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Michel R, Hazimeh D, Saad EE, Olson SL, Musselman K, Elgindy E, Borahay MA. Common Beverage Consumption and Benign Gynecological Conditions. BEVERAGES (BASEL, SWITZERLAND) 2024; 10:33. [PMID: 38948304 PMCID: PMC11211953 DOI: 10.3390/beverages10020033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
The purpose of this article is to review the effects of four commonly consumed beverage types-sugar-sweetened beverages (SSBs), caffeinated beverages, green tea, and alcohol-on five common benign gynecological conditions: uterine fibroids, endometriosis, polycystic ovary syndrome (PCOS), anovulatory infertility, and primary dysmenorrhea (PD). Here we outline a plethora of research, highlighting studies that demonstrate possible associations between beverage intake and increased risk of certain gynecological conditions-such as SSBs and dysmenorrhea-as well as studies that demonstrate a possible protective effect of beverage against risk of gynecological condition-such as green tea and uterine fibroids. This review aims to help inform the diet choices of those with the aforementioned conditions and give those with uteruses autonomy over their lifestyle decisions.
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Affiliation(s)
- Rachel Michel
- Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Baltimore, MD 21205 USA
| | - Dana Hazimeh
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD 21205 USA
| | - Eslam E. Saad
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD 21205 USA
| | - Sydney L. Olson
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD 21205 USA
| | - Kelsey Musselman
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD 21205 USA
| | - Eman Elgindy
- Department of Gynecology and Obstetrics, Zagazig University School of Medicine, Zagazig, 44519, Egypt
| | - Mostafa A. Borahay
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD 21205 USA
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Zhu P, Zhang Y, Chen Q, Qiu W, Chen M, Xue L, Lin M, Yang H. The interaction of diet, alcohol, genetic predisposition, and the risk of breast cancer: a cohort study from the UK Biobank. Eur J Nutr 2024; 63:343-356. [PMID: 37914956 PMCID: PMC10899287 DOI: 10.1007/s00394-023-03269-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 10/06/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Dietary factors have consistently been associated with breast cancer risk. However, there is limited evidence regarding their associations in women with different genetic susceptibility to breast cancer, and their interaction with alcohol consumption is also not well understood. METHODS We analyzed data from 261,853 female participants in the UK Biobank. Multivariable adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations between dietary factors and breast cancer risk. Additionally, we assessed the interaction of dietary factors with alcohol consumption and polygenic risk score (PRS) for breast cancer. RESULTS A moderately higher risk of breast cancer was associated with the consumption of processed meat (HR = 1.10, 95% CI 1.03, 1.18, p-trend = 0.016). Higher intake of raw vegetables and fresh fruits, and adherence to a healthy dietary pattern were inversely associated with breast cancer risk [HR (95% CI):0.93 (0.88-0.99), 0.87 (0.81, 0.93) and 0.93 (0.86-1.00), p for trend: 0.025, < 0.001, and 0.041, respectively]. Furthermore, a borderline significant interaction was found between alcohol consumption and the intake of processed meat with regard to breast cancer risk (P for interaction = 0.065). No multiplicative interaction was observed between dietary factors and PRS. CONCLUSION Processed meat was positively associated with breast cancer risk, and vegetables, fruits, and healthy dietary patterns were negatively associated with breast cancer risk. We found no strong interaction of dietary factors with alcohol consumption and genetic predisposition for risk of breast cancer.
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Affiliation(s)
- Pingxiu Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Xuefu North Road 1, University Town, Fuzhou, 350122, China
| | - Yanyu Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Xuefu North Road 1, University Town, Fuzhou, 350122, China
| | - Qianni Chen
- Department of Ultrasonography, Fuqing City Hospital Affiliated to Fujian Medical University, Fuqing, China
| | - Wenji Qiu
- School of Health Management, Fujian Medical University, Fuzhou, 350122, China
| | - Minhui Chen
- Department of Ultrasonography, Fuqing City Hospital Affiliated to Fujian Medical University, Fuqing, China
| | - Lihua Xue
- Department of Ultrasonography, Fuqing City Hospital Affiliated to Fujian Medical University, Fuqing, China
| | - Moufeng Lin
- No. 5 Hospital of Fuqing City, Fuzhou, 350319, China
| | - Haomin Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Xuefu North Road 1, University Town, Fuzhou, 350122, China.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels Väg 12A, 171 77, Stockholm, Sweden.
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Mirghafourvand M, Ghavami V, Moradi M, Najmabadi KM, Mollazadeh S. Psychometric evaluation of the endometriosis impact questionnaire (EIQ) in an Iranian population. BMC Womens Health 2024; 24:135. [PMID: 38378552 PMCID: PMC10877831 DOI: 10.1186/s12905-024-02975-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 02/14/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Endometriosis is a benign and chronic gynecological estrogen-dependent disease. Considering the prevalence and the importance of measuring the long-term effects of endometriosis in affected women's lives t the EIQ scale was designed and psychometrically analyzed in English in Australia, in three recall periods (last 12 months, 1 to 5 years ago and more than 5 years ago). It has never been used in Iran and its validity and reliability have not been assessed either. Therefore, the present study aimed to translate and investigate the psychometric properties of the EIQ. METHODS In this study, 200 women were selected through random sampling in 2022. After forward and backward translation, the face validity, content validity, and construct validity of EIQ (through Corrected Item-Total Correlation) were examined. To assess the reliability of the scale, both internal consistency (Cronbach's alpha) and test-retest stability methods were employed. RESULTS Impact Score with a score above 1.5 was approved. CVI and CVR values of the EIQ tool were 0.97 and 0.94, respectively. The Item to total Correlation confirmed the construct validity of all seven dimensions of the tool, more than the cut-off (0.3) except lifestyle. Cronbach's alpha coefficient and Intra Correlation Coefficient (ICC) were acceptable for all dimensions. CONCLUSION The Persian version of EIQ is a valid and reliable scale. This tool is valid and reliable for investigating the long-term impact of endometriosis in Iranian society.
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Affiliation(s)
- Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Ghavami
- Department of Biostatistics, School of Health, Social Determinants of Health Research Center, Mashhad University of Medical sciences, Mashhad, Iran
| | - Maryam Moradi
- Department Of General Practice, School Of Public Health and Preventive Medicine, Faculty Of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
| | | | - Sanaz Mollazadeh
- Department of Midwifery, Research Student Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
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Lee S, Lee SY, Lee W. Occupational characteristics and risk factors associated with endometriosis among Korean female workers. PLoS One 2023; 18:e0292362. [PMID: 37797051 PMCID: PMC10553800 DOI: 10.1371/journal.pone.0292362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023] Open
Abstract
Endometriosis is a chronic and debilitating condition that affects daily working life. Characterization of the factors associated with endometriosis in the working population can facilitate the development of prevention and intervention strategies for those at risk of endometriosis. This population-based retrospective study was conducted using the 2007-2015 National Health Insurance Service-Female Employees database. Overall, 151,386 female workers aged 15-64 years were included in the study. Participants with endometriosis were identified using the diagnosis codes in the claims data. Multivariable Cox regression analyses were used to evaluate the effect of sociodemographic, lifestyle, health, and occupational factors on endometriosis risk. Of the 151,386 participants, 4,457 were diagnosed with endometriosis. The risk of endometriosis was significantly higher in 41-60 years group (HR = 1.47 (95% CI, 1.06-2.04)) and in those with body mass index (BMI) < 18.5 kg/m2 (HR = 1.16 (95% CI, 1.05-1.27)) than 15-20 years group and those with normal BMI, respectively. According to the international standard industrial classification, occupational groups with financial and insurance activities, public administration and defence, compulsory social security, and manufacturing were at a higher risk of endometriosis. Although there was no significant association between the risk of endometriosis and type of work, the cumulative prevalence of endometriosis from 2007 to 2015 continued to rise in office workers, manual workers, and both types of workers together. The risk of endometriosis was closely linked to the occupational characteristics of female workers. This study provides a foundation for developing occupational safety and health guidelines for female workers.
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Affiliation(s)
- Seunghyun Lee
- Department of Occupational and Environmental Medicine, College of Medicine, Gachon University, Incheon, Republic of Korea
| | - Seung-Yeon Lee
- Department of Family Medicine, International Healthcare Center, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Wanhyung Lee
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
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Kim S, Han K, Choi SY, Yang SY, Choi SH, Yim JY, Kim JJ, Kim MJ. Alcohol consumption and the risk of new-onset uterine leiomyomas: a nationwide population-based study in 2.5 million Korean women aged 20 to 39 years. Am J Obstet Gynecol 2023; 229:45.e1-45.e18. [PMID: 37023913 DOI: 10.1016/j.ajog.2023.03.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/23/2023] [Accepted: 03/26/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Uterine leiomyomas are the most common benign tumors in women of childbearing age. Although there are several studies reporting the positive association of drinking alcohol with the incidence of uterine leiomyomas, studies targeting Korean women are lacking. OBJECTIVE This study aimed to investigate the association between alcohol consumption and the risk of new-onset uterine leiomyomas in Korean women of early reproductive-age. STUDY DESIGN This was a retrospective nationwide population-based cohort study using the Korean National Health Insurance Service database. Participants comprised 2,512,384 asymptomatic Korean women aged 20 to 39 years who underwent a national health examination from 2009 to 2012. The follow-up period was from the date of the first national health examination to the date of diagnosis of new-onset uterine leiomyomas or December 2018 if no uterine leiomyomas were detected. The diagnosis of uterine leiomyomas required 2 outpatient records within a year or 1 inpatient record of International Classification of Diseases, Tenth Revision (ICD-10) codes of uterine leiomyomas (D25) in the Korean National Health Insurance Service. Exclusion criteria were previously diagnosed uterine leiomyomas during the screening period (January 2002 to the date of first health examination) or uterine leiomyoma diagnosis within 1 year of baseline examination. The associations of alcohol consumption, amount drunk per drinking session, and sustained drinking over time with the risk of new-onset uterine leiomyomas were investigated. RESULTS Approximately 6.1% of women aged 20 to 39 years were diagnosed with uterine leiomyomas after an average of 4.3 years. Alcohol consumption was associated with an increased incidence of new-onset uterine leiomyomas of 12% to 16% (hazard ratio, 1.12; 95% confidence interval, 1.11-1.14 for mild-to-moderate drinkers; hazard ratio, 1.16; 95% confidence interval, 1.12-1.20 for heavy drinkers). Drinking ≥1 days per week was associated with increased risk of uterine leiomyomas (hazard ratio, 1.11; 95% confidence interval, 1.10-1.12 for drinking 1 day per week; hazard ratio, 1.15; 95% confidence interval, 1.12-1.17 for drinking ≥3 days per week), and the association increased proportionately to the amount of alcohol consumed per drinking session (hazard ratio, 1.17; 95% confidence interval, 1.15-1.19 for ≥7 glasses per drinking session). Women who also reported alcohol consumption in the questionnaire administered 2 years later (sustained drinkers) exhibited a 20% increased risk of new-onset uterine leiomyomas (hazard ratio, 1.20; 95% confidence interval, 1.17-1.22) compared with women who answered that they did not drink alcohol at both times (sustained nondrinkers). In women who discontinued drinking, the risk was 3% (hazard ratio, 1.03; 95% confidence interval, 1.01-1.06), whereas in women who became drinkers, the risk was 14% (hazard ratio, 1.14; 95% confidence interval, 1.11-1.16). CONCLUSION Having an alcohol drinking habit, the amount of alcohol consumed per drinking session, and sustained drinking over 2 years were significantly associated with the risk of new-onset uterine leiomyomas. Avoiding or discontinuing drinking could lower the risk of new-onset uterine leiomyomas in early reproductive-age women.
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Affiliation(s)
- Sunmie Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Su-Yeon Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Sun Young Yang
- Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Seung Ho Choi
- Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.
| | - Jeong Yoon Yim
- Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Jin Ju Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Min-Jeong Kim
- Department of Obstetrics and Gynecology, CHA Hospital Ilsan Medical Center, Goyang, Republic of Korea
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Shin S, Fu J, Shin WK, Huang D, Min S, Kang D. Association of food groups and dietary pattern with breast cancer risk: A systematic review and meta-analysis. Clin Nutr 2023; 42:282-297. [PMID: 36731160 DOI: 10.1016/j.clnu.2023.01.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/25/2022] [Accepted: 01/03/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND & AIMS We conducted a systematic review and meta-analysis of current evidence for the association between food groups, dietary patterns, and breast cancer risk among the Asian population. METHODS This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We performed a systematic literature search up to December 2022 in English in the PubMed, Web of Science, Embase, and Cochrane databases. Risk ratios (RRs) with 95% confidence intervals (CIs) were extracted as effect sizes. Publication bias was estimated by two different funnel plot methods. RESULTS We collected the data from 15 cohort studies and 34 case-control studies meeting the search criteria. The meta-analysis found that the consumption of fruits and, likewise, vegetables were associated with a 29% lower risk of breast cancer, respectively [RR = 0.71 (0.55, 0.93); RR = 0.71 (0.53, 0.95)]. By contrast, no significance was found between meat, soy foods, and green tea consumption and breast cancer risk (P > 0.05). However, soy protein and isoflavone intake could lower breast cancer risk by 35% and 32%, respectively [RR = 0.65 (0.51, 0.83); RR = 0.68 (0.55, 0.82)]. As for the dietary pattern, high adherence to a healthy dietary pattern and, similarly, to a healthy eating index was associated with a 38% and 51% reduction in breast cancer risk, respectively [RR = 0.62 (0.44, 0.88; RR = 0.49 (0.27, 0.87)], while high adherence to an unhealthy dietary pattern was associated with a 44% increased risk [RR = 1.44 (1.06, 1.96)]. Considering alcohol consumption, a 75% increased risk of breast cancer was found [RR = 1.75 (1.33, 2.30)]. CONCLUSION The present meta-analysis found that high intakes of fruits, vegetables, soy protein, and soy isoflavone significantly reduced the risk of breast cancer, while high intake of alcohol had a significantly increased risk. Meat, soy food, and green tea consumption were not significantly associated with breast cancer risk. Considering dietary patterns, high adherence to a healthy eating index and a healthy dietary pattern may reduce breast cancer risk. Conversely, adherence to unhealthy dietary patterns may increase breast cancer risk. However, further studies are needed to confirm the associations between dietary patterns and breast cancer in the Asian population.
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Affiliation(s)
- Sangah Shin
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, South Korea.
| | - Jialei Fu
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, South Korea
| | - Woo-Kyoung Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul 03080, South Korea; Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul 03080, South Korea
| | - Dan Huang
- Department of Preventive Medicine, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul 03080, South Korea; Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul 03080, South Korea
| | - Sukhong Min
- Department of Preventive Medicine, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul 03080, South Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul 03080, South Korea; Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul 03080, South Korea.
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Li Piani L, Chiaffarino F, Cipriani S, Viganò P, Somigliana E, Parazzini F. A systematic review and meta-analysis on alcohol consumption and risk of endometriosis: an update from 2012. Sci Rep 2022; 12:19122. [PMID: 36352037 PMCID: PMC9645754 DOI: 10.1038/s41598-022-21173-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/23/2022] [Indexed: 11/11/2022] Open
Abstract
Endometriosis is a complex and chronic disease, whose multifactorial nature has encouraged a deep investigation on the role of lifestyle factors. A strong association between alcohol intake and endometriosis risk has already been shown. We aimed to confirm this association, considering the updated literature. 23 eligible studies were identified through comprehensive literature search of PubMed and EMBASE (May 2012-October 2021). A borderline statistical significance was found comparing any alcohol consumption with no consumption (unadjusted OR 1.14; 95% CI: 0.99-1.31, p = 0.06), in contrast with a previous meta-analysis. However, we confirmed the significant association between moderate alcohol intake and endometriosis (unadjusted OR 1.22, 95% CI: 1.03-1.45, p = 0.02), also performing a sensitivity analysis (unadjusted OR 1.27, 95% CI: 1.04-1.54). Our partly divergent evidence reflects the tough challenge of isolating the impact of specific factors on the natural history of multifactorial diseases. Indeed, on one hand alcohol could be adopted by patients as a self-management therapy and on the other, it could favor the disease, promoting positive feedback with inflammatory mediators and oxidative stress. Our study encourages further investigation on the role of modifiable lifestyle factors and highlights the opportunity to adopt them to prevent or at least limit endometriosis progression.
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Affiliation(s)
- Letizia Li Piani
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy ,grid.414818.00000 0004 1757 8749Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via M. Fanti, 6, 20122 Milan, Italy
| | - Francesca Chiaffarino
- grid.414818.00000 0004 1757 8749Gynecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Sonia Cipriani
- grid.414818.00000 0004 1757 8749Gynecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Paola Viganò
- grid.414818.00000 0004 1757 8749Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via M. Fanti, 6, 20122 Milan, Italy
| | - Edgardo Somigliana
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy ,grid.414818.00000 0004 1757 8749Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via M. Fanti, 6, 20122 Milan, Italy
| | - Fabio Parazzini
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
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Coiplet E, Courbiere B, Agostini A, Boubli L, Bretelle F, Netter A. Endometriosis and environmental factors: a critical review. J Gynecol Obstet Hum Reprod 2022; 51:102418. [PMID: 35667590 DOI: 10.1016/j.jogoh.2022.102418] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 05/08/2022] [Accepted: 06/01/2022] [Indexed: 11/19/2022]
Abstract
This review provides an overview of current knowledge on the relationship between various environmental factors and endometriosis. We successively searched for a given exposure factor combined with the word "endometriosis." The literature was comprehensively analyzed and summarized by quoting only the most important and recent studies on each exposition factor. The data focused primarily on endocrine disruptors, such as dioxins and polychlorinated biphenyls, that appear to have the strongest effect. Intriguing data suggest a link with night work, sun exposure and red meat consumption. For the other risk factors studied, particularly those related to lifestyle (tobacco consumption, alcohol, coffee, soy, physical exercise), the data are not sufficient to draw conclusions. In summary, the epidemiological evidence does not support a strong, scientific link between exposure to environmental factors and endometriosis. The complexity of this disease requires advanced study designs and standardized methodology. Future studies should be carefully designed to address these issues to advance our understanding of the impact of the environment and its consequences on endometriosis.
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Affiliation(s)
- Eléna Coiplet
- Department of Gynecology and Obstetrics, AP-HM, Assistance Publique-Hôpitaux de Marseille, Marseille, France; Aix Marseille Univ, Avignon Université, CNRS, IRD, IMBE, 13005 Marseille, France
| | - Blandine Courbiere
- Department of Gynecology and Obstetrics, AP-HM, Assistance Publique-Hôpitaux de Marseille, Marseille, France; Aix Marseille Univ, Avignon Université, CNRS, IRD, IMBE, 13005 Marseille, France
| | - Aubert Agostini
- Department of Gynecology and Obstetrics, AP-HM, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Léon Boubli
- Department of Gynecology and Obstetrics, AP-HM, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Florence Bretelle
- Department of Gynecology and Obstetrics, AP-HM, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Antoine Netter
- Department of Gynecology and Obstetrics, AP-HM, Assistance Publique-Hôpitaux de Marseille, Marseille, France; Aix Marseille Univ, Avignon Université, CNRS, IRD, IMBE, 13005 Marseille, France.
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9
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Iwase M, Matsuo K, Koyanagi YNY, Ito H, Tamakoshi A, Wang C, Utada M, Ozasa K, Sugawara Y, Tsuji I, Sawada N, Tanaka S, Nagata C, Kitamura Y, Shimazu T, Mizoue T, Naito M, Tanaka K, Inoue M. Alcohol consumption and breast cancer risk in Japan: A pooled analysis of eight population-based cohort studies. Int J Cancer 2021; 148:2736-2747. [PMID: 33497475 DOI: 10.1002/ijc.33478] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/05/2021] [Accepted: 01/11/2021] [Indexed: 01/22/2023]
Abstract
Although alcohol consumption is reported to increase the incidence of breast cancer in European studies, evidence for an association between alcohol and breast cancer in Asian populations is insufficient. We conducted a pooled analysis of eight large-scale population-based prospective cohort studies in Japan to evaluate the association between alcohol (both frequency and amount) and breast cancer risk with categorization by menopausal status at baseline and at diagnosis. Estimated hazard ratios (HR) and 95% confidence intervals were calculated in the individual cohorts and combined using random-effects models. Among 158 164 subjects with 2 369 252 person-years of follow-up, 2208 breast cancer cases were newly diagnosed. Alcohol consumption had a significant association with a higher risk of breast cancer in both women who were premenopausal at baseline (regular drinker compared to nondrinker: HR 1.37, 1.04-1.81, ≥23 g/d compared to 0 g/d: HR 1.74, 1.25-2.43, P for trend per frequency category: P = .017) and those who were premenopausal at diagnosis (≥23 g/d compared to 0 g/d: HR 1.89, 1.04-3.43, P for trend per frequency category: P = .032). In contrast, no significant association was seen in women who were postmenopausal at baseline or at diagnosis, despite a substantial number of subjects and long follow-up period. Our results revealed that frequent and high alcohol consumption are both risk factors for Asian premenopausal breast cancer, similarly to previous studies in Western countries. The lack of a clear association in postmenopausal women in our study warrants larger investigation in Asia.
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Affiliation(s)
- Madoka Iwase
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.,Department of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.,Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuriko N Y Koyanagi
- Division of Cancer Information and Control, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Aichi Cancer Center Research Institute, Nagoya, Japan.,Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Chaochen Wang
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Mai Utada
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Kotaro Ozasa
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Yumi Sugawara
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Norie Sawada
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Shiori Tanaka
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuri Kitamura
- Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Taichi Shimazu
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keitaro Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Manami Inoue
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.,Department of Cancer Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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10
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Helbig M, Vesper AS, Beyer I, Fehm T. Does Nutrition Affect Endometriosis? Geburtshilfe Frauenheilkd 2021; 81:191-199. [PMID: 33574623 PMCID: PMC7870287 DOI: 10.1055/a-1207-0557] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/24/2020] [Indexed: 02/08/2023] Open
Abstract
Endometriosis is a hormone-related, chronic inflammation in women of childbearing age. The aetiology and pathogenesis of endometriosis are not yet fully understood. For other illnesses classed as lifestyle diseases, the link between nutrition and pathogenesis has already been researched and proven. With regard to these findings, the question continues to arise as to whether and how a specific diet and lifestyle could also influence pathogenesis and the progression of endometriosis. The aim of this review is to examine the data and determine what influence nutrition has on the development of endometriosis or on existing disease. The study results currently available do not permit a clear, scientific recommendation or indicate a detailed diet. In summary, it can be said that fish oil capsules in combination with vitamin B 12 have been associated with a positive effect on endometriosis symptoms (particularly of dysmenorrhoea). Alcohol and increased consumption of red meat and trans fats are associated with a negative effect. The results of the studies listed with regard to fruit and vegetables, dairy products, unsaturated fats, fibre, soy products and coffee are not clear. Therefore, the general recommendations for a balanced and varied diet in line with the guidelines of the Deutsche Gesellschaft für Ernährung e. V. [German Nutrition Society] apply, along with the recommendation to cut out alcohol. In order to be able to derive more concrete recommendations, we require further studies to investigate the influence of nutrition on endometriosis.
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Affiliation(s)
- Martina Helbig
- Klinik für Geburtshilfe und Frauenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Anne-Sophie Vesper
- Klinik für Geburtshilfe und Frauenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Ines Beyer
- Klinik für Geburtshilfe und Frauenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Tanja Fehm
- Klinik für Geburtshilfe und Frauenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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11
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Feng Y, Powell L, Vassallo AJ, Hamer M, Stamatakis E. Does adequate physical activity attenuate the associations of alcohol and alcohol‐related cancer mortality? A pooled study of 54 686 British adults. Int J Cancer 2020; 147:2754-2763. [DOI: 10.1002/ijc.33052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 04/16/2020] [Accepted: 04/24/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Yingyu Feng
- Kolling Institute, Northern Clinical School University of Sydney Sydney New South Wales Australia
| | - Lauren Powell
- Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia
| | - Amy Jo Vassallo
- Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia
| | - Mark Hamer
- UCL Faculty Medical Sciences Institute Sport Exercise & Health London UK
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia
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12
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Baglia ML, Cook LS, Mei-Tzu C, Wiggins C, Hill D, Porter P, Li CI. Alcohol, smoking, and risk of Her2-overexpressing and triple-negative breast cancer relative to estrogen receptor-positive breast cancer. Int J Cancer 2018; 143:1849-1857. [PMID: 29708591 DOI: 10.1002/ijc.31575] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/21/2018] [Accepted: 04/17/2018] [Indexed: 02/05/2023]
Abstract
Epidemiological evidence is limited on how alcohol consumption and smoking are associated with risk of different subtypes of breast cancer, such as triple-negative (TN) and human epidermal growth factor receptor 2-overexpressing (H2E) breast cancers, which may have different etiologies from more common luminal (estrogen receptor [ER+]) breast cancers. In this population-based case-case study, we evaluated the association between alcohol, smoking, and risk of H2E and TN breast cancer, compared with ER+ breast cancers, among women aged 20-69 years. Using polytomous regression, associations between alcohol consumption, smoking, and breast cancer risk were evaluated in 909 ER+, 1,290 TN, and 489 H2E breast cancer patients, with ER+ breast cancer patients as the reference group. Current alcohol consumption at diagnosis was associated with a lower risk of H2E breast cancer (odds ratio = 0.74, 95% confidence interval: 0.58-0.92) relative to ER+ cancers. No difference in association was observed by menopausal status. No association between alcohol consumption and TN breast cancer relative to ER+ breast cancer was observed. Women who smoked did not have an altered risk of TN or H2E breast cancer, relative to ER+ cancer. Our results suggest that alcohol is associated with lower risk of H2E breast cancer relative to ER+ breast cancer. This study adds to the body of epidemiologic evidence that breast cancer etiology differs by breast cancer subtype.
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Affiliation(s)
- Michelle L Baglia
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Linda S Cook
- Department of Internal Medicine, University of New Mexico (UNM) and the UNM Comprehensive Cancer Center, Albuquerque, New Mexico
| | - C Mei-Tzu
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Charles Wiggins
- Department of Internal Medicine, University of New Mexico (UNM) and the UNM Comprehensive Cancer Center, Albuquerque, New Mexico
| | - Deirdre Hill
- Department of Internal Medicine, University of New Mexico (UNM) and the UNM Comprehensive Cancer Center, Albuquerque, New Mexico
| | - Peggy Porter
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Christopher I Li
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
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13
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Ugai T, Kelemen LE, Mizuno M, Ong J, Webb PM, Chenevix‐Trench G, Wicklund KG, Doherty JA, Rossing MA, Thompson PJ, Wilkens LR, Carney ME, Goodman MT, Schildkraut JM, Berchuck A, Cramer DW, Terry KL, Cai H, Shu X, Gao Y, Xiang Y, Van Den Berg D, Pike MC, Wu AH, Pearce CL, Matsuo K. Ovarian cancer risk, ALDH2 polymorphism and alcohol drinking: Asian data from the Ovarian Cancer Association Consortium. Cancer Sci 2018; 109:435-445. [PMID: 29247577 PMCID: PMC5797830 DOI: 10.1111/cas.13470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/07/2017] [Accepted: 12/12/2017] [Indexed: 12/11/2022] Open
Abstract
The aldehyde dehydrogenase 2 (ALDH2) polymorphism rs671 (Glu504Lys) causes ALDH2 inactivation and adverse acetaldehyde exposure among Asians, but little is known of the association between alcohol consumption and rs671 and ovarian cancer (OvCa) in Asians. We conducted a pooled analysis of Asian ancestry participants in the Ovarian Cancer Association Consortium. We included seven case-control studies and one cohort study comprising 460 invasive OvCa cases, 37 borderline mucinous OvCa and 1274 controls of Asian descent with information on recent alcohol consumption. Pooled odds ratios (OR) with 95% confidence intervals (CI) for OvCa risk associated with alcohol consumption, rs671 and their interaction were estimated using logistic regression models adjusted for potential confounders. No significant association was observed for daily alcohol intake with invasive OvCa (OR comparing any consumption to none = 0.83; 95% CI = 0.58-1.18) or with individual histotypes. A significant decreased risk was seen for carriers of one or both Lys alleles of rs671 for invasive mucinous OvCa (OR = 0.44; 95% CI = 0.20-0.97) and for invasive and borderline mucinous tumors combined (OR = 0.48; 95% CI = 0.26-0.89). No significant interaction was observed between alcohol consumption and rs671 genotypes. In conclusion, self-reported alcohol consumption at the quantities estimated was not associated with OvCa risk among Asians. Because the rs671 Lys allele causes ALDH2 inactivation leading to increased acetaldehyde exposure, the observed inverse genetic association with mucinous ovarian cancer is inferred to mean that alcohol intake may be a risk factor for this histotype. This association will require replication in a larger sample.
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Affiliation(s)
- Tomotaka Ugai
- Division of Molecular and Clinical EpidemiologyAichi Cancer Center Research InstituteNagoyaJapan
- Division of HematologySaitama Medical CenterJichi Medical UniversitySaitamaJapan
| | - Linda E. Kelemen
- Department of Public Health SciencesCollege of Medicine and Hollings Cancer CenterMedical University of South CarolinaCharlestonUSA
| | - Mika Mizuno
- Department of Gynecologic OncologyAichi Cancer Center HospitalNagoyaJapan
| | - Jue‐Sheng Ong
- Genetics and Computational Biology DepartmentQIMR Berghofer Medical Research InstituteBrisbaneAustralia
| | - Penelope M. Webb
- Population Health DepartmentQIMR Berghofer Medical Research InstituteBrisbaneAustralia
| | - Georgia Chenevix‐Trench
- Genetics and Computational Biology DepartmentQIMR Berghofer Medical Research InstituteBrisbaneAustralia
| | | | - Kristine G. Wicklund
- Program in EpidemiologyDivision of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleUSA
| | - Jennifer Anne Doherty
- Huntsman Cancer InstitutePopulation Health SciencesUniversity of UtahSalt Lake CityUSA
| | - Mary Anne Rossing
- Program in EpidemiologyDivision of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleUSA
- Department of EpidemiologyUniversity of WashingtonSeattleUSA
| | - Pamela J. Thompson
- Cancer Prevention and ControlSamuel Oschin Comprehensive Cancer InstituteCedars‐Sinai Medical CenterLos AngelesUSA
| | - Lynne R. Wilkens
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluUSA
| | - Michael E. Carney
- Department of Obstetrics and GynecologyJohn A. Burns School of MedicineUniversity of HawaiiHonoluluUSA
| | - Marc T. Goodman
- Cancer Prevention and ControlSamuel Oschin Comprehensive Cancer InstituteCedars‐Sinai Medical CenterLos AngelesUSA
- Community and Population Health Research InstituteDepartment of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesUSA
| | | | - Andrew Berchuck
- Department of Obstetrics and GynecologyDuke University Medical CenterDurhamUSA
| | - Daniel W. Cramer
- Obstetrics and Gynecology Epidemiology CenterBrigham and Women's HospitalBostonUSA
- Harvard T. H. Chan School of Public HealthBostonUSA
| | - Kathryn L. Terry
- Obstetrics and Gynecology Epidemiology CenterBrigham and Women's HospitalBostonUSA
- Harvard T. H. Chan School of Public HealthBostonUSA
| | - Hui Cai
- Vanderbilt Epidemiology CenterVanderbilt University School of MedicineNashvilleUSA
| | - Xiao‐Ou Shu
- Vanderbilt Epidemiology CenterVanderbilt University School of MedicineNashvilleUSA
| | - Yu‐Tang Gao
- Department of EpidemiologyShanghai Cancer InstituteRenji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Yong‐Bing Xiang
- SKLORG & Department of EpidemiologyShanghai Cancer InstituteShanghaiChina
| | - David Van Den Berg
- Department of Preventive MedicineKeck School of MedicineUniversity of Southern California Norris Comprehensive Cancer CenterLos AngelesUSA
| | - Malcom C Pike
- Department of Preventive MedicineKeck School of MedicineUniversity of Southern California Norris Comprehensive Cancer CenterLos AngelesUSA
- Department of Epidemiology and BiostatisticsMemorial Sloan‐Kettering Cancer CenterNYUSA
| | - Anna H. Wu
- Department of Preventive MedicineKeck School of MedicineUniversity of Southern California Norris Comprehensive Cancer CenterLos AngelesUSA
| | - Celeste Leigh Pearce
- Department of Preventive MedicineKeck School of MedicineUniversity of Southern California Norris Comprehensive Cancer CenterLos AngelesUSA
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborUSA
| | - Keitaro Matsuo
- Division of Molecular and Clinical EpidemiologyAichi Cancer Center Research InstituteNagoyaJapan
- Department of EpidemiologyNagoya University Graduate School of MedicineNagoyaJapan
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14
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Chiaffarino F, Cipriani S, Ricci E, La Vecchia C, Chiantera V, Bulfoni A, Parazzini F. Alcohol consumption and risk of uterine myoma: A systematic review and meta analysis. PLoS One 2017; 12:e0188355. [PMID: 29176884 PMCID: PMC5703463 DOI: 10.1371/journal.pone.0188355] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 11/06/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The published data about alcohol consumption and uterine myoma are scanty and controversial: some studies found positive association whereas other studies showed no association. OBJECTIVES To conduct a systematic review and meta-analysis to determine whether alcohol is a risk factor for myoma. SEARCH STRATEGY A MEDLINE/EMBASE search was carried out, supplemented by manual searches of bibliographies of the selected studies. SELECTION CRITERIA Articles published as full-length papers in English. In the review we included all identified studies. Otherwise, the inclusion criteria for studies included in the meta-analysis were: a) case-control or cohort studies, reporting original data; b) studies reporting original data on the association between alcohol consumption and myoma; c) diagnosis of myoma was ultrasound or histological confirmed and/or clinically based. DATA COLLECTION AND ANALYSIS A total of 6 studies were identified for the review and 5 studies were included in the meta-analysis. The primary outcome was the incidence of uterine myoma in ever versus never alcohol drinkers and when data were available, we also analyzed categories of alcohol intake. We assessed the outcomes in the overall population and then we performed a subgroup analysis according to study design. Pooled estimates of the odds ratios (OR) with 95% confidence interval (CI) were calculated using random effects models. MAIN RESULTS The summary OR (95%CI) of myoma forever versus never alcohol intake was 1.12 (0.94-1.34) with significant heterogeneity. The summary OR for current versus never drinking was 1.33 (1.01-1.76) with no heterogeneity. CONCLUSIONS Ever alcohol consumption is not associated with myoma risk. Based on the data of two studies, current alcohol drinkers had a slightly borderline increased risk of diagnosis of myoma. In consideration of the very limited number of studies and the suggestion of a potential increased risk among current drinkers, further studies are required.
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Affiliation(s)
- Francesca Chiaffarino
- Dipartimento della Donna, del Neonato e del Bambino, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
- * E-mail:
| | - Sonia Cipriani
- Dipartimento della Donna, del Neonato e del Bambino, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Elena Ricci
- Dipartimento della Donna, del Neonato e del Bambino, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo La Vecchia
- Dipartimento di Scienze Cliniche e di Comunità, Università degli studi di Milano, Milan, Italy
| | - Vito Chiantera
- Department of Gynecology, Charitè Universitätsmedizin, Berlin, Germany
| | - Alessandro Bulfoni
- Unità di Ostetricia e Ginecologia, Humanitas San Pio X Hospital, Milan, Italy
| | - Fabio Parazzini
- Dipartimento della Donna, del Neonato e del Bambino, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Dipartimento di Scienze Cliniche e di Comunità, Università degli studi di Milano, Milan, Italy
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15
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Jacobsen KK, Lynge E, Tjønneland A, Vejborg I, von Euler-Chelpin M, Andersen ZJ. Alcohol consumption and mammographic density in the Danish Diet, Cancer and Health cohort. Cancer Causes Control 2017; 28:1429-1439. [PMID: 28965165 DOI: 10.1007/s10552-017-0970-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 09/22/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE We examined the association between alcohol consumption and mammographic density (MD) considering in detail the time of exposure and the type of alcohol. METHODS Of 5,356 women (4,489 post-menopausal) from the Danish Diet, Cancer and Health cohort (1993-1997) who attended mammographic screening in Copenhagen (1993-2001), we used MD (mixed/dense or fatty) assessed at the first screening after cohort entry. Alcohol consumption was assessed at the time of recruitment. Logistic regression was used to estimate associations [odds ratios (OR), 95% confidence intervals (CI)] between alcohol consumption and MD. RESULTS The mean age was 56.2 years, 56.5% of women had mixed/dense MD, and 91.8% were alcohol consumers. There was no association between current alcohol consumption and MD at baseline (age 50-65, on average 1 year before MD assessment) neither between age at drinking initiation and MD, in the fully adjusted model. There was a borderline statistically significantly increased OR of having mixed/dense MD in women who consumed > 7 drinks/week at age 20-29 (1.31, 95% CI 1.00-1.72) compared to non-drinkers in this age group, and no effect of drinking at age 30-39, 40-49 or after > 50 years, when adjusting for current drinking. However, when considering different types of alcohol, drinking spirits at age 20-29 was positively associated with mixed/dense breast (3-7 drinks/week: OR 1.74, 95% CI 1.12-2.72); >7 drinks/week: (OR 1.76, 95% CI 0.73-4.23). No consistent pattern was found with beer, wine, or fortified wine. CONCLUSIONS We found higher MD among women with high alcohol consumption in early adulthood (ages 20-29), in those drinking spirits.
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Affiliation(s)
- Katja Kemp Jacobsen
- Department of Technology, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark.
| | - Elsebeth Lynge
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne Tjønneland
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - Ilse Vejborg
- Department of Radiology and Diagnostic Imaging Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - My von Euler-Chelpin
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Zorana J Andersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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16
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Baglia ML, Malone KE, Tang MTC, Li CI. Alcohol Intake and Risk of Breast Cancer by Histologic Subtype and Estrogen Receptor Status Among Women Aged 55 to 74 Years. Discov Oncol 2017; 8:211-218. [PMID: 28567703 DOI: 10.1007/s12672-017-0297-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/15/2017] [Indexed: 10/19/2022] Open
Abstract
Previous studies suggest that alcohol consumption and risk of breast cancer may differ by histologic subtype and hormone receptor status, though results are not entirely consistent. In this population-based case-control study, we evaluated the association between alcohol consumption and risk of invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), and invasive ductal-lobular carcinoma (IDLC) overall and by estrogen receptor (ER) status, among women aged 55-74 years of age. Using polytomous regression, associations between current alcohol consumption, overall and by type of alcohol, and breast cancer risk were evaluated in 891 controls and 905 IDC, 567 ILC, and 489 IDLC cases. Current alcohol use was moderately associated with risk of ILC (odds ratio = 1.25, 95% confidence interval 0.99, 1.58) with a positive dose-response relationship based on average number of drinks per week consumed (P trend = 0.0005). When further stratified by ER status, alcohol use was positively associated with risk of ER+ ILC (P trend = 0.002) and ER+ IDC (P trend = 0.02), but inversely associated with risk of ER-IDC (P trend = 0.01). No association between alcohol and risk of IDLC tumors was observed. While the link between alcohol consumption and breast cancer risk is well established, our results suggest that the increased risk associated with alcohol is largely limited to ER+ ILC and ER+ IDC. Thus, avoiding or moderating alcohol consumption may be one way that women can lower their risks of these forms of breast cancer.
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Affiliation(s)
- Michelle L Baglia
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M4-C308, Seattle, WA, 98109, USA.
| | - Kathleen E Malone
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M4-C308, Seattle, WA, 98109, USA
| | - Mei-Tzu C Tang
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M4-C308, Seattle, WA, 98109, USA
| | - Christopher I Li
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M4-C308, Seattle, WA, 98109, USA
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17
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Parazzini F, Esposito G, Tozzi L, Noli S, Bianchi S. Epidemiology of endometriosis and its comorbidities. Eur J Obstet Gynecol Reprod Biol 2017; 209:3-7. [DOI: 10.1016/j.ejogrb.2016.04.021] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/11/2016] [Accepted: 04/22/2016] [Indexed: 02/07/2023]
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18
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Scoccianti C, Cecchini M, Anderson AS, Berrino F, Boutron-Ruault MC, Espina C, Key TJ, Leitzmann M, Norat T, Powers H, Wiseman M, Romieu I. European Code against Cancer 4th Edition: Alcohol drinking and cancer. Cancer Epidemiol 2016; 45:181-188. [PMID: 27816465 DOI: 10.1016/j.canep.2016.09.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Alcohol consumption is the third leading risk factor for disease and mortality in Europe. As evaluated by the International Agency for Research on Cancer (IARC) Monographs, a causal relationship is established for consumption of alcoholic beverages and cancers of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum and female breast, even at low and moderate alcohol intakes. The higher the amount of alcohol consumed, the higher the risk of developing cancer. In Europe, an estimated 10% (95% CI: 7%-13%) of all cancer cases in men and 3% (95% CI: 1%-5%) of all cancer cases in women are attributable to alcohol consumption. Several biological mechanisms explain the carcinogenicity of alcohol; among them, ethanol and its genotoxic metabolite, acetaldehyde, play a major role. Taking all this evidence into account, a recommendation of the 4th edition of European Code against Cancer is: "If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention."
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Affiliation(s)
- Chiara Scoccianti
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Michele Cecchini
- Health Policy Analyst OECD, 2 rue André Pascal, 75775 Paris Cedex 16, France
| | - Annie S Anderson
- Centre for Research into Cancer Prevention & Screening, Level 7, Mailbox 7, Ninewells Hospital & Medical School, Dundee, DD1 9SY, Scotland, United Kingdom
| | - Franco Berrino
- Fondazione IRCSS Istituto Nazionale dei Tumori, 1 via Venezian, 20133 Milan, Italy
| | | | - Carolina Espina
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, 93042 Regensburg, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom
| | - Hilary Powers
- Human Nutrition Unit, The Medical School, Beech Hill Road, Sheffield S10 2RX, United Kingdom
| | - Martin Wiseman
- World Cancer Research Fund International, Second Floor, 22 Bedford Square, London WC1 B 3HH, United Kingdom
| | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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19
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Perreault K, Bauman A, Johnson N, Britton A, Rangul V, Stamatakis E. Does physical activity moderate the association between alcohol drinking and all-cause, cancer and cardiovascular diseases mortality? A pooled analysis of eight British population cohorts. Br J Sports Med 2016; 51:651-657. [PMID: 27581162 DOI: 10.1136/bjsports-2016-096194] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine whether physical activity (PA) moderates the association between alcohol intake and all-cause mortality, cancer mortality and cardiovascular diseases (CVDs) mortality. DESIGN Prospective study using 8 British population-based surveys, each linked to cause-specific mortality: Health Survey for England (1994, 1998, 1999, 2003, 2004 and 2006) and Scottish Health Survey (1998 and 2003). PARTICIPANTS 36 370 men and women aged 40 years and over were included with a corresponding 5735 deaths and a mean of 353 049 person-years of follow-up. EXPOSURES 6 sex-specific categories of alcohol intake (UK units/week) were defined: (1) never drunk; (2) ex-drinkers; (3) occasional drinkers; (4) within guidelines (<14 (women); <21 (men)); (5) hazardous (14-35 (women); 21-49 (men)) and (6) harmful (>35 (women) >49 (men)). PA was categorised as inactive (≤7 MET-hour/week), active at the lower (>7.5 MET-hour/week) and upper (>15 MET-hour/week) of recommended levels. MAIN OUTCOMES AND MEASURES Cox proportional-hazard models were used to examine associations between alcohol consumption and all-cause, cancer and CVD mortality risk after adjusting for several confounders. Stratified analyses were performed to evaluate mortality risks within each PA stratum. RESULTS We found a direct association between alcohol consumption and cancer mortality risk starting from drinking within guidelines (HR (95% CI) hazardous drinking: 1.40 (1.11 to 1.78)). Stratified analyses showed that the association between alcohol intake and mortality risk was attenuated (all-cause) or nearly nullified (cancer) among individuals who met the PA recommendations (HR (95% CI)). CONCLUSIONS Meeting the current PA public health recommendations offsets some of the cancer and all-cause mortality risk associated with alcohol drinking.
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Affiliation(s)
- K Perreault
- Département de Médecine Sociale et Préventive, Université de Montréal, Institut de Recherche en Santé Publique, Montréal, Québec, Canada.,University of Sydney, Charles Perkins Centre, School of Public Health, Johns Hopkins Drive, Camperdown, New South Wales, Australia
| | - A Bauman
- University of Sydney, Charles Perkins Centre, School of Public Health, Johns Hopkins Drive, Camperdown, New South Wales, Australia.,Faculty of Medicine, Department of Public Health and General Practice, HUNT Research Centre, NTNU, Norwegian University of Science and Technology, Levanger, Norway
| | - N Johnson
- University of Sydney, Charles Perkins Centre, School of Public Health, Johns Hopkins Drive, Camperdown, New South Wales, Australia.,Faculty of Health Sciences, University of Sydney, Discipline of Exercise and Sport Sciences, Cumberland Campus, Lidcombe, New South Wales, Australia
| | - A Britton
- Department of Epidemiology and Public Health, University College London, London, UK
| | - V Rangul
- Faculty of Medicine, Department of Public Health and General Practice, HUNT Research Centre, NTNU, Norwegian University of Science and Technology, Levanger, Norway
| | - E Stamatakis
- University of Sydney, Charles Perkins Centre, School of Public Health, Johns Hopkins Drive, Camperdown, New South Wales, Australia.,Faculty of Health Sciences, University of Sydney, Discipline of Exercise and Sport Sciences, Cumberland Campus, Lidcombe, New South Wales, Australia.,Department of Epidemiology and Public Health, University College London, London, UK
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20
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Gelfand R, Vernet D, Bruhn K, Vadgama J, Gonzalez-Cadavid NF. Long-term exposure of MCF-12A normal human breast epithelial cells to ethanol induces epithelial mesenchymal transition and oncogenic features. Int J Oncol 2016; 48:2399-414. [PMID: 27035792 PMCID: PMC4864041 DOI: 10.3892/ijo.2016.3461] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 02/24/2016] [Indexed: 12/12/2022] Open
Abstract
Alcoholism is associated with breast cancer incidence and progression, and moderate chronic consumption of ethanol is a risk factor. The mechanisms involved in alcohol's oncogenic effects are unknown, but it has been speculated that they may be mediated by acetaldehyde. We used the immortalized normal human epithelial breast cell line MCF-12A to determine whether short- or long-term exposure to ethanol or to acetaldehyde, using in vivo compatible ethanol concentrations, induces their oncogenic transformation and/or the acquisition of epithelial mesenchymal transition (EMT). Cultures of MCF-12A cells were incubated with 25 mM ethanol or 2.5 mM acetaldehyde for 1 week, or with lower concentrations (1.0–2.5 mM for ethanol, 1.0 mM for acetaldehyde) for 4 weeks. In the 4-week incubation, cells were also tested for anchorage-independence, including isolation of soft agar selected cells (SASC) from the 2.5 mM ethanol incubations. Cells were analyzed by immunocytofluorescence, flow cytometry, western blotting, DNA microarrays, RT/PCR, and assays for miRs. We found that short-term exposure to ethanol, but not, in general, to acetaldehyde, was associated with transcriptional upregulation of the metallothionein family genes, alcohol metabolism genes, and genes suggesting the initiation of EMT, but without related phenotypic changes. Long-term exposure to the lower concentrations of ethanol or acetaldehyde induced frank EMT changes in the monolayer cultures and in SASC as demonstrated by changes in cellular phenotype, mRNA expression, and microRNA expression. This suggests that low concentrations of ethanol, with little or no mediation by acetaldehyde, induce EMT and some traits of oncogenic transformation such as anchorage-independence in normal breast epithelial cells.
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Affiliation(s)
- Robert Gelfand
- Department of Medicine, Charles Drew University (CDU), Los Angeles, CA, USA
| | - Dolores Vernet
- Department of Medicine, Charles Drew University (CDU), Los Angeles, CA, USA
| | - Kevin Bruhn
- Department of Surgery, Los Angeles Biomedical Research Institute (LABioMed) at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Jaydutt Vadgama
- Department of Medicine, Charles Drew University (CDU), Los Angeles, CA, USA
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21
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Scoccianti C, Cecchini M, Anderson AS, Berrino F, Boutron-Ruault MC, Espina C, Key TJ, Leitzmann M, Norat T, Powers H, Wiseman M, Romieu I. European Code against Cancer 4th Edition: Alcohol drinking and cancer. Cancer Epidemiol 2015; 39 Suppl 1:S67-74. [PMID: 26115567 DOI: 10.1016/j.canep.2015.01.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 11/10/2014] [Accepted: 01/16/2015] [Indexed: 12/16/2022]
Abstract
Alcohol consumption is the third leading risk factor for disease and mortality in Europe. The International Agency for Research on Cancer (IARC) Monographs provide strengthened evidence that the consumption of alcoholic beverages is causally associated with cancers of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum and female breast, even for low and moderate alcohol intakes. The risk of cancer increases in a dose-dependent manner, and the higher the amount of alcohol consumed, the higher the risk of developing cancer. Several biological mechanisms explain the carcinogenicity of alcohol; among them, ethanol and its genotoxic metabolite acetaldehyde play a major role. Taking all this evidence into account, a recommendation of the 4th edition of the European Code against Cancer (ECAC) is: "If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention."
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Affiliation(s)
- Chiara Scoccianti
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Michele Cecchini
- Health Policy Analyst OECD, 2 rue André Pascal, 75775 Paris Cedex 16, France
| | - Annie S Anderson
- Centre for Research into Cancer Prevention & Screening, Level 7, Mailbox 7, Ninewells Hospital & Medical School, Dundee, DD1 9SY, Scotland, United Kingdom
| | - Franco Berrino
- Fondazione IRCSS Istituto Nazionale dei Tumori, 1 via Venezian, 20133 Milan, Italy
| | | | - Carolina Espina
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, 93042 Regensburg, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health Imperial College London, St Mary's Campus, London W2 1 PG, United Kingdom
| | - Hilary Powers
- Human Nutrition Unit, The Medical School, Beech Hill Road, Sheffield, S10 2RX, United Kingdom
| | - Martin Wiseman
- World Cancer Research Fund International, Second Floor, 22 Bedford Square, London WC1B 3HH, United Kingdom
| | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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22
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Romieu I, Scoccianti C, Chajès V, de Batlle J, Biessy C, Dossus L, Baglietto L, Clavel-Chapelon F, Overvad K, Olsen A, Tjønneland A, Kaaks R, Lukanova A, Boeing H, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Sieri S, Tumino R, Vineis P, Panico S, Bueno-de-Mesquita HBA, van Gils CH, Peeters PH, Lund E, Skeie G, Weiderpass E, Quirós García JR, Chirlaque MD, Ardanaz E, Sánchez MJ, Duell EJ, Amiano P, Borgquist S, Wirfält E, Hallmans G, Johansson I, Nilsson LM, Khaw KT, Wareham N, Key TJ, Travis RC, Murphy N, Wark PA, Ferrari P, Riboli E. Alcohol intake and breast cancer in the European prospective investigation into cancer and nutrition. Int J Cancer 2015; 137:1921-30. [PMID: 25677034 PMCID: PMC6300114 DOI: 10.1002/ijc.29469] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 11/03/2014] [Indexed: 01/12/2023]
Abstract
Alcohol intake has been associated to breast cancer in pre and postmenopausal women; however results are inconclusive regarding tumor hormonal receptor status, and potential modifying factors like age at start drinking. Therefore, we investigated the relation between alcohol intake and the risk of breast cancer using prospective observational data from the European Prospective Investigation into Cancer and Nutrition (EPIC). Up to 334,850 women, aged 35-70 years at baseline, were recruited in ten European countries and followed up an average of 11 years. Alcohol intake at baseline and average lifetime alcohol intake were calculated from country-specific dietary and lifestyle questionnaires. The study outcomes were the Hazard ratios (HR) of developing breast cancer according to hormonal receptor status. During 3,670,439 person-years, 11,576 incident breast cancer cases were diagnosed. Alcohol intake was significantly related to breast cancer risk, for each 10 g/day increase in alcohol intake the HR increased by 4.2% (95% CI: 2.7-5.8%). Taking 0 to 5 g/day as reference, alcohol intake of >5 to 15 g/day was related to a 5.9% increase in breast cancer risk (95% CI: 1-11%). Significant increasing trends were observed between alcohol intake and ER+/PR+, ER-/PR-, HER2- and ER-/PR-HER2- tumors. Breast cancer risk was stronger among women who started drinking prior to first full-time pregnancy. Overall, our results confirm the association between alcohol intake and both hormone receptor positive and hormone receptor negative breast tumors, suggesting that timing of exposure to alcohol drinking may affect the risk. Therefore, women should be advised to control their alcohol consumption.
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Affiliation(s)
- Isabelle Romieu
- Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Chiara Scoccianti
- Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Véronique Chajès
- Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Jordi de Batlle
- Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Carine Biessy
- Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Laure Dossus
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France
- University Paris Sud, UMRS 1018, Villejuif, France
- Institut Gustave-Roussy, Villejuif, France
| | - Laura Baglietto
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia
| | - Françoise Clavel-Chapelon
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France
- University Paris Sud, UMRS 1018, Villejuif, France
- Institut Gustave-Roussy, Villejuif, France
| | - Kim Overvad
- Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark
| | - Anja Olsen
- Diet, Genes, and Environment Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- Diet, Genes, and Environment Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
| | - Pagona Lagiou
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - Dimitrios Trichopoulos
- Hellenic Health Foundation, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, "Civic-M.P.Arezzo" Hospital, ASP Ragusa, Italy
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Unit of molecular and genetic epidemiology, Human Genetics Foundation (HuGeF), Turin, Italy
| | - Salvatore Panico
- Department of Clinical and Experimental Medicine Federico II University of Naples, Naples, Italy
| | - H B As Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology University Medical Centre, Utrecht, The Netherlands
| | - Carla H van Gils
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Petra H Peeters
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Eiliv Lund
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
- Department of Genetic Epidemiology, Folkhälsan Research Center, Helsinki, Finland
- Etiological Research Unit, Cancer Registry of Norway, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | | | - María-Dolores Chirlaque
- Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
| | - Eva Ardanaz
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
- Navarre Public Health Institute, Pamplona, Spain
| | - María-José Sánchez
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
- Andalusian School of Public Health, Granada Bio-Health Research Institute (Granada.IBS), Granada, Spain
- Instituto De Investigación Biosanitaria De Granada, Granada, Spain
| | - Eric J Duell
- Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Pilar Amiano
- Public Health Division of Gipuzkoa, Gipuzkoa, Spain
| | - Signe Borgquist
- Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | | | - Göran Hallmans
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | | | - Lena Maria Nilsson
- Public Health and Clinical Medicine/Nutritional Research, Umeå University, Umeå, Sweden
| | - Kay-Tee Khaw
- University of Cambridge, School of Clinical Medicine, Clinical Gerontology Unit, Cambridge, United Kingdom
| | - Nick Wareham
- MRC Epidemiology Unit University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Neil Murphy
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Petra A Wark
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Pietro Ferrari
- Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
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23
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Cook MB, Guénel P, Gapstur SM, van den Brandt PA, Michels KB, Casagrande JT, Cooke R, Van Den Eeden SK, Ewertz M, Falk RT, Gaudet MM, Gkiokas G, Habel LA, Hsing AW, Johnson K, Kolonel LN, La Vecchia C, Lynge E, Lubin JH, McCormack VA, Negri E, Olsson H, Parisi D, Petridou ET, Riboli E, Sesso HD, Swerdlow A, Thomas DB, Willett WC, Brinton LA. Tobacco and alcohol in relation to male breast cancer: an analysis of the male breast cancer pooling project consortium. Cancer Epidemiol Biomarkers Prev 2015; 24:520-31. [PMID: 25515550 PMCID: PMC4355041 DOI: 10.1158/1055-9965.epi-14-1009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The etiology of male breast cancer is poorly understood, partly due to its relative rarity. Although tobacco and alcohol exposures are known carcinogens, their association with male breast cancer risk remains ill-defined. METHODS The Male Breast Cancer Pooling Project consortium provided 2,378 cases and 51,959 controls for analysis from 10 case-control and 10 cohort studies. Individual participant data were harmonized and pooled. Unconditional logistic regression was used to estimate study design-specific (case-control/cohort) ORs and 95% confidence intervals (CI), which were then combined using fixed-effects meta-analysis. RESULTS Cigarette smoking status, smoking pack-years, duration, intensity, and age at initiation were not associated with male breast cancer risk. Relations with cigar and pipe smoking, tobacco chewing, and snuff use were also null. Recent alcohol consumption and average grams of alcohol consumed per day were also not associated with risk; only one subanalysis of very high recent alcohol consumption (>60 g/day) was tentatively associated with male breast cancer (ORunexposed referent = 1.29; 95% CI, 0.97-1.71; OR>0-<7 g/day referent = 1.36; 95% CI, 1.04-1.77). Specific alcoholic beverage types were not associated with male breast cancer. Relations were not altered when stratified by age or body mass index. CONCLUSIONS In this analysis of the Male Breast Cancer Pooling Project, we found little evidence that tobacco and alcohol exposures were associated with risk of male breast cancer. IMPACT Tobacco and alcohol do not appear to be carcinogenic for male breast cancer. Future studies should aim to assess these exposures in relation to subtypes of male breast cancer.
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Affiliation(s)
- Michael B Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
| | - Pascal Guénel
- Inserm, CESP Center for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer, Villejuif, France. Université Paris-Sud, UMRS 1018, Villejuif, France
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | | | - Karin B Michels
- Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - John T Casagrande
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Rosie Cooke
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | | | - Marianne Ewertz
- Department of Oncology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Roni T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Mia M Gaudet
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | - George Gkiokas
- Department of Surgery, Aretaieion University Hospital, Athens, Greece
| | - Laurel A Habel
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Ann W Hsing
- Cancer Prevention Institute of California, Freemont, California. Stanford Cancer Institute, Stanford, California
| | - Kenneth Johnson
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Laurence N Kolonel
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Carlo La Vecchia
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Elsebeth Lynge
- Institute of Public Health, University of Copenhagen, Denmark
| | - Jay H Lubin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Valerie A McCormack
- Section on Environment and Radiation, International Agency for Research on Cancer, Lyon, France
| | - Eva Negri
- Istituto di Richerche Farmacologiche "Mario Negri," Milan, Italy
| | - Håkan Olsson
- Department of Oncology, Lund University, Lund, Sweden
| | | | - Eleni Th Petridou
- Department of Hygiene, Epidemiology, and Medical Statistics, Athens University Medical School, Athens, Greece
| | - Elio Riboli
- School of Public Health, Imperial College, London, United Kingdom
| | - Howard D Sesso
- Divisions of Preventive Medicine and Aging, Brigham and Women's Hospital, Boston, Massachusetts
| | - Anthony Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, Surrey, United Kingdom. Division of Breast Cancer Research, Institute of Cancer Research, London, United Kingdom
| | - David B Thomas
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts. Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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24
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Castro GD, Castro JA. Alcohol drinking and mammary cancer: Pathogenesis and potential dietary preventive alternatives. World J Clin Oncol 2014; 5:713-29. [PMID: 25300769 PMCID: PMC4129535 DOI: 10.5306/wjco.v5.i4.713] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 01/21/2014] [Accepted: 04/03/2014] [Indexed: 02/06/2023] Open
Abstract
Alcohol consumption is associated with an increased risk of breast cancer, increasing linearly even with a moderate consumption and irrespectively of the type of alcoholic beverage. It shows no dependency from other risk factors like menopausal status, oral contraceptives, hormone replacement therapy, or genetic history of breast cancer. The precise mechanism for the effect of drinking alcohol in mammary cancer promotion is still far from being established. Studies by our laboratory suggest that acetaldehyde produced in situ and accumulated in mammary tissue because of poor detoxicating mechanisms might play a role in mutational and promotional events. Additional studies indicated the production of reactive oxygen species accompanied of decreases in vitamin E and GSH contents and of glutathione transferase activity. The resulting oxidative stress might also play a relevant role in several stages of the carcinogenic process. There are reported in literature studies showing that plasmatic levels of estrogens significantly increased after alcohol drinking and that the breast cancer risk is higher in receptor ER-positive individuals. Estrogens are known that they may produce breast cancer by actions on ER and also as chemical carcinogens, as a consequence of their oxidation leading to reactive metabolites. In this review we introduce our working hypothesis integrating the acetaldehyde and the oxidative stress effects with those involving increased estrogen levels. We also analyze potential preventive actions that might be accessible. There remains the fact that alcohol drinking is just one of the avoidable causes of breast cancer and that, at present, the suggested acceptable dose for prevention of this risk is of one drink per day.
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25
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Scoccianti C, Straif K, Romieu I. Recent evidence on alcohol and cancer epidemiology. Future Oncol 2014; 9:1315-22. [PMID: 23980679 DOI: 10.2217/fon.13.94] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This review presents an overview of the impact of alcohol consumption on cancer risk. Results from the 2009 International Agency for Research on Cancer monograph as well as the most recent meta-analyses and epidemiological studies are considered. Alcohol consumption is one of the most important known risk factors for human cancer and potentially one of the most avoidable factors, but it is increasing worldwide. Ethanol in alcoholic beverages is carcinogenic to humans and causes several cancers (oral cavity, pharynx, larynx, esophagus, colorectum, liver and female breast). Cumulative lifetime consumption, frequency and drinking pattern appear to play a role in risk characterization. While the role of heavy drinking has been long recognized, new evidence suggests that light consumption (up to one drink/day) is also associated with adverse effects. In addition, some genetic polymorphisms interact with alcohol metabolism and may modify its impact.
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Affiliation(s)
- Chiara Scoccianti
- International Agency for Research on Cancer, Nutrition & Metabolism Section, 150 Cours Albert Thomas, Lyon Cedex 08, France
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26
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Scoccianti C, Lauby-Secretan B, Bello PY, Chajes V, Romieu I. Female breast cancer and alcohol consumption: a review of the literature. Am J Prev Med 2014; 46:S16-25. [PMID: 24512927 DOI: 10.1016/j.amepre.2013.10.031] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 10/29/2013] [Accepted: 10/29/2013] [Indexed: 10/25/2022]
Abstract
CONTEXT Consumption of alcoholic beverages is one of the single most important known and modifiable risk factor for human cancer. Among women, breast cancer is the most common cancer worldwide and the leading cause of cancer-related mortality. Consumption of alcoholic beverages is causally associated with female breast cancer and the association shows a linear dose-response relationship. The role of heavy drinking has been long recognized and even a moderate intake is associated with an increased risk for breast cancer. The present review is an update of the current evidence on the association between alcohol consumption and breast cancer risk. The aim is to gain further insight into this association and to improve our current understanding of the effects of the major modifying factors. EVIDENCE ACQUISITION Epidemiologic and experimental studies published since the most recent International Agency for Research on Cancer (IARC) Monograph on alcoholic beverages were identified in PubMed using a combination of keywords such as alcohol, breast cancer, polymorphisms, menopausal status. EVIDENCE SYNTHESIS Cumulative lifetime consumption, drinking frequency, drinking patterns and timing of exposure each modulate the association between alcohol consumption and breast cancer. Hormonal status, genetic polymorphisms, and nutritional factors may interact with ethanol metabolism and further influence breast cancer risk. CONCLUSIONS Better standardization among experimental and epidemiologic designs in assessing alcohol intake and timing of exposure may improve our understanding of the heterogeneity observed across studies, possibly allowing the quantification of the effects of occasional heavy drinking and the identification of a window of higher susceptibility to breast cancer development.
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Affiliation(s)
- Chiara Scoccianti
- Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon
| | | | | | - Véronique Chajes
- Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon
| | - Isabelle Romieu
- Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon.
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27
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McDonald JA, Goyal A, Terry MB. Alcohol Intake and Breast Cancer Risk: Weighing the Overall Evidence. CURRENT BREAST CANCER REPORTS 2013; 5:10.1007/s12609-013-0114-z. [PMID: 24265860 PMCID: PMC3832299 DOI: 10.1007/s12609-013-0114-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Moderate alcohol consumption has been linked to an approximate 30-50% increased risk in breast cancer. Case-control and cohort studies have consistently observed this modest increase. We highlight recent evidence from molecular epidemiologic studies and studies of intermediate markers like mammographic density that provide additional evidence that this association is real and not solely explained by factors/correlates of the exposure and outcome present in non-randomized studies. We also review evidence from studies of higher risk women including BRCA1 and BRCA2 mutation carriers. Given the incidence of heart disease is higher than breast cancer and modest alcohol consumption is associated with reduced risk of heart disease, we examine the latest evidence to evaluate if alcohol reduction should be targeted to women at high risk for breast cancer. We also review the most recent evidence on the effect of alcohol use on tumor recurrence and survival for those diagnosed with breast cancer.
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Affiliation(s)
- Jasmine A. McDonald
- 722W 168St, R719 Department of Epidemiology Mailman School of Public Health Columbia University New York, NY 10032 Phone: 212-305-9114 Fax: 212-305-9413
| | - Abhishek Goyal
- 722W 168St, R723 Department of Epidemiology Mailman School of Public Health Columbia University New York, NY 10032 Phone: 212-305-3586 Fax: 212-305-9413
| | - Mary Beth Terry
- 722W 168St, R724A Department of Epidemiology Mailman School of Public Health Columbia University New York, NY 10032; Herbert Irving Comprehensive Cancer Center 1130 St. Nicholas Ave. Columbia University New York, NY 10032
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28
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Parazzini F, Cipriani S, Bravi F, Pelucchi C, Chiaffarino F, Ricci E, Viganò P. A metaanalysis on alcohol consumption and risk of endometriosis. Am J Obstet Gynecol 2013; 209:106.e1-10. [PMID: 23707678 DOI: 10.1016/j.ajog.2013.05.039] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/15/2013] [Accepted: 05/22/2013] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To offer a general figure of the available data on the relation between alcohol intake and risk of endometriosis, we conducted a systematic review and a metaanalysis of studies published up to May 2012. STUDY DESIGN We carried out a literature search of all case-control and cohort studies published as original articles in English up to May 2012. Only those papers that were published as full-length articles were considered. Pooled estimates of the relative risks (RRs) and the corresponding 95% confidence intervals (CIs) were calculated using fixed or, when significant heterogeneity among estimates emerged, random effects models. A total of 15 studies were identified for the review. RESULTS The summary estimate was 1.24 (95% CI, 1.12-1.36) for any alcohol intake vs no alcohol intake. Considering the results of the analyses of infrequent, moderate/regular, and heavy alcohol intake vs no alcohol intake, the summary RR estimates were, respectively, 1.14 (95% CI, 0.86-1.52), 1.23 (95% CI, 1.08-1.40), and 1.19 (95% CI, 0.99-1.43). Three studies reported separate results for current and former drinkers, and the summary RR were 1.42 (95% CI, 1.14-1.76) and 1.09 (95% CI, 0.83-1.43), respectively. CONCLUSION The present metaanalysis provides evidence for an association between alcohol consumption and endometriosis risk. Further studies are needed to clarify whether alcohol consumption may exacerbate an existing disease or could be related to the severity of the disease.
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Affiliation(s)
- Fabio Parazzini
- Department of Obstetrics, Gynecology, and Neonatology, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy.
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Kenna GA, Swift RM, Hillemacher T, Leggio L. The relationship of appetitive, reproductive and posterior pituitary hormones to alcoholism and craving in humans. Neuropsychol Rev 2012; 22:211-28. [PMID: 22772772 PMCID: PMC3432156 DOI: 10.1007/s11065-012-9209-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 06/22/2012] [Indexed: 12/20/2022]
Abstract
A significant challenge for understanding alcoholism lies in discovering why some, but not other individuals, become dependent on alcohol. Genetic, environmental, cultural, developmental, and neurobiological influences are recognized as essential factors underlying a person's risk for becoming alcohol dependent (AD); however, the neurobiological processes that trigger this vulnerability are still poorly understood. Hormones are important in the regulation of many functions and several hormones are strongly associated with alcohol use. While medical consequences are important, the primary focus of this review is on the underlying confluence of appetitive/feeding, reproductive and posterior pituitary hormones associated with distinct phases of alcoholism or assessed by alcohol craving in humans. While these hormones are of diverse origin, the involvement with alcoholism by these hormone systems is unmistakable, and demonstrates the complexity of interactions with alcohol and the difficulty of successfully pursuing effective treatments. Whether alcohol associated changes in the activity of certain hormones are the result of alcohol use or are the result of an underlying predisposition for alcoholism, or a combination of both, is currently of great scientific interest. The evidence we present in this review suggests that appetitive hormones may be markers as they appear involved in alcohol dependence and craving, that reproductive hormones provide an example of the consequences of drinking and are affected by alcohol, and that posterior pituitary hormones have potential for being targets for treatment. A better understanding of the nature of these associations may contribute to diagnosing and more comprehensively treating alcoholism. Pharmacotherapies that take advantage of our new understanding of hormones, their receptors, or their potential relationship to craving may shed light on the treatment of this disorder.
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Affiliation(s)
- George A Kenna
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, USA.
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Seitz HK, Pelucchi C, Bagnardi V, La Vecchia C. Epidemiology and pathophysiology of alcohol and breast cancer: Update 2012. Alcohol Alcohol 2012; 47:204-12. [PMID: 22459019 DOI: 10.1093/alcalc/ags011] [Citation(s) in RCA: 164] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIMS To update epidemiological data on alcohol and breast cancer, with special emphasis on light alcohol consumption, and to review mechanisms of alcohol mediated mammary carcinogenesis. METHODS For epidemiological data, in November 2011 we performed a literature search in various bibliographic databases, and we conducted a meta-analysis of data on light alcohol drinking. Relevant mechanistic studies were also reviewed to November 2011. RESULTS A significant increase of the order of 4% in the risk of breast cancer is already present at intakes of up to one alcoholic drink/day. Heavy alcohol consumption, defined as three or more drinks/day, is associated with an increased risk by 40-50%. This translates into up to 5% of breast cancers attributable to alcohol in northern Europe and North America for a total of approximately 50,000 alcohol-attributable cases of breast cancer worldwide. Up to 1-2% of breast cancers in Europe and North America are attributable to light drinking alone, given its larger prevalence in most female populations when compared with heavy drinking. Alcohol increases estrogen levels, and estrogens may exert its carcinogenic effect on breast tissue either via the ER or directly. Other mechanisms may include acetaldehyde, oxidative stress, epigenetic changes due to a disturbed methyl transfer and decreased retinoic acid concentrations associated with an altered cell cycle. CONCLUSIONS Women should not exceed one drink/day, and women at elevated risk for breast cancer should avoid alcohol or consume alcohol occasionally only.
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Affiliation(s)
- Helmut K Seitz
- Centre of Alcohol Research, University of Heidelberg, Germany.
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Feasibility of Medaka (Oryzias latipes) as an Animal Model to Study Fetal Alcohol Spectrum Disorder. ADVANCES IN MOLECULAR TOXICOLOGY VOLUME 6 2012. [DOI: 10.1016/b978-0-444-59389-4.00003-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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