Alcohol consumption and breast cancer risk by estrogen receptor status: in a pooled analysis of 20 studies
Alcohol consumption and breast cancer risk by estrogen receptor status: in a pooled analysis of 20 studies
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DOI：
10.1093/ije/dyv156
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发表时间：
2016-06-01
影响因子：
7.7
通讯作者：
Smith-Warner, Stephanie A.
中科院分区：
文献类型：
--
作者：
Jung, Seungyoun;Wang, Molin;Smith-Warner, Stephanie A.
背景：乳腺癌的病因可能因雌激素受体（ER）状态而异。酒精和叶酸摄入量与乳腺癌的风险定义ER状态的协会进行了检查，在汇总分析的主要数据从20 cohols.Methods：在最大的6-18年的后续1 089 273名妇女，21 624 ER+和5113 ER-乳腺癌被确定。研究特定的多变量相对危险度（RR）计算使用考克斯比例风险回归模型，然后结合使用随机效应model.Results：饮酒与ER+和ER-乳腺癌的风险呈正相关。比较≥ 30 g/d与0 g/d饮酒量的汇总多变量RR（95%置信区间），ER+乳腺癌为1.35（1.23-1.48），ER+乳腺癌为1.28（1.10-1.49）（P趋势= 0.26）。膳食（仅从食物）和总叶酸摄入量与总体、ER+和ER-乳腺癌的风险无关;汇总的多变量RR范围为0.98至1.02，比较极端五分位数。仅在强制性叶酸强化之前的一段时间内进行的美国随访研究没有改变结果。酒精和叶酸协会没有不同的肿瘤亚型定义孕激素受体status.Conclusions：饮酒与ER+和ER-乳腺癌的风险呈正相关，即使是高叶酸摄入量的妇女。叶酸摄入量与乳腺癌风险无关。
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 (P-trend = 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.