Alcohol Use and Breast Cancer: A Critical Review.
Level 1 - systematic review of randomized trials
Systematic review of meta-analyses combined with population-attributable fraction epidemiological modeling.
PubMed 27130687 · doi:10.1111/acer.13071
What was done
The authors summarized biological mechanisms linking alcohol to breast cancer, conducted a systematic review of meta-analyses evaluating the alcohol–breast cancer risk relationship, and calculated global alcohol-attributable breast cancer incidence and mortality for 2012 using Population-Attributable Fraction (PAF) methodology with exposure and outcome data from GISAH and GLOBOCAN.
What was found
The search identified 15 meta-analyses; 13 demonstrated a dose-response relationship between alcohol intake (including light consumption) and breast cancer risk. Globally in 2012, an estimated 144,000 (95% CI: 88,000 to 200,000) breast cancer cases and 38,000 (95% CI: 2,400 to 53,000) breast cancer deaths were attributable to alcohol. Light drinkers accounted for 18.8% of these attributable cases and 17.5% of attributable deaths. Identified biological mechanisms included altered hormone levels, ethanol metabolites acting as carcinogens, and inhibition of the one-carbon metabolism pathway.
Why it matters
This review emphasizes that alcohol-associated breast cancer risk extends to low levels of consumption, showing that light drinking constitutes a meaningful fraction of the global alcohol-attributable cancer burden.
Limits
The underlying evidence rests entirely on observational studies and pooled meta-analyses, which carry risks of self-reporting bias for alcohol intake and residual confounding. The abstract does not provide numerical relative risk estimates or define the specific threshold used for light drinking, and burden calculations rely on aggregate modeling assumptions.
Cited by
- supports Alcohol consumption is classified as a Group 1 carcinogen and increases the risk of developing breast cancer.