November is: American Diabetes Month, COPD Awareness Month, Diabetic Eye Disease Month, Foot Health Issues Related to Diabetes Awareness Month, Lung Cancer Awareness Month, National Family Caregivers Month, National Healthy Skin Month, National Hospice Palliative Care Month, National Stomach Cancer Awareness Month, and Prematurity Awareness Month. Other commemorations are: Nov. 6-12: Drowsy Driving Prevention Week, Nov. 14-20: Get Smart about Antibiotics Week, Nov. 17: Great American Smokeout, Nov. 17: Prematurity Awareness Day, Nov. 19: National Survivors of Suicide Day, and Nov. 20-26: Gastroesophageal Reflux Disease Awareness Week. While we cannot address all the topics listed, we will focus on some of them.Before we leave the topics of October, I would like to address a new study (published just a few days ago) related to low levels of alcohol consumption being associated with small increased risk of breast cancer.(1) The study went from 1980 to 2008 and included 105,986 women enrolled in the Nurses' Health Study. Consumption of three (3) to six (6) alcoholic drinks per week is associated with a small increase in the risk of breast cancer, and consumption in both earlier and later adult life is also associated with an increased risk. In many studies, higher consumption of alcohol has been associated with an increased risk of breast cancer. However, the effect of low levels of drinking as is common in the United States has not been well quantified, and in fact, disputed. One epidemiological, case-control study states that, despite extensive investigation of the association between alcohol consumption and breast cancer risk, the effect of low-to-moderate alcohol intake on breast cancer incidence has been inconsistent.(2) The conclusion of the Zhang study was that low-to-moderate alcohol intake was not associated with increased risk of breast cancer in pre- or postmenopausal Chinese women. The authors of the Chen study found that when examined separately, alcohol consumption levels at ages 18 to 40 years and after age 40 years were both stronglyassociated with breast cancer risk. The association with drinking in early adult life still persisted even after controlling for alcohol intake after age 40 years. Binge drinking, but not frequency of drinking, was also associated with breast cancer risk after controlling for cumulative alcohol intake. The authors add that although the exact mechanism for the association between alcohol consumption and breast cancer is not known. One probable explanation may involve alcohol's effects on circulating estrogen levels. Their results highlight the importance of considering lifetime exposure when evaluating the effect of alcohol, and probably other dietary factors, on the carcinogenesis process. However, an individual will need to weigh the modest risks of light to moderate alcohol use on breast cancer development against the beneficial effects on cardiovascular disease to make the best personal choice regarding alcohol consumption. However, there are no data to provide assurance that giving up alcohol will reduce breast cancer risk. Future studies are required to understand differences in effect of alcohol on breast cancers by tumor hormone receptor status. As well, the role of drinking patterns, such as frequency of drinking and ‘binge’ drinking, and consumption at different times of adult life are not well understood.
1. Chen WY. Low Levels of Alcohol Consumption Associated With Small Increased Risk of Breast Cancer. JAMA. 2011; 306 : 1884-1890.
2. Zhang M and Holman CDJ. Low-to-moderate alcohol intake and breast cancer risk in Chinese women. British Journal of Cancer 105, 1089-1095 (27 September 2011).
5. Boyd LD, Hartman-Cunningham ML. Survey of diabetes knowledge and practices of dental hygienists. J Dent Hyg. 2008 Fall; 82(5):43.