Province-specific alcohol-attributable cancer deaths and years of potential life lost in China

Objective: Cancer is a major cause of death in China. As alcohol drinking, a risk factor of cancer, is common in China, we aimed to estimate the alcohol-attributable cancer deaths and years of potential life lost (YPLL) across all provinces in China. Methods: We estimated the proportion of cancer deaths and YPLL attributable to alcohol consumption at the province level. Population attributable fraction (PAF) was calculated based on: 1) prevalence of alcohol consumption, obtained from the China National Nutrition and Health Survey 2002; 2) dose-response relative risks (RRs) of alcohol consumption and site-specific cancer, extracted from published meta-analyses; 3) cancer mortality data, originated from the National Program of Cancer Registry 2013. Results: We estimated that 98,306 cancer deaths were attributable to alcohol consumption and accounted for 4.56 % of the total cancer deaths in China in 2013. Of these deaths, a total of 919,741.57 person-years premature loss of life was caused. Both overall PAF and average YPLL per 100,000 individuals were much higher in men than that in women (7.01 % vs. 0.33 % and 130.55 vs. 4.45, respectively). At the province level, overall PAF ranged from 2.14 % (95 % CI: 1.40 %–2.87 %) in Shanghai to 6.56 % (95 % CI: 4.06 %–9.05 %) in Anhui and the average YPLL per 100,000 individuals ranged from 10.97 in Tibet to 106.52 in Shandong. Conclusions: Cancer burden attributable to alcohol consumption varied across provinces in China. Province-level approaches are warranted to decrease alcohol consumption and reduce the alcohol-related cancer burden.