Adami H O, Lund E, Bergström R, Meirik O
Department of Surgery, University of Uppsala, Sweden.
Br J Cancer. 1988 Dec;58(6):832-7. doi: 10.1038/bjc.1988.320.
The possible association between cigarette smoking, alcohol consumption and the risk of development of breast cancer before the age of 45 was investigated by means of a population-based case-control study in Sweden and Norway. Information was obtained, by personal interview, from 422 (89.2%) of all eligible patients with breast cancer newly diagnosed between May 1984 and May 1985, and from 527 (80.6%) of all age-matched controls. The possible confounding effects of oral contraceptive (OC) use, education, and reproductive and several other factors were taken into account in multivariate analyses. No association was found between ever smoking (versus never smoking) and breast cancer (odds ratio 1.0; 95% confidence interval (CI) 0.8-1.3). Further, there was no relation between breast cancer and duration of smoking, age at start of regular smoking, length of time since the start of regular smoking, or number of cigarettes smoked per day. There was no significant interaction between smoking, use of OCs, parity, and breast cancer. A moderate or high current consumption of beer, wine, liquor or total alcohol did not increase the risk of breast cancer. An alcohol intake of 5 grams per day or more was associated with a decreased risk of breast cancer (odds ratio 0.6; 95% CI 0.4-0.9), but possible effects of a change in habits after diagnosis, of recall bias and of residual confounding, e.g. by dietary habits, need serious consideration.
通过在瑞典和挪威开展的一项基于人群的病例对照研究,调查了吸烟、饮酒与45岁前患乳腺癌风险之间的可能关联。通过个人访谈,从1984年5月至1985年5月期间新诊断的所有符合条件的乳腺癌患者中获取了422例(89.2%)的信息,并从所有年龄匹配的对照中获取了527例(80.6%)的信息。在多变量分析中考虑了口服避孕药(OC)使用、教育程度、生育情况和其他几个因素可能产生的混杂效应。未发现曾经吸烟(与从不吸烟相比)与乳腺癌之间存在关联(比值比1.0;95%置信区间(CI)0.8 - 1.3)。此外,乳腺癌与吸烟持续时间、开始规律吸烟的年龄、开始规律吸烟后的时长或每天吸烟数量之间均无关联。吸烟、使用OC、生育次数与乳腺癌之间不存在显著交互作用。目前适度或大量饮用啤酒、葡萄酒、烈酒或总酒精量均未增加患乳腺癌的风险。每天饮酒量达5克或更多与患乳腺癌风险降低相关(比值比0.6;95%CI 0.4 - 0.9),但诊断后习惯改变、回忆偏倚以及残余混杂因素(如饮食习惯)的可能影响需要认真考虑。