Abstract
IntroductionThe role of alcohol and breast cancer risk in Asians has not been well studied. Recent studies suggest that even moderate alcohol intake may be associated with an increase in breast cancer risk, and this may be particularly relevant as alcohol intake is traditionally low among Asians.MethodsWe investigated the association between lifetime alcohol intake (including frequency, quantity, duration, timing, and beverage type) and breast cancer in a population-based case-control study of 2,229 Asian Americans diagnosed with incident breast cancer and 2,002 matched control women in Los Angeles County. Additionally, we examined the relation between current alcohol intake and serum concentrations of sex-hormones and growth factors in a subset of postmenopausal control women.ResultsRegular lifetime alcohol intake was significantly higher in US-born than non-US-born Asian Americans (P < 0.001) and almost twice as common in Japanese- than in Chinese- and Filipino-Americans (P < 0.001). Breast cancer risk increased with increasing alcohol intake among US-born Asian Americans; the odds ratios (ORs) per 5 grams per day and per 10 years of drinking were 1.21 (95% confidence interval (CI) 1.00 to 1.45) and 1.12 (95% CI, 0.98 to 1.28), respectively. Regular alcohol intake was a significant risk factor for Japanese-, but not for Chinese- and Filipino-Americans. Current consumers compared with nondrinkers showed lower concentrations of insulin-like growth factor binding protein 3 (P = 0.03) and nonsignificantly higher concentrations of estrone and androgens.ConclusionsRegular lifetime alcohol intake is a significant breast cancer risk factor in US-born Asian Americans and Japanese Americans, emphasizing the importance of this modifiable lifestyle factor in traditionally low-risk populations.
Highlights
The role of alcohol and breast cancer risk in Asians has not been well studied
Among current drinkers, no significant differences were found in the frequency of drinking or average amount of alcohol consumed per day by Asian ethnicity, by nativity, or by Asian ethnicity and nativity combined
Among regular drinkers, no significant differences were found in the amount and duration of drinking between the three Asian groups or between US-born and non-US-born Asian Americans
Summary
The role of alcohol and breast cancer risk in Asians has not been well studied. Recent studies suggest that even moderate alcohol intake may be associated with an increase in breast cancer risk, and this may be relevant as alcohol intake is traditionally low among Asians. High consumption of alcohol has been associated consistently with an increased risk of breast cancer in studies conducted primarily among women of European ancestry [1]. The role of alcohol and breast cancer development in Asia and in Asian American women has been less studied, and the results are not consistent [2,3]. We recently completed a large population-based casecontrol study of breast cancer among Asian-American women in Los Angeles County (LAC) in which detailed information on lifetime alcohol intake (frequency, amount, duration, timing, types of alcoholic beverages) was collected. We examined the interrelations between alcohol intake, smoking status, body size, use of hormone therapy (in postmenopausal women), and various dietary factors on breast cancer risk in LAC Asian-American women
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