25 October 2016 In Cancer

OBJECTIVE: To determine the association of prediagnostic alcohol consumption with long-term mortality from breast cancer and other causes in a cohort of women with breast cancer.

METHODS: We studied a Michigan-based cohort of 939 women aged 40-84 years, who provided complete information about the type, amount and intensity of prediagnostic alcohol consumption. Associations of alcohol consumption, based on weekly volume of alcohol consumption during the year prior to breast cancer diagnosis, with mortality were evaluated in Cox proportional hazards models, with adjustment for sociodemographic factors, body mass index, smoking, comorbidity, tumor characteristics, and treatment. Differences among covariates were assessed with Pearson chi2 , Student t -tests and Wilcoxon Rank Sum tests. All statistical tests were two-sided.

RESULTS: During a median follow-up of 11 years, 724 deaths occurred overall, with 303 from breast cancer. Fifty-five percent of the women were categorized as drinkers with volume of alcohol consumption ranging from 0.75 to 36.00 drinks/week. In multivariable models, a decreased risk of other-cause mortality was associated with low alcohol drinking (0.75-3.75 drinks/week; HR = 0.61, 95% CI = 0.47-0.78), moderate volume alcohol drinking (4.00-9.75 drinks/week; HR = 0.57, 95% CI = 0.39-0.85) and low frequency (0.75-3.75 drinks/week) beer and wine intake (HR = 0.69, 95% CI = 0.50-0.96 and HR = 0.68, 95% CI = 0.52-0.88 respectively). Although the risk of breast cancer-specific mortality was not statistically significantly associated with moderate (4.00-9.75 drinks/week) and high volume (10.00-36.00 drinks/week) alcohol drinking in the overall cohort (HR = 1.43, 95% CI = 95% 0.97-2.12 and HR = 1.53, 95% CI = 0.87-2.70 respectively), there was a positive association of alcohol consumption with breast cancer-specific mortality among current smokers (HR = 1.92, 95% CI = 1.03-3.57; Pinteraction = 0.04).

CONCLUSION: In this prospective cohort study, regular consumption of 0.75-36.00 alcoholic drinks per week during the year prior to breast cancer diagnosis was associated with a reduction in other-cause mortality and with an increase in breast cancer-specific mortality among current smokers, after taking into account clinical and sociodemographic factors.

17 May 2016 In Cancer

OBJECTIVE: To test the hypothesis that postmenopausal women who increase their alcohol intake over a five year period have a higher risk of breast cancer and a lower risk of coronary heart disease compared with stable alcohol intake.

DESIGN: Prospective cohort study.

SETTING: Denmark, 1993-2012.

PARTICIPANTS: 21?523 postmenopausal women who participated in the Diet, Cancer, and Health Study in two consecutive examinations in 1993-98 and 1999-2003. Information on alcohol intake was obtained from questionnaires completed by participants.

MAIN OUTCOME MEASURES: Incidence of breast cancer, coronary heart disease, and all cause mortality during 11 years of follow-up. Information was obtained from the Danish Cancer Register, Danish Hospital Discharge Register, Danish Register of Causes of Death, and National Central Person Register. We estimated hazard ratios according to five year change in alcohol intake using Cox proportional hazards models.

RESULTS: During the study, 1054, 1750, and 2080 cases of breast cancer, coronary heart disease, and mortality occurred, respectively. Analyses modelling five year change in alcohol intake with cubic splines showed that women who increased their alcohol intake over the five year period had a higher risk of breast cancer and a lower risk of coronary heart disease than women with a stable alcohol intake. For instance, women who increased their alcohol intake by seven or 14 drinks per week (corresponding to one or two drinks more per day) had hazard ratios of breast cancer of 1.13 (95% confidence interval 1.03 to 1.23) and 1.29 (1.07 to 1.55), respectively, compared to women with stable intake, and adjusted for age, education, body mass index, smoking, Mediterranean diet score, parity, number of births, and hormone replacement therapy. For coronary heart disease, corresponding hazard ratios were 0.89 (0.81 to 0.97) and 0.78 (0.64 to 0.95), respectively, adjusted for age, education, body mass index, Mediterranean diet score, smoking, physical activity, hypertension, elevated cholesterol, and diabetes. Results among women who reduced their alcohol intake over the five year period were not significantly associated with risk of breast cancer or coronary heart disease. Analyses of all cause mortality showed that women who increased their alcohol intake from a high intake (=14 drinks per week) to an even higher intake had a higher mortality risk that women with a stable high intake.

CONCLUSION: In this study of postmenopausal women over a five year period, results support the hypotheses that alcohol intake is associated with increased risk of breast cancer and decreased risk of coronary heart disease.

26 November 2015 In Cancer

BACKGROUND: Alcohol consumption has been associated with an increased prevalence of sunburn, which is an established skin cancer risk factor.

OBJECTIVE: We investigated whether alcohol consumption is associated with risk of cutaneous basal cell carcinoma (BCC).

DESIGN: We conducted a prospective analysis on alcohol consumption and risk of BCC on the basis of data from 167,765 women in the NHS (Nurses' Health Study) (1984-2010) and NHS II (1991-2011) and 43,697 men in the Health Professionals Follow-Up Study (1986-2010). Alcohol intake was repeatedly assessed every 2-4 y over the follow-up period. HRs and 95% CIs for BCC in association with alcohol intake were computed with the use of Cox proportional hazards models with adjustment for sun exposure and other skin cancer risk factors.

RESULTS: A total of 28,951 incident BCC cases were documented over 3.74 million person-years of follow-up. Increased alcohol intake was associated with increased BCC risk in both women and men (both P-trend < 0.0001). Pooled multivariable-adjusted HRs over increasing cumulative averaged alcohol intake categories were 1.00 (reference) for nondrinkers, 1.13 (95% CI: 1.06, 1.20) for 0.1-9.9 g/d, 1.24 (95% CI: 1.14, 1.35) for 10.0-19.9 g/d, 1.27 (95% CI: 1.20, 1.35) for 20.0-29.9 g/d, and 1.22 (95% CI: 1.15, 1.30) for >/=30.0 g/d (P-trend < 0.0001, P-heterogeneity by study = 0.10 ). The association remained consistent when we used alcohol intakes over different latency periods (0-4, 4-8, 8-12, and 12-16 y) as exposures and over categories of sun exposure-related factors. In the individual alcoholic beverages, white wine and liquor were positively associated with BCC risk.

CONCLUSION: Alcohol consumption is associated with increased risk of cutaneous BCC in both women and men.

17 September 2015 In Cancer

BACKGROUND: Results from several cohort and case-control studies suggest a protective association between current alcohol intake and risk of thyroid carcinoma, but the epidemiological evidence is not completely consistent and several questions remain unanswered.

METHODS: The association between alcohol consumption at recruitment and over the lifetime and risk of differentiated thyroid carcinoma was examined in the European Prospective Investigation into Cancer and Nutrition. Among 477 263 eligible participants (70% women), 556 (90% women) were diagnosed with differentiated thyroid carcinoma over a mean follow-up of 11 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards models.

RESULTS: Compared with participants consuming 0.1-4.9 g of alcohol per day at recruitment, participants consuming 15 or more grams (approximately 1-1.5 drinks) had a 23% lower risk of differentiated thyroid carcinoma (HR=0.77; 95% CI=0.60-0.98). These findings did not differ greatly when analyses were conducted for lifetime alcohol consumption, although the risk estimates were attenuated and not statistically significant anymore. Similar results were observed by type of alcoholic beverage, by differentiated thyroid carcinoma histology or according to age, sex, smoking status, body mass index and diabetes.

CONCLUSIONS: Our study provides some support to the hypothesis that moderate alcohol consumption may be associated with a lower risk of papillary and follicular thyroid carcinomas.

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