the fact that more research on alcohol use is needed for all subsets of survivors of cancer, perhaps with an emphasis on reduction in patients who feel well and report excessive drinking.”