Drinking alcohol is an established risk factor for several malignancies, and it is a potentially modifiable risk factor for cancer. This guide updates previous guidance from SHAAP to summarise for health professionals the links between alcohol consumption and cancers, so that they can use opportunities in their work to intervene to reduce the risks. The previous guidance was produced following an expert workshop which was convened by SHAAP in 2011. This version, updated in 2019, relies on data from Information Services Division Scotland (ISD) and Scottish Public Health Observatory (ScotPHO) collaboration amongst other sources.

It is important to note that ScotPHO has revised their method for calculating alcohol attributable fractions (AAFs), resulting in more accurate estimations. This has resulted in increased AAFs for cancers, reflected in this report. Due to this revised method, the figures in this report cannot be compared to previous editions.

The role of health professionals:

Raising the issue of alcohol consumption with patients can be difficult. However, evidence from many sources suggests that patients are accepting of tactful or empathetic inquiry about aspects of their lifestyle which may have an impact on their health. Health professionals are well placed to raise the level of awareness with their patients and clients as part of a comprehensive review of their health and lifestyle. Most patients and clients welcome guidance and support to help them find the motivation to improve their health and wellbeing. Reducing alcohol consumption is often only one of a number of changes that could be made to improve quality of life, but it is one that is achievable. 

This guidance provides statistics regarding alcohol-attributable deaths to cancer in Scotland. There is strong epidemiological evidence to suggest that alcohol increases your risk of developing the following types of cancer:
• Cancer of the lip, oral cavity and pharynx
• Cancer of the larynx
• Cancer of the oesophagus
• Cancer of the breast
• Colorectal cancer
• Cancer of the liver and intrahepatic bile ducts

There is also a relationship between alcohol and cancer of the stomach, although this relationship is different from that of the cancers mentioned above. This will be expanded upon in the stomach cancer section below. Additionally, there is some evidence that alcohol is associated with several other cancers such as pancreatic cancer, lung cancer, and melanoma.