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Alcohol and breast cancer in women: a pooled analysis of cohort studies.

Abstract

OBJECTIVE

To assess the risk of invasive breast cancer associated with total and beverage-specific alcohol consumption and to evaluate whether dietary and nondietary factors modify the association.

DATA SOURCES

We included in these analyses 6 prospective studies that had at least 200 incident breast cancer cases, assessed long-term intake of food and nutrients, and used a validated diet assessment instrument. The studies were conducted in Canada, the Netherlands, Sweden, and the United States. Alcohol intake was estimated by food frequency questionnaires in each study. The studies included a total of 322647 women evaluated for up to 11 years, including 4335 participants with a diagnosis of incident invasive breast cancer.

DATA EXTRACTION

Pooled analysis of primary data using analyses consistent with each study's original design and the random-effects model for the overall pooled analyses.

DATA SYNTHESIS

For alcohol intakes less than 60 g/d (reported by >99% of participants), risk increased linearly with increasing intake; the pooled multivariate relative risk for an increment of 10 g/d of alcohol (about 0.75-1 drink) was 1.09 (95% confidence interval [CI], 1.04-1.13; P for heterogeneity among studies, .71). The multivariate-adjusted relative risk for total alcohol intakes of 30 to less than 60 g/d (about 2-5 drinks) vs nondrinkers was 1.41 (95% CI, 1.18-1.69). Limited data suggested that alcohol intakes of at least 60 g/d were not associated with further increased risk. The specific type of alcoholic beverage did not strongly influence risk estimates. The association between alcohol intake and breast cancer was not modified by other factors.

CONCLUSIONS

Alcohol consumption is associated with a linear increase in breast cancer incidence in women over the range of consumption reported by most women. Among women who consume alcohol regularly, reducing alcohol consumption is a potential means to reduce breast cancer risk.

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  • Authors+Show Affiliations

    ,

    Department of Nutrition, Harvard School of Public Health, Boston, Mass 02115, USA.

    , , , , , , , , , , , , , ,

    Source

    JAMA 279:7 1998 Feb 18 pg 535-40

    MeSH

    Alcohol Drinking
    Breast Neoplasms
    Diet
    Estrogen Replacement Therapy
    Female
    Humans
    Likelihood Functions
    Linear Models
    Menarche
    Menopause
    Multivariate Analysis
    Prospective Studies
    Regression Analysis
    Risk
    Statistics, Nonparametric

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    9480365

    Citation

    Smith-Warner, S A., et al. "Alcohol and Breast Cancer in Women: a Pooled Analysis of Cohort Studies." JAMA, vol. 279, no. 7, 1998, pp. 535-40.
    Smith-Warner SA, Spiegelman D, Yaun SS, et al. Alcohol and breast cancer in women: a pooled analysis of cohort studies. JAMA. 1998;279(7):535-40.
    Smith-Warner, S. A., Spiegelman, D., Yaun, S. S., van den Brandt, P. A., Folsom, A. R., Goldbohm, R. A., ... Hunter, D. J. (1998). Alcohol and breast cancer in women: a pooled analysis of cohort studies. JAMA, 279(7), pp. 535-40.
    Smith-Warner SA, et al. Alcohol and Breast Cancer in Women: a Pooled Analysis of Cohort Studies. JAMA. 1998 Feb 18;279(7):535-40. PubMed PMID: 9480365.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Alcohol and breast cancer in women: a pooled analysis of cohort studies. AU - Smith-Warner,S A, AU - Spiegelman,D, AU - Yaun,S S, AU - van den Brandt,P A, AU - Folsom,A R, AU - Goldbohm,R A, AU - Graham,S, AU - Holmberg,L, AU - Howe,G R, AU - Marshall,J R, AU - Miller,A B, AU - Potter,J D, AU - Speizer,F E, AU - Willett,W C, AU - Wolk,A, AU - Hunter,D J, PY - 1998/2/28/pubmed PY - 2001/8/14/medline PY - 1998/2/28/entrez SP - 535 EP - 40 JF - JAMA JO - JAMA VL - 279 IS - 7 N2 - OBJECTIVE: To assess the risk of invasive breast cancer associated with total and beverage-specific alcohol consumption and to evaluate whether dietary and nondietary factors modify the association. DATA SOURCES: We included in these analyses 6 prospective studies that had at least 200 incident breast cancer cases, assessed long-term intake of food and nutrients, and used a validated diet assessment instrument. The studies were conducted in Canada, the Netherlands, Sweden, and the United States. Alcohol intake was estimated by food frequency questionnaires in each study. The studies included a total of 322647 women evaluated for up to 11 years, including 4335 participants with a diagnosis of incident invasive breast cancer. DATA EXTRACTION: Pooled analysis of primary data using analyses consistent with each study's original design and the random-effects model for the overall pooled analyses. DATA SYNTHESIS: For alcohol intakes less than 60 g/d (reported by >99% of participants), risk increased linearly with increasing intake; the pooled multivariate relative risk for an increment of 10 g/d of alcohol (about 0.75-1 drink) was 1.09 (95% confidence interval [CI], 1.04-1.13; P for heterogeneity among studies, .71). The multivariate-adjusted relative risk for total alcohol intakes of 30 to less than 60 g/d (about 2-5 drinks) vs nondrinkers was 1.41 (95% CI, 1.18-1.69). Limited data suggested that alcohol intakes of at least 60 g/d were not associated with further increased risk. The specific type of alcoholic beverage did not strongly influence risk estimates. The association between alcohol intake and breast cancer was not modified by other factors. CONCLUSIONS: Alcohol consumption is associated with a linear increase in breast cancer incidence in women over the range of consumption reported by most women. Among women who consume alcohol regularly, reducing alcohol consumption is a potential means to reduce breast cancer risk. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/9480365/full_citation L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/279/pg/535 DB - PRIME DP - Unbound Medicine ER -