Alcohol-Attributable Cancer Deaths in Ireland: Lifetime Risk Modelling for Drinking Guidelines

To inform the update of Irish low-risk drinking guidelines, a statistical model was developed to estimate the lifetime mortality risk attributable to alcohol. Cancer is a major contributor to alcohol-related deaths in Ireland, and quantifying this burden is essential for evidence-based and equitable public health policy. This analysis focuses on the association between alcohol intake and cancer specific mortality risk. Dose–response relationships between alcohol consumption and cancers were sourced from systematic reviews. These estimates were combined with Healthy Ireland alcohol consumption data to estimate alcohol-attributable fractions (AAF) for cancer mortality. AAFs were used to estimate age and sex-specific annual risks of alcohol-attributable cancer deaths. Sex-specific lifetime risks of death were then calculated using these annual risks of death in conjunction with all-cause mortality. Cancers accounted for approximately 30% of alcohol-attributable deaths and over 4% of all cancer deaths annually in Ireland. A lifetime risk of 1 in 100 alcohol-attributable cancer death corresponded to alcohol consumption of 29 g/day for males and 18 g/day for females. For a 1 in 1,000 risk, corresponding intakes were 4 g/day for males and 2 g/day for females. Higher lifetime risks among females were primarily driven by breast cancer, alongside comparatively elevated risks of liver cancer. Increased cancer mortality risk was observed in individuals aged from 45 to 74 years across both sexes. Alcohol consumption represents a substantial and unequal component of cancer mortality in Ireland. Lifetime risks of death are evident at low levels of intake and increase with increasing consumption, with the greatest impact occurring after 45 years old. These findings support prevention strategies that are proportionate to risk and sensitive to inequities in alcohol-related cancer burden, including public awareness and policy measures to reduce alcohol-related harm.

Key messages

• Alcohol contributes substantially to cancer mortality in Ireland, with a meaningful lifetime risk even at low consumption levels, particularly among females.

• These findings add to existing evidence supporting targeted public health action to reduce alcohol-attributable cancer mortality in Ireland.