Alcohol Consumption and Survival after a Breast Cancer Diagnosis: A Literature-based Meta-analysis and Collaborative Analysis of Data for 29,239 Cases
A partie d'une revue systématique de la littérature publiée jusqu'en 2013 (11 études, 29 239 cas), cette méta-analyse évalue l'association entre une consommation d'alcool après le diagnostic d'un cancer du sein et la survie des patientes
Résumé en anglais
Background : Evidence for the association of alcohol consumption with prognosis after a diagnosis of breast cancer has been inconsistent. We have reviewed and summarised the published evidence and evaluated the association using individual patient data from multiple case cohorts.
Materials and Methods : A MEDLINE search to identify studies published up to January 2013 was performed. We combined published estimates for survival time in "moderate drinkers" versus non-drinkers. An analysis of individual participant data using Cox regression was carried out using data from eleven case cohorts.
Results : We identified eleven published studies suitable for inclusion in the meta-analysis. Moderate post-diagnosis alcohol consumption was not associated with overall survival (HR = 0.95, 95% CI 0.85-1.05), but there was some evidence of better survival associated with pre-diagnosis consumption (HR = 0.80, 95% CI 0.73-0.88). Individual data on alcohol consumption for 29,239 cases with 4,839 deaths were available from the eleven case cohorts, all of which had data on ER status. For women with ER-positive disease there was little evidence that pre- or post-diagnosis alcohol consumption is associated with breast cancer-specific mortality, with some evidence of a reduction in all-cause mortality. Based on a single study, moderate post-diagnosis alcohol intake was associated with a small reduction in breast cancer-specific mortality in women with ER-negative disease. There was no association for pre-diagnosis intake in women with ER-negative disease.
Impact : Considering the totality of the evidence, moderate post-diagnosis alcohol consumption is unlikely to have a major adverse effect on survival of women with breast cancer.
