Key Jane, Hodgson Susan, Omar Rumana Z, Jensen Tina K, Thompson Simon G, Boobis Alan R, Davies Donald S, Elliott Paul
Department of Epidemiology and Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK.
Cancer Causes Control. 2006 Aug;17(6):759-70. doi: 10.1007/s10552-006-0011-0.
To give an up-to-date assessment of the association of alcohol with female breast cancer, addressing methodological issues and shortfalls in previous overviews.
Meta-analysis of studies (any language) providing original data on incidence of first primary breast cancer and alcohol. Two reviewers independently extracted data. Study quality assessed by objective criteria including degree of control for confounding; funnel plots examined for publication bias; meta-regression techniques to explore heterogeneity. Risks associated with drinking versus not drinking and dose-response not constrained through the origin estimated using random effects methods.
Ninety-eight unique studies were included, involving 75,728 and 60,653 cases in drinker versus non-drinker and dose-response analyses, respectively. Findings were robust to study design and analytic approaches in the meta-analyses. For studies judged high quality, controlled for appropriate confounders, excess risk associated with alcohol drinking was 22% (95% CI: 9-37%); each additional 10 g ethanol/day was associated with risk higher by 10% (95% CI: 5-15%). There was no evidence of publication bias. Risk did not differ significantly by beverage type or menopausal status. Estimated population attributable risks were 1.6 and 6.0% in USA and UK, respectively.
Taking account of shortcomings in the study base and methodological concerns, we confirm the alcohol-breast cancer association. We compared our results to those of an individual patient data analysis, with similar findings. We conclude that the association between alcohol and breast cancer may be causal.
对酒精与女性乳腺癌之间的关联进行最新评估，探讨以往综述中的方法学问题和不足之处。
对提供原发性乳腺癌发病率和酒精原始数据的研究（任何语言）进行荟萃分析。两名审阅者独立提取数据。通过客观标准评估研究质量，包括混杂因素的控制程度；用漏斗图检查发表偏倚；用荟萃回归技术探索异质性。使用随机效应方法估计饮酒与不饮酒以及剂量反应与原点无关的风险。
纳入98项独特研究，饮酒者与非饮酒者分析和剂量反应分析分别涉及75728例和60653例。在荟萃分析中，研究结果对研究设计和分析方法具有稳健性。对于判断为高质量且控制了适当混杂因素的研究，饮酒相关的额外风险为22%（95%CI：9%-37%）；每天每增加10克乙醇，风险增加10%（95%CI：5%-15%）。没有证据表明存在发表偏倚。风险在饮料类型或绝经状态方面无显著差异。在美国和英国，估计人群归因风险分别为1.6%和6.0%。
考虑到研究基础的不足和方法学问题，我们证实了酒精与乳腺癌之间的关联。我们将我们的结果与个体患者数据分析的结果进行了比较，结果相似。我们得出结论，酒精与乳腺癌之间的关联可能是因果关系。
