title: Alcohol intake and breast cancer in the European prospective investigation into cancer and nutrition.
abstract: Alcohol intake has been associated to breast cancer in pre and postmenopausal women; however results are inconclusive regarding tumor hormonal receptor status, and potential modifying factors like age at start drinking. Therefore, we investigated the relation between alcohol intake and the risk of breast cancer using prospective observational data from the European Prospective Investigation into Cancer and Nutrition (EPIC). Up to 334,850 women, aged 35-70 years at baseline, were recruited in ten European countries and followed up an average of 11 years. Alcohol intake at baseline and average lifetime alcohol intake were calculated from country-specific dietary and lifestyle questionnaires. The study outcomes were the Hazard ratios (HR) of developing breast cancer according to hormonal receptor status. During 3,670,439 person-years, 11,576 incident breast cancer cases were diagnosed. Alcohol intake was significantly related to breast cancer risk, for each 10 g/day increase in alcohol intake the HR increased by 4.2% (95% CI: 2.7-5.8%). Taking 0 to 5 g/day as reference, alcohol intake of >5 to 15 g/day was related to a 5.9% increase in breast cancer risk (95% CI: 1-11%). Significant increasing trends were observed between alcohol intake and ER+/PR+, ER-/PR-, HER2- and ER-/PR-HER2- tumors. Breast cancer risk was stronger among women who started drinking prior to first full-time pregnancy. Overall, our results confirm the association between alcohol intake and both hormone receptor positive and hormone receptor negative breast tumors, suggesting that timing of exposure to alcohol drinking may affect the risk. Therefore, women should be advised to control their alcohol consumption.
authors: Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
authors: Isabelle
authors: I
authors: Romieu
authors: Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
authors: Chiara
authors: C
authors: Scoccianti
authors: Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
authors: Véronique
authors: V
authors: Chajès
authors: Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
authors: Jordi
authors: J
authors: de Batlle
authors: Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
authors: Carine
authors: C
authors: Biessy
authors: Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France.|University Paris Sud, UMRS 1018, Villejuif, France.|Institut Gustave-Roussy, Villejuif, France.
authors: Laure
authors: L
authors: Dossus
authors: Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia.|Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia.
authors: Laura
authors: L
authors: Baglietto
authors: Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France.|University Paris Sud, UMRS 1018, Villejuif, France.|Institut Gustave-Roussy, Villejuif, France.
authors: Françoise
authors: F
authors: Clavel-Chapelon
authors: Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark.
authors: Kim
authors: K
authors: Overvad
authors: Diet, Genes, and Environment Unit, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Anja
authors: A
authors: Olsen
authors: Diet, Genes, and Environment Unit, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Anne
authors: A
authors: Tjønneland
authors: Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors: Rudolf
authors: R
authors: Kaaks
authors: Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden.
authors: Annekatrin
authors: A
authors: Lukanova
authors: Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany.
authors: Heiner
authors: H
authors: Boeing
authors: Hellenic Health Foundation, Athens, Greece.|WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.|Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.
authors: Antonia
authors: A
authors: Trichopoulou
authors: WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.|Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.|Department of Epidemiology, Harvard School of Public Health, Boston, MA.
authors: Pagona
authors: P
authors: Lagiou
authors: Hellenic Health Foundation, Athens, Greece.|Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.|Department of Epidemiology, Harvard School of Public Health, Boston, MA.
authors: Dimitrios
authors: D
authors: Trichopoulos
authors: Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy.
authors: Domenico
authors: D
authors: Palli
authors: Epidemiology and Prevention Unit, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.
authors: Sabina
authors: S
authors: Sieri
authors: Cancer Registry and Histopathology Unit, "Civic-M.P.Arezzo" Hospital, ASP Ragusa, Italy.
authors: Rosario
authors: R
authors: Tumino
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.|Unit of molecular and genetic epidemiology, Human Genetics Foundation (HuGeF), Turin, Italy.
authors: Paolo
authors: P
authors: Vineis
authors: Department of Clinical and Experimental Medicine Federico II University of Naples, Naples, Italy.
authors: Salvatore
authors: S
authors: Panico
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.|National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.|Department of Gastroenterology and Hepatology University Medical Centre, Utrecht, The Netherlands.
authors: H B As
authors: HB
authors: Bueno-de-Mesquita
authors: Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Carla H
authors: CH
authors: van Gils
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.|Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Petra H
authors: PH
authors: Peeters
authors: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
authors: Eiliv
authors: E
authors: Lund
authors: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
authors: Guri
authors: G
authors: Skeie
authors: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.|Department of Genetic Epidemiology, Folkhälsan Research Center, Helsinki, Finland.|Etiological Research Unit, Cancer Registry of Norway, Oslo, Norway.|Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
authors: Elisabete
authors: E
authors: Weiderpass
authors: Public Health Directorate, Asturias, Spain.
authors: José Ramón
authors: JR
authors: Quirós García
authors: Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain.|CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain.
authors: María-Dolores
authors: MD
authors: Chirlaque
authors: CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain.|Navarre Public Health Institute, Pamplona, Spain.
authors: Eva
authors: E
authors: Ardanaz
authors: CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain.|Andalusian School of Public Health, Granada Bio-Health Research Institute (Granada.IBS), Granada, Spain.|Instituto De Investigación Biosanitaria De Granada, Granada, Spain.
authors: María-José
authors: MJ
authors: Sánchez
authors: Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain.
authors: Eric J
authors: EJ
authors: Duell
authors: Public Health Division of Gipuzkoa, Gipuzkoa, Spain.
authors: Pilar
authors: P
authors: Amiano
authors: Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden.
authors: Signe
authors: S
authors: Borgquist
authors: Department of Clinical Sciences, Lund University, Malmö, Sweden.
authors: Elisabet
authors: E
authors: Wirfält
authors: Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden.
authors: Göran
authors: G
authors: Hallmans
authors: Department of Odontology, Umeå University, Umeå, Sweden.
authors: Ingegerd
authors: I
authors: Johansson
authors: Public Health and Clinical Medicine/Nutritional Research, Umeå University, Umeå, Sweden.
authors: Lena Maria
authors: LM
authors: Nilsson
authors: University of Cambridge, School of Clinical Medicine, Clinical Gerontology Unit, Cambridge, United Kingdom.
authors: Kay-Tee
authors: KT
authors: Khaw
authors: MRC Epidemiology Unit University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
authors: Nick
authors: N
authors: Wareham
authors: Cancer Epidemiology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
authors: Timothy J
authors: TJ
authors: Key
authors: Cancer Epidemiology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
authors: Ruth C
authors: RC
authors: Travis
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
authors: Neil
authors: N
authors: Murphy
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
authors: Petra A
authors: PA
authors: Wark
authors: Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
authors: Pietro
authors: P
authors: Ferrari
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
authors: Elio
authors: E
authors: Riboli
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000378:metabolism*; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000378:metabolism*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: alcohol consumption; breast cancer; prospective study