© 2007 European Society for Medical Oncology
letters to the editor |
Reply to ‘Alcohol consumption and risk of Hodgkin's lymphoma and multiple myeloma: a multicentre case-control study’ by Gorini et al.
A study by Gorini et al. [1] showed a favourable effect of alcohol consumption for Hodgkin's lymphoma (HL), overall and for non-smokers, and a non significant inverse association with multiple myeloma (MM). These findings are consistent with some [2], but not with other studies [3]. Findings from a recent pooled analysis [4] suggested that people who drink alcoholic beverages have a lower risk of Non-Hodgkin lymphoma (NHL). However, the role of alcohol on lymphoid neoplasms risk is still uncertain [5].Our study group started the investigation of the association between alcohol intake and lymphoid neoplasms in the early 1990’s through case–control studies conducted in Northern Italy [3]. Briefly, cases were 966 subjects (aged 17–79 years; median 58) with incident, histologically confirmed HL (n = 158), NHL (n = 446), MM (n = 141) and soft tissue sarcomas (n = 221). Controls were 1295 patients (aged 17–79 years; median 57) admitted to hospitals in the same catchment areas for acute, nonneoplastic, nonimmunologic, nondigestive tract diseases. Information was collected in the hospital by trained interviewers using a structured questionnaire, including questions on sociodemographic characteristics, anthropometric measures, history of medical conditions, a few selected occupational and environmental exposures, smoking and alcohol drinking. We re-analyzed these data to assess if the findings by Gorini et al. could be confirmed in earlier investigations. Odds ratios (OR) and 95% confidence intervals (CI) were computed using multiple logistic regression, including terms for age, center, sex and tobacco, when required.
Table 1 gives the distribution of cases and controls according to total alcohol consumption and the corresponding OR and 95% CI overall and in strata of smoking habits. The ORs for the highest level of alcohol drinking (
5 drinks per day) were 0.66 for HL, 0.91 for NHL, 1.16 for MM, 0.67 for soft tissue sarcoma. None of the trends in risk was significant. The associations were similar in never and ever smokers.
|
We also investigated the association with different types of alcoholic beverages, but no appreciable difference emerged among wine, beer and spirits.
The major strengths of our study were the high participation rate (i.e. almost complete) and the similar catchment areas of cases and controls. On the other hand, the use of hospital controls may overestimate drinking in the reference group, since drinking may be related to several conditions requiring hospital admission. However, we excluded from the control group patients admitted for chronic conditions, particularly those related to alcohol intake.
Our study, based on a population with frequent and regular alcohol intake, was compatible with a modest favourable effect of alcohol drinking on lymphoid neoplasms, but do not support the existence of an interaction with tobacco as suggested by Gorini et al. [1].
1 Istituto di Ricerche Farmacologiche "Mario Negri", Milano
2 Scuola di Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Pavia, Pavia, Italy
3 International Agency for Research on Cancer, Lyon Cedex, France
4 Unità di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano (PN)
5 Istituto di Statistica Medica e Biometria "G. A. Maccacaro", Università degli Studi di Milano, Milan, Italy
* E-mail: liliana{at}marionegri.it
Acknowledgements
This work was conducted with the contribution of the Italian Association for Cancer Research, the Italian League Against Cancer. The authors thank Ms I. Garimoldi for editorial assistance, the Italian Ministry of Education (PRIN 2005). The work in this paper was undertaken while CLV was a senior fellow at the International Agency for Research on Cancer.
References
1. Gorini G, Stagnaro E, Fontana V, et al. Alcohol consumption and risk of Hodgkin's lymphoma and multiple myeloma: a multicentre case-control study. Ann Oncol (2007) 18:143–148.
2. Nieters A, Deeg E, Becker N. Tobacco and alcohol consumption and risk of lymphoma: results of a population-based case-control study in Germany. Int J Cancer (2006) 118:422–430.[CrossRef][Web of Science][Medline]
3. Tavani A, Pregnolato A, Negri E, et al. Diet and risk of lymphoid neoplasms and soft tissue sarcomas. Nutr Cancer (1997) 27:256–260.[Web of Science][Medline]
4. Morton LM, Zheng T, Holford TR, et al. Alcohol consumption and risk of non-Hodgkin lymphoma: a pooled analysis. Lancet Oncol (2005) 6:469–476.[CrossRef][Web of Science][Medline]
5. Boffetta P. Alcohol and cancer: benefits in addition to risk? Lancet Oncol (2005) 6:442–443.[CrossRef][Web of Science][Medline]
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||