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Title: 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
Authors: N. Hamajima
K. Hirose
K. Tajima
T. Rohan
E. E. Calle
C. W. Heath
R. J. Coates
J. M. Liff
R. Talamini
N. Chantarakul
S. Koetsawang
D. Rachawat
A. Morabia
L. Schuman
W. Stewart
M. Szklo
C. Bain
F. Schofield
V. Siskind
P. Band
A. J. Coldman
R. P. Gallagher
T. G. Hislop
P. Yang
L. M. Kolonel
A. M.Y. Nomura
J. Hu
K. C. Johnson
Y. Mao
S. De Sanjosé
N. Lee
P. Marchbanks
H. W. Ory
H. B. Peterson
H. G. Wilson
P. A. Wingo
K. Ebeling
D. Kunde
P. Nishan
J. L. Hopper
G. Colditz
V. Gajalakshmi
N. Martin
T. Pardthaisong
S. Silpisornkosol
C. Theetranont
B. Boosiri
S. Chutivongse
P. Jimakorn
P. Virutamasen
C. Wongsrichanalai
M. Ewertz
H. O. Adami
L. Bergkvist
C. Magnusson
I. Persson
J. Chang-Claude
C. Paul
D. C.G. Skegg
G. F.S. Spears
P. Boyle
T. Evstifeeva
J. R. Daling
W. B. Hutchinson
K. Malone
E. A. Noonan
J. L. Stanford
D. B. Thomas
N. S. Weiss
E. White
N. Andrieu
A. Brêmond
F. Clavel
B. Gairard
J. Lansac
L. Piana
R. Renaud
A. Izquierdo
P. Viladiu
H. R. Cuevas
P. Ontiveros
A. Palet
S. B. Salazar
N. Aristizabal
A. Cuadros
L. Tryggvadottir
H. Tulinius
A. Bachelot
M. G. Lê
J. Peto
S. Franceschi
F. Lubin
B. Modan
E. Ron
Y. Wax
G. D. Friedman
R. A. Hiatt
F. Levi
T. Bishop
Cancer Research UK
Aichi Cancer Center Hospital and Research Institute
Albert Einstein College of Medicine of Yeshiva University
American Cancer Society
Emory University
IRCCS Centro Di Riferimento Oncologico Aviano
Mahidol University
Johns Hopkins University
University of Queensland
British Columbia Cancer Agency
University of Hawaii System
Canadian Cancer Registries Epidemiology Research Group
Catalan Oncology Institute
Centers for Disease Control and Prevention
Max Delbruck Center for Molecular Medicine
University of Melbourne
Brigham and Women's Hospital
Cancer Institute India
Chiang Mai University
Chulalongkorn University
Kraeftens Bekaempelse
Karolinska Institutet
German Cancer Research Center
University of Otago
Istituto Europeo di Oncologia
Fred Hutchinson Cancer Research Center
Girona Cancer Registry
Hospital General de Mexico
Hospital Universitario
Icelandic Cancer Society
Institut de Cancerologie Gustave Roussy
London School of Hygiene & Tropical Medicine
International Agency for Research on Cancer
Chaim Sheba Medical Center Israel
Kaiser Permanente
Institut Universitaire de Medecine Sociale et Preventive Lausanne
Onkoloski institut Ljubljana
Loma Linda University Adventist Health Sciences Center
Skånes universitetssjukhus
Maastricht University
University of the Philippines Manila
Istituto di Ricerche Farmacologiche Mario Negri
Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
Istituto di Statistica Medica e Biometria
Nairobi Centre for Research in Reproduction
National Cancer Institute
National Institute of Child Health and Human Development
National University of Singapore
The Netherlands Cancer Institute
New South Wales Cancer Council
Columbia University Medical Center
Ontario Cancer Treatment and Research Foundation
Clinical Trial Service Unit
Radiation Effects Research Foundation Hiroshima
Royal College of General Practitioners' Oral Contraception Study
Universidad de Costa Rica
Medical Center of Fudan University
Shanghai Institute of Planned Parenthood Research
Tianjin Cancer Institute and Hospital
Universitetet i Tromso
Vanderbilt University
University of Athens Medical School
Universidad de Chile
University of Edinburgh
University of Minnesota School of Public Health
The University of North Carolina at Chapel Hill
University of Nottingham
University of Southern California
University of Wisconsin
Organisation Mondiale de la Sante
Keywords: Biochemistry, Genetics and Molecular Biology;Medicine
Issue Date: 18-Nov-2002
Citation: British Journal of Cancer. Vol.87, No.11 (2002), 1234-1245
Abstract: 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% Cl 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 22255 women with breast cancer and 40832 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% Cl 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 littte 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. © 2002 Cancer Research UK.
ISSN: 00070920
Appears in Collections:Scopus 2001-2005

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