Giovannucci E, Stampfer M J, Colditz G A, Manson J E, Rosner B A, Longnecker M P, Speizer F E, Willett W C
Harvard Medical School, Boston, MA.
Cancer Causes Control. 1993 Sep;4(5):441-8. doi: 10.1007/BF00050863.
Recall and selection bias are well-recognized potential problems in case-control studies of alcohol and cancer, but few analyses have attempted to assess the direction and the magnitude of these potential biases. We thus examined alcohol consumption in relation to risk of breast cancer using dietary questionnaires administered both before and after the diagnosis of breast cancer in the Nurses' Health Study (United States). Among cohort members who completed a dietary questionnaire in 1986 and who were free of cancer, 616 were diagnosed with breast cancer during follow-up to December 1989. These cases and 1,277 controls (a random sample of cohort members who did not develop cancer up to 1990) then were sent another questionnaire inquiring about their diet in 1985. Four hundred and ninety-four cases (80.2 percent) and 999 controls (78.2 percent) responded to the second questionnaire. The analysis based on the prospective (1986) questionnaire demonstrated an elevated risk of breast cancer among women who drank 30 or more g of alcohol daily (about two drinks) relative to nondrinkers (odds ratio [OR] = 1.55, 95 percent confidence interval [CI] = 1.01-2.39). The analysis based on the retrospective questionnaire also indicated a similar but slightly attenuated elevation of risk of breast cancer among women who drank at least 30 g daily (OR = 1.42, CI = 0.85-2.40). In these data, bias due to selection and recall had only minor effects on reported intake of alcohol consumption.
回忆偏倚和选择偏倚是酒精与癌症病例对照研究中公认的潜在问题，但很少有分析尝试评估这些潜在偏倚的方向和程度。因此，我们在美国护士健康研究中，使用乳腺癌诊断前后发放的饮食问卷，研究了饮酒与患乳腺癌风险之间的关系。在1986年完成饮食问卷且无癌症的队列成员中，有616人在随访至1989年12月期间被诊断出患有乳腺癌。这些病例和1277名对照（从至1990年未患癌症的队列成员中随机抽取）随后收到了另一份询问其1985年饮食情况的问卷。494例病例（80.2%）和999名对照（78.2%）回复了第二份问卷。基于前瞻性（1986年）问卷的分析表明，与不饮酒者相比，每天饮用30克或更多酒精（约两杯）的女性患乳腺癌的风险升高（比值比[OR]=1.55，95%置信区间[CI]=1.01 - 2.39）。基于回顾性问卷的分析也表明，每天至少饮用30克酒精的女性患乳腺癌的风险有类似但略有减弱的升高（OR = 1.42，CI = 0.85 - 2.40）。在这些数据中，选择偏倚和回忆偏倚对报告的酒精摄入量仅有轻微影响。
