Red wine, white wine, beer and hard liquor present same risk

Kaiser Permanente Study Shows Alcohol Consumption - No Matter Beverage Type - Linked to Breast Cancer Risk


OAKLAND, Calif., Sept. 27 - One of the largest individual
studies of the effects of alcohol on the risk of breast cancer shows that
it makes no difference whether a woman drinks wine, beer or spirits
(liquor). It is the alcohol itself (ethyl alcohol) and the quantity
consumed that increases breast cancer risk. In fact, the increased breast
cancer risk from drinking three or more alcoholic drinks a day is similar
to the increased breast cancer risk from smoking a packet of cigarettes or
more a day, according to Kaiser Permanente researchers Yan Li, MD, PhD and
Arthur Klatsky, MD.
"Population studies have consistently linked drinking alcohol to an
increased risk of female breast cancer, but until now there has been little
data, most of it conflicting, about an independent role played by the
choice of beverage type," said Klatsky, who is presenting these findings on
September 27th at the European Cancer Conference (ECCO 14) in Barcelona,
Spain.
Li, a Kaiser Permanente oncologist, Klatsky, an investigator with the
Kaiser Permanente Division of Research in Oakland, CA and their Kaiser
Permanente colleagues studied the drinking habits of 70,033 multi-ethnic
women who had supplied information during health examinations between
1978-1985. By 2004, 2,829 of these women were diagnosed with breast cancer.
In one analysis, researchers compared the role of total alcohol intake
among women who favored one type of drink over another with women who had
no clear preference. In another analysis, researchers looked at the
possible independent role of frequency of drinking each beverage type.
Finally, they examined the role of total alcohol intake, comparing it with
women who drank less than one alcoholic drink a day.
The study found there was no difference between wine, beer or spirits
in the risk of developing breast cancer. Even when wine was divided into
red and white, there was no difference. However, when researchers looked at
the relationship between breast cancer risk and total alcohol intake, they
found that women who drank between one and two alcoholic drinks per day
increased their risk of breast cancer by 10 percent compared with light
drinkers who drank less than one drink a day. The risk of breast cancer
increased by 30 percent in women who drank more than three drinks a day.
Results were similar when researchers looked at groups stratified by
age and ethnicity. "Statistical analyses limited to strata of wine
preferrers, beer preferrers, spirits preferrers or non-preferrers each
showed that heavier drinking -- compared to light drinking -- was related
to breast cancer risk in each group. This strongly confirms the relation of
ethyl alcohol to increased risk," said Klatsky.
"A 30 percent increased risk is not trivial. To put it into context, it
is not much different from the increased risk associated with women taking
estrogenic hormones. Incidentally, in previous research completed at Kaiser
Permanente, we have found that smoking a pack of cigarettes or more per day
is related to a similar (30 percent) increased risk of breast cancer,"
Klatsky said.
Although breast cancer incidence varies between populations and only a
small proportion of women are heavy drinkers, Dr Klatsky said that a 30
percent increase in the relative risk of breast cancer from heavy drinking
might translate into approximately an extra 5 percent of all women
developing breast cancer as a result of their habit.
Other studies, including research from the same authors, have shown
light-moderate alcohol drinking can protect against heart attacks, but
Klatsky said that different mechanisms were probably at work.
"We think that the heart protection benefit from alcohol is real, and
is probably derived largely from alcohol-induced higher HDL ('good')
cholesterol, reduced blood clotting and reduced diabetes. None of these
mechanisms are known to have anything to do with breast cancer. The
possible but unproven additional coronary benefit from drinking wine (red
or white) may be related to favorable drinking patterns common among wine
drinkers or to the favorable traits of wine drinkers, as evidenced by other
United States and Danish studies," Klatsky said.
Klatsky said that all medical advice needed to be personalized to the
individual. "Our findings provide more evidence for why heavy drinkers
should quit or cut down."
The Kaiser Permanente research group has been involved in studies of
alcohol drinking and health for more than three decades, including in the
area of heart disease. Kaiser Permanente is uniquely positioned to conduct
such research because investigators have access to data about a large,
multi-ethnic population with a variety of drinking habits.
About Kaiser Permanente
The Kaiser Permanente Division of Research conducts, publishes, and
disseminates epidemiologic and health services research to improve the
health and medical care of Kaiser Permanente members and the society at
large. It seeks to understand the determinants of illness and well-being
and to improve the quality and cost-effectiveness of health care.
Currently, DOR's 400-plus staff is working on more than 250 epidemiological
and health services research projects.
Kaiser Permanente is America's leading integrated health plan. Founded
in 1945, it is a not-for-profit; group practice prepayment program
headquartered in Oakland, Calif. Kaiser Permanente serves the health care
needs of more than 8.7 million members in nine states and the District of
Columbia. Today it encompasses the not-for-profit Kaiser Foundation Health
Plan, Inc., Kaiser Foundation Hospitals and their subsidiaries, and the
for-profit Permanente Medical Groups. Nationwide, Kaiser Permanente
includes approximately 156,000 technical, administrative and clerical
employees and caregivers, and more than 13, 000 physicians representing all
specialties. (PRN)