Vaeth P A, Satariano W A
Division of Public Health Biology and Epidemiology, School of Public Health, University of California at Berkeley, 94720, USA.
Alcohol Clin Exp Res. 1998 Jun;22(4):928-34.
The stage at which breast cancer is diagnosed is an important determinant of prognosis. In contrast to the many investigations of the relationship between alcohol consumption and the risk of developing breast cancer, few have examined how alcohol consumption may affect the stage of this cancer at diagnosis. This article examines the relationship between alcohol intake and breast cancer stage and assesses consumption in relation to the volume of drinks consumed per week and the patterns of consumption 1 year prior to the breast cancer diagnosis. A total of 1191 women, aged 40 to 84 years, with newly diagnosed breast cancer were identified through the population-based Metropolitan Detroit Cancer Surveillance System, a participant of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. Of these, 1011 (85%) were interviewed 2 to 4 months following diagnosis. The analyses for this article were limited to 920 cases with local and regional stage disease. The bivariate analysis showed that frequent drinkers were more likely than abstainers or infrequent drinkers to present with regional disease. Logistic regression showed that frequent drinkers were 1.45 times more likely than infrequent drinkers to be diagnosed with later stage breast cancer (95% CI: 1.01-2.10; p = 05). The association between alcohol consumption and disease stage may be due to the relationship between heavy consumption and other unhealthy behaviors. In addition, women who drink more frequently may have less awareness of and access to cancer screening services. Heavy exposure to alcohol may also contribute to accelerated tumor growth once breast cancer is present.
乳腺癌的诊断阶段是预后的重要决定因素。与众多关于饮酒与患乳腺癌风险之间关系的研究不同，很少有研究探讨饮酒如何影响该癌症的诊断阶段。本文研究了酒精摄入量与乳腺癌阶段之间的关系，并根据每周饮酒量以及乳腺癌诊断前1年的饮酒模式评估了饮酒情况。通过基于人群的底特律大都市癌症监测系统（美国国家癌症研究所监测、流行病学和最终结果计划的参与者），共确定了1191名年龄在40至84岁之间、新诊断为乳腺癌的女性。其中，1011名（85%）在诊断后2至4个月接受了访谈。本文的分析仅限于920例局部和区域阶段疾病的病例。双变量分析表明，经常饮酒者比戒酒者或不常饮酒者更有可能出现区域疾病。逻辑回归显示，经常饮酒者被诊断为晚期乳腺癌的可能性是不常饮酒者的1.45倍（95%置信区间：1.01 - 2.10；p = 0.05）。饮酒与疾病阶段之间的关联可能归因于大量饮酒与其他不健康行为之间的关系。此外，饮酒更频繁的女性可能对癌症筛查服务的知晓度和可及性较低。一旦患乳腺癌，大量饮酒也可能导致肿瘤生长加速。
