Abstract
The objective was to evaluate the association between alcohol consumption and risk of breast cancer. Data from 38 epidemiologic studies on alcohol consumption in relation to risk of breast cancer in women were included in a meta-analysis. A qualitative literature review also was conducted. The results showed strong evidence of a dose-response relation; however, the slope of the dose-response curve was quite modest. For example, daily consumption of one alcoholic drink was associated with an 11 percent increase (95 percent confidence interval, seven to 16 percent) in the risk of breast cancer compared with nondrinkers. An explanation for the marked variation in results across studies was not found. The modest size of the association and variation in results across studies leave the causal role of alcohol in question. The evidence that alcohol consumption affects the risk of breast cancer, however, appears to be growing stronger.
Similar content being viewed by others
References
Longnecker MP, Berlin JA, Orza MJ, Chalmers TC. A meta-analysis of alcohol consumption in relation to risk of breast cancer.JAMA 1988;260: 652–6.
National Health Interview Survey 1983 Alcohol Supplement, data tape. Hyattsville, Maryland National Center for Health Statistics, Division of Health Interview Statistics, 1985.
Greenland S. Quantitative methods in the review of epidemiologic literature.Epidemiol Rev 1987;9: 1–30.
Greenland S, Longnecker MP. Methods for trend estimation from summarized dose-response data, with applications to meta-analysis.Am J Epidemiol 1992;135: 1301–9.
Berlin JA, Longnecker MP, Greenland S. Meta-analysis of epidemiologic dose-response data.Epidemiology 1993;4: 218–28.
DerSimonian R, Laird N. Meta-analysis in clinical trials.Controlled Clin Trials 1986;7: 177–88.
Hiatt RA, Bawol RD. Alcoholic beverage consumption and breast cancer incidence.Am J Epidemiol 1984;120: 676–83.
Hiatt RA, Klatsky A, Armstrong MA. Alcohol and breast cancer.Prev Med 1988;17: 683–5.
Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Hennekens CH, Speizer FE. Moderate alcohol consumption and the risk of breast cancer.N Engl J Med 1987;316: 1174–80.
Schatzkin A, Jones Y, Hoover RN, et al. Alcohol consumption and breast cancer in the epidemiologic follow-up study of the First National Health and Nutrition Examination Survey.N Engl J Med 1987;316: 1169–73.
Harvey EB, Schairer C, Brinton LA, Hoover RN, Fraumeni JF Jr. Alcohol consumption and breast cancer.JNCI 1987;78: 657–61.
Rosenberg L, Slone D, Shapiro S, et al. Breast cancer and alcoholic-beverage consumption.Lancet 1982;1: 267–70.
Webster LA, Layde PM, Wingo PA, Ory HW. Alcohol consumption and risk of breast cancer.Lancet 1983;ii: 724–6.
Paganini-Hill A, Ross RK. Breast cancer and alcohol consumption [Letter].Lancet 1983;ii: 626–7.
Byers T, Funch DP. Alcohol and breast cancer [Letter].Lancet 1982;i: 799–800.
Rohan TE, McMichael AJ. Alcohol consumption and risk of breast cancer.Int J Cancer 1988;41: 695–9.
Talamini R, La Vecchia C, Decarli A, et al.: Social factors, diet and breast cancer in a northern Italian population.Br J Cancer 1994;49; 723–9.
O'Connell DL, Hulka BS, Chambless LE, Wilkinson WE, Deubner DC. Cigarette smoking, alcohol consumption, and breast cancer risk.JNCI 1987;78: 229–34.
Harris RE, Wynder EL. Breast cancer and alcohol consumption. A study in weak associations.JAMA 1988;259: 2867–71.
Le MG, Hill C, Kramar A, Flamant R. Alcoholic beverage consumption and breast cancer in a French casecontrol study.Am J Epidemiol 1984;120: 350–7.
La Vecchia C, Decarli A, Franceschi S, Pampallona S, Tognoni G. Alcohol consumption and the risk of breast cancer in women.JNCI 1985;75: 61–5.
Begg CB, Walker AM, Wessen B, Zelen M Alcohol consumption and breast cancer [Letter].Lancet 1983;i: 293–4.
Klatsky AL, Armstrong MA, Friedman GD. Alcohol consumption and 17-year cancer mortality [Abstract].Am J Epidemiol 1987;126: 770.
Williams RR, Horm JW. Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: Interview study from the Third National Cancer Survey.JNCI 1977;58; 525–47.
Katsouyanni K, Trichopoulos D, Boyle P, et al.: Diet and breast cancer: a case-control study in Greece.Int J Cancer 1986;38: 815–20.
Miller DR, Rosenberg L, Clarke AE, Shapiro S. Breast cancer risk and alcoholic beverage drinking [Abstract].Am J Epidemiol 1987;126: 736.
Van't Veer P, Kok FJ, Hermus RJ, Sturmans F. Alcohol dose, frequency and age at first exposure in relation to the risk of breast cancer.Int J Epidemiol 1989;18: 511–7.
Young TB. A case-control study of breast cancer and alcohol consumption habits.Cancer 1989;64: 552–8.
Chu SY, Lee NC, Wingo PA, Webster LA. Alcohol consumption and the risk of breast cancer.Am J Epidemiol 1989;130: 867–77.
Rosenberg L, Palmer JR, Miller DR, Clarke EA, Shapiro S. A case-control study of alcoholic beverage consumption and breast cancer.Am J Epidemiol 1990;131: 6–14.
Schatzkin A, Carter CL, Green SB, et al. Is alcohol consumption related to breast cancer? Results from the Framingham Heart Study.JNCI 1989;81: 31–5.
Kato I, Tominaga S, Terao C. Alcohol consumption and cancers of hormone-related organs in females.Jpn J Clin Onc 1989;19: 202–7.
Toniolo P, Riboli E, Protta F, Charrel M, Cappa APM. Breast cancer and alcohol consumption: a case-control study in Northern Italy.Cancer Res 1989;49: 5203–6.
Richardson S, de Vincenzi I, Pujol H, Gerber M. Alcohol consumption in a case-control study of breast cancer in southern France.Int J Cancer 1989;44: 84–9.
Cusimano R, Dardanoni G, Dardanoni L et al. Risk factors of female cancers in Ragusa population (Sicily). 2. Breast cancer.Eur J Epidemiol 1989;5: 497–506.
Meara J, McPherson K, Roberts M, Jones L, Vessey M. Alcohol, cigarette smoking and breast cancer.Br J Cancer 1989;60: 70–3.
Adami HO, Lund E, Bergstrom R, Meirik O. Cigarette smoking, alcohol consumption and risk of breast cancer in young women.Br J Cancer 1988;58: 832–7.
Dupont WD, Page DL, Rogers LW, Parl FF. Influence of exogenous estrogens, proliferative breast disease, and other variables on breast cancer risk.Cancer 1989;63: 948–57.
Garfinkel L, Boffetta P, Stellman SD. Alcohol and breast cancer: a cohort study.Prev Med 1988;17: 686–93.
Simon MS, Carman W, Wolfe R, Schottenfeld D. Alcohol consumption and the risk of breast cancer: a report from the Tecumsch Community Health Study.J Clin Epidemiol 1991;44: 755–61.
Metzger LS, Reif JS, Lopez L. Diet, alcohol and breast cancer [Abstract].Am J Epidemiol 1990;132: 816.
Reynolds P, Camacho T, Kaplan GA. Alcohol consumption and breast cancer: prospective evidence from the Alameda County Study [Abstract].Am J Epidemiol 1988;128: 930.
La Vecchia C, Negri E, Parazzini F, et al.: Alcohol and breast cancer: update from an Italian case-control study.Eur J Cancer Clin Oncol 1989;25: 1711–7.
Nasca PC, Baptiste MS, Field NA, et al. An epidemiological case-control study of breast cancer and alcohol consumption.Int J Epidemiol 1990;19: 532–8.
Howe G, Rohan T, Decarli A, et al. The association between alcohol and breast cancer risk: evidence from the combined analysis of six dietary case-control studies.Int J Cancer 1991;47: 707–10.
Ewertz M. Alcohol consumption and breast cancer risk in Denmark.Cancer Causes Control 1991;2: 247–52.
Sneyd MJ, Paul C, Spears GF, Skegg DC. Alcohol consumption and risk of breast cancer.Int J Cancer 1991;48: 812–5.
Ferraroni M, Decarli A, Willett WC, Marubini E. Alcohol and breast cancer risk: a case-control study from northern Italy.Int J Epidemiol 1991;20: 859–64.
Longnecker MP, Newcomb PA, Mittendorf R, et al. Risk of breast cancer in relation to past and recent alcohol consumption [Abstract].Am J Epidemiol 1992;136: 1001.
Iscovich JM, Iscovich RB, Howe G Shiboski S, Kaldor JM. A case-control study of diet and breast cancer in Argentina.Int J Cancer 1989;44: 770–6.
Miller AB, Kelly A, Choi NW, et al. A study of diet and breast cancer.Am J Epidemiol 1978;107: 499–509.
Marubini E, Decarli A, Costa A, et al. The relationship of dietary intake and serum levels of retinol and beta-carotene with breast cancer. Results of a case-control study.Cancer 1988;61: 173–80.
Friedenreich CM, Howe GR, Miller AB, Jain MG. A cohort study of alcohol consumption and risk of breast cancer.Am J Epidemiol 1993;137: 512–20.
Gapstur SM, Potter JD, Sellers TA, Folsom AR. Increased risk of breast cancer with alcohol consumption in postmenopausal women.Am J Epidemiol 1992;136: 1221–31.
Pawlega J. Breast cancer and smoking, vodka drinking and dietary habits. A case-control study.Acta Oncol 1992;31: 387–92.
Zaridze D, Lifanova Y, Maximovitch D, Day NE, Duffy SW. Diet, alcohol consumption and reproductive factors in a case-control study of breast cancer in Moscow.Int J Cancer 1991;48: 493–501.
Begg CB, Berlin JA: Publication bias: a problem in interpreting medical data.JR Stat Soc 1988;151: 419–63.
Longnecker MP. Re: “The evaluation of the data collection process for a multicenter, populational-based casecontrol design” [Letter].Am J Epidemiol 1989;129(6): 1311.
Harris JR, Lippman ME, Veronesi U, Willett W Breast cancer (1).N Engl J Med 1992;327: 319–28.
Kelsey JL, Gammon MD. The epidemiology of breast cancer.CA Cancer J Clin 1991;41: 146–65.
Frezza M di Padova C, Pozzato G, Terpin M, Baraona E, Lieber CS. High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism.N Engl J Med 1990;322: 95–9.
Colditz GA, Stampfer MJ, Willett WC, Hennekens CH, Rosner B, Speizer FE. Prospective study of estrogen replacement therapy and risk of breast cancer in postmenopausal women.JAMA 1990;264: 2648–53.
Schatzkin A, Piantadosi S, Micozzi M, Bartee D. Alcohol consumption and breast cancer: a cross-national correlation study.Int J Epidemiol 1989;18: 28–31.
Monson RR, Lyon JL. Proportional mortality among alcoholics.Cancer 1975;36: 1077–9.
Adelstein A, White G. Alcoholism and mortality.Popul Trends 1976;6: 7–13.
Casagrande JT, Hanisch R, Pike MC, Ross RK, Brown JB, Henderson BE. A case-control study of male breast cancer.Cancer Res 1988;48: 1326–30.
Rothman KJ, Poole C. A strengthening programme for weak associations.Int J Epidemiol 1988;17: 955–9.
Garro AJ, Lieber CS. Alcohol and cancer.Ann Rev Pharmacol Toxicol 1990;30: 219–49.
Reichman ME, Judd JT, Longcope C, et al. Effects of alcohol consumption on plasma and urinary hormone concentrations in premenopausal women.JNCI 1993;85: 722–7.
Gavaler JS, Love K, Van Thiel D,et al. An international study of the relationship between alcohol consumption and postmenopausal estradiol levels.Alcohol Alcohol 1991; (Suppl. 1): 327–30.
Key TJ, Pike MC. The role of oestrogens and progestagens in the epidemiology and prevention of breast cancer.Eur J Cancer Clin Oncol 1988;24: 29–43.
Grubbs CJ, Juliana MM, Whitaker LM. Effect of ethanol on initiation of methylnitrosousea (MNU)- and dimethylbenzanthracene (DMBA)-induced mammary cancers [Abstract].Proc Am Assoc Cancer Res 1988;29: 148.
Singletary KW, McNary MQ, Odoms AM, Nelshoppen J, Wallig MA. Ethanol consumption and DMBA-induced mammary carcinogenesis in rats.Nutr Cancer 1991;16: 13–23.
Preston-Martin S, Pike MC, Ross RK, Jones PA, Henderson BE. Increased cell division as a cause of human cancer.Cancer 1990;50: 7415–21.
Rogers AE, Conner BH. Dimethylbenzanthracene-induced mammary tumorigenesis in ethanol-fed rats.Nutr Res 1990;10: 915–28.
Rohan TE, Cook MG. Alcohol consumption and risk of benign proliferative epithelial disorders of the breast in women.Int J Cancer 1989;43: 631–6.
Rosner B, Spiegelman D, Willett WC. Correction of logistic regression relative risk estimates and confidence intervals for measurement error: the case of multiple covariates measured with error.Am J Epidemiol 1990;132: 734–45.
Hill AB. The environment and disease: Association or causation?Proc R Soc Med 1965;58: 295–300.
Rothman KJ.Modern Epidemiology. Boston: Little, Brown and Company, 1986.
Friedman LA, Kimball AW. Coronary heart disease mortality and alcohol consumption in Framingham.Am J Epidemiol 1986;124: 481–9.
Klatsky AL, Friedman GD, Siegelaub AB. Alcohol and mortality. A ten-year Kaiser-Permanente experience.Ann Intern Med 1981;95: 139–45.
Martin-Moreno JM, Boyle P, Gorgojo L, et al. Alcoholic beverage consumption and risk of breast cancer in Spain.Cancer Causes Control 1993;4: 345–53.
Hurley J, Horowitz J.Alcohol and Health. New York: Hemisphere Publishing Corporation, 1990.
Willett WC.Nutritional Epidemiology. New York: Oxford University Press, 1990.
Kleinbaum DG, Kupper LL, Morgenstern H.Epidemiologic Research. Belmont, California, Lifetime Learning Publications, 1982.
Author information
Authors and Affiliations
Additional information
An earlier version of this manuscript was presented to the President's Cancer Panel, Special Commission on Breast Cancer, Reston, Virginia (USA), 23 September 1992.
Rights and permissions
About this article
Cite this article
Longnecker, M.P. Alcoholic beverage consumption in relation to risk of breast cancer: meta-analysis and review. Cancer Causes Control 5, 73–82 (1994). https://doi.org/10.1007/BF01830729
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01830729