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Int J Cancer. 2015 Oct 15;137(8):1921-30. doi: 10.1002/ijc.29469. Epub 2015 Jul 14.

Alcohol intake and breast cancer in the European prospective investigation into cancer and nutrition.

Author information

1
Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
2
Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France.
3
University Paris Sud, UMRS 1018, Villejuif, France.
4
Institut Gustave-Roussy, Villejuif, France.
5
Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia.
6
Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia.
7
Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark.
8
Diet, Genes, and Environment Unit, Danish Cancer Society Research Center, Copenhagen, Denmark.
9
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
10
Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden.
11
Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany.
12
Hellenic Health Foundation, Athens, Greece.
13
WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.
14
Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.
15
Department of Epidemiology, Harvard School of Public Health, Boston, MA.
16
Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy.
17
Epidemiology and Prevention Unit, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.
18
Cancer Registry and Histopathology Unit, "Civic-M.P.Arezzo" Hospital, ASP Ragusa, Italy.
19
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
20
Unit of molecular and genetic epidemiology, Human Genetics Foundation (HuGeF), Turin, Italy.
21
Department of Clinical and Experimental Medicine Federico II University of Naples, Naples, Italy.
22
National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
23
Department of Gastroenterology and Hepatology University Medical Centre, Utrecht, The Netherlands.
24
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
25
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
26
Department of Genetic Epidemiology, Folkhälsan Research Center, Helsinki, Finland.
27
Etiological Research Unit, Cancer Registry of Norway, Oslo, Norway.
28
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
29
Public Health Directorate, Asturias, Spain.
30
Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain.
31
CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain.
32
Navarre Public Health Institute, Pamplona, Spain.
33
Andalusian School of Public Health, Granada Bio-Health Research Institute (Granada.IBS), Granada, Spain.
34
Instituto De Investigación Biosanitaria De Granada, Granada, Spain.
35
Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain.
36
Public Health Division of Gipuzkoa, Gipuzkoa, Spain.
37
Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden.
38
Department of Clinical Sciences, Lund University, Malmö, Sweden.
39
Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden.
40
Department of Odontology, Umeå University, Umeå, Sweden.
41
Public Health and Clinical Medicine/Nutritional Research, Umeå University, Umeå, Sweden.
42
University of Cambridge, School of Clinical Medicine, Clinical Gerontology Unit, Cambridge, United Kingdom.
43
MRC Epidemiology Unit University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
44
Cancer Epidemiology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.

Abstract

Alcohol intake has been associated to breast cancer in pre and postmenopausal women; however results are inconclusive regarding tumor hormonal receptor status, and potential modifying factors like age at start drinking. Therefore, we investigated the relation between alcohol intake and the risk of breast cancer using prospective observational data from the European Prospective Investigation into Cancer and Nutrition (EPIC). Up to 334,850 women, aged 35-70 years at baseline, were recruited in ten European countries and followed up an average of 11 years. Alcohol intake at baseline and average lifetime alcohol intake were calculated from country-specific dietary and lifestyle questionnaires. The study outcomes were the Hazard ratios (HR) of developing breast cancer according to hormonal receptor status. During 3,670,439 person-years, 11,576 incident breast cancer cases were diagnosed. Alcohol intake was significantly related to breast cancer risk, for each 10 g/day increase in alcohol intake the HR increased by 4.2% (95% CI: 2.7-5.8%). Taking 0 to 5 g/day as reference, alcohol intake of >5 to 15 g/day was related to a 5.9% increase in breast cancer risk (95% CI: 1-11%). Significant increasing trends were observed between alcohol intake and ER+/PR+, ER-/PR-, HER2- and ER-/PR-HER2- tumors. Breast cancer risk was stronger among women who started drinking prior to first full-time pregnancy. Overall, our results confirm the association between alcohol intake and both hormone receptor positive and hormone receptor negative breast tumors, suggesting that timing of exposure to alcohol drinking may affect the risk. Therefore, women should be advised to control their alcohol consumption.

KEYWORDS:

alcohol consumption; breast cancer; prospective study

PMID:
25677034
DOI:
10.1002/ijc.29469
[Indexed for MEDLINE]
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