TABLE 2.
HRs of incident basal cell carcinoma according to alcohol intake in the NHS (1984–2010), NHS II (1991–2011), and HPFS (1986–2010)1
| Simple updated (0–4-y lag) |
Cumulative average |
|||||||
| Alcohol intake | Cases, n | Person-years, thousands | Age-adjusted HR (95% CI) | Multivariable-adjusted HR (95% CI) | Cases,n | Person-years, thousands | Age-adjusted HR (95% CI) | Multivariable-adjusted HR (95% CI) |
| NHS | ||||||||
| None | 4995 | 607 | 1.00 | 1.00 | 2818 | 383 | 1.00 | 1.00 |
| 0.1–9.9 g/d | 5535 | 621 | 1.19 (1.15, 1.24) | 1.13 (1.09, 1.18) | 7573 | 831 | 1.23 (1.18, 1.28) | 1.16 (1.11, 1.21) |
| 10.0–19.9 | 2002 | 183 | 1.38 (1.31, 1.45) | 1.26 (1.19, 1.33) | 1983 | 183 | 1.46 (1.38, 1.55) | 1.31 (1.23, 1.39) |
| 20.0–29.9 g/d | 449 | 41 | 1.42 (1.29, 1.56) | 1.27 (1.15, 1.40) | 720 | 63 | 1.50 (1.38, 1.62) | 1.32 (1.22, 1.44) |
| ≥30.0 g/d | 685 | 65 | 1.32 (1.22, 1.43) | 1.22 (1.12, 1.32) | 572 | 56 | 1.39 (1.27, 1.52) | 1.27 (1.16, 1.39) |
| P-trend | — | — | <0.0001 | <0.0001 | — | — | <0.0001 | <0.0001 |
| NHS II | ||||||||
| None | 1948 | 596 | 1.00 | 1.00 | 1373 | 473 | 1.00 | 1.00 |
| 0.1–9.9 g/d | 2895 | 697 | 1.24 (1.17, 1.31) | 1.15 (1.08, 1.22) | 3826 | 864 | 1.27 (1.19, 1.35) | 1.17 (1.10, 1.25) |
| 10.0–19.9 g/d | 829 | 137 | 1.47 (1.35, 1.59) | 1.28 (1.17, 1.39) | 592 | 108 | 1.48 (1.34, 1.63) | 1.27 (1.14, 1.40) |
| 20.0–29.9 g/d | 145 | 26 | 1.34 (1.13, 1.58) | 1.14 (0.96, 1.35) | 148 | 25 | 1.49 (1.26, 1.77) | 1.28 (1.08, 1.52) |
| ≥30.0 g/d | 196 | 28 | 1.47 (1.27, 1.70) | 1.29 (1.11, 1.50) | 74 | 14 | 1.42 (1.12, 1.79) | 1.24 (0.98, 1.57) |
| P-trend | — | — | <0.0001 | <0.0001 | — | — | <0.0001 | <0.0001 |
| HPFS | ||||||||
| None | 2139 | 182 | 1.00 | 1.00 | 1501 | 139 | 1.00 | 1.00 |
| 0.1–9.9 g/d | 3302 | 280 | 1.05 (1.00, 1.11) | 1.02 (0.96, 1.07) | 3956 | 326 | 1.12 (1.06, 1.19) | 1.06 (0.99, 1.12) |
| 10.0–19.9 g/d | 2041 | 148 | 1.18 (1.11, 1.26) | 1.09 (1.03, 1.16) | 1980 | 144 | 1.26 (1.17, 1.34) | 1.15 (1.07, 1.23) |
| 20.0–29.9 g/d | 656 | 46 | 1.22 (1.12, 1.33) | 1.11 (1.02, 1.22) | 824 | 54 | 1.33 (1.22, 1.45) | 1.22 (1.11, 1.33) |
| ≥30.0 g/d | 1134 | 80 | 1.20 (1.12, 1.29) | 1.15 (1.07, 1.24) | 1011 | 73 | 1.23 (1.13, 1.33) | 1.18 (1.08, 1.28) |
| P-trend | — | — | <0.0001 | <0.0001 | — | — | <0.0001 | <0.0001 |
| Meta-analysis, women in the NHS and NHS II | ||||||||
| None | 6943 | 1203 | 1.00 | 1.00 | 4191 | 856 | 1.00 | 1.00 |
| 0.1–9.9 g/d | 8430 | 1318 | 1.21 (1.17, 1.25) | 1.14 (1.10, 1.18) | 11,399 | 1695 | 1.24 (1.20, 1.28) | 1.16 (1.12, 1.21) |
| 10.0–19.9 g/d | 2831 | 320 | 1.41 (1.33, 1.50) | 1.26 (1.21, 1.32) | 2575 | 291 | 1.47 (1.39, 1.54) | 1.30 (1.23, 1.37) |
| 20.0–29.9 g/d | 594 | 67 | 1.40 (1.29, 1.52) | 1.23 (1.12, 1.35) | 868 | 88 | 1.49 (1.39, 1.61) | 1.32 (1.22, 1.42) |
| ≥30.0 g/d | 881 | 93 | 1.37 (1.24, 1.51) | 1.23 (1.15, 1.33) | 646 | 70 | 1.39 (1.28, 1.51) | 1.27 (1.16, 1.38) |
| P-trend | — | — | <0.0001 | <0.0001 | — | — | <0.0001 | <0.0001 |
| Meta-analysis, women and men in the NHS, NHS II, and HPFS | ||||||||
| None | 9082 | 1385 | 1.00 | 1.00 | 5692 | 995 | 1.00 | 1.00 |
| 0.1–9.9 g/d | 11,732 | 1598 | 1.16 (1.06, 1.26) | 1.10 (1.02, 1.18) | 15,355 | 2021 | 1.20 (1.13, 1.29) | 1.13 (1.06, 1.20) |
| 10.0–19.9 g/d | 4872 | 468 | 1.34 (1.18, 1.51) | 1.20 (1.09, 1.33) | 4555 | 435 | 1.39 (1.25, 1.55) | 1.24 (1.14, 1.35) |
| 20.0–29.9 g/d | 1250 | 113 | 1.32 (1.19, 1.46) | 1.17 (1.07, 1.29) | 1692 | 142 | 1.43 (1.31, 1.55) | 1.27 (1.20, 1.35) |
| ≥30.0 g/d | 2015 | 173 | 1.31 (1.18, 1.44) | 1.19 (1.13, 1.26) | 1657 | 143 | 1.32 (1.19, 1.45) | 1.22 (1.15, 1.30) |
| P-trend | — | — | <0.0001 | <0.0001 | — | — | <0.0001 | <0.0001 |
| Per 10-g/d increase | — | — | 1.09 (1.04, 1.15) | 1.06 (1.03, 1.08) | — | — | 1.11 (1.04, 1.17) | 1.06 (1.03, 1.10) |
Multivariable analyses in Cox proportional hazards models were adjusted for age, BMI (in kg/m2; <18.5, 18.5–24.9, 25.0–29.9, 30.0–34.9, or ≥35.0), smoking status (never, past, or current with 1–14, 15–24, or ≥25 cigarettes/d), physical activity (quintiles), caffeine intake (quintiles), ethnicities (Southern European, Scandinavian, other Caucasian, nonwhite, or other ancestry), family history of melanoma (yes or no), natural hair color (red, blonde, light brown, dark brown, or black), number of moles on arms or legs (none, 1–2, 3–5, 6–9, or ≥10), skin reaction to sun exposure as a child/adolescent (none/some redness, burn, or painful burn/blisters), number of severe sunburns (none, 1–2, 3–4, 5–9, or ≥10), cumulative UV flux since baseline (quintiles), average time spent in direct sunlight in summer months (<2, 2–5, or ≥6 h/wk), and use of sunscreen in summer months (yes or no). Results in different cohorts were pooled with the use of a random-effects model. HPFS, Health Professionals Follow-Up Study; NHS, Nurses’ Health Study.