Alcohol and breast cancer: A cohort study

doi:10.1016/0091-7435(88)90086-2

Preventive Medicine

Volume 17, Issue 6, November 1988, Pages 686-693

https://doi.org/10.1016/0091-7435(88)90086-2 Get rights and content

Abstract

The relation between alcohol consumption and several causes of death, including breast cancer, was examined in a population of 581, 321 women enrolled in a prospective study in 1959 and followed for 12 years. Women who drank occasionally had about the same breast cancer mortality rate as nondrinkers; those who drank occasionaly had about the same breast cancer mortality rate as nondrinkers; those who drank one to four drinks per day had SMRs 7–26% higher; five drinks per day, 1.89; and six or more drinks per day, 1.65. The two highest-consumption groups' risks were significantly higher than those of nondrinkers after multivariate adjustment for several breast cancer risk factors. Distinctive dose-response relationships were observed for two known alcohol-related conditions: cirrhosis of the liver and cancer of the aero-digestive tract, suggesting that results for other causes are not seriously biased by misclassification of drinking habits. Death rates from all causes combined were elevated for drinkers of three or more drinks per day. Whether or not the association of elevated breast cancer death rates ultimately turns out to be causal, there is ample reason to continue to warn the public against excessive drinking.

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Nonheavy Alcohol Use Associates With Liver Fibrosis and Nonalcoholic Steatohepatitis in the Framingham Heart Study
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Citation Excerpt :
In observational studies, the challenges of adequately accounting for all these differences may lead to residual confounding and underestimation of alcohol-related risk. Our finding that nonheavy alcohol use may contribute to fibrosis and at-risk NASH is consistent with multiple population-based studies investigating alcohol and clinical liver-related outcomes.4,7,41–43 For example, the Finnish Health 2000 study demonstrated that among nonheavy alcohol users (<140 g/wk for women or <210 g/wk for men), drinking more alcohol per week associated with increased hospitalization for liver disease, hepatocellular carcinoma, and liver-related death.4
While heavy alcohol use consistently associates with liver disease, the effects of nonheavy alcohol consumption are less understood. We aimed to investigate the relationship between nonheavy alcohol use and chronic liver disease.
This cross-sectional study included 2629 current drinkers in the Framingham Heart Study who completed alcohol use questionnaires and transient elastography. We defined fibrosis as liver stiffness measurement (LSM) ≥8.2 kPa. We defined at-risk nonalcoholic steatohepatitis (NASH) as FibroScan-aspartate aminotransferase (FAST) score >0.35 (90% sensitivity) or ≥0.67 (90% specificity). We performed logistic regression to investigate associations of alcohol use measures with fibrosis and NASH, adjusting for sociodemographic and metabolic factors. Subgroup analysis excluded heavy drinkers (>14 drinks per week for women or >21 for men).
In this sample (mean age 54.4 ± 8.9 years, 53.3% women), mean LSM was 5.6 ± 3.4 kPa, 8.2% had fibrosis, 1.9% had NASH by FAST ≥0.67, and 12.4% had NASH by FAST >0.35. Participants drank 6.2 ± 7.4 drinks per week. Total drinks per week and frequency of drinking associated with increased odds of fibrosis (adjusted odds ratio [aOR], 1.18; 95% confidence interval [CI], 1.04–1.33; and aOR, 1.08; 95% CI, 1.01–1.16, respectively). Risky weekly drinking, present in 17.4%, also associated with fibrosis (aOR, 1.49; 95% CI, 1.03–2.14). After excluding 158 heavy drinkers, total drinks per week remained associated with fibrosis (aOR, 1.16; 95% CI, 1.001–1.35). Multiple alcohol use measures positively associated with FAST >0.35.
In this community cohort, we demonstrate that nonheavy alcohol use associates with fibrosis and NASH, after adjustment for metabolic factors. Longitudinal studies are needed to determine the benefits of moderating alcohol use to reduce liver-related morbidity and mortality.
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2004, Preventive Medicine
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Methods. Human studies assessing the effects of moderate alcohol consumption (≤40 g/day) on coronary heart disease, stroke, blood pressure, diseases of the liver, gallbladder, bile duct, and pancreas, cancer of the mouth/pharynx/larynx/oesophagus, stomach, colon/rectum, and breast, foetal alcohol syndrome/foetal alcohol effects, as well as all-cause mortality, published in the 10–15 years before 1999, have been systematically reviewed. The quality of studies has been evaluated using a self-constructed evaluation scheme. As a result of comparing the critical endpoints of alcohol intake related to morbidity and mortality, the TUALs have been derived.
Results. The TUALs have been set at 10–12 g/day for healthy women and 20–24 g/day for healthy men of the adult population (18 years and older). Additional guidelines on alcohol use have been defined, taking into account further important aspects like alcohol consumption patterns and high-risk groups.
Conclusions. The TUALs are not intended to be recommended intake levels. However, if the TUALs and the additional guidelines are followed, a relation of alcohol consumption to an increased risk of alcohol-associated diseases is unlikely for the majority of the population.
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2020, Genes
Unveiling sex-based differences in the effects of alcohol abuse: a comprehensive functional meta-analysis of transcriptomic studies
2020, bioRxiv

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^☆: Presented at the Workshop on Alcohol and Breast Cancer, American Health Foundation, December 1, 1987

View full text

Alcohol and breast cancer: A cohort study☆

Abstract

Alcohol consumption and breast cancer (Letter)

Lancet

Alcohol and breast cancer (Letter)

Lancet

Alcohol consumption and breast cancer

Smoking in relation to the death rates of one million men and women

Natl. Cancer Inst. Monogr.

Coronary heart disease, stroke, and aortic aneurysm

Alcohol consumption and breast cancer

Alcohol consumption and breast cancer

J. Natl. Cancer Inst.

Alcohol beverage consumption and breast cancer incidence

American J. Epidemiol.

Alcohol consumption and the risk of breast cancer in women

J. Natl. Cancer Inst.