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Alcoholic Drinks: Cancer and Strokes

Volume 506: debated on Monday 22 February 2010

To ask the Secretary of State for Health (1) what the cost to the NHS was of treating strokes caused by the consumption of alcohol in the last year for which figures are available; (316281)

(2) what the cost to the NHS was of treating (a) depression and (b) dementia attributable to alcohol in the last year for which figures are available;

(3) what the cost to the NHS was of treating breast cancer attributable to alcohol consumption in the last year for which figures are available;

(4) what the causes are of (a) breast cancer and (b) heart disease; and what proportion of cases of each were attributable to each such factor in the last 12 months;

(5) what the cost to the NHS was of treating (a) breast cancer and (b) heart disease attributable to the consumption of alcohol in the last year for which figures are available;

(6) how many reported cases of stroke there were in the last year for which figures are available; and in how many such cases the consumption of alcohol was a direct causal factor;

(7) what the cost to the NHS was of treating cancer of the (a) mouth, (b) oesophagus and (c) larynx attributable to the consumption of alcohol in the last year for which figures are available.

The cost of treating specific alcohol-related conditions, such as breast cancer, heart disease, stroke or mental health conditions can be given only at a disproportionate cost. However, alcohol misuse is estimated to cost the national health service around £2.7 billion per annum, which is broken down in the following table.

Estimates of the annual cost of alcohol misuse to the NHS in England

Cost estimate (£ million)

Hospital in-patient and day visits

Directly attributable to alcohol misuse

167.6

Partly attributable to alcohol misuse

1,022.7

Hospital out-patient visits

272.4

Accident and emergency visits

645.7

Ambulance services

372.4

NHS GP consultations

102.1

Practice nurse consultations

9.5

Laboratory tests

n/a

Dependency prescribed drugs

2.1

Specialist treatment services

55.3

Other health care costs

54.4

Total

2,704.1

There are a variety of direct risk factors that can lead to cancer and heart disease, but we know that tobacco, poor diet, genetics, such as a mutated BRC2 gene, and alcohol can cause cancer or heart disease in some individuals.

From work carried out by the North West Public Health Observatory we are able to estimate what the proportion of hospital admissions are due to alcohol consumption, this is know as the alcohol attributable fraction (AAF). The following table provides the AAFs for cancer of the oesophagus, cancer of the larynx, breast cancer. As there is no AAF for stroke, we have provided AAFs for haemorrhagic stroke, ischaemic stroke as a proxy and as there is no AAF for heart disease, we have provided AAFs for alcoholic cardiomyopathy, ischaemic heart disease, cardiac arrhythmias and heart failure as a proxy. There are no such appropriate proxy AAFs for dementia or depression.

AAFs for haemorrhagic stroke, ischaemic stroke, cancer of the lip, oral cavity and pharynx, cancer of the oesophagus, cancer of the larynx, breast cancer and hypertension, alcoholic cardiomyopathy, ischaemic heart disease, cardiac arrhythmias and heart failure

Percentage

Condition

Alcohol attributable factor

Male

Female

Haemorrhagic stroke

24

10

Ischaemic stroke

4

*-6

Cancer of the lip, oral cavity and pharynx

47

28

Cancer of the oesophagus

26

13

Cancer of the larynx

29

16

Breast cancer

n/a

7

Hypertensive disease

28

13

Alcoholic cardiomyopathy

100

100

Ischaemic heart disease

*-6

*-4

Cardiac arrhythmias

33

25

Heart failure

0.4

0.2

Source: Alcohol-attributable fractions for England, North West Public Health Observatory, 2008

It is important to note that although recent meta-analyses showed that alcohol consumption was found to have protective effects on the risk of four conditions: ischaemic heart disease (IHD); ischaemic stroke, type II diabetes; and cholelithiasis, the health benefits for heart disease mostly accrue at low levels of consumption (no more than one-two units daily is needed for the main protective effect) and the benefits are mainly only seen in men over 40 years old and in postmenopausal women. Drinking above the recommended lower-risk levels, of not regularly drinking more than three-four units per day for men and not regularly drinking more than two-three units per day for women, however, does increase the risk of both ischaemic heart disease and ischaemic stroke compared to non-drinkers.

In 2008-09, there were 84,926 hospital admissions due to stroke. As there is no AAF for stroke we cannot say how many of these admissions were due to alcohol, but we can provide the number of hospital admissions for alcohol-related haemorrhagic stroke and alcohol-related ischaemic stroke as a proxy. In 2008-09, there were 2,445 admissions for alcohol-related haemorrhagic stroke and 1,197 admissions for alcohol-related ischaemic stroke.