Reply to 'Alcohol consumption and risk of Hodgkin's lymphoma and multiple myeloma: a multicentre case-control study' by Gorini et al

Alcohol consumption and risk of multiple myeloma in the NIH-AARP Diet and Health Study

The epidemiologic evidence regarding the relationship between alcohol consumption and multiple myeloma (MM) risk remains limited and inconsistent, although recent studies suggest a potential protective effect. We prospectively investigated the risk of MM in relation to alcohol consumption frequency among 499,292 participants enrolled in the National Institutes of Health (NIH)-AARP Diet and Health Study in 1995-1996. A total of 1,312 MM cases were identified during follow-up through December 2011. Hazard ratios (HR) and 95% confidence intervals (CI) for categories of alcohol consumption relative to those defined as light drinkers (<1 drink/week) were estimated using multivariate Cox proportional hazard models. Overall, increasing frequency of alcohol consumption was inversely associated with MM (p-trend = 0.01), with a statistically significant association among those who consumed 2 drinks per day (HR = 0.70, 95% CI: 0.50, 0.98); similar but not statistically significant associations were observed for greater frequency of alcohol consumption. Among women, risk of MM was reduced among those who consumed less than one drink per day (HR = 0.73, 95% CI: 0.56, 0.97) and associations with greater frequency of alcohol consumption were inverse although not statistically significant. The findings of this large prospective investigation suggest that moderate alcohol consumption may be associated with reduced future risk of MM.

Alcohol consumption over time and risk of lymphoid malignancies in the California Teachers Study cohort

Several previous studies found inverse associations between alcohol consumption and risk of non-Hodgkin lymphoma (NHL) and multiple myeloma. However, most studies were retrospective, and few distinguished former drinkers or infrequent drinkers from consistent nondrinkers. Therefore, the authors investigated whether history of alcohol drinking affected risks of NHL and multiple myeloma among 102,721 eligible women in the California Teachers Study, a prospective cohort study in which 496 women were diagnosed with B-cell NHL and 101 were diagnosed with multiple myeloma between 1995-1996 and December 31, 2007. Incidence rate ratios and 95% confidence intervals were estimated using Cox proportional hazards regression. Risk of all types of B-cell NHL combined or multiple myeloma was not associated with self-reported past consumption of alcohol, beer, wine, or liquor at ages 18-22 years, at ages 30-35 years, or during the year before baseline. NHL subtypes were inconsistently associated with alcohol intake. However, women who were former alcohol drinkers at baseline were at elevated risk of overall B-cell NHL (rate ratio = 1.46, 95% confidence interval: 1.08, 1.97) and follicular lymphoma (rate ratio = 1.81, 95% confidence interval: 1.00, 3.28). The higher risk among former drinkers emphasizes the importance of classifying both current and past alcohol consumption and suggests that factors related to quitting drinking, rather than alcohol itself, may increase B-cell NHL risk.

Association of alcohol intake with the risk of malignant lymphoma and plasma cell myeloma in Japanese: a population-based cohort study (Japan Public Health Center-based Prospective Study)

Few studies have evaluated the association between alcohol intake and the risk of the lymphoid neoplasms malignant lymphoma (ML) and plasma cell myeloma (PCM) among Asian populations. We conducted a large-scale population-based cohort study of 95,520 Japanese subjects (45,453 men and 50,067 women; age 40-69 years at baseline) with an average 13 years of follow-up, during which a total of 257 cases of ML and 89 of PCM were identified. Hazard ratios and 95% confidence intervals were estimated using a Cox regression model adjusted for potential confounders. Alcohol intake of > or = 300 g/week was associated with a significantly lower risk of lymphoid neoplasms (hazard ratio, 0.60; 95% confidence interval, 0.37-0.98) than occasional drinking at a frequency of <1 day/month, and the trend for alcohol consumption was significant (P = 0.028). A similar trend was observed for the subcategories of ML, PCM, and non-Hodgkin lymphoma (NHL), albeit that the results were significant only for alcohol consumption at > or = 300 g/week in NHL patients, probably due to the small number of subjects in each category. In conclusion, we found that alcohol had an inverse association with the risk of lymphoid neoplasms, particularly the risk of NHL, among a Japanese population.