Unexpectedly, a study found that more than 70% of cancer survivors were current drinkers, indicating the need for intervention and strategies to reduce harmful drinking habits.
Alcohol consumption and risky drinking behaviors were prevalent among cancer survivors, including those actively receiving treatment, according to the results of a study published in the Journal of the American Medical Association.
In 2022, there were more than 18 million cancer survivors in the United States, which makes identifying behavioral factors that may improve survivorship and quality of life a public health priority.
Despite the evidence that alcohol consumption is associated with a higher risk of recurrence or onset of new cancers in patients, there is a lack of alcohol consumption guidelines in place for cancer survivors to adhere to. In addition, there is a limited understanding of alcohol drinking patterns among cancer survivors in the United States, including frequency and risky behaviors.
The investigators sought to address these knowledge gaps by comprehensively characterizing alcohol consumption patterns among cancer survivors, both overall and during cancer treatment.
Participants were identified from the National Institutes of Health All of Us Research program, which collects data using methods such as survey responses, biospecimen collection, and physical measurements. In total, 15,199 cancer survivors comprised the overall cohort of participants.
Of the total cohort, 11,815 (77.7%) were current drinkers (women, 7344 of 9508 [77.2%]; men, 3971 of 5049 [78.6%]). Compared with non-Hispanic White individuals, cancer survivors who were Hispanic (OR, 0.65; 95% CI, 0.56-0.76), non-Hispanic Black (OR, 0.71; 95% CI, 0.61-0.82), and of other race and ethnicity (OR, 0.49; 95% CI, 0.41-0.58) were less likely to be current drinkers.
Survivors who were diagnosed with alcohol-related cancers were 16% more likely (OR, 1.16; 95% CI, 1.06-1.27) to be current drinkers. Furthermore, former smokers (OR, 1.27; 95% CI, 1.16-1.39) and current smokers (OR, 1.44; 95% CI, 1.22-1.70) were more likely to be current drinkers compared with individuals who never smoked.
Among the survivors who were current drinkers, 1541 (13.0%) exceeded moderate drinking (women, 777 of 7344 [10.6%]; men, 696 of 3971 [17.5%]), and 2812 (23.8%) reported binge drinking (women, 1560 of 7344 [21.2%]; men, 1119 of 3971 [28.2%]). Multivariable adjustment revealed that survivors who were younger than 65 years of age, who were men, who were Hispanic, with cancer diagnosed before 18 years of age, or who ever smoked were more likely to exceed moderate drinking habits.
Hazardous drinking habits were found in 4527 current drinkers (38.3%), with similar prevalence among women and men. Survivors who had cancer diagnosed before 18 years of age were more likely to be hazardous drinkers (OR, 1.52; 95% CI, 1.11-2.08) compared with those diagnosed at 65 years of age or older. These hazardous drinking habits in the former group were associated with more frequent heavy drinking and binge drinking.
The survey identified that 1839 cancer survivors had received treatment within the past year. Of these individuals, 1405 (76.4%) self-reported as current drinkers, which was similar to the prevalence in the overall cohort of patients. Among current drinkers who received a recent cancer diagnosis, 170 (12.1%) exceeded moderate drinking, 329 (23.4%) reported binge drinking, and 540 (38.4%) reported engaging in hazardous drinking.
Although future studies are necessary, the investigators discussed how these results highlight the need for immediate interventions to reduce alcohol intake among US cancer survivors. Targeted efforts are especially warranted for survivors with cancer diagnosed before 18 years of age and those who ever smoked, as they were more likely to be hazardous drinkers, the authors wrote.
To better account for the immediate and unmet needs to intervene on behalf of individuals with risky drinking behaviors in oncologic care settings, clinicians should collect alcohol consumption information while informing survivors of the potential harms of risky drinking to reduce alcohol use, the investigators discussed.
“Given the short- and long-term adverse treatment and oncologic outcomes associated with alcohol consumption, additional research and implementation studies are critical to address this emerging concern among cancer survivors,” the study authors concluded.
Shi M, Luo C, Oduyale OK, et al. Alcohol consumption among adults with a cancer diagnosis in the All of Us research program. JAMA Netw Open. 2023;6(8):e2328328. doi:10.1001/jamanetworkopen.2023.28328