Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI.
Int J Cancer. 2014 Mar 15;134(6):1504-10. doi: 10.1002/ijc.28476. Epub 2013 Oct 9.
Higher alcohol consumption, even at moderate levels, has been associated with an increased risk of breast cancer in epidemiological studies. However, prior studies were conducted in mostly white populations. To assess the relationship of alcohol consumption to postmenopausal breast cancer risk in a multiethnic population of largely never, light or moderate drinkers, we prospectively examined the association in 85,089 women enrolled in the Multiethnic Cohort in Hawaii and California. During a mean follow-up of 12.4 years, 3,885 incident invasive breast cancer cases were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models, controlling for potential confounders. Higher alcohol consumption was associated with increased risk of breast cancer: compared to nondrinkers, HRs were 1.23 (95% CI: 1.06-1.42), 1.21 (95% CI: 1.00-1.45), 1.12 (95% CI: 0.95-1.31) and 1.53 (95% CI: 1.32-1.77) for 5-9.9, 10-14.9, 15-29.9 and ≥ 30 g/day of alcohol, respectively. The positive association was seen in African American, Japanese American, Latino and white, but not in Native Hawaiian women, and in those with tumors that were both positive and negative for estrogen and progesterone receptors (ER/PR). This prospective study supports previous findings that light to moderate alcohol consumption increases breast cancer risk, and demonstrates this association in several ethnic groups besides whites, independent of ER/PR status.
更高的酒精摄入量,即使是适度的,也与流行病学研究中的乳腺癌风险增加有关。然而,先前的研究主要是在白人人群中进行的。为了评估在一个主要是从不饮酒、轻度饮酒或中度饮酒的多民族人群中,饮酒与绝经后乳腺癌风险的关系,我们前瞻性地检查了夏威夷和加利福尼亚州的多民族队列中 85089 名女性的关联。在平均 12.4 年的随访期间,确定了 3885 例侵袭性乳腺癌病例。使用 Cox 比例风险模型估计风险比(HR)和 95%置信区间(CI),并控制了潜在的混杂因素。较高的酒精摄入量与乳腺癌风险增加相关:与不饮酒者相比,HR 分别为 1.23(95%CI:1.06-1.42)、1.21(95%CI:1.00-1.45)、1.12(95%CI:0.95-1.31)和 1.53(95%CI:1.32-1.77),分别为 5-9.9、10-14.9、15-29.9 和≥30 g/天的酒精摄入量。这种正相关关系在非裔美国人、日裔美国人、拉丁裔和白人中可见,但在夏威夷原住民女性中不可见,也在雌激素和孕激素受体(ER/PR)阳性和阴性的肿瘤中可见。这项前瞻性研究支持了先前的发现,即轻度至中度饮酒会增加乳腺癌风险,并证明了这种关联在除白人以外的几个种族群体中存在,独立于 ER/PR 状态。