The relation between alcoholic beverage consumption and risk of breast cancer was examined. We used data from a population-based, case-control study that included almost all incident cases occurring in five Spanish regions from February 1990 to July 1991. A total of 762 women between 18 and 75 years of age, with a histologically confirmed, first diagnosis of breast cancer, were compared with 988 control women. Alcoholic beverage intake was measured by an interviewer-administered, semiquantitative food-frequency questionnaire. We used ‘nondrinkers’ as the reference category and divided the remainder into four categories according to alcohol intake. The multiple logistic analyses included not only alcohol intake but also possible confounding factors such as total caloric intake, age, socioeconomic status, and reproductive and medical histories. Even at moderate levels of alcohol intake (less than 8 g/day), a 50 percent increase in risk of breast cancer was found. The trend across categories of intake was statistically significant for wine and distilled drinks, as well as total alcohol intake. Consumption of 20 g or more of alcohol per day was associated with a 70 percent elevation in breast cancer risk compared with that of nondrinkers (adjusted relative risk (RR)=1.7,95 percent confidence interval = 1.3–2.3). Although the magnitude of the RR observed in our study was modest, our findings provide further support for a positive association between alcohol consumption and risk of breast cancer.
Similar content being viewed by others
References
Blot WJ. Alcohol and cancer. Cancer Res 1992; 52 (Suppl.): 2119s–23s.
Williams RR, Horm JW. Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: Interview study from the Third National Cancer Survey. JNCI 1977; 58: 525–47.
Rosenberg L, Slone D, Shapiro S, et al. Breast cancer and alcoholic-beverage consumption. Lancet 1982; i: 267–70.
Lé MG, Hill C, Kramar A, Flamant R. Alcoholic beverage consumption and breast cancer in a French case-control study. Am J Epidemiol 1984; 120: 350–7.
Hiatt RA, Bawol RD. Alcoholic beverage consumption and breast cancer incidence. Am J Epidemiol 1984; 120: 676–83.
Talamini R, La Vecchia C, Decarli A, et al. Social factors, diet and breast cancer in a Northern Italian population. Br J Cancer 1984; 49: 723–9.
La Vecchia C, Decarli A, Franceschi S, Pampallona S, Tognoni G. Alcohol consumption and the risk of breast cancer in women. JNCI 1985; 75: 61–5.
O'Connell DL, Hulka BS, Chambless LE, Wilkinson WE, Deubner DC. Cigarette smoking, alcohol consumption, and breast cancer risk. JNCI 1987; 78: 229–34.
Schatzkin A, Jones Y, Hoover RN, et al. Alcohol consumption and breast cancer in the epidemiologic follow-up study of the first National Health and Nutrition Examination Survey. N Engl J Med 1987; 316: 1169–73.
Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Hennekens CH, Speizer FE. Moderate alcohol consumption and the risk of breast cancer. N Engl J Med 1987; 316: 1174–80.
Harvey EB, Schairer C, Brinton LA, Hoover RN, Fraumeni JFJr. Alcohol consumption and breast cancer. JNCI 1987; 78: 657–61.
Hiatt RA, Klatsky AL, Armstrong MA. Alcohol consumption and the risk of breast cancer in a prepaid health plan. Cancer Res 1988; 48: 2284–7.
Rohan TE, McMichael AJ. Alcohol consumption and risk of breast cancer. Int J Cancer 1988; 41: 695–9.
Young T. Breast cancer and alcohol consumption habits (Abstract). Am J Epidemiol 1988; 128: 913.
Garfinkel L, Boffetta P, Stellman SD. Alcohol and breast cancer: A cohort study. Prev Med 1988; 17: 686–93.
Toniolo P, Riboli E, Protta F, Charrel M, Cappa APM. Breast cancer and alcohol consumption: A case-control study in northern Italy. Cancer Res 1989; 49: 5203–6.
Kato I, Tominaga S, Terao C. Alcohol consumption and cancer of hormone-related organs in females. Jap J Clin Oncol 1989; 19: 202–7.
Ewertz M. Alcohol consumption and breast cancer risk in Denmark. Cancer Causes Control 1991; 2: 247–52.
Ferraroni M, Decarli A, Willett WC, Marubini E. Alcohol and breast cancer risk: A case-control study from Northern Italy. Int J Epidemiol 1991; 20: 859–64.
Longnecker MP, Berlin JA, Orza MJ, Chalmers TC. A meta-analysis of alcohol consumption in relation to the risk of breast cancer. JAMA 1988; 260: 652–6.
Howe G, Rohan T, Decarli A, et al. The association between alcohol and breast cancer risk: Evidence from the combined analysis of six dietary case-control studies. Int J Cancer 1991; 47: 707–10.
Byers T, Funch DP. Alcohol and breast cancer (Letter). Lancet 1982; i: 799–800.
Begg CB, Walker AM, Wessen B, Zelen M. Alcohol consumption and breast cancer (Letter). Lancet 1983; i: 293–4.
Webster LA, Layde PM, Wingo PA, Ory HW (The Cancer and Steroid Hormone Study Group). Alcohol consumption and risk of breast cancer. Lancet 1983; ii: 724–6.
Paganini-Hill A, Ross RK. Breast cancer and alcohol consumption. Lancet 1983; ii: 626–7.
Harris RE, Wynder EL. Breast cancer and alcohol consumption: A study in weak associations. JAMA 1988; 259: 2867–71.
Schatzkin A, Green S, Carter C, et al. Alcohol and breast cancer in the Framingham Heart Study (Abstract). Am J Epidemiol 1988; 128: 913.
Chu SY, Lee NC, Wingo PA, Webster LA. Alcohol consumption and the risk of breast cancer. Am J Epidemiol 1989; 130: 867–77.
Rosenberg L, Palmer JR, Miller DR, Clarke EA, Shapiro S. A case-control study of alcoholic beverage consumption and breast cancer. Am J Epidemiol 1990; 131: 6–14.
Martin-Moreno JM, Willett WC, Gorgojo L, et al. Dietary habits, nutrition and breast cancer in Spain: a population-based case-control study. In: Martin-Moreno JM. Nutritional epidemiology of breast cancer in Spain. Doctoral thesis, Harvard School of Public Health, Boston, MA, 1992: 66–114.
Martin-Moreno JM, Boyle P, Gorgojo L, et al. Development and validation of a food frequency questionnaire in Spain. Int J Epidemiol 1993 (in press).
Varela G. Tablas de composicion de alimentos. Madrid: Instituto de Nutricion de C.S.I.C., 1980.
Jimenez A, Cervera P. Tabla de composicion de alimentos. Barcelona: Laboratorios Wander, 1988.
Andujar M, Morciras-Varela O, Gil F. Tablas de composicion de alimentos. Madrid: Instituto de Nutricion y Bromatologia (C.S.I.C.), 1990.
Aguilar M. Dietetica: Un Programa para la Nutricion, Version 2.0. Madrid: CONAYCITE, 1991.
Baker RJ, Clarke MRB, Nelder JA. The Generalised Linear Interactive Modelling (GLIM) System, Release 3.77. Oxford, UK: Numerical Algorithms Group, 1985.
Willett WC. Implications of total energy intake for epidemiologic studies of breast and colon cancer. Am J Clin Nutr 1987; 45: 354–60.
Willett WC, Stampfer MJ. Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 1986; 124: 17–27.
Van't Veer P, Kok FJ, Hermus RJJ, Sturmans F. Alcohol dose, frequency and age at first exposure in relation to the risk of breast cancer. Int J Epidemiol 1989; 18: 511–7.
Gapstur SM, Potter JD, Sellers TA, Folsom AR. Increased risk of breast cancer with alcohol consumption in postmenopausal women. Am J Epidemiol 1992; 136: 1221–31.
Rohan TE, Cook MG. Alcohol consumption and risk of benign proliferative epithelial disorders of the breast in women. Int J Cancer 1989; 43: 631–6.
Wang DY, Fentiman IS. Epidemiology and endocrinology of benign breast disease. Breast Cancer Res Treat 1985; 6: 5–36.
London SJ, Connolly JL, Schnitt SJ, Colditz GA. A prospective study of benign breast disease and the risk of breast cancer. JAMA 1992; 267: 941–4.
Singletary KW, McNary MQ, Odoms AM, Nelshoppen J, Wallig MA. Ethanol consumption and DMBA-induced mammary carcinogenesis in rats. Nutr Cancer 1991; 16: 13–23.
Gavaler JS, Van Thiel DH. Reproductive consequences of alcohol abuse: males and females compared and contrasted. Mutat Res 1987; 186: 269–77.
McDermott EWM, O'Dwyer PJ, O'Higgins NJ. Dietary alcohol intake does not increase the incidence of experimentally induced mammary carcinoma. Eur J Surg Oncol 1992; 18: 251–4.
Hackney JF, Engelman RW, Good RA. Ethanol calories do not enhance breast cancer in isocalorically fed C3H/Ou mice. Nutr Cancer 1992; 18: 245–53.
William RR. Breast and thyroid cancer and malignant melanoma prompted by alcohol-induced pituitary secretion of prolactin TSH and MSH. Lancet 1976; i: 996–9.
Author information
Authors and Affiliations
Additional information
This work was supported by Grant No. 89/0059 from the Spanish “Fondo de Investigacion Sanitaria.” Dr Martin-Moreno is indebted to the Italian “Fondazione per la Formazione Oncologica” for awarding him a “Paolo Baffi” Fellowship in 1991–1992, and to the Spanish “Fundacion Mapfre Medicina” for a research fellowship award in 1991. Dr Gorgojo is a postdoctoral fellow of the “Programa de Formación de Personal del Instituto de Salud Carlos III.”
Rights and permissions
About this article
Cite this article
Martin-Moreno, J.M., Boyle, P., Gorgojo, L. et al. Alcoholic beverage consumption and risk of breast cancer in Spain. Cancer Causes Control 4, 345–353 (1993). https://doi.org/10.1007/BF00051337
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00051337