Schootman Mario, Deshpande Anjali D, Lynskey Michael T, Pruitt Sandi L, Lian Min, Jeffe Donna B
Division of Health Behavior Research, Department of Medicine, Washington University School of Medicine, Saint Louis, MO 63108, USA.
J Prim Care Community Health. 2013 Jan;4(1):50-8. doi: 10.1177/2150131912443133. Epub 2012 Apr 18.
Breast cancer survivors who consume alcohol excessively are at increased risk of recurrence and have worse prognosis. Because the environments in which people live shape many health behaviors, there has been increased attention to how neighborhood environments (eg, alcohol outlet availability) may influence alcohol consumption. The authors hypothesized that proximity to alcohol outlets increases the likelihood of excessive consumption (ie, more than 1 drink/day) among breast cancer survivors independent of their personal or neighborhood characteristics.
With the Missouri Cancer Registry, the authors conducted a cross-sectional study of 1047 female breast cancer survivors (aged 27-96 years) 1 year after diagnosis. Using telephone interviews, the authors obtained data regarding survivors' alcohol consumption during the past 30 days and several covariates of alcohol use. They also obtained street addresses of all licensed alcohol outlets in Missouri and calculated the road network distance between a participant's address of residence and the nearest alcohol outlet, using a geographic information system. Logistic regression was used to determine if distance was independently associated with excessive alcohol consumption.
Eighteen percent of participants reported consuming more than 1 drink on average per day. Women who lived within 3 miles of the nearest outlet were more likely to report excessive alcohol consumption (odds ratio: 2.09; 95% confidence interval: 1.08, 4.05) than women who lived at least 3 miles from the nearest outlet in adjusted analysis.
Opportunities exist to reduce excessive alcohol use among breast cancer survivors through policy (eg, restricting number of alcohol outlets) and behavioral (eg, counseling) interventions.
过度饮酒的乳腺癌幸存者复发风险增加，预后较差。由于人们生活的环境塑造了许多健康行为，邻里环境（如酒精销售点的可及性）如何影响饮酒行为受到了更多关注。作者假设，对于乳腺癌幸存者而言，居住地与酒精销售点的距离较近会增加其过度饮酒（即每天饮酒超过1杯）的可能性，且不受其个人或邻里特征的影响。
作者利用密苏里州癌症登记处的数据，对1047名确诊1年后的女性乳腺癌幸存者（年龄在27 - 96岁之间）进行了一项横断面研究。通过电话访谈，作者获取了幸存者过去30天的饮酒数据以及一些饮酒相关的协变量信息。他们还获取了密苏里州所有持牌酒精销售点的街道地址，并使用地理信息系统计算了参与者居住地址与最近酒精销售点之间的道路网络距离。采用逻辑回归分析来确定距离是否与过度饮酒独立相关。
18%的参与者报告平均每天饮酒超过1杯。在调整分析中，居住在距离最近销售点3英里以内的女性比居住在距离最近销售点至少3英里以外的女性更有可能报告过度饮酒（优势比：2.09；95%置信区间：1.08，4.05）。
通过政策干预（如限制酒精销售点数量）和行为干预（如咨询），有机会减少乳腺癌幸存者的过度饮酒行为。
