飲酒和少女良性乳房疾病風險增加有關


  【24drs.com】April 12, 2010 — 根據線上發表於4月12日小兒科(Pediatrics)期刊的研究,有飲酒的少女發生良性乳房疾病(benign breast disease,BBD)的風險顯著高於很少喝或未曾飲酒的少女。
  
  麻州波士頓哈佛醫學院、布萊根婦女醫院Catherine S. Berkey醫師等研究者寫道,BBD是乳癌的風險因素之一,有相當多證據指出,成人飲酒會增加乳癌風險,因此,青少年飲酒量和BBD的關係與乳癌有關。
  
  在一篇婦女回憶年輕時飲酒習慣的回溯研究中,18-22歲時的飲酒情況已經被視為是BBD的一個風險因素,研究者解釋,現在這篇文章的資料則是來自「Growing Up Today Study (GUTS)」這項研究 ,這是首次採用前瞻方式評估青少年飲酒量和BBD發生率的研究。
  
  始於1996年的GUTS研究,在研究開始時納入9037名年紀介於9-15歲的女孩,這些研究對象從1996-2001年每年回答問卷,並且在2003、2005與2007年進行追蹤調查,進行2003年的調查時,研究對象的年紀介於16-23歲,調查包括了飲酒量的問題,2005和2007年的調查則是關於BBD。
  
  在2005和2007年自願回來接受調查的6899人中,總共有67人報告有切片證實的BBD,80人接受BBD診斷但是未經切片證實。將「從未飲酒或每週飲酒不到一次者」作為參考指標,隨著每週飲酒量增加超過每週一次,發生BBD的勝算比(OR)也隨之增加:
  * 每週不到1杯(OR,1.00)
  * 每週1-2杯(OR,1.6)
  * 每週3-5杯(OR,3.0)
  * 每週6-7杯(OR,5.5)
  
  開始有BBD的婦女其年紀比沒有BBD者年長約8 個月,她們比較常飲酒、每次喝較多杯、比較常狂飲。校正年紀、身體質量指數、初經年紀、首次開始規律飲酒時的年紀、母親的乳癌和BBD病史等之後, BBD和飲酒的關係依舊存在。
  
  【研究限制】
  這篇研究的主要限制在於,研究者信賴研究對象自我報告的飲酒量,此外,研究者指出,這可能會導致低估飲酒和BBD之間的真實關係,而且,雖然他們試著納入每個干擾因素,仍可能有些變項被研究者低估或忽略了,不過,這篇研究結果支持那些稍早發表的前瞻研究,增加了這些研究的正確性。
  
  【結論】
  研究者結論表示,這些發現指出飲酒量和BBD風險之間的關聯,甚至可能和後來的乳癌有關。特別值得注意的是,當許多少女上大學且開始增加飲酒量時,此關聯才會出現。後續研究若證實這些發現,應鼓勵年輕女性限制飲酒的量與頻率,或許有助於其中某些人避免BBD和乳癌。
  
  研究作者們皆宣告沒有相關財務關係。
  
  Pediatrics. 線上發表於2010年4月12日。

Alcohol Intake Linked With Increased Risk for Benign Breast Disease in Teen Girls

By Norra MacReady
Medscape Medical News

April 12, 2010 — Teenage girls who drink alcohol have a significantly increased risk for the development of benign breast disease (BBD) vs girls who rarely or never drink, according to a study reported online April 12 in Pediatrics.

BBD is a risk factor for breast cancer, and "a massive body of evidence indicates that adult alcohol intake increases risk of breast cancer. Thus, the relationship between adolescent alcohol consumption and BBD has implications for breast cancer," write the study authors, led by Catherine S. Berkey, ScD, of Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

Alcohol intake between the ages of 18 and 22 years has already been implicated as a BBD risk factor in a retrospective study, in which women recalled their youthful drinking habits decades later. The data in this article come from the Growing Up Today Study (GUTS), which is the first prospective assessment of the relationship between alcohol consumption and BBD incidence during adolescence, the investigators explain.

Begun in 1996, GUTS enrolled 9037 girls between the ages of 9 and 15 years at baseline. The participants answered questionnaires annually from 1996 through 2001, as well as follow-up surveys in 2003, 2005, and 2007. The 2003 survey, administered when the subjects were 16 to 23 years old, contained questions about alcohol consumption. The 2005 and 2007 surveys asked about BBD.

Of the 6899 volunteers who returned the surveys from 2005 and 2007, a total of 67 reported having biopsy-confirmed BBD, and 80 had received BBD diagnoses that were never confirmed on biopsy. With abstention or drinking less than once a week used as a reference, any level of alcohol consumption starting at once a week was associated with an increased odds ratio (OR) for the development of BBD:

  • Less than 1 drink per week (OR, 1.00)
  • 1 to 2 drinks per week (OR, 1.6)
  • 3 to 5 drinks per week (OR, 3.0)
  • 6 to 7 drinks per week, OR, (5.5)

The women who went on to have BBD were approximately 8 months older than the women without BBD, and they reported more frequent alcohol consumption, more drinks per occasion, and more episodes of binge drinking. The relationship between BBD and drinking persisted after adjustment for age, body mass index, age at menarche, age when the subjects first began drinking regularly, and parental history of breast cancer and BBD.

Study Limitations

A major limitation of the study is that the investigators relied on the subjects' self-reports of their alcohol consumption. Still, the study authors point out, if anything, this most likely would have resulted in an underestimate of the true relationship between drinking and BBD. Also, although they tried to account for every confounding variable, it is possible that the researchers may have underestimated or overlooked some variables. However, the results of this study support those of earlier, retrospective studies, which add to the validity of these studies.

Conclusion

The researchers conclude that these findings point to an association between the level of alcohol consumption and the risk for BBD and, possibly, subsequent breast cancer. Of particular concern is the association can appear just when many young women enter college and increase their alcohol intake even more. Should further research confirm these findings, encouraging young women to limit the amount and frequency of their imbibing may help some of them avoid BBD and breast cancer.

The study authors have disclosed no relevant financial relationships.

Pediatrics. Published online April 12, 2010.

    
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