TY - JOUR
T1 - Alcohol consumption and breast cancer risk by estrogen receptor status
T2 - In a pooled analysis of 20 studies
AU - Jung, Seungyoun
AU - Wang, Molin
AU - Anderson, Kristin
AU - Baglietto, Laura
AU - Bergkvist, Leif
AU - Bernstein, Leslie
AU - van den Brandt, Piet A.
AU - Brinton, Louise
AU - Buring, Julie E.
AU - Heather Eliassen, A.
AU - Falk, Roni
AU - Gapstur, Susan M.
AU - Giles, Graham G.
AU - Goodman, Gary
AU - Hoffman-Bolton, Judith
AU - Horn-Ross, Pamela L.
AU - Inoue, Manami
AU - Kolonel, Laurence N.
AU - Krogh, Vittorio
AU - Lof, Marie
AU - Maas, Paige
AU - Miller, Anthony B.
AU - Neuhouser, Marian L.
AU - Park, Yikyung
AU - Robien, Kim
AU - Rohan, Thomas E.
AU - Scarmo, Stephanie
AU - Schouten, Leo J.
AU - Sieri, Sabina
AU - Stevens, Victoria L.
AU - Tsugane, Schoichiro
AU - Visvanathan, Kala
AU - Wilkens, Lynne R.
AU - Wolk, Alicja
AU - Weiderpass, Elisabete
AU - Willett, Walter C.
AU - Zeleniuch-Jacquotte, Anne
AU - Zhang, Shumin M.
AU - Zhang, Xuehong
AU - Ziegler, Regina G.
AU - Smith-Warner, Stephanie A.
N1 - Publisher Copyright:
© The Author 2015.
PY - 2016/6
Y1 - 2016/6
N2 - Background: Breast cancer aetiology may differ by estrogen receptor (ER) status. Associations of alcohol and folate intakes with risk of breast cancer defined by ER status were examined in pooled analyses of the primary data from 20 cohorts. Methods: During a maximum of 6-18 years of follow-up of 1 089 273 women, 21 624 ER+ and 5113 ER- breast cancers were identified. Study-specific multivariable relative risks (RRs) were calculated using Cox proportional hazards regression models and then combined using a random-effects model. Results: Alcohol consumption was positively associated with risk of ER+ and ER- breast cancer. The pooled multivariable RRs (95% confidence intervals) comparing≥30 g/d with 0 g/day of alcohol consumption were 1.35 (1.23-1.48) for ER+ and 1.28 (1.10-1.49) for ER- breast cancer (Ptrend≤0.001; Pcommon-effects by ER status: 0.57). Associations were similar for alcohol intake from beer, wine and liquor. The associations with alcohol intake did not vary significantly by total (from foods and supplements) folate intake (Pinteraction≥0.26). Dietary (from foods only) and total folate intakes were not associated with risk of overall, ER+ and ER- breast cancer; pooled multivariable RRs ranged from 0.98 to 1.02 comparing extreme quintiles. Following-up US studies through only the period before mandatory folic acid fortification did not change the results. The alcohol and folate associations did not vary by tumour subtypes defined by progesterone receptor status. Conclusions: Alcohol consumption was positively associated with risk of both ER+ and ER- breast cancer, even among women with high folate intake. Folate intake was not associated with breast cancer risk.
AB - Background: Breast cancer aetiology may differ by estrogen receptor (ER) status. Associations of alcohol and folate intakes with risk of breast cancer defined by ER status were examined in pooled analyses of the primary data from 20 cohorts. Methods: During a maximum of 6-18 years of follow-up of 1 089 273 women, 21 624 ER+ and 5113 ER- breast cancers were identified. Study-specific multivariable relative risks (RRs) were calculated using Cox proportional hazards regression models and then combined using a random-effects model. Results: Alcohol consumption was positively associated with risk of ER+ and ER- breast cancer. The pooled multivariable RRs (95% confidence intervals) comparing≥30 g/d with 0 g/day of alcohol consumption were 1.35 (1.23-1.48) for ER+ and 1.28 (1.10-1.49) for ER- breast cancer (Ptrend≤0.001; Pcommon-effects by ER status: 0.57). Associations were similar for alcohol intake from beer, wine and liquor. The associations with alcohol intake did not vary significantly by total (from foods and supplements) folate intake (Pinteraction≥0.26). Dietary (from foods only) and total folate intakes were not associated with risk of overall, ER+ and ER- breast cancer; pooled multivariable RRs ranged from 0.98 to 1.02 comparing extreme quintiles. Following-up US studies through only the period before mandatory folic acid fortification did not change the results. The alcohol and folate associations did not vary by tumour subtypes defined by progesterone receptor status. Conclusions: Alcohol consumption was positively associated with risk of both ER+ and ER- breast cancer, even among women with high folate intake. Folate intake was not associated with breast cancer risk.
KW - Alcohol
KW - Breast cancer
KW - Cohort study
KW - Epidemiology
KW - Estrogen receptor
KW - Folate
KW - Pooled analyses
KW - Progesterone receptor
UR - http://www.scopus.com/inward/record.url?scp=85013628908&partnerID=8YFLogxK
U2 - 10.1093/ije/dyv156
DO - 10.1093/ije/dyv156
M3 - Article
C2 - 26320033
AN - SCOPUS:85013628908
SN - 0300-5771
VL - 45
SP - 916
EP - 928
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
IS - 3
ER -