初潮至首次怀孕期间的饮酒量：一项前瞻性研究乳腺癌风险。
Alcohol intake between menarche and first pregnancy: a prospective study of breast cancer risk.
机构信息
Affiliations of authors: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO (YL, GAC); Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO (GAC); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BR, CSB, WYC, RMT); Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (LCC, SJS, JLC); Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA (WCW).
出版信息
J Natl Cancer Inst. 2013 Oct 16;105(20):1571-8. doi: 10.1093/jnci/djt213. Epub 2013 Aug 28.
BACKGROUND
Adult alcohol consumption during the previous year is related to breast cancer risk. Breast tissue is particularly susceptible to carcinogens between menarche and first full-term pregnancy. No study has characterized the contribution of alcohol consumption during this interval to risks of proliferative benign breast disease (BBD) and breast cancer.
METHODS
We used data from 91,005 parous women in the Nurses' Health Study II who had no cancer history, completed questions on early alcohol consumption in 1989, and were followed through June 30, 2009, to analyze breast cancer risk. A subset of 60,093 women who had no history of BBD or cancer in 1991 and were followed through June 30, 2001, were included in the analysis of proliferative BBD. Relative risks (RRs) were estimated using Cox proportional hazard regression.
RESULTS
We identified 1609 breast cancer cases and 970 proliferative BBD cases confirmed by central histology review. Alcohol consumption between menarche and first pregnancy, adjusted for drinking after first pregnancy, was associated with risks of breast cancer (RR = 1.11 per 10 g/day intake; 95% confidence interval [CI] = 1.00 to 1.23) and proliferative BBD (RR = 1.16 per 10 g/day intake; 95% CI = 1.02 to 1.32). Drinking after first pregnancy had a similar risk for breast cancer (RR = 1.09 per 10 g/day intake; 95% CI = 0.96 to 1.23) but not for BBD. The association between drinking before first pregnancy and breast neoplasia appeared to be stronger with longer menarche to first pregnancy intervals.
CONCLUSIONS
Alcohol consumption before first pregnancy was consistently associated with increased risks of proliferative BBD and breast cancer.
背景
成人在过去一年中的饮酒量与乳腺癌风险有关。在初潮到首次足月妊娠期间，乳腺组织对致癌物特别敏感。没有研究描述过这段时间内饮酒对增生性良性乳腺疾病（BBD）和乳腺癌风险的贡献。
方法
我们利用护士健康研究 II 中 91005 名已育妇女的数据，这些妇女在研究开始时没有癌症病史，于 1989 年完成了关于早期饮酒的问题调查，并随访至 2009 年 6 月 30 日，以分析乳腺癌风险。在 1991 年没有 BBD 或癌症病史且随访至 2001 年 6 月 30 日的 60093 名妇女中，有一部分人被纳入增生性 BBD 的分析。使用 Cox 比例风险回归估计相对风险（RR）。
结果
我们确定了 1609 例乳腺癌病例和 970 例经中心组织学复查确诊的增生性 BBD 病例。初潮到首次妊娠期间的饮酒量（调整了首次妊娠后的饮酒量）与乳腺癌（RR=1.11/10 g/天摄入；95%置信区间[CI]：1.00-1.23）和增生性 BBD（RR=1.16/10 g/天摄入；95%CI：1.02-1.32）风险相关。首次妊娠后饮酒与乳腺癌（RR=1.09/10 g/天摄入；95%CI：0.96-1.23）的风险相似，但与 BBD 无关。初潮到首次妊娠期间饮酒与乳腺肿瘤之间的关联似乎与初潮到首次妊娠的间隔时间较长有关。
结论
首次妊娠前饮酒与增生性 BBD 和乳腺癌风险的增加一致相关。
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