A Systematic Review of Alcohol Interventions for People Living with and beyond Cancer

Background

There is a wealth of evidence pointing to a link between alcohol drinking and cancer.  There is also evidence to suggest that people who have been diagnosed with cancer continue to behave in a way which is risky to their health by smoking cigarettes, eating an unhealthy diet, not exercising, and/or drinking too much alcohol.

Almost 50% of people diagnosed with cancer are expected to survive for at least five years. This has led to an increased interest in developing healthy lifestyle interventions to reduce the risk of cancer reoccurring. Most research to date has looked at the impact of interventions for improving diet, stopping people from smoking, and encouraging people to take part in exercise. However, there is the potential that these interventions, which promote a healthy lifestyle, can also encourage people to drink less alcohol.

The aim of this study was to review all scientific studies, which report the results of healthy lifestyle interventions for people who have had a cancer diagnosis, to see whether or not these interventions can lead to people who have been diagnosed with cancer drinking less alcohol.

Electronic databases were searched for all studies published in the last 30 years, which were conducted in any country, and described healthy lifestyle interventions for people who had been diagnosed with cancer. In order to be eligible for inclusion in this review, articles needed to report how much alcohol participants were drinking before and after the intervention.

Findings

Database searches identified 19,579 articles, which were potentially eligible for the systematic review. Two independent researchers checked eligibility by reading each study’s title and abstract. This reduced the number of potential articles to 94. Following this the full text of the remaining 94 articles was read by two independent reviewers before a final decision was made. This resulted in seven articles being identified as eligible for inclusion in this review.

The results of this systematic review highlight that none of the interventions had a specific focus on alcohol use, and instead tended to focus on healthy eating, and exercise. Only one article described an intervention which led to participants drinking less alcohol compared to those who did not receive the intervention. Three further articles described studies where both those who received the intervention and those who did not receive it reported drinking less alcohol at the end of the study. This suggests that the interventions described in these articles had no impact on alcohol use which would have reduced over time regardless of receiving an intervention.

The vast majority of the participants across all seven studies were white women who had been diagnosed with breast cancer.  This suggests that the results of these studies cannot be generalised to non-white women or men, or people diagnosed with a cancer other than breast cancer. The limited impact of these interventions on reducing how much alcohol people drink after a cancer diagnosis, as well as the low number of male participants and people with different cancers, suggests that further research is needed. This will allow us to assess if interventions focussing specifically on encouraging people who have been diagnosed with cancer to drink less alcohol can be effective.

Implications

• There is a lack of interventions specifically focused on reducing how much alcohol people drink after they have received a cancer diagnosis.
• General lifestyle interventions have a limited impact on alcohol use for those who have received a cancer diagnosis.
• Only one study in this systematic review was conducted in the United Kingdom suggesting a lack of focus on how much alcohol people are drinking in this country following a cancer diagnosis.

Conclusion

This review highlights there is a lack of interventions which have a specific focus on reducing how much alcohol people are drinking following a diagnosis for cancer. Alcohol use can increase the risk of secondary or recurrent cancer, especially in people who have been diagnosed with breast cancer, and head and neck cancers. Therefore, there is a need for more research to explore the potential for interventions to encourage people who have been diagnosed with cancer to drink less alcohol, which can reduce this risk.