Alcohol is a known carcinogen for humans, increasing the risk of oral, pharyngeal, laryngeal, oesophageal, liver, colorectal and (female) breast cancers.1-3 There is also evidence that the risk of developing these cancers increases with higher levels of alcohol consumption (i.e. there is a dose-response relationship).4, 5 Even small amounts of alcohol can increase cancer risk1, and the joint effects of alcohol consumption and behavioural risk factors, such as smoking and poor dietary practices, further increase risk of cancers.1, 2, 6
Aboriginal and Torres Strait Islander people are less likely to drink alcohol, compared to wider Australian community, but those who drink are more likely to do so at risky levels.7 The 2011 Australian Burden of Disease Study indicated that alcohol consumption contributed to 2.8% of the disease burden for cancer for Aboriginal and Torres Strait Islander people.7
About this measure
In 2010, it was estimated that alcohol-attributable cancer was responsible for about 4.2% of all global cancer deaths, and 4.6% of all potential Years-of-Life-Lost.8 It has also been estimated that 3% – 6% of all cancer cases in Australia are attributable to consumption of alcohol.6,9 On this basis, given that the incidence of cancer in 2012 (excluding non-melanoma skin cancers) was 122,093 cases, up to 7,326 cancers could be attributed to the consumption of alcohol.
Consumption of alcohol increases the risk of developing cancer.2 The National Health and Medical Research Council (NHMRC) provides evidence-based guidance on reducing health risks associated with alcohol consumption.10 The 2009 NHMRC Guidelines on reducing these health risks states that:
- For healthy men and women, drinking no more than two standard drinks on any one day reduces the lifetime risk of harm from alcohol-related disease or injury (Guideline I).
- For children and young people under 18 years of age, not drinking alcohol is the safest option.
- A standard drink of alcohol in Australia is approximately one shot of spirit.
The measure ‘proportion of people aged 15 years and over reporting consumption of no alcohol in the previous 12 months’ includes those who reported consuming no alcohol in the previous 12 or more months and those who reported having never consumed alcohol.
For a comparison with the broader Australian community see the NCCI ‘Alcohol consumption' .
Current status
Alcohol consumption - low risk guideline
In 2018-19, 79.4% of Aboriginal and Torres Strait Islander people aged 15 years and over did not exceed the lifetime risk guideline for alcohol consumption, with lower rates among males than among females (69.9% compared with 87.1%). Among young Aboriginal and Torres Strait Islander people aged 15-17 years the proportion not exceeding the guideline was 95.7%.
Alcohol consumption - no alcohol
In 2018-19, 71.4% of young Aboriginal and Torres Strait Islander people aged 15-17 years did not consume alcohol in the previous 12 months (64.2% among males, 77.3% among females). For Aboriginal and Torres Strait Islander people aged 15 years and over, 29.9% did not consume alcohol in the previous 12 months (23.9% among males and 35.5% among females).
Trends
Alcohol consumption - low risk guideline
Data for previous years are available for proportions exceeding the low risk guideline, and is the comparison described here. In 2012-13 and 2018-19 the proportions of Aboriginal and Torres Strait Islander people aged 15 years or over exceeding the low risk guideline for alcohol consumption remained about the same (18.0% in 2012-13, 18.4% in 2018-19). Alcohol consumption was similar between years among males (26.3% in 2012-13, 28.2% in 2018-19), whilst among females the proportion was unchanged (10.0% in each year).
Alcohol consumption - no alcohol
From 2012-13 to 2018-19 proportions of Aboriginal and Torres Strait Islander people aged 15 years or over not consuming alcohol increased slightly (26.4% in 2012-13, 29.9% in 2018-19). A slight change was observed among males (21.8% in 2012-13, 23.9% in 2018-19), whilst among females the proportion not consuming increased (30.8% in 2012-13, 35.5% in 2018-19).
Tackling alcohol consumption
The National Aboriginal and Torres Strait Islander Peoples Drug Strategy recognises that harmful alcohol consumption is a consequence of the social determinants of health, that is the impact of social disadvantage on individuals and communities leading to poorer health and greater exposure to cancer risk factors (e.g. smoking, alcohol consumption). The overarching approach of the National Drug Strategy for reducing alcohol consumption is harm minimisation, which encompasses the three pillars of: supply reduction (reducing the availability of alcohol) demand reduction (reducing the appeal of alcohol and alcohol consumption) and harm reduction (reducing the impacts of alcohol use).
About the data
Alcohol consumption - low risk guideline
This measure shows the proportions of people who had consumed more than two standard drinks per day, exceeding the lifetime risk alcohol guideline.
Numerator: Number of persons who consumed an average of more than two standard drinks per day.
Denominator: Number of persons aged 15 years and over.
Alcohol consumption - no alcohol - adults
This measure shows the proportions of people aged 15 years and over who reported consuming no alcohol in the previous 12 months and those who had never consumed alcohol.
Numerator: Number of persons who reported consuming no alcohol in the previous 12 months and those who had never consumed alcohol.
Denominator: Number of persons aged 15 years and over.
Data sources
ABS 2012-13, 2018-19 National Aboriginal and Torres Strait Islander Health Survey.
References
Activity in this area
Data:
Australian Bureau of Statistics. 4715.0 - National Aboriginal and Torres Strait Islander Health Survey, 2018-19. Canberra: ABS; 2019; [Accessed May 2020]; Available at: https://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4715.0Main+Features12018-19?OpenDocument
Australian Bureau of Statistics. 4727.0.55.001 – Australian Aboriginal and Torres Strait Islander Health Survey: First Results, Australia, 2012-13. Canberra: ABS; 2013 [Accessed May 2020]; Available at: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4727.0.55.001main+features12012-13.
Policy:
National Health and Medical Research Council (NHMRC). Australian guidelines to reduce health risks from drinking alcohol. Canberra: NHMRC; 2020; Available at: https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-reduce-health-risks-drinking-alcohol
National Alcohol Strategy 2016-2021. http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-drugs-alcohol-index.htm
National Aboriginal and Torres Strait Islander Peoples Drug Strategy 2014-2019. https://www.health.gov.au/resources/publications/national-aboriginal-and-torres-strait-islander-peoples-drug-strategy-2014-2019
Cancer Australia. National Aboriginal and Torres Strait Islander Cancer Framework. 2015
Cancer Australia. Optimal Care Pathway for Aboriginal and Torres Strait Islander people with cancer. 2018 Available from: https://canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/optimal-care-pathway-aboriginal-and-torres-strait-islander-people-cancer
References
1. Cancer Australia. Lifestyle risk factors and the primary prevention of cancer. Sydney: Cancer Australia; 2015 [Accessed May 2020]; Available at: http://canceraustralia.gov.au/publications-and-resources/position-statements/lifestyle-risk-factors-and-primary-prevention-cancer
2. International Agency for Research on Cancer. Personal Habits and Indoor Combustions. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Lyon: IARC; 2012.
3. World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington, DC: American Institute for Cancer Research; 2007.
4. Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. British journal of cancer. 2015;112(3):580-93. Epub 2014/11/26.
5.Schutze M, Boeing H, Pischon T, Rehm J, Kehoe T, Gmel G, et al. Alcohol attributable burden of incidence
6. Pandeya N, Wilson LF, Webb PM, Neale RE, Bain CJ, Whiteman DC. Cancers in Australia in 2010 attributable to the consumption of alcohol. Australian and New Zealand journal of public health. 2015;39(5):408-13. Epub 2015/10/07.
7. Australian Institute of Health and Welfare 2016. Australian Burden of Disease Study: Impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2011. Australian Burden of Disease Study series no. 6. Cat. no. BOD 7. Canberra: AIHW.
8. Rehm K, Shield KD. Alcohol and mortality: Global alcohol-attributable deaths from cancer, liver cirrhosis, and injury in 2010. Alcohol Research: Current Reviews. 2013;35(2):174-83.
9. Winstanley MH, Pratt IS, Chapman K, Griffin HJ, Croager EJ, Olver IN, et al. Alcohol and cancer: a position statement from Cancer Council Australia. The Medical journal of Australia. 2011;194(9):479-82. Epub 2011/05/04.
10. National Health and Medical Research Council (NHMRC). Australian guidelines to reduce health risks from drinking alcohol. Canberra: NHMRC; 2020 [Accessed January 2022]; Available at: https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-reduce-health-risks-drinking-alcohol