TABLE 4.
HRs of incident basal cell carcinoma according to cumulative averaged alcoholic beverage intake in the NHS (1984–2010), NHS II (1991–2011), and HPFS (1986–2010)1
| Beer |
Red wine |
White wine |
Liquor |
|||||||||
| Alcohol intake | Cases, n | Person-years, thousands | Multivariable-adjusted HR (95% CI) | Cases, n | Person-years, thousands | Multivariable-adjusted HR (95% CI) | Cases, n | Person-years, thousands | Multivariable-adjusted HR (95% CI) | Cases, n | Person-years, thousands | Multivariable-adjusted HR (95% CI) |
| NHS | ||||||||||||
| None | 9246 | 1057 | 1.00 | 6797 | 812 | 1.00 | 4292 | 574 | 1.00 | 6393 | 793 | 1.00 |
| <2.5 g/d | 3362 | 340 | 0.98 (0.94, 1.02) | 5671 | 589 | 0.97 (0.93, 1.01) | 6282 | 667 | 1.13 (1.08, 1.19) | 4330 | 456 | 1.08 (1.03, 1.13) |
| 2.5–4.9 g/d | 465 | 46 | 0.95 (0.87, 1.05) | 757 | 72 | 0.99 (0.91, 1.07) | 1548 | 144 | 1.25 (1.17, 1.34) | 798 | 76 | 1.10 (1.02, 1.19) |
| 5.0–9.9 g/d | 351 | 41 | 0.93 (0.84, 1.04) | 285 | 28 | 0.92 (0.81, 1.04) | 863 | 75 | 1.23 (1.13, 1.33) | 935 | 84 | 1.20 (1.12, 1.29) |
| ≥10.0 g/d | 242 | 33 | 0.84 (0.74, 0.96) | 156 | 16 | 1.00 (0.85, 1.18) | 681 | 57 | 1.35 (1.24, 1.37) | 1210 | 108 | 1.20 (1.12, 1.28) |
| P-trend | — | — | 0.001 | — | — | 0.74 | — | — | <0.0001 | — | — | <0.0001 |
| NHS II | ||||||||||||
| None | 3100 | 867 | 1.00 | 4054 | 1078 | 1.00 | 2233 | 713 | 1.00 | 3519 | 1010 | 1.00 |
| <2.5 g/d | 1992 | 414 | 1.06 (0.99, 1.12) | 1601 | 339 | 0.99 (0.93, 1.06) | 2921 | 624 | 1.09 (1.02, 1.16) | 2063 | 398 | 1.10 (1.04, 1.17) |
| 2.5–4.9 g/d | 475 | 92 | 1.10 (0.99, 1.21) | 240 | 47 | 0.91 (0.80, 1.05) | 514 | 93 | 1.20 (1.08, 1.34) | 252 | 34 | 1.43 (1.25, 1.64) |
| 5.0–9.9 g/d | 288 | 72 | 1.00 (0.88, 1.14) | 92 | 16 | 0.96 (0.77, 1.18) | 217 | 34 | 1.15 (0.99, 1.34) | 109 | 26 | 1.01 (0.83, 1.22) |
| ≥10.0 g/d | 158 | 39 | 1.13 (0.96, 1.33) | 26 | 5 | 0.88 (0.59, 1.29) | 128 | 21 | 1.18 (0.98, 1.42) | 70 | 15 | 1.07 (0.84, 1.36) |
| P-trend | — | — | 0.29 | — | — | 0.44 | — | — | 0.009 | — | — | 0.17 |
| HPFS | ||||||||||||
| None | 3058 | 262 | 1.00 | 3939 | 337 | 1.00 | 2982 | 262 | 1.00 | 3449 | 310 | 1.00 |
| <2.5 g/d | 3290 | 251 | 1.03 (0.97, 1.09) | 3904 | 300 | 0.97 (0.92, 1.03) | 4512 | 347 | 1.02 (0.96, 1.08) | 2708 | 215 | 1.06 (1.01, 1.13) |
| 2.5–4.9 g/d | 971 | 64 | 1.07 (0.99, 1.16) | 862 | 61 | 0.98 (0.90, 1.07) | 1078 | 80 | 1.03 (0.94, 1.11) | 667 | 46 | 1.05 (0.96, 1.14) |
| 5.0–9.9 g/d | 1091 | 86 | 1.07 (0.98, 1.16) | 374 | 24 | 1.01 (0.90, 1.13) | 433 | 29 | 1.07 (0.95, 1.19) | 1037 | 73 | 1.15 (1.06, 1.24) |
| ≥10.0 g/d | 862 | 73 | 1.06 (0.97, 1.15) | 193 | 14 | 1.00 (0.86, 1.17) | 267 | 18 | 1.10 (0.96, 1.25) | 1411 | 93 | 1.15 (1.07, 1.23) |
| P-trend | — | — | 0.38 | — | — | 0.94 | — | — | 0.08 | — | — | 0.002 |
| Meta-analysis, women in the NHS and NHS II | ||||||||||||
| None | 12,346 | 1924 | 1.00 | 10,851 | 1890 | 1.00 | 6525 | 1287 | 1.00 | 9912 | 1803 | 1.00 |
| <2.5 g/d | 5354 | 754 | 1.01 (0.94, 1.09) | 7272 | 928 | 0.97 (0.94, 1.01) | 9203 | 1291 | 1.12 (1.07, 1.16) | 6393 | 854 | 1.09 (1.05, 1.13) |
| 2.5–4.9 g/d | 940 | 138 | 1.02 (0.89, 1.17) | 997 | 119 | 0.97 (0.90, 1.04) | 2062 | 237 | 1.24 (1.17, 1.31) | 1050 | 110 | 1.25 (0.96, 1.61) |
| 5.0–9.9 g/d | 639 | 113 | 0.96 (0.89, 1.04) | 377 | 44 | 0.93 (0.83, 1.03) | 1080 | 109 | 1.21 (1.12, 1.30) | 1044 | 110 | 1.13 (0.95, 1.34) |
| ≥10.0 g/d | 400 | 72 | 0.97 (0.73, 1.29) | 182 | 21 | 0.98 (0.85, 1.14) | 809 | 78 | 1.30 (1.15, 1.46) | 1280 | 123 | 1.19 (1.12, 1.27) |
| P-trend | — | — | 0.67 | — | — | 0.51 | — | — | <0.0001 | — | — | <0.0001 |
| Meta-analysis, women and men in the NHS, NHS II, and HPFS | ||||||||||||
| None | 15,404 | 2186 | 1.00 | 14,790 | 2227 | 1.00 | 9507 | 1549 | 1.00 | 13361 | 2113 | 1.00 |
| <2.5 g/d | 8644 | 1005 | 1.01 (0.97, 1.06) | 11176 | 1228 | 0.97 (0.94, 1.00) | 13,715 | 1638 | 1.08 (1.01, 1.15) | 9101 | 1069 | 1.08 (1.05, 1.11) |
| 2.5–4.9 | 1911 | 202 | 1.04 (0.96, 1.13) | 1859 | 180 | 0.97 (0.92, 1.03) | 3140 | 317 | 1.16 (1.02, 1.31) | 1717 | 156 | 1.17 (1.00, 1.37) |
| 5.0–9.9 g/d | 1730 | 199 | 1.01 (0.92, 1.10) | 751 | 68 | 0.96 (0.89, 1.04) | 1513 | 138 | 1.15 (1.05, 1.26) | 2081 | 183 | 1.16 (1.08, 1.24) |
| ≥10.0 g/d | 1262 | 145 | 1.00 (0.85, 1.17) | 375 | 35 | 0.99 (0.89, 1.10) | 1076 | 96 | 1.22 (1.06, 1.40) | 2691 | 216 | 1.17 (1.12, 1.23) |
| P-trend | — | — | 0.71 | — | — | 0.67 | — | — | <0.0001 | — | — | <0.0001 |
| Per 10- g/d increase | — | — | 0.99 (0.92, 1.06) | — | — | 0.99 (0.94, 1.04) | — | — | 1.10 (1.06, 1.15) | — | — | 1.05 (1.03, 1.07) |
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), use of sunscreen in summer months (yes or no), and the other alcoholic beverages listed in the table (e.g., analyses for consumption of beer were adjusted for consumption of red wine, white wine and liquor, and vice versa). Results in different cohorts were pooled with the use of a random-effects model. HPFS, Health Professionals Follow-Up Study; NHS, Nurses’ Health Study.