Alcohol drinking, consumption patterns and breast cancer among Danish nurses: a cohort study

Mørch, Lina Steinrud; Johansen, Ditte; Thygesen, Lau Caspar; Tjønneland, Anne; Løkkegaard, Ellen; Stahlberg, Claudia; Grønbæk, Morten

doi:10.1093/eurpub/ckm036

Cited by 51 publications

(31 citation statements)

References 21 publications

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“…The few studies that have previously evaluated binge drinking have reported positive associations between current binging and breast cancer, with binging being defined as consuming more drinks over the weekend (22) and as ever drinking ≥6 drinks/day in a typical month (21). One case-control study also found effect-measure modification of current alcohol consumption by current binge drinking status, with elevated risk limited to the highest category of drinkers (≥91 g/week) who also reported binging (defined as 5 or more drinks in one sitting) (23).…”

Section: Discussionmentioning

confidence: 99%

Lifetime Alcohol Intake, Binge Drinking Behaviors, and Breast Cancer Risk

White¹,

DeRoo²,

Weinberg³

et al. 2017

American Journal of Epidemiology

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The prevalence of binge drinking in the United States is rising. While alcohol is a risk factor for breast cancer, less is known about the impact of episodic heavy drinking. In 2003-2009, women aged 35-74 years who were free of breast cancer were enrolled in the Sister Study (n = 50,884). Residents of the United States or Puerto Rico who had a sister with breast cancer were eligible. Multivariable Cox regression was used to estimate adjusted hazard ratios and 95% confidence intervals for breast cancer. During follow-up (mean = 6.4 years), 1,843 invasive breast cancers were diagnosed. Increased breast cancer risk was observed for higher lifetime alcohol intake (for ≥230 drinks/year vs. <60 drinks/year, hazard ratio (HR) = 1.35, 95% confidence interval (CI): 1.15, 1.58). Relative to lowlevel drinkers (<60 drinks/year), hazard ratios were increased for ever binge drinking (HR = 1.29, 95% CI: 1.15, 1.45) or blacking out (HR = 1.39, 95% CI: 1.17, 1.64). Compared with low-level drinkers who never binged, moderate drinkers (60-229 drinks/year) who binged had a higher risk (HR = 1.25, 95% CI: 1.08, 1.44). There was evidence of effect modification between moderate lifetime drinking and binging (relative excess risk due to interaction = 0.33, 95% CI: 0.10, 0.57). Our findings support the established association between lifetime alcohol intake and breast cancer and provide evidence for an increased risk associated with heavy episodic drinking, especially among moderate lifetime drinkers. alcohol; alcohol drinking; binge drinking; breast cancer Abbreviations: BMI, body mass index; CI, confidence interval; ER, estrogen receptor; HR, hazard ratio; RERI, relative excess risk due to interaction.

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Section: Discussionmentioning

confidence: 99%

Lifetime Alcohol Intake, Binge Drinking Behaviors, and Breast Cancer Risk

White¹,

DeRoo²,

Weinberg³

et al. 2017

American Journal of Epidemiology

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“…10, 11 In terms of binge drinking, a prospective study showed a non-linear association with the highest risk among those who consumed 4-5 drinks per weekday or 16-21 drinks per weekend and lower risks for those who drank more, but they had few cases in the highest categories and contrary to most studies, non-drinkers had an increased risk of breast cancer. 33 A case-control study found a non statistically significant increased risk associated with binge drinking limited to high alcohol consumers. 34 After controlling for cumulative average intake, we observed an association with binge drinking, but not frequency of drinking.…”

Section: Discussionmentioning

confidence: 99%

Moderate Alcohol Consumption During Adult Life, Drinking Patterns, and Breast Cancer Risk

Chen

Rosner²,

Hankinson³

et al. 2011

JAMA

424

318

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Context Multiple studies have linked alcohol consumption to breast cancer risk, but the risk of lower levels of consumption has not been well quantified. In addition, the role of drinking patterns (i.e. frequency of drinking and “binge” drinking) and consumption at different times of adult life are not well understood. Objective To evaluate the association of breast cancer with alcohol consumption during adult life, including quantity, frequency, and age at consumption. Design, Setting, and Participants Prospective observational study of 105,986 women enrolled in the Nurses’ Health Study followed from 1980 until 2008 with early adult and eight updated alcohol assessments during this time. Main Outcome Measures Relative risks of developing invasive breast cancer. Results 7690 cases developed during 2.4 million person-years of follow-up. Increasing alcohol consumption was associated with increased breast cancer risk that was statistically significant at levels as low as 5.0-9.9 gm/day, equivalent to 3-6 drinks/week (RR 1.15 (95% CI 1.06-1.24) 332 cases/100,000 person-years). After controlling for cumulative alcohol intake, binge drinking, but not frequency of drinking, was associated with breast cancer risk. Alcohol intake both earlier and later in adult life was independently associated with risk. Conclusion Low levels of alcohol consumption were associated with a small increase in breast cancer risk, with the most consistent measure being cumulative alcohol intake throughout adult life. Alcohol intake both earlier and later in adult life was independently associated with risk.

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“…However, alcohol consumed between menarche and the first pregnancy (among parous women) has been associated with an increased risk of proliferative benign breast disease and breast cancer . Patterns of alcohol consumption are also hypothesized to modify the risk relationship between alcohol consumption and breast cancer; however, only a few drinking pattern studies exist (irregular heavy drinking occasions; see Rehm et al, 1996) and epidemiological evidence on this effect modification is limited and inconsistent (Chen et al, 2011;Horn-Ross et al, 2004;Jeffreys et al, 2013;Lash and Aschengrau, 2000;Mørch et al, 2007;Tjønneland et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Alcohol Use and Breast Cancer: A Critical Review

Shield

Soerjomataram

Rehm

2016

Alcoholism Clin & Exp Res

147

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The objective of this study was to outline the biological pathways of alcohol-attributable breast cancer, the epidemiological risk relationship between alcohol consumption and breast cancer, and the global burden of breast cancer incidence and mortality attributable to alcohol consumption, with a focus on light drinking. First, the literature regarding the biological mechanisms of how alcohol affects the risk of breast cancer was reviewed and summarized. Second, a search of meta-analyses that evaluated the risk relationship between alcohol consumption and breast cancer was conducted. Last, the burden of alcohol-attributable breast cancer incidence and mortality was estimated by means of a Population-Attributable Fraction methodology. Data on alcohol consumption were obtained from the Global Information System on Alcohol and Health, and data on cancer incidence and mortality were obtained from the GLOBOCAN database. Alcohol consumption affects breast cancer risk through the alteration in hormone levels and the associated biological pathways, the metabolism of ethanol resulting in carcinogens, and the inhibition of the one carbon metabolism pathway. The systematic review found 15 meta-analyses on the risk relationship between alcohol consumption (also light consumption) and the risk of breast cancer. All but 2 of these analyses showed a dose-response relationship between alcohol consumption and the risk of breast cancer. An estimated 144,000 (95% confidence interval [CI]: 88,000 to 200,000) breast cancer cases and 38,000 (95% CI: 2,400 to 53,000) breast cancer deaths globally in 2012 were attributable to alcohol, with 18.8% of these cases and 17.5% of these deaths affecting women who were light alcohol consumers. All levels of evidence showed a risk relationship between alcohol consumption and the risk of breast cancer, even at low levels of consumption. Due to this strong relationship, and to the amount of alcohol consumed globally, the incidence of and mortality from alcohol-attributable breast cancer is large.

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Alcohol drinking, consumption patterns and breast cancer among Danish nurses: a cohort study

Cited by 51 publications

References 21 publications

Lifetime Alcohol Intake, Binge Drinking Behaviors, and Breast Cancer Risk

Lifetime Alcohol Intake, Binge Drinking Behaviors, and Breast Cancer Risk

Moderate Alcohol Consumption During Adult Life, Drinking Patterns, and Breast Cancer Risk

Alcohol Use and Breast Cancer: A Critical Review

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