Hiatt R A, Bawol R D
Am J Epidemiol. 1984 Nov;120(5):676-83. doi: 10.1093/oxfordjournals.aje.a113934.
Recent case-control studies have suggested that alcohol consumption may be associated with breast cancer incidence. This report is a retrospective cohort study of over 95,000 women who were members of the Kaiser Foundation Health Plan of Northern California. The stated alcohol consumption of these women was recorded at a multiphasic screening examination taken from 1964 to 1972 prior to any diagnosis of breast cancer. The incidence of breast cancer in this cohort was greater for women who drank, and among these drinkers, incidence increased in an irregular trend with heavier alcohol consumption. Control for the effects of race, education, smoking, and reproductive variables related to breast cancer all but eliminated the overall increased relative risk of drinkers compared with that of nondrinkers. However, the relatively small group of women who stated that they had three or more alcoholic drinks per day (5.2 per cent of the total) had a significantly elevated relative risk of 1.4 (p = 0.035) compared with nondrinkers, despite control for all available confounding variables. No significant interaction effect of smoking and alcohol was found. Women who had less than three drinks per day had no increased relative risk over nondrinkers. The results of this study might be explained either by an unrecognized carcinogenic effect of alcohol on breast tissue or by the confounding effect of other factors associated with heavy alcohol use.
近期的病例对照研究表明，饮酒可能与乳腺癌发病率有关。本报告是一项针对超过95,000名北加利福尼亚凯撒基金会健康计划成员女性的回顾性队列研究。这些女性的饮酒情况记录于1964年至1972年进行的多阶段筛查检查中，当时她们尚未被诊断出患有乳腺癌。在这个队列中，饮酒女性的乳腺癌发病率更高，而且在这些饮酒者中，发病率随着饮酒量的增加呈不规则趋势上升。对种族、教育程度、吸烟以及与乳腺癌相关的生殖变量的影响进行控制后，与不饮酒者相比，饮酒者总体上相对风险增加的情况几乎消除。然而，相对较少的一部分女性（占总数的5.2%）表示她们每天饮用三杯或更多酒精饮料，尽管对所有可用的混杂变量进行了控制，但与不饮酒者相比，她们的相对风险仍显著升高至1.4（p = 0.035）。未发现吸烟与饮酒之间存在显著的交互作用。每天饮酒少于三杯的女性与不饮酒者相比，相对风险并未增加。本研究结果可能是由于酒精对乳腺组织存在未被认识到的致癌作用，或者是与大量饮酒相关的其他因素的混杂作用所致。
