Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20852, USA.
Int J Cancer. 2011 Jun 15;128(12):2953-61. doi: 10.1002/ijc.25623. Epub 2010 Oct 8.
Previous investigations have provided conflicting results regarding whether alcohol consumption affects endometrial cancer risk, although in many of these studies the highest category of alcohol intake examined was limited. Further, most were unable to resolve how alcohol associations are affected by beverage type, the presence of other endometrial cancer risk factors, or tumor characteristics. To address these issues, we prospectively evaluated the association between alcohol intake and incident endometrial cancer (n = 1,491) in a cohort of 114,414 US women enrolled in the NIH-AARP Diet and Health Study. We calculated relative risks (RR) and 95% confidence intervals (CI) using Cox proportional hazards regression. After adjustment for age, body mass index (BMI), smoking and other potential confounders, the multivariable RRs (and 95% CIs) compared with nondrinkers were 0.97 (0.87-1.09) for >0-<12 g of alcohol/day, 1.06 (0.87-1.31) for 12-<24 g/day and 0.93 (0.71-1.20) for ≥ 24 g/day (p trend = 0.90). There was, however, some suggestion of higher risks associated with alcohol consumption among lean women (BMI, <25) and users of menopausal hormone therapy, with significant interactions with both parameters (respective interaction p-values of 0.002 and 0.005). The relationship was also enhanced, albeit nonsignificantly so, for low grade cancers. Our results do not support that alcohol is a strong contributor to endometrial cancer risk, but slight risk increases may prevail among some users or for selected tumor characteristics.
先前的研究对于饮酒是否会影响子宫内膜癌风险的结果存在争议,尽管在这些研究中,有相当一部分研究仅局限于最高饮酒量的分析。此外,大多数研究都无法确定酒精与饮料类型、其他子宫内膜癌风险因素的存在或肿瘤特征之间的关联会受到何种影响。为了解决这些问题,我们前瞻性地评估了 114414 名参加美国国家卫生研究院-美国退休人员协会饮食与健康研究的美国女性中饮酒与子宫内膜癌发病风险(n=1491)之间的关联。我们使用 Cox 比例风险回归计算了相对风险(RR)和 95%置信区间(CI)。在调整年龄、体重指数(BMI)、吸烟和其他潜在混杂因素后,与非饮酒者相比,RR(95%CI)分别为>0-<12 g/天(0.97[0.87-1.09])、12-<24 g/天(1.06[0.87-1.31])和≥24 g/天(0.93[0.71-1.20])(p 趋势=0.90)。然而,对于偏瘦的女性(BMI<25)和使用绝经激素治疗的女性,饮酒与较高的风险之间存在一定的关联,且与这两个参数均存在显著的交互作用(相应的交互 p 值分别为 0.002 和 0.005)。对于低级别癌症,这种关联也有所增强,尽管没有统计学意义。我们的结果并不支持酒精是子宫内膜癌风险的一个重要因素,但对于某些使用者或某些特定肿瘤特征,风险可能会略微增加。