Rosenberg L, Palmer J R, Miller D R, Clarke E A, Shapiro S
Slone Epidemiology Unit, School of Public Health, Boston University School of Medicine, Brookline, MA 02146.
Am J Epidemiol. 1990 Jan;131(1):6-14. doi: 10.1093/oxfordjournals.aje.a115486.
In many studies, moderate alcohol consumption has been associated with increases in the risk of breast cancer of about 50-100%. The authors examined recent alcoholic beverage consumption in relation to the risk of breast cancer in a case-control study of women aged less than 70 years, conducted in Toronto, Ontario, Canada, from 1982 to 1986: 607 breast cancer cases identified in a cancer hospital were compared with 1,214 controls matched to the cases on neighborhood and decade of age. The subjects were interviewed at home. Confounding factors were controlled by conditional logistic regression. The relative risk estimates for women who consumed alcohol, relative to women who drank less than one alcoholic beverage (drink) per month, were close to 1.0: for women who drank at least one alcoholic beverage per day, the multivariate estimate was 0.9 (95% confidence interval 0.6-1.2). Among subgroups of women, including those at low baseline risk, there was also no association. For a subset of cases compared with hospital controls, once again there was no association. The relative risk (RR) estimate was elevated for women who drank at least one beer daily (RR = 1.7) and reduced for women who drank at least one glass of wine daily (RR = 0.7), but neither estimate was statistically significant. The results suggest that recent alcohol consumption does not influence the risk of breast cancer. Selection bias cannot be ruled out, however. In addition, because determinants of alcohol use are not well understood, control of confounding may have been incomplete in the present study and in other observational studies of alcohol and breast cancer.
在许多研究中,适度饮酒与乳腺癌风险增加约50%-100%有关。作者在1982年至1986年于加拿大多伦多安大略省开展的一项针对70岁以下女性的病例对照研究中,研究了近期酒精饮料消费与乳腺癌风险的关系:将一家癌症医院确诊的607例乳腺癌病例与1214名在社区和年龄十年方面与病例匹配的对照进行比较。研究对象在家中接受访谈。通过条件逻辑回归控制混杂因素。饮酒女性相对于每月饮用少于一杯酒精饮料(饮品)的女性的相对风险估计值接近1.0:对于每天至少饮用一杯酒精饮料的女性,多变量估计值为0.9(95%置信区间0.6-1.2)。在女性亚组中,包括那些基线风险较低的亚组,也没有关联。对于与医院对照相比的一部分病例,同样没有关联。每天至少饮用一杯啤酒的女性的相对风险(RR)估计值升高(RR = 1.7),而每天至少饮用一杯葡萄酒的女性的相对风险估计值降低(RR = 0.7),但这两个估计值均无统计学意义。结果表明,近期饮酒不会影响乳腺癌风险。然而,不能排除选择偏倚。此外,由于对饮酒决定因素了解不足,在本研究以及其他关于酒精与乳腺癌的观察性研究中,混杂因素的控制可能并不完全。