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Alcohol intake and breast cancer risk: the European Prospective Investigation into Cancer and Nutrition (EPIC)

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Abstract

Objective

Most epidemiologic studies have suggested an increased risk of breast cancer with increasing alcohol intake. Using data from 274,688 women participating in the European Prospective Investigation into Cancer and Nutrition study (EPIC), we investigated the relation between alcohol intake and the risk of breast cancer.

Methods

Incidence rate ratios (IRRs) based on Cox proportional hazard models were calculated using reported intake of alcohol, recent (at baseline) and lifetime exposure. We adjusted for known risk factors and stratified according to study center as well as potentially modifying host factors.

Results

During 6.4 years of follow up, 4,285 invasive cases of breast cancer within the age group 35–75 years were identified. For all countries together the IRR per 10 g/day higher recent alcohol intake (continuous) was 1.03 (95% confidence interval (CI): 1.01–1.05). When adjusted, no association was seen between lifetime alcohol intake and risk of breast cancer. No difference in risk was shown between users and non-users of HRT, and there was no significant interaction between alcohol intake and BMI, HRT or dietary folate.

Conclusion

This large European study supports previous findings that recent alcohol intake increases the risk of breast cancer.

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Abbreviations

BMI:

Body mass index

IRR:

Incidence rate ratio

CI:

Confidence interval

EPIC:

European Prospective Investigation into Cancer and Nutrition

HRT:

Hormone replacement therapy

Pre:

Premenopausal

Peri:

Perimenopausal

Post:

Postmenopausal

PY:

Person years

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Acknowledgments

We would like to thank all the participants in the EPIC study. The authors acknowledge the important technical support given by Programmer Katja Boll and secretarial help by Jytte Fogh Larsen. Financial support: Grant sponsor: Europe Against Cancer programme of the European Commission (SANCO); Grant sponsor: Deutsche Krebshilfe; Grant sponsor: German Cancer Research Center; Grant sponsor: German Federal Ministry of Education and Research; Grant Sponsor: Danish Cancer Society; Grant sponsor: Health Research Fund of the Spanish Ministry of Health; Grant sponsor: Spanish regional governments of Andalusia, Asturia, Basque County, Murcia and Navarra; Grant sponsor: Cancer Research UK; Grant sponsor: Medical Research Council, UK; Grant sponsor: Stroke Association, UK; Grant sponsor: British Heart Foundation; Grant sponsor: Department off Health, UK; Grant sponsor: Food Standards Agency, UK; Grant sponsor: Wellcome Trust, UK; Greek Ministry of Health; Grant sponsor: Greek Ministry of Education; Grant sponsor: Italian Association for Research on Cancer; Grant sponsor: Italian National Research Council; Grant sponsor: Dutch Ministry of Public Health, Welfare and Sports; Grant sponsor: National Cancer Registry and regional cancer registries of Amsterdam, East and Maastricht, the Netherlands; Grant sponsor: World Cancer Research Fund; Grant sponsor: Swedish Cancer Society; Grant sponsor: Swedish Scientific Council; Grant sponsor: Regional Government of Skåne, Sweden; Grant sponsor: The Norwegian Cancer Society, The Norwegian Research Counsil; Grant sponsor: French League Against Cancer, 3 M Company, Mutuelle Générale de l’Education Nationale. French Institute of Health and Medical Research (INSERM), Gustave Roussey Institute, “Fondation de France”, several departmental councils in France; Grant sponsor: the ISC III Network RCESP (C03/09), Spain.

Author information

Authors and Affiliations

  1. Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark

    Anne Tjønneland, Jane Christensen, Anja Olsen, Connie Stripp & Birthe L. Thomsen

  2. Department of Clinical Epidemiology, Aalborg Hospital and Aarhus University Hospital, Aarhus, Denmark

    Kim Overvad

  3. Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands

    Petra H. M. Peeters & Carla H. van Gils

  4. National Institute for Public Health and the Environment, Bilthoven, Netherlands

    H. Bas Bueno-de-Mesquita & Marga C. Ocké

  5. INSERM, ERI-20, Institut Gustave Roussy, Villejuif, France

    Anne Thiebaut, Agnès Fournier & Françoise Clavel-Chapelon

  6. Epidemiology Unit, National Cancer Institute, Milan, Italy

    Franco Berrino

  7. Molecular and Nutritional Epidemiology Unit, CSPO-Scientific Institute of Tuscany, Florence, Italy

    Domenico Palli

  8. Cancer Registry, Azienda Ospedaliera “Civile-M.P. Arezzo”, Ragusa, Italy

    Rosario Tumino

  9. Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy

    Salvatore Panico

  10. Cancer Epidemiology Department, University of Turin, Turin, Italy

    Paolo Vineis

  11. Unit of Epidemiology, Catalan Institute of Oncology, Barcelona, Spain

    Antonio Agudo

  12. Public Health Institute of Navarra, Pamplona, Spain

    Eva Ardanaz

  13. Andalusian School of Public Health, Granada, Spain

    Carmen Martinez-Garcia

  14. Department of Public Health of Guipuzkoa, San Sebastian, Spain

    Pilar Amiano

  15. Epidemiology Department, Regional Health Council, Murcia, Spain

    Carmen Navarro

  16. Health Information Unit, Public Health and Planning Directorate, Health and Health Services Council, Principality of Asturias, Oviedo, Spain

    José R. Quirós

  17. Epidemiology Unit, Cancer Research UK, Oxford University, Oxford, UK

    Tim J. Key & Gillian Reeves

  18. Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK

    Kay-Tee Khaw

  19. MRC Dunn Human Nutrition Unit, Welcome Trust/MRC Building, Cambridge, UK

    Sheila Bingham

  20. Department of Hygiene and Epidemiology, School of Medicine, University of Athens, Athens, Greece

    Antonia Trichopoulou, Dimitrios Trichopoulos & Androniki Naska

  21. Division of Clinical Epidemiology, German Cancer Research Center, Heidelberg, Germany

    Gabriele Nagel & Jenny Chang-Claude

  22. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany

    Heiner Boeing & Petra H. Lahmann

  23. Department of Surgery, Malmö University Hospital, Malmo, Sweden

    Jonas Manjer

  24. Department of Clinical Sciences, Lund University, Malmo, Sweden

    Elisabet Wirfält

  25. Public Health and Clinical Medicine, Nutritional Research, University Hospital of Northern Sweden, Umea, Sweden

    Göran Hallmans & Ingegerd Johansson

  26. Institute of Community Medicine, University of Tromsø, Tromso, Norway

    Eiliv Lund & Guri Skeie

  27. Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway

    Anette Hjartåker

  28. Nutrition and Hormones Group, International Agency for Research on Cancer, Lyon, France

    Pietro Ferrari, Nadia Slimani & Rudolf Kaaks

  29. Department of Epidemiology & Public Health, Faculty of Medicine, Imperial College, London, UK

    Elio Riboli

  30. Imperial College, London, UK

    Paolo Vineis

Authors
  1. Anne Tjønneland
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  2. Jane Christensen
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  3. Anja Olsen
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  4. Connie Stripp
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  5. Birthe L. Thomsen
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  6. Kim Overvad
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  7. Petra H. M. Peeters
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  8. Carla H. van Gils
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  9. H. Bas Bueno-de-Mesquita
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  10. Marga C. Ocké
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  11. Anne Thiebaut
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  12. Agnès Fournier
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  13. Françoise Clavel-Chapelon
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  14. Franco Berrino
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  15. Domenico Palli
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  16. Rosario Tumino
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  17. Salvatore Panico
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  18. Paolo Vineis
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  19. Antonio Agudo
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  20. Eva Ardanaz
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  21. Carmen Martinez-Garcia
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  22. Pilar Amiano
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  23. Carmen Navarro
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  24. José R. Quirós
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  25. Tim J. Key
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  26. Gillian Reeves
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  27. Kay-Tee Khaw
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  28. Sheila Bingham
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  29. Antonia Trichopoulou
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  30. Dimitrios Trichopoulos
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  31. Androniki Naska
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  32. Gabriele Nagel
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  33. Jenny Chang-Claude
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  34. Heiner Boeing
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  35. Petra H. Lahmann
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  36. Jonas Manjer
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  37. Elisabet Wirfält
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  38. Göran Hallmans
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  39. Ingegerd Johansson
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  40. Eiliv Lund
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  41. Guri Skeie
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  42. Anette Hjartåker
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  43. Pietro Ferrari
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  44. Nadia Slimani
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  45. Rudolf Kaaks
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  46. Elio Riboli
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Corresponding author

Correspondence to Anne Tjønneland.

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Tjønneland, A., Christensen, J., Olsen, A. et al. Alcohol intake and breast cancer risk: the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes Control 18, 361–373 (2007). https://doi.org/10.1007/s10552-006-0112-9

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  • DOI: https://doi.org/10.1007/s10552-006-0112-9

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