Alcohol consumption and breast cancer risk by estrogen receptor status

In a pooled analysis of 20 studies

Seungyoun Jung, Molin Wang, Kristin Anderson, Laura Baglietto, Leif Bergkvist, Leslie Bernstein, Piet A. van den Brandt, Louise Brinton, Julie E. Buring, A. Heather Eliassen, Roni Falk, Susan M. Gapstur, Graham G. Giles, Gary Goodman, Judith Hoffman-Bolton, Pamela L. Horn-Ross, Manami Inoue, Laurence N. Kolonel, Vittorio Krogh, Marie Lof & 21 others Paige Maas, Anthony B. Miller, Marian L. Neuhouser, Yikyung Park, Kim Robien, Thomas E. Rohan, Stephanie Scarmo, Leo J. Schouten, Sabina Sieri, Victoria L. Stevens, Schoichiro Tsugane, Kala Visvanathan, Lynne R. Wilkens, Alicja Wolk, Elisabete Weiderpass, Walter C. Willett, Anne Zeleniuch-Jacquotte, Shumin M. Zhang, Xuehong Zhang, Regina G. Ziegler, Stephanie A. Smith-Warner

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)916-928
Number of pages13
JournalInternational Journal of Epidemiology
Volume45
Issue number3
DOIs
StatePublished - Jan 1 2016

Fingerprint

Alcohol Drinking
Estrogen Receptors
Breast Neoplasms
Folic Acid
Alcohols
Progesterone Receptors
Wine
Dietary Supplements
Proportional Hazards Models
Confidence Intervals
Food

Keywords

  • Alcohol
  • Breast cancer
  • Cohort study
  • Epidemiology
  • Estrogen receptor
  • Folate
  • Pooled analyses
  • Progesterone receptor

ASJC Scopus subject areas

  • Epidemiology

Cite this

Jung, S., Wang, M., Anderson, K., Baglietto, L., Bergkvist, L., Bernstein, L., ... Smith-Warner, S. A. (2016). Alcohol consumption and breast cancer risk by estrogen receptor status: In a pooled analysis of 20 studies. International Journal of Epidemiology, 45(3), 916-928. https://doi.org/10.1093/ije/dyv156

Alcohol consumption and breast cancer risk by estrogen receptor status : In a pooled analysis of 20 studies. / Jung, Seungyoun; Wang, Molin; Anderson, Kristin; Baglietto, Laura; Bergkvist, Leif; Bernstein, Leslie; van den Brandt, Piet A.; Brinton, Louise; Buring, Julie E.; Heather Eliassen, A.; Falk, Roni; Gapstur, Susan M.; Giles, Graham G.; Goodman, Gary; Hoffman-Bolton, Judith; Horn-Ross, Pamela L.; Inoue, Manami; Kolonel, Laurence N.; Krogh, Vittorio; Lof, Marie; Maas, Paige; Miller, Anthony B.; Neuhouser, Marian L.; Park, Yikyung; Robien, Kim; Rohan, Thomas E.; Scarmo, Stephanie; Schouten, Leo J.; Sieri, Sabina; Stevens, Victoria L.; Tsugane, Schoichiro; Visvanathan, Kala; Wilkens, Lynne R.; Wolk, Alicja; Weiderpass, Elisabete; Willett, Walter C.; Zeleniuch-Jacquotte, Anne; Zhang, Shumin M.; Zhang, Xuehong; Ziegler, Regina G.; Smith-Warner, Stephanie A.

In: International Journal of Epidemiology, Vol. 45, No. 3, 01.01.2016, p. 916-928.

Research output: Contribution to journalArticle

Jung, S, Wang, M, Anderson, K, Baglietto, L, Bergkvist, L, Bernstein, L, van den Brandt, PA, Brinton, L, Buring, JE, Heather Eliassen, A, Falk, R, Gapstur, SM, Giles, GG, Goodman, G, Hoffman-Bolton, J, Horn-Ross, PL, Inoue, M, Kolonel, LN, Krogh, V, Lof, M, Maas, P, Miller, AB, Neuhouser, ML, Park, Y, Robien, K, Rohan, TE, Scarmo, S, Schouten, LJ, Sieri, S, Stevens, VL, Tsugane, S, Visvanathan, K, Wilkens, LR, Wolk, A, Weiderpass, E, Willett, WC, Zeleniuch-Jacquotte, A, Zhang, SM, Zhang, X, Ziegler, RG & Smith-Warner, SA 2016, 'Alcohol consumption and breast cancer risk by estrogen receptor status: In a pooled analysis of 20 studies', International Journal of Epidemiology, vol. 45, no. 3, pp. 916-928. https://doi.org/10.1093/ije/dyv156
Jung, Seungyoun ; Wang, Molin ; Anderson, Kristin ; Baglietto, Laura ; Bergkvist, Leif ; Bernstein, Leslie ; van den Brandt, Piet A. ; Brinton, Louise ; Buring, Julie E. ; Heather Eliassen, A. ; Falk, Roni ; Gapstur, Susan M. ; Giles, Graham G. ; Goodman, Gary ; Hoffman-Bolton, Judith ; Horn-Ross, Pamela L. ; Inoue, Manami ; Kolonel, Laurence N. ; Krogh, Vittorio ; Lof, Marie ; Maas, Paige ; Miller, Anthony B. ; Neuhouser, Marian L. ; Park, Yikyung ; Robien, Kim ; Rohan, Thomas E. ; Scarmo, Stephanie ; Schouten, Leo J. ; Sieri, Sabina ; Stevens, Victoria L. ; Tsugane, Schoichiro ; Visvanathan, Kala ; Wilkens, Lynne R. ; Wolk, Alicja ; Weiderpass, Elisabete ; Willett, Walter C. ; Zeleniuch-Jacquotte, Anne ; Zhang, Shumin M. ; Zhang, Xuehong ; Ziegler, Regina G. ; Smith-Warner, Stephanie A. / Alcohol consumption and breast cancer risk by estrogen receptor status : In a pooled analysis of 20 studies. In: International Journal of Epidemiology. 2016 ; Vol. 45, No. 3. pp. 916-928.
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abstract = "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.",
keywords = "Alcohol, Breast cancer, Cohort study, Epidemiology, Estrogen receptor, Folate, Pooled analyses, Progesterone receptor",
author = "Seungyoun Jung and Molin Wang and Kristin Anderson and Laura Baglietto and Leif Bergkvist and Leslie Bernstein and {van den Brandt}, {Piet A.} and Louise Brinton and Buring, {Julie E.} and {Heather Eliassen}, A. and Roni Falk and Gapstur, {Susan M.} and Giles, {Graham G.} and Gary Goodman and Judith Hoffman-Bolton and Horn-Ross, {Pamela L.} and Manami Inoue and Kolonel, {Laurence N.} and Vittorio Krogh and Marie Lof and Paige Maas and Miller, {Anthony B.} and Neuhouser, {Marian L.} and Yikyung Park and Kim Robien and Rohan, {Thomas E.} and Stephanie Scarmo and Schouten, {Leo J.} and Sabina Sieri and Stevens, {Victoria L.} and Schoichiro Tsugane and Kala Visvanathan and Wilkens, {Lynne R.} and Alicja Wolk and Elisabete Weiderpass and Willett, {Walter C.} and Anne Zeleniuch-Jacquotte and Zhang, {Shumin M.} and Xuehong Zhang and Ziegler, {Regina G.} and Smith-Warner, {Stephanie A.}",
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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.

PY - 2016/1/1

Y1 - 2016/1/1

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

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DO - 10.1093/ije/dyv156

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SP - 916

EP - 928

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

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