Risk of uterine leiomyomata in relation to tobacco, alcohol and caffeine consumption in the Black Women's Health Study

Lauren A Wise; Julie R Palmer; Bernard L Harlow; Donna Spiegelman; Elizabeth A Stewart; Lucile L Adams-Campbell; Lynn Rosenberg

doi:10.1093/humrep/deh309

Lifestyle and Environment · Substances

Risk of uterine leiomyomata in relation to tobacco, alcohol and caffeine consumption in the Black Women's Health Study

Wise LA, Palmer JR, Harlow BL, Spiegelman D, Stewart EA, Adams-Campbell LL, Rosenberg L

Published August 2004 Human reproduction (Oxford, England), 19(8), 1746-54

DOI 10.1093/humrep/deh309 PMID 15218005 PMC PMC1876785

RRM Academy Synopsis

Alcohol, especially beer, is linked to fibroid risk in Black women

Among 21,885 premenopausal Black women followed for four years, seven or more beers a week was associated with 1.57 times the fibroid rate of non-drinkers (95% CI 1.17–2.11). Cigarette smoking and caffeine showed no overall association with fibroids.

Key Findings

Among 21,885 premenopausal women followed from 1997 to 2001, 2177 developed fibroids confirmed by ultrasound (n = 1920) or hysterectomy (n = 257) over 73,426 person-years.
Versus non-drinkers, beer at under 1, 1–6 and 7+ drinks a week gave adjusted incidence rate ratios (IRRs) of 1.11 (95% CI 0.98–1.27), 1.18 (1.00–1.40) and 1.57 (1.17–2.11).
Versus women who had not drunk alcohol, current drinkers had an adjusted IRR of 1.13 (95% CI 1.01–1.25), and women with 20 or more years of drinking had 1.32 (95% CI 1.11–1.58).
Cigarette smoking showed little evidence of an association: adjusted IRRs were 0.88 (95% CI 0.77–1.01) for current and 0.95 (95% CI 0.84–1.08) for former smokers versus women who had not smoked.
Coffee and caffeine showed no overall association. Among women under 35, three or more cups of caffeinated coffee a day carried an IRR of 1.53 (95% CI 1.06–2.22) versus almost none.

Interpretation

The Black Women's Health Study is a prospective cohort. Women gave alcohol and caffeine information mainly on a 1995 questionnaire, then reported new fibroid diagnoses on questionnaires in 1999 and 2001. Enrollment ran mainly through subscribers of Essence magazine, so the findings describe US Black women. Diagnoses were self-reported as ultrasound or hysterectomy confirmed. In a random sample of cases, medical records for 123 women matched 118 reports (96%). The rate ratio rose with each higher beer category and showed no steady rise with wine or liquor. The authors call the associations modest and say the beer finding requires confirmation by future studies.

RRM Context

Restorative reproductive medicine treats a reproductive condition as a question about cause. The authors observe that few modifiable risk factors for fibroids have been identified. They also note that most earlier research enrolled white women. They report this cohort of Black women as the first to compare fibroid risk by type of alcoholic drink.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background

Tobacco, alcohol and caffeine consumption may influence risk of uterine leiomyomata via changes in ovarian function or hormone metabolism.

Methods

We prospectively assessed the relation of these exposures to risk of self-reported uterine leiomyomata in the Black Women's Health Study. From 1997 to 2001, we followed 21,885 premenopausal women with intact uteri and no prior myoma diagnosis. Cox regression models were used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs).

Results

During 73,426 person-years of follow-up, 2177 incident cases of uterine leiomyomata confirmed by ultrasound (n = 1920) or hysterectomy (n = 257) were reported. Cigarette smoking was not associated with risk of uterine leiomyomata. Risk was positively associated with years of alcohol consumption and current consumption of alcohol, particularly beer. Relative to non-drinkers, multivariate IRRs for beer consumption of < 1, 1-6 and 7+ drinks/week were 1.11 (95% CI 0.98-1.27), 1.18 (95% CI 1.00-1.40) and 1.57 (95% CI 1.17-2.11), respectively. Heavy coffee and caffeine consumption were not associated with risk overall, but IRRs were increased among women aged < 35 years.

Conclusions

In US black women, risk of uterine leiomyomata was positively associated with current consumption of alcohol, particularly beer. Cigarette smoking and caffeine consumption were unrelated to risk overall.

Topics

Lifestyle and Environment Substances Alcohol

Lifestyle and Environment › Substances › Alcohol

Lauren A Wise, Julie R Palmer, Bernard L Harlow, Donna Spiegelman, Elizabeth A Stewart, Lucile L Adams-Campbell, Lynn Rosenberg

L Wise, J Palmer, B Harlow, D Spiegelman, Liz Stewart, Beth Stewart, Betsy Stewart, E Stewart, L Adams-Campbell, L Rosenberg

PMID 15218005 15218005 DOI 10.1093/humrep/deh309 10.1093/humrep/deh309 Wise et al. 2004, Wise 2004

Risk of uterine leiomyomata in relation to tobacco, alcohol and caffeine consumption in the Black Women's Health Study

Alcohol, especially beer, is linked to fibroid risk in Black women

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

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