Ερευνητικό υλικό ΕΚΠΑ

Alcohol, tobacco and breast cancer - collaborative reanalysis of
individual data from 53 epidemiological studies, including 58515 women
with breast cancer and 95067 women without the disease

Αγγλικά

Alcohol and tobacco consumption are closely correlated and published
results on their association with breast cancer have not always allowed
adequately for confounding between these exposures. Over 80% of the
relevant information worldwide on alcohol and tobacco consumption and
breast cancer were collated, checked and analysed centrally. Analyses
included 58515 women with invasive breast cancer and 95067 controls from
53 studies. Relative risks of breast cancer were estimated, after
stratifying by study, age, parity and, where appropriate, women’s age
when their first child was born and consumption of alcohol and tobacco.
The average consumption of alcohol reported by controls from developed
countries was 6.0 g per day, i.e. about half a unit/drink of alcohol per
day, and was greater in ever-smokers than never-smokers, (8.4 g per day
and 5.0 g per day, respectively). Compared with women who reported
drinking no alcohol, the relative risk of breast cancer was 1.32 (1.19 -
1.45, P < 0.00001) for an intake of 35 - 44 g per day alcohol, and 1.46
(1.33 - 1.61, P < 0.00001) for greater than or equal to 45 g per day
alcohol. The relative risk of breast cancer increased by 7.1% (95% CI
5.5-8.7%; P<0.00001) for each additional 10 g per day intake of
alcohol, i.e. for each extra unit or drink of alcohol consumed on a
daily basis. This increase was the same in ever-smokers and
never-smokers (7.1 % per 10 g per day, P < 0.00001, in each group). By
contrast, the relationship between smoking and breast cancer was
substantially confounded by the effect of alcohol. When analyses were
restricted to 22 255 women with breast cancer and 40 832 controls who
reported drinking no alcohol, smoking was not associated with breast
cancer (compared to never-smokers, relative risk for ever-smokers= 1.03,
95% CI 0.98 - 1.07, and for current smokers=0.99, 0.92 - 1.05). The
results for alcohol and for tobacco did not vary substantially across
studies, study designs, or according to 15 personal characteristics of
the women; nor were the findings materially confounded by any of these
factors. If the observed relationship for alcohol is causal, these
results suggest that about 4% of the breast cancers in developed
countries are attributable to alcohol. In developing countries, where
alcohol consumption among controls averaged only 0.4 g per day, alcohol
would have a negligible effect on the incidence of breast cancer. In
conclusion, smoking has little or no independent effect on the risk of
developing breast cancer; the effect of alcohol on breast cancer needs
to be interpreted in the context of its beneficial effects, in
moderation, on cardiovascular disease and its harmful effects on
cirrhosis and cancers of the mouth, larynx, oesophagus and liver. (C)
2002 Cancer Research UK.

2002

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Collaborative Group on Hormonal Factors in Breast
Cancer

British Journal of Cancer

Nature Publishing Group

87

11

1234-1245

breast cancer; alcohol; tobacco; smoking; collaborative analysis

https://doi.org/10.1038/sj.bjc.6600596

10.1038/sj.bjc.6600596

https://pergamos.lib.uoa.gr/uoa/dl/object/3082620