Alcohol, tobacco and breast cancer--collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease.
Alcohol, tobacco and breast cancer--collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease.
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DOI：
10.1038/sj.bjc.6600596
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发表时间：
2002-11-18
影响因子：
8.8
通讯作者：
Meirik, O
中科院分区：
文献类型：
--
作者：
Beral, V;Hamajima, N;Hirose, K;Rohan, T;Calle, EE;Heath, CW;Coates, RJ;Liff, JM;Talamini, R;Chantarakul, N;Koetsawang, S;Rachawat, D;Morabia, A;Schuman, L;Stewart, W;Szklo, M;Bain, C;Schofield, F;Siskind, V;Band, P;Coldman, AJ;Gallagher, RP;Hislop, TG;Yang, P;Kolonel, LM;Nomura, AMY;Hu, J;Johnson, KC;Mao, Y;De Sanjose, S;Lee, N;Marchbanks, P;Ory, HW;Peterson, HB;Wilson, HG;Wingo, PA;Ebeling, K;Kunde, D;Nishan, P;Hopper, JL;Colditz, G;Gajalakshmi, V;Martin, N;Pardthaisong, T;Solpisornkosol, S;Theetranont, C;Boosiri, B;Chutivongse, S;Jimakorn, P;Virutamasen, P;Wongsrichanalai, C;Ewertz, M;Adami, HO;Bergkvist, L;Magnusson, C;Persson, I;Chang-Claude, J;Paul, C;Skegg, DCG;Spears, GFS;Boyle, P;Evstifeeva, T;Daling, JR;Hutchinson, WB;Malone, K;Noonan, EA;Stanford, JL;Thomas, DB;Weiss, NS;White, E;Andrieu, N;Brêmond, A;Clavel, F;Gairard, B;Lansac, J;Piana, L;Renaud, R;Izquierdo, A;Viladiu, P;Cuevas, HR;Ontiveros, P;Palet, A;Salazar, SB;Arsitizabal, N;Cuadros, A;Tryggvadottir, L;Tulinius, H;Bachelot, A;Lê, MG;Peto, J;Franceschi, S;Lubin, F;Modan, B;Ron, E;Wax, Y;Friedman, GD;Hiatt, RA;Levi, F;Bishop, T;Kosmelj, K;Primic-Zakelj, M;Ravnihar, B;Stare, J;Beeson, WL;Fraser, G;Bulbrook, RD;Cuzick, J;Duffy, SW;Fentiman, IS;Hayward, JL;Wang, DY;McMichael, AJ;McPherson, K;Hanson, RL;Leske, MC;Mahoney, MC;Nasca, PC;Varma, AO;Weinstein, AL;Moller, TR;Olsson, H;Ranstam, J;Goldbohm, RA;van den Brandt, PA;Apelo, RA;Baens, J;de la Cruz, JR;Javier, B;Lacaya, LB;Ngelangel, CA;La Vecchia, C;Negri, E;Marubini, E;Ferraroni, M;Gerber, M;Richardson, S;Segala, C;Gatei, D;Kenya, P;Kungu, A;Mati, JG;Brinton, LA;Hoover, R;Schairer, C;Spirtas, R;Lee, HP;Rookus, MA;van Leeuwen, FE;Schoenberg, JA;McCredie, M;Gammon, MD;Clarke, EA;Jones, L;Neil, A;Vessey, M;Yeates, D;Appleby, P;Banks, E;Bull, D;Crossley, B;Goodill, A;Green, J;Hermon, C;Key, T;Langston, N;Lewis, C;Reeves, G;Collins, R;Doll, R;Peto, R;Mabuchi, K;Preston, D;Hannaford, P;Kay, C;Rosero-Bixby, L;Gao, YT;Jin, F;Yuan, JM;Wei, HY;Yun, T;Zhiheng, C;Berry, G;Cooper Booth, J;Jelihovsky, T;MacLennan, R;Shearman, R;Wang, QS;Baines, CJ;Miller, AB;Wall, C;Lund, E;Stalsberg, H;Shu, XO;Zheng, W;Katsouyanni, K;Trichopoulou, A;Trichopoulos, D;Dabancens, A;Martinez, L;Molina, R;Salas, O;Alexander, XE;Anderson, K;Folsom, AR;Hulka, BS;Bernstein, L;Enger, S;Haile, RW;Paganini-Hill, A;Pike, MC;Ross, RK;Ursin, G;Yu, MC;Longnecker, MP;Newcomb, P;Bergkvist, L;Kalache, A;Farley, TMM;Holck, S;Meirik, O
酒精和烟草消费密切相关，关于其与乳腺癌相关性的已发表结果并不总是充分考虑这些暴露之间的混杂因素。全世界超过80%的关于酒精和烟草消费与乳腺癌的相关信息是集中整理、检查和分析的。分析包括来自53项研究的58515名浸润性乳腺癌妇女和95067名对照。 在按研究、年龄、产次以及妇女第一个孩子出生时的年龄和烟酒消费量进行分层后，对乳腺癌的相对风险进行了估计。来自发达国家的对照组报告的平均饮酒量为每天6.0克，即每天约半个单位/杯酒精，曾经吸烟者的饮酒量高于从不吸烟者（分别为每天8.4克和每天5.0克）。与不饮酒的妇女相比，每天饮酒35-44 g的妇女患乳腺癌的相对危险度为1.32（1.19-1.45，P<0.00001），每天饮酒1.45 g的妇女患乳腺癌的相对危险度为1.46（1.33-1.61，P<0.00001）。乳腺癌的相对风险增加7.1%（95% CI 5.5-8.7%; P<0.00001），每天每增加10 g酒精摄入量，即每天每增加一个单位或饮用一杯酒精。这种增加在曾经吸烟者和从不吸烟者中是相同的（每组中每10 g每天增加7.1%，P<0.00001）。相比之下，吸烟和乳腺癌之间的关系基本上被酒精的影响所混淆。当分析仅限于22255例乳腺癌妇女和40832例报告不饮酒的对照组时，吸烟与乳腺癌无关（与从不吸烟者相比，曾经吸烟者的相对风险=1.03，95%CI 0.98-1.07，当前吸烟者的相对风险=0.99，0.92-1.05）。 酒精和烟草的结果在不同的研究、研究设计或女性的15个个人特征之间没有实质性差异;这些发现也没有受到任何这些因素的实质性混淆。如果酒精与乳腺癌之间存在因果关系，那么这些结果表明，发达国家约4%的乳腺癌可归因于酒精。在发展中国家，对照组的酒精消费量平均每天仅为0.4克，酒精对乳腺癌发病率的影响可以忽略不计。总之，吸烟对患乳腺癌的风险几乎没有或没有独立影响;酒精对乳腺癌的影响需要在其对心血管疾病的有益影响（适度）和对肝硬化和口腔癌、喉癌、食道癌和肝癌的有害影响的背景下加以解释。英国癌症杂志（2002）87，1234-1245。www.bjcancer.com © 2002英国癌症研究中心
Alcohol and tobacco consumption are closely correlated and published results on their association with breast cancer have not always allowed adequately for confounding between these exposures. Over 80% of the relevant information worldwide on alcohol and tobacco consumption and breast cancer were collated, checked and analysed centrally. Analyses included 58 515 women with invasive breast cancer and 95 067 controls from 53 studies. Relative risks of breast cancer were estimated, after stratifying by study, age, parity and, where appropriate, women's age when their first child was born and consumption of alcohol and tobacco. The average consumption of alcohol reported by controls from developed countries was 6.0 g per day, i.e. about half a unit/drink of alcohol per day, and was greater in ever-smokers than never-smokers, (8.4 g per day and 5.0 g per day, respectively). Compared with women who reported drinking no alcohol, the relative risk of breast cancer was 1.32 (1.19–1.45, P<0.00001) for an intake of 35–44 g per day alcohol, and 1.46 (1.33–1.61, P<0.00001) for ⩾45 g per day alcohol. The relative risk of breast cancer increased by 7.1% (95% CI 5.5–8.7%; P<0.00001) for each additional 10 g per day intake of alcohol, i.e. for each extra unit or drink of alcohol consumed on a daily basis. This increase was the same in ever-smokers and never-smokers (7.1% per 10 g per day, P<0.00001, in each group). By contrast, the relationship between smoking and breast cancer was substantially confounded by the effect of alcohol. When analyses were restricted to 22 255 women with breast cancer and 40 832 controls who reported drinking no alcohol, smoking was not associated with breast cancer (compared to never-smokers, relative risk for ever-smokers=1.03, 95% CI 0.98–1.07, and for current smokers=0.99, 0.92–1.05). The results for alcohol and for tobacco did not vary substantially across studies, study designs, or according to 15 personal characteristics of the women; nor were the findings materially confounded by any of these factors. If the observed relationship for alcohol is causal, these results suggest that about 4% of the breast cancers in developed countries are attributable to alcohol. In developing countries, where alcohol consumption among controls averaged only 0.4 g per day, alcohol would have a negligible effect on the incidence of breast cancer. In conclusion, smoking has little or no independent effect on the risk of developing breast cancer; the effect of alcohol on breast cancer needs to be interpreted in the context of its beneficial effects, in moderation, on cardiovascular disease and its harmful effects on cirrhosis and cancers of the mouth, larynx, oesophagus and liver. British Journal of Cancer (2002) 87, 1234–1245. doi:10.1038/sj.bjc.6600596 www.bjcancer.com © 2002 Cancer Research UK
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影响因子：
8.8
作者：
Enger, SM;Ross, RK;Paganini-Hill, A;Longnecker, MP;Bernstein, L
通讯作者：
Bernstein, L
影响因子：
5
作者：
CHU, SY;LEE, NC;WEBSTER, LA
通讯作者：
WEBSTER, LA
影响因子：
2.3
作者：
Feigelson, HS;Calle, EE;Thun, MJ
通讯作者：
Thun, MJ
影响因子：
5
作者：
FRIEDENREICH, CM;HOWE, GR;JAIN, MG
通讯作者：
JAIN, MG
影响因子：
7.7
作者：
HISLOP, TG;COLDMAN, AJ;KAN, L
通讯作者：
KAN, L