Alcohol Consumption and Breast Cancer in the Epidemiologic Follow-up Study of the First National Health and Nutrition Examination Survey

We investigated the relation between alcohol consumption and breast cancer in the Epidemiologic Follow-up Study of the first National Health and Nutrition Examination Survey, a cohort study based on a sample of the U.S. population. A total of 7188 women 25 to 74 years of age who were examined during the period 1971 through 1975 were included in the analysis. Information about alcohol consumption was obtained during the base-line interview. The median follow-up period for this cohort was 10 years. One hundred twenty-one cases of breast cancer that developed after the baseline examination were identified through hospital records or death certificates. The relative-risk estimate for any amount of drinking relative to no drinking was 1.5 (95 percent confidence interval, 1.1 to 2.2). The estimates for three levels of consumption, from the lowest to the highest, were 1.4 (confidence interval, 0.9 to 2.3), 1.5 (0.9 to 2.6), and 1.6 (1.0 to 2.7), in comparison to no drinking at all. These relative-risk estimates were not materially affected by adjustment for known risk factors for breast cancer or for several dietary factors. The results of this study, consistent with those of two other cohort studies and a number of case–control studies, suggest that moderate alcohol consumption is associated with an elevation in the risk of breast cancer of 50 to 100 percent. (N Engl J Med 1987; 316: 1169–73.) SEVERAL epidemiologic studies have shown a relation between moderate drinking and breast cancer. Hiatt and Bawol reported a 40 percent excess risk of breast cancer in women who had three or more drinks per day in a cohort study based on the members of a prepaid group practice. 1 In a cohort study of U.S. nurses by Willett and coworkers, women who reported moderate alcohol consumption were approximately 50 percent more likely to go on to have breast cancer than those who drank little or no alcohol. 2 Although some case–control studies have not found an association between alcohol consumption and breast . . .