Alcohol consumption and breast cancer risk among postmenopausal women following the cessation of hormone therapy use: the California Teachers Study
Published Date:Jul 25 2012
Source:Cancer Epidemiol Biomarkers Prev. 21(11):2006-2013.
Aged, 80 And Over
Estrogen Replacement Therapy
Proportional Hazards Models
Surveys And Questionnaires
Pubmed Central ID:PMC3721729
Funding:HHSN261201000034C/PHS HHS/United States
HHSN261201000036C/PHS HHS/United States
HHSN261201000035C/CA/NCI NIH HHS/United States
HHSN261201000035C/PHS HHS/United States
HHSN261201000036C/CA/NCI NIH HHS/United States
U58 DP000807/DP/NCCDPHP CDC HHS/United States
K05 CA136967/CA/NCI NIH HHS/United States
HHSN261201000035I/CA/NCI NIH HHS/United States
R01 CA077398/CA/NCI NIH HHS/United States
R01 CA77398/CA/NCI NIH HHS/United States
HHSN261201000034C/CA/NCI NIH HHS/United States
Alcohol consumption increases breast cancer risk, but its effect may be modified by hormone therapy (HT) use, such that exposure to both may be synergistic. Because many women stopped taking HT after mid-2002, it is important to quantify risks associated with alcohol consumption in the context of HT cessation, as these risks may be more relevant to cancer prevention efforts today.
Among 40,680 eligible postmenopausal California Teachers Study cohort participants, 660 were diagnosed with invasive breast cancer before 2010. Multivariate Cox proportional hazards regression models were used to estimate relative risks (RR) and 95% confidence intervals (CI).
Increased breast cancer risk associated with alcohol consumption was observed among postmenopausal women who were current HT users (RR=1.60, 95% CI: 1.13–2.26 and RR=2.11, 95% CI: 1.41–3.15 for <20 and ≥20 g/d of alcohol), with risks being similar by HT preparation. Alcohol did not increase risk among women who had stopped using HT within 3 years or 3–4 years before completing the follow-up questionnaire or in the more distant past. Results were similar for ER+ and ER+PR+ tumors; while power was limited, no increase in risk was observed for ER- tumors.
Following the cessation of HT use, alcohol consumption is not significantly associated with breast cancer risk, although a non-significant increased risk was observed among women who never used HT.
Our findings confirm that concurrent exposure to HT and alcohol has a substantial adverse impact on breast cancer risk. However, after HT cessation, this risk is reduced.
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