The latest critique from The ISFAR considers the link between alcohol consumption and uterine cancer

The latest critique from The ISFAR considers the link between alcohol consumption and uterine cancer

Most epidemiologic studies have shown that moderate alcohol consumption does not increase the risk of uterine cancer, and some have suggested an inverse or J-shaped relation.

In a new analysis from the Nurses’ Health Study, with 68,067 female participants aged 34–59 years in 1980, investigators have related repeatedly-assessed long-term alcohol intake, and related the cumulative average intake over time to the risk of invasive uterine cancer. A total of 794 cases of invasive endometrial adenocarcinoma were identified over a 30-year follow-up period.

 The authors report an inverse association among alcohol drinkers (multivariable RR=0.81; 95% CI: 0.68–0.96) compared with nondrinkers. Women with an intake of less than 5 grams of alcohol per day (an average of approximately one-half drink per day) had a 22% lower risk of endometrial cancer (multivariable RR=0.78; 95% CI: 0.66–0.94), with no further decrease evident from larger amounts of alcohol.

In comparison with non-drinkers, the relative risk was similarly reduced for consumers of more than 30g of alcohol per day, but the number of subjects in this category was small, and a potential increase in risk from heavy drinking could not be adequately assessed in this study.

Forum members considered this to be a very well-done prospective study, with clear and biologically plausible results.

By having repeated assessments of alcohol, an estimate of long-term average consumption was possible. The approximately 20% lower risk of uterine cancer among subjects with light alcohol intake remained statistically significant after multi-variate adjustments for known potential confounders. Reviewers agreed with the authors that a potential mechanism for the association could be a reduction in insulin concentrations and improved insulin sensitivity that have been shown to occur with moderate alcohol consumption.  Further, the frequently-demonstrated inverse relation for alcohol with obesity may also play a mechanistic role.

Overall, this study adds to accumulating scientific data showing that moderate drinking does not increase the risk of uterine cancer, and probably is associated with a reduction in risk.

To read the full critique, click here.

These critiques are published with the permission of The ISFAR.