Impact of reducing alcohol consumption through price-based policies on cancer incidence in Germany 2020-50-a simulation study

Abstract

Background and aims: Alcohol is a major cancer risk factor and contributes considerably to the cancer burden in Germany. We aimed to provide projections of preventable cancer cases under different price-based alcohol policy scenarios.

Design: A macro-simulation approach was used to estimate numbers and proportions of cancer cases prevented under different price-based alcohol policy scenarios.

Setting and participants: Published price elasticities for main alcoholic beverages were applied to the mean daily intake of pure alcohol in the German population calculated from the German Health Interview and Examination Survey for Adults 2008-11 (DEGS1) to obtain hypothetical exposure distributions of alcohol consumption under different scenarios of changing price for alcoholic beverages.

Measurements: Age, sex and cancer site-specific potential impact fractions were calculated for different scenarios of changing the price of alcohol (single price increases, repeated price increases, volumetric price increase) for each year of a 30-year study period (2020-50).

Findings: Over a 30-year horizon, an estimated 4.7% (men = 10.1%, women = 1.4%) of alcohol-related cancer cases could be prevented in Germany, if alcohol intake above risk thresholds were reduced to levels below risk thresholds. Accordingly, the burden of new cancers would be reduced by approximately 244 000 cases (men = 200 000, women = 44 000). Of all price-based alcohol policy scenarios, a 100% price increase on alcoholic beverages was estimated to be most effective with approximately 213 000 (4.1%; men = 167 000; women = 47 000) preventable alcohol-related cancer cases, followed by 5-yearly 25% price increases (2.8%; men = 115 000, women = 29 000) and a volumetric price increase according to the beverage-specific alcohol content (1.9%; men = 72 000, women = 24 000).

Conclusions: Simulations suggest that a substantial number of alcohol-related cancer cases could be avoided in Germany by applying price-based policies to reduce consumption of alcoholic beverages.

Keywords: Alcohol control; cancer; policy intervention; potential impact fraction; prevention; simulation.