Open Access Open Badges Research article

Attributable fraction of alcohol consumption on cancer using population-based nationwide cancer incidence and mortality data in the Republic of Korea

Sohee Park12, Hai-Rim Shin13*, Boram Lee1, Aesun Shin14, Kyu-Won Jung1, Duk-Hee Lee5, Sun Ha Jee6, Sung-Il Cho7, Sue Kyung Park48, Mathieu Boniol9, Paolo Boffetta10 and Elisabete Weiderpass11121314

Author Affiliations

1 Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, South Korea

2 Department of Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, South Korea

3 Western Pacific Regional Office, World Health Organization, Manila, Philippines

4 Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea

5 Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea

6 Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, South Korea

7 Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, South Korea

8 Department of Biomedical Science, Seoul National University Graduate School, Cancer Research Institute, Seoul National University, Seoul, South Korea

9 International Prevention Research Institute, Lyon, France

10 The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

11 Cancer Registry of Norway, Oslo, Norway

12 Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Artic University of Norway, Tromsø, Norway

13 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

14 Samfundet Folkhälsan, Helsinki, Finland

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BMC Cancer 2014, 14:420  doi:10.1186/1471-2407-14-420

Published: 10 June 2014



In the Republic of Korea, cancer is the most common cause of death, and cancer incidence and mortality rates are the highest in East Asia. As alcoholic beverages are carcinogenic to humans, we estimated the burden of cancer related to alcohol consumption in the Korean population.


The cancer sites studied were those for which there is convincing evidence of a positive association with alcohol consumption: oral cavity, pharynx, esophagus, colon, rectum, liver, larynx and female breast. Sex- and cancer-specific population attributable fractions (PAF) were calculated based on: 1) the prevalence of alcohol drinkers among adults ≥20 years of age in 1989; 2) the average daily alcohol consumption (g/day) among drinkers in 1998; 3) relative risk (RR) estimates for the association between alcohol consumption and site-specific cancer incidence obtained either from a large Korean cohort study or, when more than one Korean study was available for a specific cancer site, meta-analyses were performed and the resulting meta-RRs were used; 4) national cancer incidence and mortality data from 2009.


Among men, 3% (2,866 cases) of incident cancer cases and 2.8% (1,234 deaths) of cancer deaths were attributable to alcohol consumption. Among women, 0.5% (464 cancer cases) of incident cancers and 0.1% (32 deaths) of cancer deaths were attributable to alcohol consumption. In particular, the PAF for alcohol consumption in relation to oral cavity cancer incidence among Korean men was 29.3%, and the PAFs for pharyngeal and laryngeal cancer incidence were 43.3% and 25.8%, respectively. Among Korean women, the PAF for colorectal cancer incidence was the highest (4.2%) and that for breast cancer incidence was only 0.2%. Avoiding alcohol consumption, or reducing it from the median of the highest 4th quartile of consumption (56.0 g/day for men, 28.0 g/day for women) to the median of the lowest quartile (2.80 g/day for men, 0.80 g/day for women), would reduce the burden of alcohol-related cancers in Korea.


A reduction in alcohol consumption would decrease the cancer burden and a significant impact is anticipated specifically for the cancers oral cavity, pharynx, and larynx among men in the Republic of Korea.

Risk factor; Population attributable fraction; Lifestyle; Asia