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Trial highlights lack of awareness on alcohol and breast cancer link


Anastasia Tsirtsakis


7/06/2023 4:03:07 PM

But an Australian study looking at the effectiveness of alcohol intervention targeting women has shown promise for change.

A woman pouring a glass of wine.
Prior to the alcohol intervention, just one in five study participants were aware that drinking alcohol was a risk factor for breast cancer.

Alcohol consumption accounts for 6.6% of breast cancer cases in post-menopausal women and 18% of breast cancer deaths.
 
Despite being a major modifiable risk factor, awareness of the risk alcohol poses remains low.
 
In a bid to address this knowledge gap, Monash University teamed up with Turning Point, the national addiction treatment, training and research centre, and the Victorian Health Promotion Foundation (VicHealth) to develop an alcohol intervention designed for women attending breast screening appointments – and the research findings have shown its effectiveness.
 
The randomised trial findings for Health4Her, published in the Medical Journal of Australia, included 557 women aged over 40 with an average of 60 years who attended routine breast screening in Melbourne between February and August 2021.
 
While the majority of participants (82%) had recently consumed alcohol, only one in five (20%) were aware that drinking was a risk factor for breast cancer.
 
However, this awareness was found to have increased four weeks after receiving the Health4Her intervention to 65%.
 
Study lead Dr Jasmin Grigg said the research findings are ‘encouraging’.
 
‘There is now strong evidence that even very light drinking increases breast cancer risk,’ she said.
 
‘We know that population-based breast screening programs are uniquely positioned to provide women with health information and strategies to reduce risk of breast cancer, at a time when breast cancer is top of mind.
 
‘With data showing nearly 1.9 million Australian women were screened by BreastScreen Australia in 2018– 2019, health messaging about this specific risk offered in this supportive environment has potential for extensive reach.’
 
In addition to improving awareness around breast cancer risk, the study findings also show that the intervention helped to increase participants’ alcohol literacy, with the proportion of participants able to identify:

  • the amount of alcohol in a standard drink up from 11% to 23%
  • the number of standard drinks in an average serve of wine up from 8% to 22%
  • the maximum weekly consumption recommended by Australian Alcohol Guidelines up from 4% to 16%.
The intervention, which researchers developed with the input of women, included personalised feedback about drinking levels, information about alcohol harms, positive messaging about the health benefits of reducing consumption, and strategies to keep drinking in a low-risk range. 
 
It also included information on other ways to reduce breast cancer risk, such as exercise and keeping weight in a healthy range.
 
The research did, however, show that despite the intervention increasing alcohol literacy among participants, that it didn’t significantly change alcohol consumption.
 
While the study focused on opportunistic education through breast screening services, Dr Alia Kaderbhai, Chair of RACGP Specific Interests Breast Medicine, said that GPs should also be discussing lifestyle modifications with patients – regardless of gender.
 
‘Any opportunity for intervention around risk reduction is a no brainer and will be a great benefit to reducing the risk of breast cancer in the population,’ she told newsGP.
 
‘One of the most important lifestyle factors is alcohol consumption, along with obesity. So, ensuring that patients are engaging in physical activity regularly, that they’re not smoking and they’re eating a well-balanced, healthy diet.’
 
Dr Kaderbhai is concerned that media headlines promoting drinking a glass of red wine daily is not only misleading but can also give people permission to drink a certain amount every day – without understanding that it puts them at risk of not only breast cancer, but other diseases.
 
‘What is underestimated is how even just one drink can increase your risk and that is where I think the literacy is lagging or probably not quite up to date because I don’t think there’s a good understanding of what is a safe amount,’ she said.
 
‘One of the other confusing things is that there are different organisations that advise different things.
 
‘The Australian Alcohol Consumption Guidelines are different to the Cancer Australia Guidelines, which are different to the World Health Organization Guidelines – so there’s a bit of mixed messaging as well.’
 
Drinking at risky levels has significantly increased among women of middle and older age – cohorts that are at the highest lifetime risk of developing breast cancer, but who have been traditionally overlooked in alcohol health promotion.
 
Kathryn Elliott understands the consequences of this firsthand. She was 46 when she was diagnosed with locally advanced breast cancer – a pivotal moment that led her to question whether there was a potential link to her long-term binge drinking patterns.
 
‘Knowledge around this issue is low given 1000–2000 breast cancer cases each year in Australia can be directly attributable to alcohol consumption,’ she said.
 
‘We need to talk about it so that people understand the harms alcohol products cause. Given alcohol is a major modifiable risk factor I’m glad I’ve been able to make this significant change to my lifestyle.’
 
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