Alcohol Consumption and Survival after a Breast Cancer Diagnosis: A Literature-Based Meta-analysis and Collaborative Analysis of Data for 29,239 Cases
Identifieur interne : 001F46 ( Pmc/Curation ); précédent : 001F45; suivant : 001F47Alcohol Consumption and Survival after a Breast Cancer Diagnosis: A Literature-Based Meta-analysis and Collaborative Analysis of Data for 29,239 Cases
Auteurs : Alaa M. G. Ali [Royaume-Uni, Égypte] ; Marjanka K. Schmidt [Pays-Bas] ; Manjeet K. Bolla [Royaume-Uni] ; Qin Wang [Royaume-Uni] ; M. Gago-Dominguez ; J. Esteban Castelao ; Angel Carracedo [Arabie saoudite] ; Victor Mu Oz Garz N ; Stig E. Bojesen ; B Rge G. Nordestgaard ; Henrik Flyger ; Jenny Chang-Claude [Allemagne] ; Alina Vrieling [Pays-Bas, Allemagne] ; Anja Rudolph [Allemagne] ; Petra Seibold [Allemagne] ; Heli Nevanlinna ; Taru A. Muranen ; Kirsimari Aaltonen ; Carl Blomqvist ; Keitaro Matsuo [Japon] ; Hidemi Ito [Japon] ; Hiroji Iwata [Japon] ; Akiyo Horio [Japon] ; Esther M. John ; Mark Sherman ; Jolanta Lissowska [Pologne] ; Jonine Figueroa [États-Unis] ; Montserrat Garcia-Closas [Royaume-Uni] ; Hoda Anton-Culver [États-Unis] ; Mitul Shah [Royaume-Uni] ; John L. Hopper [Australie] ; Antonia Trichopoulou [Grèce] ; Bas Bueno-De-Mesquita [Royaume-Uni, Pays-Bas, Malaisie] ; Vittorio Krogh [Italie] ; Elisabete Weiderpass [Finlande, Norvège, Suède] ; Anne Andersson ; Françoise Clavel-Chapelon [France] ; Laure Dossus [France] ; Guy Fagherazzi [France] ; Petra H. Peeters [Pays-Bas] ; Anja Olsen [Danemark] ; Gordon C. Wishart ; Douglas F. Easton [Royaume-Uni] ; Signe Borgquist [Suède] ; Kim Overvad [Danemark] ; Aurelio Barricarte ; Carlos A. González [Espagne] ; María-José Sánchez [Espagne] ; Pilar Amiano [Espagne] ; Elio Riboli [Royaume-Uni] ; Tim Key [Royaume-Uni] ; Paul D. Pharoah [Royaume-Uni]Source :
- Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology [ 1055-9965 ] ; 2014.
Abstract
Evidence for an association of alcohol consumption with prognosis after a diagnosis of breast cancer has been inconsistent. We have reviewed and summarized the published evidence and evaluated the association using individual patient data from multiple case cohorts.
A MEDLINE search to identify studies published up to January 2013 was performed. We combined published estimates of survival time for “moderate drinkers” versus nondrinkers. An analysis of individual participant data using Cox regression was carried out using data from 11 case cohorts.
We identified 11 published studies suitable for inclusion in the meta-analysis. Moderate post-diagnosis alcohol consumption was not associated with overall survival [HR, 0.95; 95% confidence interval (CI), 0.85–1.05], but there was some evidence of better survival associated with prediagnosis 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 11 case cohorts, all of which had data on estrogen receptor (ER) status. For women with ER-positive disease, there was little evidence that pre- or postdiagnosis alcohol consumption is associated with breast cancer–specific mortality, with some evidence of a negative association with all-cause mortality. On the basis of a single study, moderate postdiagnosis alcohol intake was associated with a small reduction in breast cancer–specific mortality for women with ER-negative disease. There was no association with prediagnosis intake for women with ER-negative disease.
There was little evidence that pre- or post-diagnosis alcohol consumption is associated with breast cancer–specific mortality for women with ER-positive disease. There was weak evidence that moderate post-diagnosis alcohol intake is associated with a small reduction in breast cancer–specific mortality in ER-negative disease.
Considering the totality of the evidence, moderate postdiagnosis alcohol consumption is unlikely to have a major adverse effect on the survival of women with breast cancer.
Url:
DOI: 10.1158/1055-9965.EPI-13-0901
PubMed: 24636975
PubMed Central: 4542077
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M. Gago-Dominguez<affiliation><nlm:aff id="A15">Genomic Medicine Group, Galician Foundation of Genomic Medicine, Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saude (SERGAS), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela</nlm:aff>
<wicri:noCountry code="subfield">Santiago de Compostela</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A16">Oncology and Genetics Unit, University Hospital of Vigo, Galicia Health Service (SERGAS)</nlm:aff>
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</affiliation>
<affiliation><nlm:aff id="A15">Genomic Medicine Group, Galician Foundation of Genomic Medicine, Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saude (SERGAS), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela</nlm:aff>
<wicri:noCountry code="subfield">Santiago de Compostela</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A24">King Abdulaziz University, Jeddah, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>King Abdulaziz University, Jeddah</wicri:regionArea>
</affiliation>
<affiliation><nlm:aff id="A17">Radiotherapy Department, University Hospital of Vigo, Vigo</nlm:aff>
<wicri:noCountry code="subfield">Vigo</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A26">Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen</nlm:aff>
<wicri:noCountry code="subfield">University of Copenhagen</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A26">Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen</nlm:aff>
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</affiliation>
<affiliation><nlm:aff id="A27">Department of Breast Surgery, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen</nlm:aff>
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</affiliation>
<affiliation><nlm:aff id="A31">Department of Obstetricts and Gynecology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
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</affiliation>
<affiliation><nlm:aff id="A31">Department of Obstetricts and Gynecology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
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<affiliation><nlm:aff id="A32">Department of Obstetricts and Gynecology and Oncology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
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<affiliation><nlm:aff id="A33">Department of Oncology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
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<affiliation><nlm:aff id="A33">Department of Oncology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
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<affiliation><nlm:aff id="A33">Department of Oncology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
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<affiliation><nlm:aff id="A39">Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda</nlm:aff>
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<affiliation><nlm:aff id="A12">National Institute for Public Health and the Environment, Bilthoven</nlm:aff>
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<affiliation wicri:level="1"><nlm:aff id="A13">Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands</nlm:aff>
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Le document en format XML
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<author><name sortKey="Schmidt, Marjanka K" sort="Schmidt, Marjanka K" uniqKey="Schmidt M" first="Marjanka K." last="Schmidt">Marjanka K. Schmidt</name>
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<author><name sortKey="Bolla, Manjeet K" sort="Bolla, Manjeet K" uniqKey="Bolla M" first="Manjeet K." last="Bolla">Manjeet K. Bolla</name>
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<author><name sortKey="Wang, Qin" sort="Wang, Qin" uniqKey="Wang Q" first="Qin" last="Wang">Qin Wang</name>
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<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
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<author><name sortKey="Gago Dominguez, M" sort="Gago Dominguez, M" uniqKey="Gago Dominguez M" first="M." last="Gago-Dominguez">M. Gago-Dominguez</name>
<affiliation><nlm:aff id="A15">Genomic Medicine Group, Galician Foundation of Genomic Medicine, Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saude (SERGAS), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela</nlm:aff>
<wicri:noCountry code="subfield">Santiago de Compostela</wicri:noCountry>
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<author><name sortKey="Castelao, J Esteban" sort="Castelao, J Esteban" uniqKey="Castelao J" first="J. Esteban" last="Castelao">J. Esteban Castelao</name>
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<wicri:noCountry code="subfield">Galicia Health Service (SERGAS)</wicri:noCountry>
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<author><name sortKey="Carracedo, Angel" sort="Carracedo, Angel" uniqKey="Carracedo A" first="Angel" last="Carracedo">Angel Carracedo</name>
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<wicri:noCountry code="subfield">Santiago de Compostela</wicri:noCountry>
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<affiliation wicri:level="1"><nlm:aff id="A24">King Abdulaziz University, Jeddah, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>King Abdulaziz University, Jeddah</wicri:regionArea>
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<author><name sortKey="Garz N, Victor Mu Oz" sort="Garz N, Victor Mu Oz" uniqKey="Garz N V" first="Victor Mu Oz" last="Garz N">Victor Mu Oz Garz N</name>
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<author><name sortKey="Bojesen, Stig E" sort="Bojesen, Stig E" uniqKey="Bojesen S" first="Stig E." last="Bojesen">Stig E. Bojesen</name>
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<affiliation><nlm:aff id="A26">Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen</nlm:aff>
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<author><name sortKey="Nordestgaard, B Rge G" sort="Nordestgaard, B Rge G" uniqKey="Nordestgaard B" first="B Rge G." last="Nordestgaard">B Rge G. Nordestgaard</name>
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<affiliation><nlm:aff id="A26">Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen</nlm:aff>
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<author><name sortKey="Flyger, Henrik" sort="Flyger, Henrik" uniqKey="Flyger H" first="Henrik" last="Flyger">Henrik Flyger</name>
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<wicri:noCountry code="subfield">University of Copenhagen</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Chang Claude, Jenny" sort="Chang Claude, Jenny" uniqKey="Chang Claude J" first="Jenny" last="Chang-Claude">Jenny Chang-Claude</name>
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<wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea>
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</author>
<author><name sortKey="Vrieling, Alina" sort="Vrieling, Alina" uniqKey="Vrieling A" first="Alina" last="Vrieling">Alina Vrieling</name>
<affiliation wicri:level="3"><nlm:aff id="A11">Department for Health Evidence, Radboud University Medical Centre, Nijmegen</nlm:aff>
<country>Pays-Bas</country>
<placeName><settlement type="city">Nimègue</settlement>
<region type="province" nuts="2">Gueldre</region>
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<wicri:orgArea>Department for Health Evidence, Radboud University Medical Centre</wicri:orgArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A30">Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Rudolph, Anja" sort="Rudolph, Anja" uniqKey="Rudolph A" first="Anja" last="Rudolph">Anja Rudolph</name>
<affiliation wicri:level="1"><nlm:aff id="A30">Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea>
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<author><name sortKey="Seibold, Petra" sort="Seibold, Petra" uniqKey="Seibold P" first="Petra" last="Seibold">Petra Seibold</name>
<affiliation wicri:level="1"><nlm:aff id="A30">Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Nevanlinna, Heli" sort="Nevanlinna, Heli" uniqKey="Nevanlinna H" first="Heli" last="Nevanlinna">Heli Nevanlinna</name>
<affiliation><nlm:aff id="A31">Department of Obstetricts and Gynecology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
<wicri:noCountry code="subfield">University of Helsinki and Helsinki University Central Hospital</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Muranen, Taru A" sort="Muranen, Taru A" uniqKey="Muranen T" first="Taru A." last="Muranen">Taru A. Muranen</name>
<affiliation><nlm:aff id="A31">Department of Obstetricts and Gynecology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
<wicri:noCountry code="subfield">University of Helsinki and Helsinki University Central Hospital</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Aaltonen, Kirsimari" sort="Aaltonen, Kirsimari" uniqKey="Aaltonen K" first="Kirsimari" last="Aaltonen">Kirsimari Aaltonen</name>
<affiliation><nlm:aff id="A32">Department of Obstetricts and Gynecology and Oncology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
<wicri:noCountry code="subfield">University of Helsinki and Helsinki University Central Hospital</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A33">Department of Oncology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
<wicri:noCountry code="subfield">University of Helsinki and Helsinki University Central Hospital</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Blomqvist, Carl" sort="Blomqvist, Carl" uniqKey="Blomqvist C" first="Carl" last="Blomqvist">Carl Blomqvist</name>
<affiliation><nlm:aff id="A33">Department of Oncology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
<wicri:noCountry code="subfield">University of Helsinki and Helsinki University Central Hospital</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Matsuo, Keitaro" sort="Matsuo, Keitaro" uniqKey="Matsuo K" first="Keitaro" last="Matsuo">Keitaro Matsuo</name>
<affiliation wicri:level="1"><nlm:aff id="A35">Division of Epidemiology and Prevention, Aichi Cancer Center Central Hospital, Nagoya, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Division of Epidemiology and Prevention, Aichi Cancer Center Central Hospital, Nagoya</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Ito, Hidemi" sort="Ito, Hidemi" uniqKey="Ito H" first="Hidemi" last="Ito">Hidemi Ito</name>
<affiliation wicri:level="1"><nlm:aff id="A35">Division of Epidemiology and Prevention, Aichi Cancer Center Central Hospital, Nagoya, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Division of Epidemiology and Prevention, Aichi Cancer Center Central Hospital, Nagoya</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Iwata, Hiroji" sort="Iwata, Hiroji" uniqKey="Iwata H" first="Hiroji" last="Iwata">Hiroji Iwata</name>
<affiliation wicri:level="1"><nlm:aff id="A36">Department of Breast Oncology, Aichi Cancer Center Central Hospital, Nagoya, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Breast Oncology, Aichi Cancer Center Central Hospital, Nagoya</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Horio, Akiyo" sort="Horio, Akiyo" uniqKey="Horio A" first="Akiyo" last="Horio">Akiyo Horio</name>
<affiliation wicri:level="1"><nlm:aff id="A36">Department of Breast Oncology, Aichi Cancer Center Central Hospital, Nagoya, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Breast Oncology, Aichi Cancer Center Central Hospital, Nagoya</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="John, Esther M" sort="John, Esther M" uniqKey="John E" first="Esther M." last="John">Esther M. John</name>
<affiliation><nlm:aff id="A37">Cancer Prevention Institute of California, Fremont</nlm:aff>
<wicri:noCountry code="subfield">Fremont</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Sherman, Mark" sort="Sherman, Mark" uniqKey="Sherman M" first="Mark" last="Sherman">Mark Sherman</name>
<affiliation><nlm:aff id="A39">Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda</nlm:aff>
<wicri:noCountry code="subfield">Bethesda</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Lissowska, Jolanta" sort="Lissowska, Jolanta" uniqKey="Lissowska J" first="Jolanta" last="Lissowska">Jolanta Lissowska</name>
<affiliation wicri:level="1"><nlm:aff id="A41">The M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>The M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Figueroa, Jonine" sort="Figueroa, Jonine" uniqKey="Figueroa J" first="Jonine" last="Figueroa">Jonine Figueroa</name>
<affiliation wicri:level="2"><nlm:aff id="A40">Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
</placeName>
<wicri:cityArea>Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Garcia Closas, Montserrat" sort="Garcia Closas, Montserrat" uniqKey="Garcia Closas M" first="Montserrat" last="Garcia-Closas">Montserrat Garcia-Closas</name>
<affiliation wicri:level="3"><nlm:aff id="A5">Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton and Break through Breast Cancer Research Centre, Institute of Cancer Research, London</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
<wicri:orgArea>Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton and Break through Breast Cancer Research Centre, Institute of Cancer Research</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Anton Culver, Hoda" sort="Anton Culver, Hoda" uniqKey="Anton Culver H" first="Hoda" last="Anton-Culver">Hoda Anton-Culver</name>
<affiliation wicri:level="2"><nlm:aff id="A38">Department of Epidemiology, University of California-Irvine, Irvine, California</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Epidemiology, University of California-Irvine, Irvine</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Shah, Mitul" sort="Shah, Mitul" uniqKey="Shah M" first="Mitul" last="Shah">Mitul Shah</name>
<affiliation wicri:level="4"><nlm:aff id="A3">Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
</author>
<author><name sortKey="Hopper, John L" sort="Hopper, John L" uniqKey="Hopper J" first="John L." last="Hopper">John L. Hopper</name>
<affiliation wicri:level="1"><nlm:aff id="A42">Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Trichopoulou, Antonia" sort="Trichopoulou, Antonia" uniqKey="Trichopoulou A" first="Antonia" last="Trichopoulou">Antonia Trichopoulou</name>
<affiliation><nlm:aff id="A43">Hellenic Health Foundation</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A44">WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology, and Medical Statistics, University of Athens Medical School, Athens, Greece</nlm:aff>
<country xml:lang="fr">Grèce</country>
<wicri:regionArea>WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology, and Medical Statistics, University of Athens Medical School, Athens</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Bueno De Mesquita, Bas" sort="Bueno De Mesquita, Bas" uniqKey="Bueno De Mesquita B" first="Bas" last="Bueno-De-Mesquita">Bas Bueno-De-Mesquita</name>
<affiliation wicri:level="3"><nlm:aff id="A6">School of Public Health, Imperial College London, London</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
<wicri:orgArea>School of Public Health, Imperial College London</wicri:orgArea>
</affiliation>
<affiliation><nlm:aff id="A12">National Institute for Public Health and the Environment, Bilthoven</nlm:aff>
<wicri:noCountry code="subfield">Bilthoven</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A13">Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A54">Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia</nlm:aff>
<country xml:lang="fr">Malaisie</country>
<wicri:regionArea>Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Krogh, Vittorio" sort="Krogh, Vittorio" uniqKey="Krogh V" first="Vittorio" last="Krogh">Vittorio Krogh</name>
<affiliation wicri:level="1"><nlm:aff id="A45">Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionaledei Tumori, Milan, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionaledei Tumori, Milan</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Weiderpass, Elisabete" sort="Weiderpass, Elisabete" uniqKey="Weiderpass E" first="Elisabete" last="Weiderpass">Elisabete Weiderpass</name>
<affiliation wicri:level="1"><nlm:aff id="A34">Samfundet Folkhälsan, Helsinki, Finland</nlm:aff>
<country xml:lang="fr">Finlande</country>
<wicri:regionArea>Samfundet Folkhälsan, Helsinki</wicri:regionArea>
</affiliation>
<affiliation><nlm:aff id="A46">Department of Community Medicine, University of Tromsø, The Artic University of Norway, Tromsø</nlm:aff>
<wicri:noCountry code="subfield">Tromsø</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A47">Department of Research, Cancer Registry of Norway, Oslo, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Department of Research, Cancer Registry of Norway, Oslo</wicri:regionArea>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="A48">Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm</nlm:aff>
<country>Suède</country>
<placeName><settlement type="city">Stockholm</settlement>
<region nuts="2">Svealand</region>
</placeName>
<wicri:orgArea>Department of Medical Epidemiology and Biostatistics, Karolinska Institutet</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Andersson, Anne" sort="Andersson, Anne" uniqKey="Andersson A" first="Anne" last="Andersson">Anne Andersson</name>
<affiliation><nlm:aff id="A49">Department of Radiation Sciences, Oncology, University of Umeå, Umeå</nlm:aff>
<wicri:noCountry code="subfield">Umeå</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Clavel Chapelon, Francoise" sort="Clavel Chapelon, Francoise" uniqKey="Clavel Chapelon F" first="Françoise" last="Clavel-Chapelon">Françoise Clavel-Chapelon</name>
<affiliation><nlm:aff id="A51">Inserm, Centre for Research in Epidemiology and Population Health</nlm:aff>
<wicri:noCountry code="subfield">Centre for Research in Epidemiology and Population Health</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A52">Univ Paris Sud, UMRS</nlm:aff>
<wicri:noCountry code="subfield">UMRS</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A53">Institut Gustave-Roussy, Villejuif, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Gustave-Roussy, Villejuif</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Dossus, Laure" sort="Dossus, Laure" uniqKey="Dossus L" first="Laure" last="Dossus">Laure Dossus</name>
<affiliation><nlm:aff id="A51">Inserm, Centre for Research in Epidemiology and Population Health</nlm:aff>
<wicri:noCountry code="subfield">Centre for Research in Epidemiology and Population Health</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A52">Univ Paris Sud, UMRS</nlm:aff>
<wicri:noCountry code="subfield">UMRS</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A53">Institut Gustave-Roussy, Villejuif, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Gustave-Roussy, Villejuif</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Fagherazzi, Guy" sort="Fagherazzi, Guy" uniqKey="Fagherazzi G" first="Guy" last="Fagherazzi">Guy Fagherazzi</name>
<affiliation><nlm:aff id="A51">Inserm, Centre for Research in Epidemiology and Population Health</nlm:aff>
<wicri:noCountry code="subfield">Centre for Research in Epidemiology and Population Health</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A52">Univ Paris Sud, UMRS</nlm:aff>
<wicri:noCountry code="subfield">UMRS</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A53">Institut Gustave-Roussy, Villejuif, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Gustave-Roussy, Villejuif</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Peeters, Petra H" sort="Peeters, Petra H" uniqKey="Peeters P" first="Petra H." last="Peeters">Petra H. Peeters</name>
<affiliation wicri:level="1"><nlm:aff id="A14">Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Pays-Bas</country>
<wicri:regionArea>Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Olsen, Anja" sort="Olsen, Anja" uniqKey="Olsen A" first="Anja" last="Olsen">Anja Olsen</name>
<affiliation wicri:level="3"><nlm:aff id="A28">Danish Cancer Society Research Center, Copenhagen</nlm:aff>
<country>Danemark</country>
<placeName><settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
</placeName>
<wicri:orgArea>Danish Cancer Society Research Center</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Wishart, Gordon C" sort="Wishart, Gordon C" uniqKey="Wishart G" first="Gordon C." last="Wishart">Gordon C. Wishart</name>
<affiliation><nlm:aff id="A4">Faculty of Health, Social Care & Education, Anglia Ruskin University, Cambridge</nlm:aff>
<wicri:noCountry code="subfield">Cambridge</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Easton, Douglas F" sort="Easton, Douglas F" uniqKey="Easton D" first="Douglas F." last="Easton">Douglas F. Easton</name>
<affiliation wicri:level="4"><nlm:aff id="A2">Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="A3">Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
</author>
<author><name sortKey="Borgquist, Signe" sort="Borgquist, Signe" uniqKey="Borgquist S" first="Signe" last="Borgquist">Signe Borgquist</name>
<affiliation wicri:level="1"><nlm:aff id="A50">Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>Division of Oncology, Department of Clinical Sciences, Lund University, Lund</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Overvad, Kim" sort="Overvad, Kim" uniqKey="Overvad K" first="Kim" last="Overvad">Kim Overvad</name>
<affiliation wicri:level="1"><nlm:aff id="A29">Department of Public Health, Aarhus University, Aarhus, Denmark</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Department of Public Health, Aarhus University, Aarhus</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Barricarte, Aurelio" sort="Barricarte, Aurelio" uniqKey="Barricarte A" first="Aurelio" last="Barricarte">Aurelio Barricarte</name>
<affiliation><nlm:aff id="A18">Navarre Public Health Institute, Pamplona</nlm:aff>
<wicri:noCountry code="subfield">Pamplona</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A19">Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP)</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gonzalez, Carlos A" sort="Gonzalez, Carlos A" uniqKey="Gonzalez C" first="Carlos A." last="González">Carlos A. González</name>
<affiliation wicri:level="3"><nlm:aff id="A20">Chief Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Barcelona</nlm:aff>
<country>Espagne</country>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
<wicri:orgArea>Chief Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO)</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Sanchez, Maria Jose" sort="Sanchez, Maria Jose" uniqKey="Sanchez M" first="María-José" last="Sánchez">María-José Sánchez</name>
<affiliation><nlm:aff id="A21">Andalusian School of Public Health, Granada</nlm:aff>
<wicri:noCountry code="subfield">Granada</wicri:noCountry>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="A22">CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid</nlm:aff>
<country>Espagne</country>
<placeName><settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
<wicri:orgArea>CIBER de Epidemiología y Salud Pública (CIBERESP)</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Amiano, Pilar" sort="Amiano, Pilar" uniqKey="Amiano P" first="Pilar" last="Amiano">Pilar Amiano</name>
<affiliation wicri:level="1"><nlm:aff id="A23">Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Riboli, Elio" sort="Riboli, Elio" uniqKey="Riboli E" first="Elio" last="Riboli">Elio Riboli</name>
<affiliation wicri:level="3"><nlm:aff id="A6">School of Public Health, Imperial College London, London</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
<wicri:orgArea>School of Public Health, Imperial College London</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Key, Tim" sort="Key, Tim" uniqKey="Key T" first="Tim" last="Key">Tim Key</name>
<affiliation wicri:level="1"><nlm:aff id="A7">Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Pharoah, Paul D" sort="Pharoah, Paul D" uniqKey="Pharoah P" first="Paul D." last="Pharoah">Paul D. Pharoah</name>
<affiliation wicri:level="4"><nlm:aff id="A2">Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="A3">Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
</author>
</titleStmt>
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<idno type="pmid">24636975</idno>
<idno type="pmc">4542077</idno>
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<idno type="RBID">PMC:4542077</idno>
<idno type="doi">10.1158/1055-9965.EPI-13-0901</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Alcohol Consumption and Survival after a Breast Cancer Diagnosis: A Literature-Based Meta-analysis and Collaborative Analysis of Data for 29,239 Cases</title>
<author><name sortKey="Ali, Alaa M G" sort="Ali, Alaa M G" uniqKey="Ali A" first="Alaa M. G." last="Ali">Alaa M. G. Ali</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Department of Public Health and Primary Care, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A8">Department of Biostatistics and Cancer Epidemiology, South Egypt Cancer Institute, Assiut, Egypt</nlm:aff>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Department of Biostatistics and Cancer Epidemiology, South Egypt Cancer Institute, Assiut</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Schmidt, Marjanka K" sort="Schmidt, Marjanka K" uniqKey="Schmidt M" first="Marjanka K." last="Schmidt">Marjanka K. Schmidt</name>
<affiliation wicri:level="3"><nlm:aff id="A9">Divisions of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam</nlm:aff>
<country>Pays-Bas</country>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
<wicri:orgArea>Divisions of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital</wicri:orgArea>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="A10">Divisions of Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwen-hoek Hospital, Amsterdam</nlm:aff>
<country>Pays-Bas</country>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
<wicri:orgArea>Divisions of Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwen-hoek Hospital</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Bolla, Manjeet K" sort="Bolla, Manjeet K" uniqKey="Bolla M" first="Manjeet K." last="Bolla">Manjeet K. Bolla</name>
<affiliation wicri:level="4"><nlm:aff id="A2">Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
</author>
<author><name sortKey="Wang, Qin" sort="Wang, Qin" uniqKey="Wang Q" first="Qin" last="Wang">Qin Wang</name>
<affiliation wicri:level="4"><nlm:aff id="A2">Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
</author>
<author><name sortKey="Gago Dominguez, M" sort="Gago Dominguez, M" uniqKey="Gago Dominguez M" first="M." last="Gago-Dominguez">M. Gago-Dominguez</name>
<affiliation><nlm:aff id="A15">Genomic Medicine Group, Galician Foundation of Genomic Medicine, Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saude (SERGAS), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela</nlm:aff>
<wicri:noCountry code="subfield">Santiago de Compostela</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Castelao, J Esteban" sort="Castelao, J Esteban" uniqKey="Castelao J" first="J. Esteban" last="Castelao">J. Esteban Castelao</name>
<affiliation><nlm:aff id="A16">Oncology and Genetics Unit, University Hospital of Vigo, Galicia Health Service (SERGAS)</nlm:aff>
<wicri:noCountry code="subfield">Galicia Health Service (SERGAS)</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Carracedo, Angel" sort="Carracedo, Angel" uniqKey="Carracedo A" first="Angel" last="Carracedo">Angel Carracedo</name>
<affiliation><nlm:aff id="A15">Genomic Medicine Group, Galician Foundation of Genomic Medicine, Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saude (SERGAS), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela</nlm:aff>
<wicri:noCountry code="subfield">Santiago de Compostela</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A24">King Abdulaziz University, Jeddah, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>King Abdulaziz University, Jeddah</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Garz N, Victor Mu Oz" sort="Garz N, Victor Mu Oz" uniqKey="Garz N V" first="Victor Mu Oz" last="Garz N">Victor Mu Oz Garz N</name>
<affiliation><nlm:aff id="A17">Radiotherapy Department, University Hospital of Vigo, Vigo</nlm:aff>
<wicri:noCountry code="subfield">Vigo</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Bojesen, Stig E" sort="Bojesen, Stig E" uniqKey="Bojesen S" first="Stig E." last="Bojesen">Stig E. Bojesen</name>
<affiliation><nlm:aff id="A25">Copenhagen General Population Study</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A26">Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen</nlm:aff>
<wicri:noCountry code="subfield">University of Copenhagen</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Nordestgaard, B Rge G" sort="Nordestgaard, B Rge G" uniqKey="Nordestgaard B" first="B Rge G." last="Nordestgaard">B Rge G. Nordestgaard</name>
<affiliation><nlm:aff id="A25">Copenhagen General Population Study</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A26">Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen</nlm:aff>
<wicri:noCountry code="subfield">University of Copenhagen</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Flyger, Henrik" sort="Flyger, Henrik" uniqKey="Flyger H" first="Henrik" last="Flyger">Henrik Flyger</name>
<affiliation><nlm:aff id="A27">Department of Breast Surgery, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen</nlm:aff>
<wicri:noCountry code="subfield">University of Copenhagen</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Chang Claude, Jenny" sort="Chang Claude, Jenny" uniqKey="Chang Claude J" first="Jenny" last="Chang-Claude">Jenny Chang-Claude</name>
<affiliation wicri:level="1"><nlm:aff id="A30">Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Vrieling, Alina" sort="Vrieling, Alina" uniqKey="Vrieling A" first="Alina" last="Vrieling">Alina Vrieling</name>
<affiliation wicri:level="3"><nlm:aff id="A11">Department for Health Evidence, Radboud University Medical Centre, Nijmegen</nlm:aff>
<country>Pays-Bas</country>
<placeName><settlement type="city">Nimègue</settlement>
<region type="province" nuts="2">Gueldre</region>
</placeName>
<wicri:orgArea>Department for Health Evidence, Radboud University Medical Centre</wicri:orgArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A30">Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Rudolph, Anja" sort="Rudolph, Anja" uniqKey="Rudolph A" first="Anja" last="Rudolph">Anja Rudolph</name>
<affiliation wicri:level="1"><nlm:aff id="A30">Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Seibold, Petra" sort="Seibold, Petra" uniqKey="Seibold P" first="Petra" last="Seibold">Petra Seibold</name>
<affiliation wicri:level="1"><nlm:aff id="A30">Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Nevanlinna, Heli" sort="Nevanlinna, Heli" uniqKey="Nevanlinna H" first="Heli" last="Nevanlinna">Heli Nevanlinna</name>
<affiliation><nlm:aff id="A31">Department of Obstetricts and Gynecology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
<wicri:noCountry code="subfield">University of Helsinki and Helsinki University Central Hospital</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Muranen, Taru A" sort="Muranen, Taru A" uniqKey="Muranen T" first="Taru A." last="Muranen">Taru A. Muranen</name>
<affiliation><nlm:aff id="A31">Department of Obstetricts and Gynecology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
<wicri:noCountry code="subfield">University of Helsinki and Helsinki University Central Hospital</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Aaltonen, Kirsimari" sort="Aaltonen, Kirsimari" uniqKey="Aaltonen K" first="Kirsimari" last="Aaltonen">Kirsimari Aaltonen</name>
<affiliation><nlm:aff id="A32">Department of Obstetricts and Gynecology and Oncology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
<wicri:noCountry code="subfield">University of Helsinki and Helsinki University Central Hospital</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A33">Department of Oncology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
<wicri:noCountry code="subfield">University of Helsinki and Helsinki University Central Hospital</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Blomqvist, Carl" sort="Blomqvist, Carl" uniqKey="Blomqvist C" first="Carl" last="Blomqvist">Carl Blomqvist</name>
<affiliation><nlm:aff id="A33">Department of Oncology, University of Helsinki and Helsinki University Central Hospital</nlm:aff>
<wicri:noCountry code="subfield">University of Helsinki and Helsinki University Central Hospital</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Matsuo, Keitaro" sort="Matsuo, Keitaro" uniqKey="Matsuo K" first="Keitaro" last="Matsuo">Keitaro Matsuo</name>
<affiliation wicri:level="1"><nlm:aff id="A35">Division of Epidemiology and Prevention, Aichi Cancer Center Central Hospital, Nagoya, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Division of Epidemiology and Prevention, Aichi Cancer Center Central Hospital, Nagoya</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Ito, Hidemi" sort="Ito, Hidemi" uniqKey="Ito H" first="Hidemi" last="Ito">Hidemi Ito</name>
<affiliation wicri:level="1"><nlm:aff id="A35">Division of Epidemiology and Prevention, Aichi Cancer Center Central Hospital, Nagoya, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Division of Epidemiology and Prevention, Aichi Cancer Center Central Hospital, Nagoya</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Iwata, Hiroji" sort="Iwata, Hiroji" uniqKey="Iwata H" first="Hiroji" last="Iwata">Hiroji Iwata</name>
<affiliation wicri:level="1"><nlm:aff id="A36">Department of Breast Oncology, Aichi Cancer Center Central Hospital, Nagoya, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Breast Oncology, Aichi Cancer Center Central Hospital, Nagoya</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Horio, Akiyo" sort="Horio, Akiyo" uniqKey="Horio A" first="Akiyo" last="Horio">Akiyo Horio</name>
<affiliation wicri:level="1"><nlm:aff id="A36">Department of Breast Oncology, Aichi Cancer Center Central Hospital, Nagoya, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Breast Oncology, Aichi Cancer Center Central Hospital, Nagoya</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="John, Esther M" sort="John, Esther M" uniqKey="John E" first="Esther M." last="John">Esther M. John</name>
<affiliation><nlm:aff id="A37">Cancer Prevention Institute of California, Fremont</nlm:aff>
<wicri:noCountry code="subfield">Fremont</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Sherman, Mark" sort="Sherman, Mark" uniqKey="Sherman M" first="Mark" last="Sherman">Mark Sherman</name>
<affiliation><nlm:aff id="A39">Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda</nlm:aff>
<wicri:noCountry code="subfield">Bethesda</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Lissowska, Jolanta" sort="Lissowska, Jolanta" uniqKey="Lissowska J" first="Jolanta" last="Lissowska">Jolanta Lissowska</name>
<affiliation wicri:level="1"><nlm:aff id="A41">The M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>The M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Figueroa, Jonine" sort="Figueroa, Jonine" uniqKey="Figueroa J" first="Jonine" last="Figueroa">Jonine Figueroa</name>
<affiliation wicri:level="2"><nlm:aff id="A40">Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
</placeName>
<wicri:cityArea>Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Garcia Closas, Montserrat" sort="Garcia Closas, Montserrat" uniqKey="Garcia Closas M" first="Montserrat" last="Garcia-Closas">Montserrat Garcia-Closas</name>
<affiliation wicri:level="3"><nlm:aff id="A5">Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton and Break through Breast Cancer Research Centre, Institute of Cancer Research, London</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
<wicri:orgArea>Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton and Break through Breast Cancer Research Centre, Institute of Cancer Research</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Anton Culver, Hoda" sort="Anton Culver, Hoda" uniqKey="Anton Culver H" first="Hoda" last="Anton-Culver">Hoda Anton-Culver</name>
<affiliation wicri:level="2"><nlm:aff id="A38">Department of Epidemiology, University of California-Irvine, Irvine, California</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Epidemiology, University of California-Irvine, Irvine</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Shah, Mitul" sort="Shah, Mitul" uniqKey="Shah M" first="Mitul" last="Shah">Mitul Shah</name>
<affiliation wicri:level="4"><nlm:aff id="A3">Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
</author>
<author><name sortKey="Hopper, John L" sort="Hopper, John L" uniqKey="Hopper J" first="John L." last="Hopper">John L. Hopper</name>
<affiliation wicri:level="1"><nlm:aff id="A42">Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Trichopoulou, Antonia" sort="Trichopoulou, Antonia" uniqKey="Trichopoulou A" first="Antonia" last="Trichopoulou">Antonia Trichopoulou</name>
<affiliation><nlm:aff id="A43">Hellenic Health Foundation</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A44">WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology, and Medical Statistics, University of Athens Medical School, Athens, Greece</nlm:aff>
<country xml:lang="fr">Grèce</country>
<wicri:regionArea>WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology, and Medical Statistics, University of Athens Medical School, Athens</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Bueno De Mesquita, Bas" sort="Bueno De Mesquita, Bas" uniqKey="Bueno De Mesquita B" first="Bas" last="Bueno-De-Mesquita">Bas Bueno-De-Mesquita</name>
<affiliation wicri:level="3"><nlm:aff id="A6">School of Public Health, Imperial College London, London</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
<wicri:orgArea>School of Public Health, Imperial College London</wicri:orgArea>
</affiliation>
<affiliation><nlm:aff id="A12">National Institute for Public Health and the Environment, Bilthoven</nlm:aff>
<wicri:noCountry code="subfield">Bilthoven</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A13">Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A54">Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia</nlm:aff>
<country xml:lang="fr">Malaisie</country>
<wicri:regionArea>Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Krogh, Vittorio" sort="Krogh, Vittorio" uniqKey="Krogh V" first="Vittorio" last="Krogh">Vittorio Krogh</name>
<affiliation wicri:level="1"><nlm:aff id="A45">Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionaledei Tumori, Milan, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionaledei Tumori, Milan</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Weiderpass, Elisabete" sort="Weiderpass, Elisabete" uniqKey="Weiderpass E" first="Elisabete" last="Weiderpass">Elisabete Weiderpass</name>
<affiliation wicri:level="1"><nlm:aff id="A34">Samfundet Folkhälsan, Helsinki, Finland</nlm:aff>
<country xml:lang="fr">Finlande</country>
<wicri:regionArea>Samfundet Folkhälsan, Helsinki</wicri:regionArea>
</affiliation>
<affiliation><nlm:aff id="A46">Department of Community Medicine, University of Tromsø, The Artic University of Norway, Tromsø</nlm:aff>
<wicri:noCountry code="subfield">Tromsø</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A47">Department of Research, Cancer Registry of Norway, Oslo, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Department of Research, Cancer Registry of Norway, Oslo</wicri:regionArea>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="A48">Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm</nlm:aff>
<country>Suède</country>
<placeName><settlement type="city">Stockholm</settlement>
<region nuts="2">Svealand</region>
</placeName>
<wicri:orgArea>Department of Medical Epidemiology and Biostatistics, Karolinska Institutet</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Andersson, Anne" sort="Andersson, Anne" uniqKey="Andersson A" first="Anne" last="Andersson">Anne Andersson</name>
<affiliation><nlm:aff id="A49">Department of Radiation Sciences, Oncology, University of Umeå, Umeå</nlm:aff>
<wicri:noCountry code="subfield">Umeå</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Clavel Chapelon, Francoise" sort="Clavel Chapelon, Francoise" uniqKey="Clavel Chapelon F" first="Françoise" last="Clavel-Chapelon">Françoise Clavel-Chapelon</name>
<affiliation><nlm:aff id="A51">Inserm, Centre for Research in Epidemiology and Population Health</nlm:aff>
<wicri:noCountry code="subfield">Centre for Research in Epidemiology and Population Health</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A52">Univ Paris Sud, UMRS</nlm:aff>
<wicri:noCountry code="subfield">UMRS</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A53">Institut Gustave-Roussy, Villejuif, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Gustave-Roussy, Villejuif</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Dossus, Laure" sort="Dossus, Laure" uniqKey="Dossus L" first="Laure" last="Dossus">Laure Dossus</name>
<affiliation><nlm:aff id="A51">Inserm, Centre for Research in Epidemiology and Population Health</nlm:aff>
<wicri:noCountry code="subfield">Centre for Research in Epidemiology and Population Health</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A52">Univ Paris Sud, UMRS</nlm:aff>
<wicri:noCountry code="subfield">UMRS</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A53">Institut Gustave-Roussy, Villejuif, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Gustave-Roussy, Villejuif</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Fagherazzi, Guy" sort="Fagherazzi, Guy" uniqKey="Fagherazzi G" first="Guy" last="Fagherazzi">Guy Fagherazzi</name>
<affiliation><nlm:aff id="A51">Inserm, Centre for Research in Epidemiology and Population Health</nlm:aff>
<wicri:noCountry code="subfield">Centre for Research in Epidemiology and Population Health</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A52">Univ Paris Sud, UMRS</nlm:aff>
<wicri:noCountry code="subfield">UMRS</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A53">Institut Gustave-Roussy, Villejuif, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Gustave-Roussy, Villejuif</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Peeters, Petra H" sort="Peeters, Petra H" uniqKey="Peeters P" first="Petra H." last="Peeters">Petra H. Peeters</name>
<affiliation wicri:level="1"><nlm:aff id="A14">Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Pays-Bas</country>
<wicri:regionArea>Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Olsen, Anja" sort="Olsen, Anja" uniqKey="Olsen A" first="Anja" last="Olsen">Anja Olsen</name>
<affiliation wicri:level="3"><nlm:aff id="A28">Danish Cancer Society Research Center, Copenhagen</nlm:aff>
<country>Danemark</country>
<placeName><settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
</placeName>
<wicri:orgArea>Danish Cancer Society Research Center</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Wishart, Gordon C" sort="Wishart, Gordon C" uniqKey="Wishart G" first="Gordon C." last="Wishart">Gordon C. Wishart</name>
<affiliation><nlm:aff id="A4">Faculty of Health, Social Care & Education, Anglia Ruskin University, Cambridge</nlm:aff>
<wicri:noCountry code="subfield">Cambridge</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Easton, Douglas F" sort="Easton, Douglas F" uniqKey="Easton D" first="Douglas F." last="Easton">Douglas F. Easton</name>
<affiliation wicri:level="4"><nlm:aff id="A2">Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="A3">Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
</author>
<author><name sortKey="Borgquist, Signe" sort="Borgquist, Signe" uniqKey="Borgquist S" first="Signe" last="Borgquist">Signe Borgquist</name>
<affiliation wicri:level="1"><nlm:aff id="A50">Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>Division of Oncology, Department of Clinical Sciences, Lund University, Lund</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Overvad, Kim" sort="Overvad, Kim" uniqKey="Overvad K" first="Kim" last="Overvad">Kim Overvad</name>
<affiliation wicri:level="1"><nlm:aff id="A29">Department of Public Health, Aarhus University, Aarhus, Denmark</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Department of Public Health, Aarhus University, Aarhus</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Barricarte, Aurelio" sort="Barricarte, Aurelio" uniqKey="Barricarte A" first="Aurelio" last="Barricarte">Aurelio Barricarte</name>
<affiliation><nlm:aff id="A18">Navarre Public Health Institute, Pamplona</nlm:aff>
<wicri:noCountry code="subfield">Pamplona</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A19">Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP)</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gonzalez, Carlos A" sort="Gonzalez, Carlos A" uniqKey="Gonzalez C" first="Carlos A." last="González">Carlos A. González</name>
<affiliation wicri:level="3"><nlm:aff id="A20">Chief Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Barcelona</nlm:aff>
<country>Espagne</country>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
<wicri:orgArea>Chief Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO)</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Sanchez, Maria Jose" sort="Sanchez, Maria Jose" uniqKey="Sanchez M" first="María-José" last="Sánchez">María-José Sánchez</name>
<affiliation><nlm:aff id="A21">Andalusian School of Public Health, Granada</nlm:aff>
<wicri:noCountry code="subfield">Granada</wicri:noCountry>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="A22">CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid</nlm:aff>
<country>Espagne</country>
<placeName><settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
<wicri:orgArea>CIBER de Epidemiología y Salud Pública (CIBERESP)</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Amiano, Pilar" sort="Amiano, Pilar" uniqKey="Amiano P" first="Pilar" last="Amiano">Pilar Amiano</name>
<affiliation wicri:level="1"><nlm:aff id="A23">Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Riboli, Elio" sort="Riboli, Elio" uniqKey="Riboli E" first="Elio" last="Riboli">Elio Riboli</name>
<affiliation wicri:level="3"><nlm:aff id="A6">School of Public Health, Imperial College London, London</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
<wicri:orgArea>School of Public Health, Imperial College London</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Key, Tim" sort="Key, Tim" uniqKey="Key T" first="Tim" last="Key">Tim Key</name>
<affiliation wicri:level="1"><nlm:aff id="A7">Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Pharoah, Paul D" sort="Pharoah, Paul D" uniqKey="Pharoah P" first="Paul D." last="Pharoah">Paul D. Pharoah</name>
<affiliation wicri:level="4"><nlm:aff id="A2">Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="A3">Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge</nlm:aff>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Cambridge</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Angleterre de l'Est</region>
</placeName>
<orgName type="university">Université de Cambridge</orgName>
</affiliation>
</author>
</analytic>
<series><title level="j">Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology</title>
<idno type="ISSN">1055-9965</idno>
<idno type="eISSN">1538-7755</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Evidence for an association of alcohol consumption with prognosis after a diagnosis of breast cancer has been inconsistent. We have reviewed and summarized the published evidence and evaluated the association using individual patient data from multiple case cohorts.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">A MEDLINE search to identify studies published up to January 2013 was performed. We combined published estimates of survival time for “moderate drinkers” versus nondrinkers. An analysis of individual participant data using Cox regression was carried out using data from 11 case cohorts.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">We identified 11 published studies suitable for inclusion in the meta-analysis. Moderate post-diagnosis alcohol consumption was not associated with overall survival [HR, 0.95; 95% confidence interval (CI), 0.85–1.05], but there was some evidence of better survival associated with prediagnosis 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 11 case cohorts, all of which had data on estrogen receptor (ER) status. For women with ER-positive disease, there was little evidence that pre- or postdiagnosis alcohol consumption is associated with breast cancer–specific mortality, with some evidence of a negative association with all-cause mortality. On the basis of a single study, moderate postdiagnosis alcohol intake was associated with a small reduction in breast cancer–specific mortality for women with ER-negative disease. There was no association with prediagnosis intake for women with ER-negative disease.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">There was little evidence that pre- or post-diagnosis alcohol consumption is associated with breast cancer–specific mortality for women with ER-positive disease. There was weak evidence that moderate post-diagnosis alcohol intake is associated with a small reduction in breast cancer–specific mortality in ER-negative disease.</p>
</sec>
<sec id="S5"><title>Impact</title>
<p id="P5">Considering the totality of the evidence, moderate postdiagnosis alcohol consumption is unlikely to have a major adverse effect on the survival of women with breast cancer.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9200608</journal-id>
<journal-id journal-id-type="pubmed-jr-id">2299</journal-id>
<journal-id journal-id-type="nlm-ta">Cancer Epidemiol Biomarkers Prev</journal-id>
<journal-id journal-id-type="iso-abbrev">Cancer Epidemiol. Biomarkers Prev.</journal-id>
<journal-title-group><journal-title>Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology</journal-title>
</journal-title-group>
<issn pub-type="ppub">1055-9965</issn>
<issn pub-type="epub">1538-7755</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24636975</article-id>
<article-id pub-id-type="pmc">4542077</article-id>
<article-id pub-id-type="doi">10.1158/1055-9965.EPI-13-0901</article-id>
<article-id pub-id-type="manuscript">NIHMS714698</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Alcohol Consumption and Survival after a Breast Cancer Diagnosis: A Literature-Based Meta-analysis and Collaborative Analysis of Data for 29,239 Cases</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Ali</surname>
<given-names>Alaa M.G.</given-names>
</name>
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</contrib>
<contrib contrib-type="author"><name><surname>Schmidt</surname>
<given-names>Marjanka K.</given-names>
</name>
<xref ref-type="aff" rid="A9">9</xref>
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</contrib>
<contrib contrib-type="author"><name><surname>Bolla</surname>
<given-names>Manjeet K.</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wang</surname>
<given-names>Qin</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gago-Dominguez</surname>
<given-names>M.</given-names>
</name>
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</contrib>
<contrib contrib-type="author"><name><surname>Castelao</surname>
<given-names>J. Esteban</given-names>
</name>
<xref ref-type="aff" rid="A16">16</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Carracedo</surname>
<given-names>Angel</given-names>
</name>
<xref ref-type="aff" rid="A15">15</xref>
<xref ref-type="aff" rid="A24">24</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Garzón</surname>
<given-names>Victor Muñoz</given-names>
</name>
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</contrib>
<contrib contrib-type="author"><name><surname>Bojesen</surname>
<given-names>Stig E.</given-names>
</name>
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<contrib contrib-type="author"><name><surname>Nordestgaard</surname>
<given-names>Børge G.</given-names>
</name>
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</contrib>
<contrib contrib-type="author"><name><surname>Flyger</surname>
<given-names>Henrik</given-names>
</name>
<xref ref-type="aff" rid="A27">27</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chang-Claude</surname>
<given-names>Jenny</given-names>
</name>
<xref ref-type="aff" rid="A30">30</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Vrieling</surname>
<given-names>Alina</given-names>
</name>
<xref ref-type="aff" rid="A11">11</xref>
<xref ref-type="aff" rid="A30">30</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rudolph</surname>
<given-names>Anja</given-names>
</name>
<xref ref-type="aff" rid="A30">30</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Seibold</surname>
<given-names>Petra</given-names>
</name>
<xref ref-type="aff" rid="A30">30</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nevanlinna</surname>
<given-names>Heli</given-names>
</name>
<xref ref-type="aff" rid="A31">31</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Muranen</surname>
<given-names>Taru A.</given-names>
</name>
<xref ref-type="aff" rid="A31">31</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Aaltonen</surname>
<given-names>Kirsimari</given-names>
</name>
<xref ref-type="aff" rid="A32">32</xref>
<xref ref-type="aff" rid="A33">33</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Blomqvist</surname>
<given-names>Carl</given-names>
</name>
<xref ref-type="aff" rid="A33">33</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Matsuo</surname>
<given-names>Keitaro</given-names>
</name>
<xref ref-type="aff" rid="A35">35</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ito</surname>
<given-names>Hidemi</given-names>
</name>
<xref ref-type="aff" rid="A35">35</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Iwata</surname>
<given-names>Hiroji</given-names>
</name>
<xref ref-type="aff" rid="A36">36</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Horio</surname>
<given-names>Akiyo</given-names>
</name>
<xref ref-type="aff" rid="A36">36</xref>
</contrib>
<contrib contrib-type="author"><name><surname>John</surname>
<given-names>Esther M.</given-names>
</name>
<xref ref-type="aff" rid="A37">37</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sherman</surname>
<given-names>Mark</given-names>
</name>
<xref ref-type="aff" rid="A39">39</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lissowska</surname>
<given-names>Jolanta</given-names>
</name>
<xref ref-type="aff" rid="A41">41</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Figueroa</surname>
<given-names>Jonine</given-names>
</name>
<xref ref-type="aff" rid="A40">40</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Garcia-Closas</surname>
<given-names>Montserrat</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Anton-Culver</surname>
<given-names>Hoda</given-names>
</name>
<xref ref-type="aff" rid="A38">38</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Shah</surname>
<given-names>Mitul</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hopper</surname>
<given-names>John L.</given-names>
</name>
<xref ref-type="aff" rid="A42">42</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Trichopoulou</surname>
<given-names>Antonia</given-names>
</name>
<xref ref-type="aff" rid="A43">43</xref>
<xref ref-type="aff" rid="A44">44</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bueno-de-Mesquita</surname>
<given-names>Bas</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
<xref ref-type="aff" rid="A12">12</xref>
<xref ref-type="aff" rid="A13">13</xref>
<xref ref-type="aff" rid="A54">54</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Krogh</surname>
<given-names>Vittorio</given-names>
</name>
<xref ref-type="aff" rid="A45">45</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Weiderpass</surname>
<given-names>Elisabete</given-names>
</name>
<xref ref-type="aff" rid="A34">34</xref>
<xref ref-type="aff" rid="A46">46</xref>
<xref ref-type="aff" rid="A47">47</xref>
<xref ref-type="aff" rid="A48">48</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Andersson</surname>
<given-names>Anne</given-names>
</name>
<xref ref-type="aff" rid="A49">49</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Clavel-Chapelon</surname>
<given-names>Françoise</given-names>
</name>
<xref ref-type="aff" rid="A51">51</xref>
<xref ref-type="aff" rid="A52">52</xref>
<xref ref-type="aff" rid="A53">53</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dossus</surname>
<given-names>Laure</given-names>
</name>
<xref ref-type="aff" rid="A51">51</xref>
<xref ref-type="aff" rid="A52">52</xref>
<xref ref-type="aff" rid="A53">53</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fagherazzi</surname>
<given-names>Guy</given-names>
</name>
<xref ref-type="aff" rid="A51">51</xref>
<xref ref-type="aff" rid="A52">52</xref>
<xref ref-type="aff" rid="A53">53</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Peeters</surname>
<given-names>Petra H.</given-names>
</name>
<xref ref-type="aff" rid="A14">14</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Olsen</surname>
<given-names>Anja</given-names>
</name>
<xref ref-type="aff" rid="A28">28</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wishart</surname>
<given-names>Gordon C.</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Easton</surname>
<given-names>Douglas F.</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Borgquist</surname>
<given-names>Signe</given-names>
</name>
<xref ref-type="aff" rid="A50">50</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Overvad</surname>
<given-names>Kim</given-names>
</name>
<xref ref-type="aff" rid="A29">29</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Barricarte</surname>
<given-names>Aurelio</given-names>
</name>
<xref ref-type="aff" rid="A18">18</xref>
<xref ref-type="aff" rid="A19">19</xref>
</contrib>
<contrib contrib-type="author"><name><surname>González</surname>
<given-names>Carlos A.</given-names>
</name>
<xref ref-type="aff" rid="A20">20</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sánchez</surname>
<given-names>María-José</given-names>
</name>
<xref ref-type="aff" rid="A21">21</xref>
<xref ref-type="aff" rid="A22">22</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Amiano</surname>
<given-names>Pilar</given-names>
</name>
<xref ref-type="aff" rid="A23">23</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Riboli</surname>
<given-names>Elio</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Key</surname>
<given-names>Tim</given-names>
</name>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pharoah</surname>
<given-names>Paul D.</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Public Health and Primary Care, University of Cambridge</aff>
<aff id="A2"><label>2</label>
Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge</aff>
<aff id="A3"><label>3</label>
Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge</aff>
<aff id="A4"><label>4</label>
Faculty of Health, Social Care & Education, Anglia Ruskin University, Cambridge</aff>
<aff id="A5"><label>5</label>
Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton and Break through Breast Cancer Research Centre, Institute of Cancer Research, London</aff>
<aff id="A6"><label>6</label>
School of Public Health, Imperial College London, London</aff>
<aff id="A7"><label>7</label>
Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom</aff>
<aff id="A8"><label>8</label>
Department of Biostatistics and Cancer Epidemiology, South Egypt Cancer Institute, Assiut, Egypt</aff>
<aff id="A9"><label>9</label>
Divisions of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam</aff>
<aff id="A10"><label>10</label>
Divisions of Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwen-hoek Hospital, Amsterdam</aff>
<aff id="A11"><label>11</label>
Department for Health Evidence, Radboud University Medical Centre, Nijmegen</aff>
<aff id="A12"><label>12</label>
National Institute for Public Health and the Environment, Bilthoven</aff>
<aff id="A13"><label>13</label>
Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands</aff>
<aff id="A14"><label>14</label>
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands</aff>
<aff id="A15"><label>15</label>
Genomic Medicine Group, Galician Foundation of Genomic Medicine, Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saude (SERGAS), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela</aff>
<aff id="A16"><label>16</label>
Oncology and Genetics Unit, University Hospital of Vigo, Galicia Health Service (SERGAS)</aff>
<aff id="A17"><label>17</label>
Radiotherapy Department, University Hospital of Vigo, Vigo</aff>
<aff id="A18"><label>18</label>
Navarre Public Health Institute, Pamplona</aff>
<aff id="A19"><label>19</label>
Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP)</aff>
<aff id="A20"><label>20</label>
Chief Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Barcelona</aff>
<aff id="A21"><label>21</label>
Andalusian School of Public Health, Granada</aff>
<aff id="A22"><label>22</label>
CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid</aff>
<aff id="A23"><label>23</label>
Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain</aff>
<aff id="A24"><label>24</label>
King Abdulaziz University, Jeddah, Saudi Arabia</aff>
<aff id="A25"><label>25</label>
Copenhagen General Population Study</aff>
<aff id="A26"><label>26</label>
Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen</aff>
<aff id="A27"><label>27</label>
Department of Breast Surgery, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen</aff>
<aff id="A28"><label>28</label>
Danish Cancer Society Research Center, Copenhagen</aff>
<aff id="A29"><label>29</label>
Department of Public Health, Aarhus University, Aarhus, Denmark</aff>
<aff id="A30"><label>30</label>
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany</aff>
<aff id="A31"><label>31</label>
Department of Obstetricts and Gynecology, University of Helsinki and Helsinki University Central Hospital</aff>
<aff id="A32"><label>32</label>
Department of Obstetricts and Gynecology and Oncology, University of Helsinki and Helsinki University Central Hospital</aff>
<aff id="A33"><label>33</label>
Department of Oncology, University of Helsinki and Helsinki University Central Hospital</aff>
<aff id="A34"><label>34</label>
Samfundet Folkhälsan, Helsinki, Finland</aff>
<aff id="A35"><label>35</label>
Division of Epidemiology and Prevention, Aichi Cancer Center Central Hospital, Nagoya, Japan</aff>
<aff id="A36"><label>36</label>
Department of Breast Oncology, Aichi Cancer Center Central Hospital, Nagoya, Japan</aff>
<aff id="A37"><label>37</label>
Cancer Prevention Institute of California, Fremont</aff>
<aff id="A38"><label>38</label>
Department of Epidemiology, University of California-Irvine, Irvine, California</aff>
<aff id="A39"><label>39</label>
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda</aff>
<aff id="A40"><label>40</label>
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland</aff>
<aff id="A41"><label>41</label>
The M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland</aff>
<aff id="A42"><label>42</label>
Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia</aff>
<aff id="A43"><label>43</label>
Hellenic Health Foundation</aff>
<aff id="A44"><label>44</label>
WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology, and Medical Statistics, University of Athens Medical School, Athens, Greece</aff>
<aff id="A45"><label>45</label>
Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionaledei Tumori, Milan, Italy</aff>
<aff id="A46"><label>46</label>
Department of Community Medicine, University of Tromsø, The Artic University of Norway, Tromsø</aff>
<aff id="A47"><label>47</label>
Department of Research, Cancer Registry of Norway, Oslo, Norway</aff>
<aff id="A48"><label>48</label>
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm</aff>
<aff id="A49"><label>49</label>
Department of Radiation Sciences, Oncology, University of Umeå, Umeå</aff>
<aff id="A50"><label>50</label>
Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden</aff>
<aff id="A51"><label>51</label>
Inserm, Centre for Research in Epidemiology and Population Health</aff>
<aff id="A52"><label>52</label>
Univ Paris Sud, UMRS</aff>
<aff id="A53"><label>53</label>
Institut Gustave-Roussy, Villejuif, France</aff>
<aff id="A54"><label>54</label>
Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia</aff>
<author-notes><corresp id="FN1"><bold>Corresponding Author:</bold>
Alaa M.G. Ali, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge CB18RN, United Kingdom. Phone: 447853871399; Fax: 00441223740147; <email>dr_alaa382@yahoo.com</email>
or <email>amg64@medschl.cam.ac.uk</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>11</day>
<month>8</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>17</day>
<month>3</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub"><month>6</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>19</day>
<month>8</month>
<year>2015</year>
</pub-date>
<volume>23</volume>
<issue>6</issue>
<fpage>934</fpage>
<lpage>945</lpage>
<pmc-comment>elocation-id from pubmed: 10.1158/1055-9965.EPI-13-0901</pmc-comment>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Evidence for an association of alcohol consumption with prognosis after a diagnosis of breast cancer has been inconsistent. We have reviewed and summarized the published evidence and evaluated the association using individual patient data from multiple case cohorts.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">A MEDLINE search to identify studies published up to January 2013 was performed. We combined published estimates of survival time for “moderate drinkers” versus nondrinkers. An analysis of individual participant data using Cox regression was carried out using data from 11 case cohorts.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">We identified 11 published studies suitable for inclusion in the meta-analysis. Moderate post-diagnosis alcohol consumption was not associated with overall survival [HR, 0.95; 95% confidence interval (CI), 0.85–1.05], but there was some evidence of better survival associated with prediagnosis 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 11 case cohorts, all of which had data on estrogen receptor (ER) status. For women with ER-positive disease, there was little evidence that pre- or postdiagnosis alcohol consumption is associated with breast cancer–specific mortality, with some evidence of a negative association with all-cause mortality. On the basis of a single study, moderate postdiagnosis alcohol intake was associated with a small reduction in breast cancer–specific mortality for women with ER-negative disease. There was no association with prediagnosis intake for women with ER-negative disease.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">There was little evidence that pre- or post-diagnosis alcohol consumption is associated with breast cancer–specific mortality for women with ER-positive disease. There was weak evidence that moderate post-diagnosis alcohol intake is associated with a small reduction in breast cancer–specific mortality in ER-negative disease.</p>
</sec>
<sec id="S5"><title>Impact</title>
<p id="P5">Considering the totality of the evidence, moderate postdiagnosis alcohol consumption is unlikely to have a major adverse effect on the survival of women with breast cancer.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
</record>
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