title: Prospective association between alcohol intake and hormone-dependent cancer risk: modulation by dietary fiber intake.
abstract: BACKGROUND
  Alcohol intake is associated with increased circulating concentrations of sex hormones, which in turn may increase hormone-dependent cancer risk. This association may be modulated by dietary fiber intake, which has been shown to decrease steroid hormone bioavailability (decreased blood concentration and increased sex hormone-binding globulin concentration). However, this potential modulation has not been investigated in any prospective cohort.
  
  
  OBJECTIVE
  Our objectives were to study the relation between alcohol intake and the risk of hormone-dependent cancers (breast, prostate, ovarian, endometrial, and testicular) and to investigate whether dietary fiber intake modulated these associations.
  
  
  METHODS
  This prospective observational analysis included 3771 women and 2771 men who participated in the Supplémentation en Vitamines et Minéraux Antioxydants study (1994-2007) and completed at least 6 valid 24-h dietary records during the first 2 y of follow-up. After a median follow-up of 12.1 y, 297 incident hormone-dependent cancer cases, including 158 breast and 123 prostate cancers, were diagnosed. Associations were tested via multivariate Cox proportional hazards models.
  
  
  RESULTS
  Overall, alcohol intake was directly associated with the risk of hormone-dependent cancers (tertile 3 vs. tertile 1: HR: 1.36; 95% CI: 1.00, 1.84; P-trend = 0.02) and breast cancer (HR: 1.70; 95% CI: 1.11, 2.61; P-trend = 0.04) but not prostate cancer (P-trend = 0.3). In stratified analyses (by sex-specific median of dietary fiber intake), alcohol intake was directly associated with hormone-dependent cancer (tertile 3 vs. tertile 1: HR: 1.76; 95% CI: 1.10, 2.82; P-trend = 0.002), breast cancer (HR: 2.53; 95% CI: 1.30, 4.95; P-trend = 0.02), and prostate cancer (HR: 1.37; 95% CI: 0.65, 2.89; P-trend = 0.02) risk among individuals with low dietary fiber intake but not among their counterparts with higher dietary fiber intake (P-trend = 0.9, 0.8, and 0.6, respectively). The P-interaction between alcohol and dietary fiber intake was statistically significant for prostate cancer (P = 0.01) but not for overall hormone-dependent (P = 0.2) or breast (P = 0.9) cancer.
  
  
  CONCLUSIONS
  In line with mechanistic hypotheses and experimental data, this prospective study suggested that dietary fiber intake might modulate the association between alcohol intake and risk of hormone-dependent cancer. This trial was registered at clinicaltrials.gov as NCT00272428.
authors.affiliation: Sorbonne Paris Cité Epidemiology and Biostatistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125, Cnam, Paris 13, 7, and 5 Universities, Bobigny, France; and.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Chhim
authors.affiliation: Sorbonne Paris Cité Epidemiology and Biostatistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125, Cnam, Paris 13, 7, and 5 Universities, Bobigny, France; and.
authors.forename: Philippine
authors.initials: P
authors.lastname: Fassier
authors.affiliation: Sorbonne Paris Cité Epidemiology and Biostatistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125, Cnam, Paris 13, 7, and 5 Universities, Bobigny, France; and.
authors.forename: Paule
authors.initials: P
authors.lastname: Latino-Martel
authors.affiliation: Sorbonne Paris Cité Epidemiology and Biostatistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125, Cnam, Paris 13, 7, and 5 Universities, Bobigny, France; and.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Druesne-Pecollo
authors.affiliation: Sorbonne Paris Cité Epidemiology and Biostatistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125, Cnam, Paris 13, 7, and 5 Universities, Bobigny, France; and Oncology and.
authors.forename: Laurent
authors.initials: L
authors.lastname: Zelek
authors.affiliation: Oncology and.
authors.forename: Lucie
authors.initials: L
authors.lastname: Duverger
authors.affiliation: Sorbonne Paris Cité Epidemiology and Biostatistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125, Cnam, Paris 13, 7, and 5 Universities, Bobigny, France; and Public Health Departments, Avicenne Hospital, Bobigny, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
authors.affiliation: Sorbonne Paris Cité Epidemiology and Biostatistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125, Cnam, Paris 13, 7, and 5 Universities, Bobigny, France; and.
authors.forename: Pilar
authors.initials: P
authors.lastname: Galan
authors.affiliation: Sorbonne Paris Cité Epidemiology and Biostatistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125, Cnam, Paris 13, 7, and 5 Universities, Bobigny, France; and.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Deschasaux
authors.affiliation: Sorbonne Paris Cité Epidemiology and Biostatistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125, Cnam, Paris 13, 7, and 5 Universities, Bobigny, France; and m.touvier@eren.smbh.univ-paris13.fr.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Touvier
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000097:blood / Q000453:epidemiology; D015930:Diet Records; D004043:Dietary Fiber / Q000008:administration & dosage*; D016889:Endometrial Neoplasms / Q000097:blood / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013736:Testicular Neoplasms / Q000097:blood / Q000453:epidemiology
chemical_list: D004043:Dietary Fiber; D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin
keywords: alcohol; breast cancer; dietary fiber; hormone-dependent cancer; prospective study; prostate cancer