Light to moderate intake of alcohol, drinking patterns, and risk of cancer: results from two prospective US cohort studies.
Light to moderate intake of alcohol, drinking patterns, and risk of cancer: results from two prospective US cohort studies.
复制标题
DOI：
10.1136/bmj.h4238
复制
发表时间：
2015-08-18
期刊：
影响因子：
--
通讯作者：
Giovannucci EL
中科院分区：
文献类型：
--
作者：
Cao Y;Willett WC;Rimm EB;Stampfer MJ;Giovannucci EL
目的量化女性和男性所有饮酒水平的总体癌症风险，重点是轻度至中度饮酒和从不吸烟者;并评估饮酒模式对总体癌症风险的影响。设计两项前瞻性队列研究。美国的医疗保健专业人员。参与者88084名女性和47881名男性参加了护士健康研究（从1980年开始）和卫生专业人员随访研究（从1986年开始），直到2010年。主要结果和测量癌症的相对风险。结果在3144853人年中，女性和男性分别记录了19269和7571例（不包括非晚期前列腺癌）癌症事件。与不饮酒者相比，轻度至中度饮酒者患总癌症的相对风险分别为1.02（95%置信区间0.98至1.06）和1.04（1.00至1.09; Ptrend=0.12）。男性的相应值分别为1.03（0.96至1.11），1.05（0.97至1.12）和1.06（0.98至1.15; P趋势=0.31），酒精摄入量为0.1-4.9，5-14.9和15-29.9克/天。轻度至中度饮酒与总癌症的相关性在曾经吸烟者或从不吸烟者中相似，尽管中度以上的饮酒量（特别是≥30 g/天）与曾经吸烟者总癌症风险的相关性比从不吸烟者更强。对于先验定义的男性酒精相关癌症，从不吸烟的轻度和中度饮酒者的风险并未明显增加（Ptrend=0.18）。然而，对于女性来说，即使是5-14.9克/天的饮酒量也与酒精相关癌症的风险增加有关（相对风险1.13（95%置信区间1.06至1.20）），由乳腺癌驱动。在调整了总酒精摄入量后，更频繁和更重的间歇性饮酒与总癌症风险没有进一步相关。结论：轻度至中度饮酒与总体癌症风险的最小增加相关。对于从不吸烟的男性来说，轻度和中度饮酒（每天最多两杯）不会明显增加与酒精相关的癌症风险。然而，对于从不吸烟的女性来说，即使每天喝一杯酒，与酒精有关的癌症（主要是乳腺癌）的风险也会增加。
Objectives To quantify risk of overall cancer across all levels of alcohol consumption among women and men separately, with a focus on light to moderate drinking and never smokers; and assess the influence of drinking patterns on overall cancer risk. Design Two prospective cohort studies. Setting Health professionals in the United States. Participants 88 084 women and 47 881 men participating in the Nurses’ Health Study (from 1980) and Health Professionals Follow-up Study (from 1986), followed until 2010. Main outcomes and measures Relative risks of cancer. Results 19 269 and 7571 (excluding non-advanced prostate cancers) incident cancers were documented among women and men, respectively, over 3 144 853 person years. Compared with non-drinkers, light to moderate drinkers had relative risks of total cancer of 1.02 (95% confidence interval 0.98 to 1.06) and 1.04 (1.00 to 1.09; Ptrend=0.12) for alcohol intake of 0.1-4.9 and 5-14.9 g/day among women, respectively. Corresponding values for men were 1.03 (0.96 to 1.11), 1.05 (0.97 to 1.12), and 1.06 (0.98 to 1.15; Ptrend=0.31) for alcohol intake of 0.1-4.9, 5-14.9, and 15-29.9 g/day, respectively. Associations for light to moderate drinking and total cancer were similar among ever or never smokers, although alcohol consumption above moderate levels (in particular ≥30 g/day) was more strongly associated with risk of total cancer among ever smokers than never smokers. For a priori defined alcohol related cancers in men, risk was not appreciably increased for light and moderate drinkers who never smoked (Ptrend=0.18). However, for women, even an alcohol consumption of 5-14.9 g/day was associated with increased risk of alcohol related cancer (relative risk 1.13 (95% confidence interval 1.06 to 1.20)), driven by breast cancer. More frequent and heavy episodic drinking was not further associated with risk of total cancer after adjusting for total alcohol intake. Conclusion Light to moderate drinking is associated with minimally increased risk of overall cancer. For men who have never smoked, risk of alcohol related cancers is not appreciably increased for light and moderate drinking (up to two drinks per day). However, for women who have never smoked, risk of alcohol related cancers (mainly breast cancer) increases even within the range of up to one alcoholic drink a day.