诊断前饮酒与浸润性乳腺癌黑人女性和白人女性的死亡率风险。
Pre-diagnosis alcohol consumption and mortality risk among black women and white women with invasive breast cancer.
机构信息
Department of Population Sciences, Beckman Research Institute, City of Hope, 1500 East Duarte Rd, Duarte, CA, 91010, USA.
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA.
出版信息
BMC Cancer. 2019 Aug 13;19(1):800. doi: 10.1186/s12885-019-5991-8.
BACKGROUND
Alcohol consumption is associated with increased risk of breast cancer; however, its association with subsequent risk of breast cancer death is unclear.
METHODS
We followed 4523 women with complete information on relevant risk factors for mortality; these women were 35 to 64 years of age when diagnosed with incident invasive breast cancer between 1994 and 1998. During follow up (median, 8.6 years), 1055 women died; 824 died from breast cancer. The information on alcohol consumption before diagnosis was collected shortly after breast cancer diagnosis (average: 5.1 months) during an in-person interview which used a structured questionnaire. Multivariable Cox proportional hazards regression models provided hazard ratios (HRs) and 95% confidence intervals (CIs) for breast cancer-specific mortality, mortality due to causes other than breast cancer, and all-cause mortality associated with alcohol consumption from age 15 years until breast cancer diagnosis and during recent periods of time prior to breast cancer diagnosis.
RESULTS
Average weekly alcohol consumption from age 15 years until breast cancer diagnosis was inversely associated with breast cancer-specific mortality (P = 0.01). Compared to non-drinkers, women in the highest average weekly alcohol consumption category (≥7 drinks/week) had 25% lower risk of breast cancer-specific mortality (HR = 0.75, 95% CI = 0.56-1.00). Breast cancer mortality risk was also reduced among women in the highest average weekly alcohol consumption category in two recent time periods (5-year period ending 2-years prior to breast cancer diagnosis, HR = 0.74, 95% CI = 0.57-0.95; 2-year period immediately prior to breast cancer diagnosis: HR = 0.73, 95% CI = 0.56-0.95). Furthermore, analyses of average weekly alcohol consumption by beverage type from age 15 years until breast cancer diagnosis suggested that wine consumption was inversely associated with breast cancer-specific mortality risk (wine P = 0.06, beer P = 0.24, liquor P = 0.74). No association with any of these alcohol consumption variables was observed for mortality risk due to causes other than breast cancer.
CONCLUSIONS
Overall, we found no evidence that alcohol consumption before breast cancer diagnosis increases subsequent risk of death from breast cancer.
背景
饮酒与乳腺癌风险增加相关；然而，其与乳腺癌死亡后风险的关联尚不清楚。
方法
我们随访了 4523 名女性，这些女性在 1994 年至 1998 年期间被诊断出患有浸润性乳腺癌时，年龄在 35 至 64 岁之间，且具有完整的死亡相关风险因素信息。在随访期间（中位数为 8.6 年），有 1055 名女性死亡，其中 824 人死于乳腺癌。在乳腺癌诊断后不久（平均为 5.1 个月），通过面对面访谈和使用结构化问卷收集了诊断前的饮酒信息。多变量 Cox 比例风险回归模型提供了饮酒与乳腺癌特异性死亡率、非乳腺癌原因死亡率和全因死亡率之间的风险比（HR）和 95%置信区间（CI），饮酒起始于 15 岁，直至乳腺癌诊断，以及乳腺癌诊断前的近期时间段。
结果
从 15 岁到乳腺癌诊断，平均每周饮酒量与乳腺癌特异性死亡率呈负相关（P=0.01）。与不饮酒者相比，每周饮酒量最高的女性（≥7 杯/周）乳腺癌特异性死亡率降低 25%（HR=0.75，95%CI=0.56-1.00）。在两个最近的时间段内，每周饮酒量最高的女性乳腺癌死亡率也有所降低（5 年时间，截止至乳腺癌诊断前 2 年，HR=0.74，95%CI=0.57-0.95；2 年时间，即乳腺癌诊断前的最后时间，HR=0.73，95%CI=0.56-0.95）。此外，对从 15 岁到乳腺癌诊断的每周平均饮酒量进行的按饮料类型分析表明，葡萄酒的摄入与乳腺癌特异性死亡率呈负相关（葡萄酒 P=0.06，啤酒 P=0.24，白酒 P=0.74）。然而，在任何这些饮酒变量中，均未观察到与乳腺癌以外原因的死亡率风险相关。
结论
总的来说，我们没有发现乳腺癌诊断前饮酒会增加乳腺癌死亡后风险的证据。
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