Skip to main content

Advertisement

SpringerLink
Log in

Moderate alcohol intake and cancer: the role of underreporting

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

There is compelling evidence that heavy alcohol drinking is related to increased risk of several cancer types, but the relationship of light–moderate drinking is less clear. We explored the role of inferred underreporting among light–moderate drinkers on the association between alcohol intake and cancer risk.

Methods

In a cohort of 127,176 persons, we studied risk of any cancer, a composite of five alcohol-associated cancer types, and female breast cancer. Alcohol intake was reported at baseline health examinations, and 14,880 persons were subsequently diagnosed with cancer. Cox proportional hazard models were controlled for seven covariates. Based on other computer-stored information about alcohol habits, we stratified subjects into 18.4 % (23,363) suspected of underreporting, 46.5 % (59,173) not suspected of underreporting, and 35.1 % (44,640) of unsure underreporting status.

Results

Persons reporting light–moderate drinking had increased cancer risk in this cohort. For example, the hazard ratios (95 % confidence intervals) for risk of any cancer were 1.10 (1.04–1.17) at <1 drink per day and 1.15 (1.08–1.23) at 1–2 drinks per day. Increased risk of cancer was concentrated in the stratum suspected of underreporting. For example, among persons reporting 1–2 drinks per day risk of any cancer was 1.33 (1.21–1.45) among those suspected of underreporting, 0.98 (0.87–1.09) among those not suspected, and 1.20 (1.10–1.31) among those of unsure status. These disparities were similar for the alcohol-related composite and for breast cancer.

Conclusions

We conclude that the apparent increased risk of cancer among light–moderate drinkers may be substantially due to underreporting of intake.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bagnardi V, Rota M, Botteri E, Tramaceri I, Islami F, Fedente V et al (2013) Light alcohol drinking and cancer: a meta-analysis. Ann Oncol 2:701–708

    Google Scholar 

  2. Jin M, Cai S, Guo J, Zhu Y, Li M, Yu Y et al (2013) Alcohol drinking and all cancer mortality: a meta-analysis. Ann Oncol 3:807–816

    Article  Google Scholar 

  3. Li Y, Baer D, Friedman GD, Udaltsova N, Shim V, Klatsky AL (2008) Wine, liquor, beer and risk of breast cancer in a large population. Eur J Cancer 45(5):843–850

    Article  PubMed  Google Scholar 

  4. Seitz HK, Pelucchi C, Bagnardi V, La Vecchia C (2012) Epidemiology and pathophysiology of alcohol and breast cancer: update 2012. Alcohol Alcohol 47(3):204–212

    Article  PubMed  Google Scholar 

  5. Winstanley MH, Pratt IS, Chapman K, Griffin HJ, Croager ST, Olver IN et al (2011) Alcohol and cancer: a position statement from Cancer Council Australia. Med J Aust 194(9):479–482

    PubMed  Google Scholar 

  6. Nelson DE, Jarman DW, Rehm J, Greenfield TK, Rey G, Kerr WC et al (2013) Alcohol-attributable cancer deaths and years of potential life lost in the United states. Am J Public Health 103(4):641–648

    Article  PubMed Central  PubMed  Google Scholar 

  7. Allen NE, Beral V, Casabonne D, Kan SW, Reeves GK, Brown A et al (2009) Moderate alcohol intake and cancer incidence in women. J Natl Cancer Inst 101(5):296–305

    Article  PubMed  Google Scholar 

  8. Klatsky AL (1994) Epidemiology of coronary heart disease—influence of alcohol. Alcohol Clin Exp Res 18(1):88–96

    Article  CAS  PubMed  Google Scholar 

  9. Klatsky AL (1999) [Editorial]. Is it the drink or the drinker? Circumstantial evidence only raises a probability. Editorial. Am J Clin Nutr 69(1):2–3

    CAS  PubMed  Google Scholar 

  10. Klatsky AL, Gunderson E, D G, Kipp H, Udaltsova N, Friedman GD (2006) Higher prevalence of systemic HTN among moderate alcohol drinkers: exploring the role of under-reporting. J Stud Alcohol 67(3):421–428

    PubMed  Google Scholar 

  11. Klatsky AL, Udaltsova N (2013) Commentary. Abounding confounding. Addiction 108(9):1549–1552

    Article  PubMed  Google Scholar 

  12. Collen MF, Davis LF (1969) The multitest laboratory in health care. J Occup Med 11(7):355–360

    CAS  PubMed  Google Scholar 

  13. Tran HN, Li Y, Siu D, Baer D, Friedman GD, Udaltsova N, Klatsky AL (2013) Predictors of lung cancer: noteworthy cell type differences. Perm J 17(2):23–29

    Article  PubMed Central  PubMed  Google Scholar 

  14. Klatsky AL, Armstrong MA, Landy C, Udaltsova N (2003) The effect of coronary disease on changes in drinking in an older population. Alcohol Res 8:211–213

    Google Scholar 

  15. Klatsky AL, Armstrong MA, Kipp H (1990) Correlates of alcoholic beverage preference: traits of persons who choose wine, liquor, or beer. Br J Addict 85(10):1279–1289

    Article  CAS  PubMed  Google Scholar 

  16. Friedman GD, Klatsky AL (1994) Is alcohol good for your health? [Editorial]. N Engl J Med 329(25):1882–1883

    Article  Google Scholar 

Download references

Acknowledgments

The research was performed at the Division of Research of the Kaiser Permanente Medical Care Program, Oakland CA with support by a Community Budget grant from the Kaiser Foundation Research Institute to Yan Li, MD, PhD as Principal Investigator. Data collection in 1978–1985 was supported by a grant to Dr. Arthur L. Klatsky from the Alcoholic Beverage Medical Research Foundation of Baltimore, MD. We are grateful to Cynthia Landy for assistance with data collection.

Author information

Authors and Affiliations

  1. Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA, USA

    Arthur L. Klatsky, Natalia Udaltsova & Gary D. Friedman

  2. Department of Hematology and Oncology, Kaiser Permanente Medical Care Program, Oakland, CA, USA

    Yan Li & David Baer

  3. Department of Internal Medicine, Kaiser Permanente Medical Care Program, Oakland, CA, USA

    H. Nicole Tran

  4. Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA

    Gary D. Friedman

Authors
  1. Arthur L. Klatsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Natalia Udaltsova
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David Baer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H. Nicole Tran
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gary D. Friedman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Arthur L. Klatsky.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Klatsky, A.L., Udaltsova, N., Li, Y. et al. Moderate alcohol intake and cancer: the role of underreporting. Cancer Causes Control 25, 693–699 (2014). https://doi.org/10.1007/s10552-014-0372-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-014-0372-8

Keywords

Search

Navigation