Modelling the number of avoidable new cancer cases in France attributable to alcohol consumption by following official recommendations: a simulation study

Aims To predict the effects of perfect adherence to the French alcohol consumption guidelines, a maximum of 10 standard alcoholic drinks per week with no more than two standard alcoholic drinks per day, during a 36-year period (2014–50). Design This simulation study is an adaption of the Sheffield Alcohol Policy Model. The dose–response relationship between alcohol consumption and alcohol-attributable cancer risks was defined by cancer site-specific risk functions, each modelled as a continuous risk. These estimates were used to compute the potential impact fraction (PIF) associated with alcohol consumption by cancer site. Setting The French general adult population during a 36-year period (2014–50). Participants For the baseline scenario, the current distribution of consumption levels, the counterfactual scenario and perfect adherence to the French alcohol consumption guidelines, we generated for each gender and age group 1000 randomly distributed alcohol consumption values from calibrated group-specific gamma distribution. Measurements The predicted number of new cancer cases among men and women in France between 2015 and 2050 that could have been prevented by following the French government's alcohol consumption guidelines. Findings The simulation predicted that perfect adherence to the French government's alcohol consumption guidelines would prevent, on average, an estimated 15 952 cancer cases per year after the PIF reached its full effect, which would have represented 4.5% of new cancer cases in 2015. The number of averted cancer cases over the study period were highest for oral cavity, oropharynx and hypopharynx cancer (respectively, 118 462, 95% CI = 113 803–123 022 and 11 167, 95% CI = 10 149–12 229] for men and women; liver and intrahepatic bile ducts cancer (123 447, 95% CI = 112 581–133 404 and 2825, 95% CI = 2208,4095); colorectal cancer (89 859, 95% CI = 84 651–95 355 and 12 847, 95% CI = 11 545–14 245); and female breast cancer (61 649, 95% CI = 56 330–67 452). Conclusion This simulation study of the French general population predicted that perfect adherence to the French government's alcohol consumption guidelines (no more than 10 standard alcoholic drinks per week and two per day) would prevent almost 16 000 cancer cases per year.