Changing mortality from esophageal cancer in males in Denmark and other European countries, in relation to changing levels of alcohol consumption

Age-specific mortality rates from esophageal cancer in men are considered by year of birth in European countries with different levels of alcohol consumption. In countries with high and increasing levels of alcohol consumption (Denmark, Hungary, Federal Republic of Germany, and Czechoslovakia) successive birth cohorts born after about 1910 experience increasing mortality from esophageal cancer in all age-groups. No clear trend in esophageal cancer mortality was observed in countries starting from lower levels of alcohol consumption, even in the presence of increasing consumption (Sweden, Norway, Finland, Netherlands, Poland, UK). There was an apparent threshold around 8 l of ethanol per capita per year. Likewise, no upward trend in esophageal cancer mortality was observed in countries with high and stable alcohol consumption (France, Italy, Portugal). These findings are in agreement with results of analytic epidemiologic studies which indicate that esophageal cancer mortality is only slightly affected by moderate doses of alcohol, but rises steeply with consumption of large quantities. The incidence and mortality of esophageal cancer is likely to increase further in the future in countries where the level of alcohol consumption was relatively high in 1960 and where consumption increased further in the 1960s and 1970s.