The study was the work of lead author Dr Polly Newcomb, head of the Cancer Prevention Program in the Public Health Sciences Division at the Fred Hutchinson Center in Seattle, Washington, and colleagues from other research centers, and is published online in the March issue of Cancer Epidemiology, Biomarkers and Prevention.

Newcomb said in a press statement that she and her colleagues were interested in finding out what effect red wine might have on breast cancer risk, particularly since it has been singled out in other studies as being beneficial, such as on risk of heart disease and prostate cancer.

“The general evidence is that alcohol consumption overall increases breast-cancer risk, but the other studies made us wonder whether red wine might in fact have some positive value,” explained Newcomb.

For the study the researchers interviewed 6,327 women who had breast cancer and 7,558 age-matched controls who did not. All the participants were from Wisconsin, Massachusetts and New Hampshire and aged from 20 to 69.

They asked them how often they drank alcohol (red wine, white wine, spirits/liquor, and beer) and other questions relevant to breast cancer risk, including how old they were when/if they first became pregnant, whether there was any family history of breast cancer, and whether they had used hormonal replacement therapy (HRT).

The frequency of alcohol consumption in both the breast cancer and the control group was the same, and the proportion of women consuming red and white wine was also the same in both groups.

The results showed there was no difference between red and white wine with respect to risk of having breast cancer.

The researchers found that women who had 14 or more drinks a week, regardless of type (red or white wine, spirits/liquor or beer) were 24 per cent more likely to have breast cancer compared with women who did not drink alcohol at all.

Newcomb said that neither red nor white wine appeared to have any benefits.

“If a woman drinks, she should do so in moderation — no more than one drink a day,” she said.

“And if a woman chooses red wine, she should do so because she likes the taste, not because she thinks it may reduce her risk of breast cancer,” added Newcomb.

This is not the first study to find that moderate alcohol consumption increases breast cancer risk for women. For example, a large UK study published last week in the Journal of the National Cancer Institute found that even moderate amounts of alcohol could increase a woman’s chance of developing breast cancer or other cancers by 13 per cent.

The National Cancer Institute, which is part of the National Institutes of Health, sponsored the research.

“No Difference Between Red Wine or White Wine Consumption and Breast Cancer Risk.”
Polly A. Newcomb, Hazel B. Nichols, Jeannette M. Beasley, Kathleen Egan, Linda Titus-Ernstoff, John M. Hampton, and Amy Trentham-Dietz.
Cancer Epidemiology, Biomarkers and Prevention, March 2009 18: 1007-1010.

“Our findings support multiple nutrition recommendations that men should limit intake to no more than two alcoholic beverages per day and women should limit intake to no more than one,” said lead author Jeanine M. Genkinger, Ph.D., an assistant professor at the Lombardi Comprehensive Cancer Center. A drink is defined as 12 ounces of beer, four ounces of wine, or 1.5 ounces of 80-proof distilled liquor.

Genkinger and colleagues conducted a pooled analysis of the primary data from 14 research studies, for a population that included 862,664 individuals. Researchers identified 2,187 individuals diagnosed with pancreatic cancer during the study.

“This is one of the largest studies ever to look at dietary factors in relation to pancreatic cancer risk,” said Genkinger.

If individuals consumed 30 or more grams of alcohol per day, compared with no alcohol per day, their risk of pancreatic cancer increased by 22 percent.

No difference was observed by type of alcohol, according to Genkinger.

The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world’s oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 28,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and 80 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. The AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention. The AACR’s most recent publication and its sixth major journal, Cancer Prevention Research, is dedicated exclusively to cancer prevention, from preclinical research to clinical trials. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.

Although the relationship between alcohol and esophageal squamous cell carcinoma is well established, studies investigating the association between alcohol intake and reflux esophagitis (RE), Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC) have reported inconsistent findings. Furthermore, little is known regarding the effect of alcohol on BE, especially related to alcohol types.

Two recent studies published in Gastroenterology further our understanding of these illnesses. Gastroenterology is the official journal of the American Gastroenterological Association (AGA) Institute.

Education Status Is Significantly Inversely Associated with BE Risk

A new diagnosis of BE is associated with alcohol types, and the effects are modified by the presence of vitamin supplement use, according to a new study in Gastroenterology. The observed associations are independent of demographic and life-style factors that are related to choice of alcoholic beverages, including vitamin supplement use. In addition, higher education level is inversely related to the risk.

People with BE have a 30 to 125 fold increased risk of developing EAC compared to the general population. The incidence of EAC has increased by more than 500 percent in the last three decades, more rapidly than any other malignancy in the U.S. The rate of increase is most predominant among Caucasian males, suggesting that environmental or lifestyle factors may play important roles in the change in incidence.

“The identification of risk factors for BE may provide information on early events in the carcinogenic pathway for EAC that could lead to effective intervention strategies,” said Ai Kubo, PhD, of Kaiser Permanente and lead author of the study.

This study is the first community or population-based study in the U.S. to evaluate alcohol and socio-demographic factors as risk factors for BE. Using a case-control study within the Kaiser Permanente Northern California membership, patients with a new diagnosis of BE (n=320) between 2002 and 2005 were matched to persons with gastroesophageal reflux disease (GERD; n=316) and to population controls (n=317). Information was collected using validated questionnaires during direct in-person interviews; analyses used multivariate unconditional logistic regression.

Total alcohol use was not significantly associated with the risk of BE, although stratification by beverage type showed an inverse association for wine drinkers compared to nondrinkers (seven+ drinks wine/week versus none: OR=0.44, 95 percent CI (0.20-0.99); multivariate analysis). Among population controls, those who preferred wine were more likely to have college degrees and regularly take vitamin supplements than those who preferred beer or liquor. Adjustment for these factors or GERD symptoms did not eliminate the inverse association between wine consumption and BE. Education status was significantly inversely associated with the risk of BE.

“Future studies examining the interaction between vitamin supplement and alcohol types and how socioeconomic status may affect GERD and BE are needed,” added Dr. Kubo.

Total Alcohol Consumption at 21 Is Significantly Associated with RE

Alcohol consumption in early adulthood may lead to the development of reflux esophagitis (RE), according to a new study in Gastroenterology. However, more recent alcohol consumption does not appear to confer any increased risk of RE, BE or EAC. In fact, wine consumption may reduce the risk of these esophageal disorders.

Gastroesophageal reflux (GER) symptoms are common in Western societies with 10 to 20 percent of adults experiencing at least weekly symptoms. GER is the main predisposing risk factor for erosive RE, BE and EAC; alcohol may increase GER by causing relaxation of the lower esophageal sphincter.

Using data collected as part of an all-Ireland case-control study, the FINBAR (Factors INfluencing the Barrett’s Adenocarcinoma Relationship) study, information relating to alcohol consumption (at age 21 and five years before the interview date) was collected from 230 RE, 224 BE and 227 EAC patients and 260 frequency-matched population controls. Logistic regression analyses were used to compare alcohol consumption in the three case groups to controls with adjustment for potential confounders. The FINBAR study is one of the largest case-control studies to date to investigate the association between alcohol consumption and RE, BE and EAC using the same control group.

Population controls reporting GER symptoms were less likely than controls without symptoms to drink alcohol five years before the interview date (OR 0.44, 95 percent CI 0.20-0.99). No associations were observed between total alcohol consumption five years before the interview date and RE, BE or EAC (ORs, 95 percent CI: 1.26, 0.78-2.05, 0.72, 0.43-1.21 and 0.75, 0.46-1.22, respectively). Wine was inversely associated with RE (OR 0.45, 95 percent CI 0.27-0.75). Total alcohol consumption at age 21 was significantly associated with RE (OR 2.24, 95 percent CI 1.35-3.74), but not with BE or EAC (ORs, 95 percent CI: 1.06, 0.63-1.79 and 1.27, 0.77-2.10, respectively).

These preliminary findings warrant further research. Future studies should consider the influence of reflux symptoms and the temporality of the association carefully when interpreting the association between alcohol and RE, BE and EAC.

About the AGA Institute

The American Gastroenterological Association (AGA) is dedicated to the mission of advancing the science and practice of gastroenterology. Founded in 1897, the AGA is one of the oldest medical-specialty societies in the U.S. Comprised of two non-profit organizations – the AGA and the AGA Institute – our more than 17,000 members include physicians and scientists who research, diagnose and treat disorders of the gastrointestinal tract and liver. The AGA, a 501(c6) organization, administers all membership and public policy activities, while the AGA Institute, a 501(c3) organization, runs the organization’s practice, research and educational programs. On a monthly basis, the AGA Institute publishes two highly respected journals, Gastroenterology and Clinical Gastroenterology and Hepatology. The organization’s annual meeting is Digestive Disease Week®, which is held each May and is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. For more information, please visit http://www.gastro.org/.

About Gastroenterology

Gastroenterology, the official journal of the AGA Institute, is the most prominent scientific journal in the specialty and is in the top 1 percent of indexed medical journals internationally. The journal publishes clinical and basic science studies of all aspects of the digestive system, including the liver and pancreas, as well as nutrition. The journal is abstracted and indexed in Biological Abstracts, CABS, Chemical Abstracts, Current Contents, Excerpta Medica, Index Medicus, Nutrition Abstracts and Science Citation Index. For more information, visit http://www.gastrojournal.org.

Drinking a glass of wine a day may lower the risk of Barrett’s esophagus, a condition that precedes esophageal cancer.

Barrett’s esophagus, which affects about 5 percent of the population, occurs when heartburn or acid reflux permanently damages the lining of the esophagus. People with this condition are 30 to 40 times more likely to develop a type of esophageal cancer called esophageal adenocarcinoma. In the last 30 years, the incidence of esophageal cancer in the United States has increased 500 percent.

In this Kaiser Permanente study, researchers looked at 953 men and women in Northern California and found that those who drank one or more glasses of red or white wine a day were 56 percent less likely to develop Barrett’s esophagus. Beer or liquor did not lower the risk, and the protective effect of wine didn’t increased with higher consumption.

The study was published in the March issue of Gastroenterology. Two other studies in the same issue of the journal reported similar findings. An Australian study found that people who drink wine were less likely to develop adenocarcinoma, and Irish researchers reported that drinking wine reduces the risk of esophagitis, an irritation of the esophagus that follows chronic heartburn and often precedes Barrett’s esophagus and cancer.

It’s not clear why wine may lower the risk of Barrett’s esophagus. Researchers suggest it may be because antioxidants in wine neutralize the damage done by gastroesophageal reflux disease. Or it may be because wine drinkers typically have food with their wine, thereby reducing the potentially damaging effects that drinking alcohol alone can have on esophageal tissue.

The wine study is part of a larger Kaiser Permanente study led by Corley looking at the link between Barrett’s esophagus and abdominal obesity and consumption of dietary antioxidants, fruits and vegetables. That study found that eating eight servings of fruit and vegetables a day and maintaining normal body weight can reduce the risk of Barrett’s esophagus.

“My advice to people trying to prevent Barrett’s esophagus is: Keep a normal body weight and follow a diet high in antioxidants and high in fruits and vegetables,” Corley said. “We already knew that red wine was good for the heart, so perhaps here is another added benefit of a healthy lifestyle and a single glass of wine a day.”

Click Here For More Information

For the study, Naomi Allen of the University of Oxford and colleagues analyzed data from 1,280,296 women between ages 45 and 75 who attended breast cancer screening clinics between 1996 and 2001. According to the Times, this sample size represented one-quarter of British women in that age group. The researchers tracked the women for an average of more than seven years and collected cancer data from a national registry. They found that 68,775 women received cancer diagnoses during the study period (Maugh, Los Angeles Times, 2/25). About one-quarter of the women in the study group reported no alcohol use, and nearly all of the remaining women reported consuming fewer than three drinks daily. The women on average reported consuming one drink per day. For the study, the researchers compared cancer rates among women who drank two or fewer drinks per week with women who consumed more (AP/Google.com, 2/24).

According to the study’s findings, consuming one alcoholic beverage per day was associated with 11 additional breast cancer cases per 1,000 women each year. A daily drink also was associated with one additional case of oral and pharynx cancers, one case of rectal cancer, and 0.7 additional cases of esophageal, laryngeal and liver cancers. These findings indicate that a single daily drink could add 15 additional cancer cases to the base rate of 118 cancers per 1,000 women. In addition, two daily drinks could add 30 additional cancer cases and three daily drinks could add 45 cases (Los Angeles Times, 2/25). Based on the study’s findings, the researchers estimated that low to moderate alcohol consumption accounts for about 5% of all cancer cases diagnosed among women in the U.S. each year. In addition, about 11% of breast cancer cases, or about 20,000 extra cases per year, might result from alcohol consumption, the researchers said. According to the researchers, all types of alcohol had the same effect on cancer risk.

According to Allen, the “take home message” of the study is that “[i]f you are regularly drinking even one drink per day, that’s increasing your risk for cancer.” She added, “There doesn’t seem to be a threshold at which alcohol consumption is safe.” In an editorial accompanying the study, Michael Lauer and Paul Sorlie of the National Heart, Lung and Blood Institute write that cancer is the “major cause of death by far” among middle-aged women. Therefore, they write that “the only reasonable recommendation we can make is there is no clear evidence that alcohol has medical benefits” (Stein, Washington Post, 2/25).

Although several researchers noted that the study’s findings were consistent with previous research, others questioned some aspects of the study. For example, the study relied on self-reported degrees of alcohol consumption and it had no data on overall death rates (Los Angeles Times, 2/25). In addition, the study does not distinguish between women who consumed only one or two drinks each day and women who consumed seven drinks at one time. Some researchers expressed concern that the study would cause unnecessary alarm among women about the risks of drinking alcohol. Eric Rimm of the Harvard School of Public Health said, “We can’t use this to scare people away from alcohol” (Washington Post, 2/25).

According to the Times, Allen currently is conducting a study to assess the potential cardiovascular benefits of alcohol consumption among the same group of women. “Only then will we be in a position to comment on the overall benefit” of alcohol consumption, she said (Los Angeles Times, 2/25). In addition, the federal government is rewriting its dietary guidelines regarding alcohol consumption and plans to consider Allen’s study during this process, the Post reports. Linda Van Horn, professor of preventive medicine at Northwestern University, said “No one study is ever sufficient to make a recommendation. But it will be added to the body of literature that will be reviewed” (Washington Post, 2/25). Philip Brooks, an alcohol and cancer researcher at the National Institutes of Health, said “You have to balance all those things out. This kind of information is important for people to know and to consult with their physicians about the various risk factors they have” (AP/Google.com, 2/24).

ABC’s “World News with Charles Gibson” on Tuesday reported on the study (Gibson, “World News with Charles Gibson,” ABC, 2/24).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

“Even relatively low levels of drinking — on the order of one alcoholic drink per day — increase a woman’s risk of developing cancer,” said lead researcher Naomi Allen, from the cancer epidemiology unit at the University of Oxford in the United Kingdom. “Because a high proportion of women drink low amounts of alcohol regularly and because most of the increased risk is for breast cancer, the risk among women associated with drinking alcohol is of particular importance.”

In fact, the study found that moderate drinking accounts for 13 percent of breast, liver, rectum and upper respiratory/digestive tract cancers among women.

The association between moderate alcohol intake and breast cancer in women is well-known, the researchers point out. What’s new here, they say, is the finding that even low levels of drinking can raise a woman’s risk of developing cancer of the liver and rectum. For women who smoke, cancers of the mouth and throat were also linked to high alcohol consumption.

The report is published in the Feb. 24 online edition of the Journal of the National Cancer Institute.

For the study, Allen’s team collected data on more than 1.2 million middle-age British women participating in the Million Women Study. The researchers used the National Health Service Central Registries to identify cancer cases among these women.

Most women in the study had about a drink a day, and a smaller percentage had three or more drinks a day, the researchers found. Over more than seven years of follow-up, 68,775 women developed cancer.

“These findings are robust, and alcohol consumption was assessed several times before women were diagnosed with cancer, making these estimates reliable,” Allen said.

Overall, the risk of cancer increased as alcohol consumption increased. The type of alcohol consumed appeared to make no difference.

Women who drank and also smoked faced increased risk of cancers of the oral cavity and pharynx, esophagus, and larynx (voice box), the researchers found.

The study suggests “that in developed countries, where women typically consume low-moderate amounts of alcohol, we estimate that for every additional drink regularly consumed each day, there would be about 15 extra cases of cancers of the breast, liver, rectum and mouth and throat diagnosed for every 1,000 women up to the age of 75,” Allen said. “Most of this excess risk is due to breast cancer.”

Susan M. Gapstur, vice president of epidemiology at the American Cancer Society, said the findings confirm and expand on those from previous studies in men and in smaller cohorts of women.

But several questions remain unanswered, she said. “For example, researchers remain concerned about the pattern of consumption,” Gapstur said. “It is unclear, for example, whether someone who drinks several glasses of wine on one day during the week has the same risk as someone who drinks one glass of wine per day with a meal. In addition, the effects of quitting or reducing drinking on cancer risk are also unclear.”

The American Cancer Society currently recommends limiting intake to one drink a day for women and two drinks a day for men, Gapstur said.

On the other hand, numerous studies have suggested that alcohol, especially red wine, might help deter heart disease — complicating decisions around drinking and health.

“If you do not drink, there is no reason to start drinking,” Gapstur reasoned. “However, in light of the findings from the Million Women Study, women who are concerned about their cancer risk versus their risk of cardiovascular disease might want to discuss the potential risks and benefits of even low alcohol intake with their health-care providers.”

In an accompanying journal editorial, Dr. Michael Lauer, director of the Division of Prevention and Population Sciences at the U.S. National Heart, Lung and Blood Institute, said he believes the risk for cancer might outweigh any perceived benefit in terms of heart disease.

“People who are not drinkers should not start drinking to prevent heart disease, and even people who are drinking should discuss this with their physicians,” he said. “And as part of that conversation, they should consider other conditions than heart disease. We cannot just focus on heart disease.”

More information

The American Cancer Society has more on alcohol and cancer.

* The aldehyde dehydrogenase (ALDH2*2) allele is considered protective against alcoholism.

* Intravenous administration of an anti-Aldh2 antisense gene can curtail long-term drinking among rodents.

Just as the risk of developing alcoholism is strongly influenced by genetic factors, mutations in gene coding – such as the aldehyde dehydrogenase (ALDH2*2) allele – also appear to protect against the risk. Scientists have only just begun to apply gene-therapy techniques to the alcohol-research field. A proof-of-principle study has found that administering an anti-Aldh2 antisense gene in rodents can curtail their urge to drink.

Results are published in the January issue of Alcoholism: Clinical & Experimental Research.

“An ‘experiment of nature’ is observed in some individuals of East Asian origin, who are 66 to 99 percent protected against alcoholism,” explained Yedy Israel, professor of pharmacological and toxicological chemistry at the Universidad de Chile, and adjunct professor of pathology, anatomy and cell biology at Thomas Jefferson University in Philadelphia. “These individuals carry a genetic mutation that inactivates the aldehyde dehydrogenase-2 enzyme, which is needed to eliminate products of alcohol metabolism. When they drink, they experience nausea, facial redness and a pounding heart.” Israel, past president of the U.S. Research Society on Alcoholism, is the study’s corresponding author.

Israel added that although gene therapy is predominantly associated with helping “bubble babies” – children who must live in a sterile bubble because they lack all immunity and may die of infections – there are presently 1,300 clinical gene-therapy trials for different conditions worldwide.

“Gene therapy is a technique that has been proposed for a number of human conditions, mostly to correct inborn errors that lead to severe conditions,” noted Richard Deitrich, Professor Emeritus at the University of Colorado School of Medicine. “In terms of alcohol research, however, this is certainly ‘cutting edge.’ The goal here is to silence a gene or at least impair its function, thereby mimicking a genetic condition that some Asian individuals normally have that protects them from developing alcoholism.”

Researchers used rats that were initially bred as heavy alcohol drinkers, and then further rendered alcohol dependent through a two-month period of unlimited, voluntary intake of the equivalent of premium beer, followed by withdrawal, followed by a one-hour “happy hour” each day. During this hour, the animals drank 10 times more alcohol than what is normally consumed. An anti-Aldh2 antisense gene was then intravenously administered, with the intent of “shutting off” ALDH2 activity.

“Animals that were given a single intravenous injection of the antisense gene therapy reduced their consumption by one half, for a full month, which was the duration of the study,” said Israel. “This would appear to have implications for a social-drinking pattern, and the notion of ‘harm reduction,’ where full abstinence is not the only acceptable goal.”

“These findings are a long way from being applied to humans,” cautioned Deitrich. “There are both practical and theoretical issues that need to be addressed. For example, does the antisense gene get into the brain” Presumably not, but that needs to be shown. Is there any crossover of the antisense gene into reproductive organs, such as sperm or eggs” Again, presumably not, but that also needs to be shown. Can they target the liver specifically” What is the duration of the effect” This study went out to 34 days, but the treatment will not be feasible if it requires once-a-month treatment.”

On a more theoretical level, Deitrich wondered about the treatment applications of gene therapy for alcoholism. “For example, should it be reserved to treat individuals who are already dependent or should it also be offered to individuals not yet alcohol dependent but drinking heavily” What would be the effect on the individual who takes the treatment but continues to drink, as do some of the heterozygous individuals” These individuals have a higher incidence of cancers of the throat and upper respiratory tract. However, the authors point out that if they can target the liver with the antisense therapy, other tissues would retain their ability to remove acetaldehyde. This is not the case for East Asians in whom ALDH is inactive in all tissues.”

Despite the questions that remain, Deitrich added, “this is a remarkable paper and, even if these studies are never translated to humans, it is an important addition to the alcohol- research field.”

Israel and his colleagues are planning to examine methods by which they can deliver genes through a single treatment that can last for a period of one year to a lifetime. “Given that the main problem in the pharmacological treatment of alcoholism is that patients do not adhere to the treatment, and that the effect of most recent medications is only moderate at best, gene therapy shows great potential value for the treatment of alcoholism,” Israel said. “A rapid transfer of gene-therapy possibilities into the clinic will depend on how these new studies proceed.”

Researchers from the Minneapolis VA Medical Center documented the quitting success of 462 people who tried to simultaneously give up alcohol and cigarettes. The study appears in the January edition of the journal Alcoholism: Clinical and Experimental Research.

At the beginning of the study, participants smoked at least five cigarettes a day and were alcohol dependent. Among the group, typical problematic drinking symptoms included repeatedly imbibing more than planned, difficulty quitting or cutting down, and continuing to drink even though drinking caused problems such as hangovers or sleeping difficulty.

All participants received intensive alcohol and smoking cessation treatment. Up to a year and a half later, researchers surveyed the participants and asked about their alcohol and tobacco habits.

“Among those who were depressed, the odds of drinking, the next time you checked in with them six months later, were 1.5 times greater than the odds of drinking for individuals without significant depressive symptoms,” said lead study author Molly Kodl.

Of the people who were depressed, the majority suffered only mild to moderate mood problems.

“With significant depression, people report mood that is down in the dumps, loss of interest in things they used to enjoy, low energy, appetite changes and difficulty concentrating,” Kodl said.

While depression seems to lessen the chances of alcohol abstinence, the study did not find a similar association for tobacco dependence.

“Depression did not significantly impact the odds of succeeding in quitting smoking in this study,” Kodl said.

Substance abuse researcher Robert West says many people do not receive an initial assessment for depression when they join a treatment program.

“It depends very much on the program,” said West, professor of health psychology at the Cancer Research UK Health Behaviour Unit at the University College London.

But Kodl said: “Our study suggests that treating depression may help people recover from alcohol use problems, although more research is needed on this topic.”

Kodl MM, et al. “The impact of depressive symptoms on alcohol and cigarette consumption following treatment for alcohol and nicotine dependence.” Alcoholism: Clinical and Experimental Research. 32(1), 2008.

Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States

http://www.hbns.org

The more miscarriages or abortions a woman has, the greater are her chances of giving birth to a child that is underweight or premature in the future, the research shows.

Low birthweight (under 2500 g) and premature birth (less than 37 weeks) are two of the major contributors to deaths among newborn babies and infants.

The authors used data from the United States Collaborative Perinatal Project, which was set up in 1959 to look at the associations between factors during pregnancy and birth and childhood development.

In total, more than 45,500 mother and child pairs were assessed. Nearly 40% of the mothers had one or two children and almost two thirds were between 20 and 29 years of age.

Rates of low birthweight and premature birth were highest among mothers who were black, young or old, poorly educated, and unmarried.

But there was a strong association between miscarriage and abortion and an early or underweight birth, even after adjusting for other influential factors, such as smoking, high blood pressure and heavy drinking.

Women who had had one, two, or three or more miscarriages or abortions in the past were almost three, five, and 9 times as likely to give birth to an underweight child as those without previous miscarriages or abortions.

Similarly, women who had one miscarriage or abortion were 67% more likely to have a premature birth, while those who had had three or more were over three times as likely to do so compared with those with no history of miscarriage or abortion.

The authors acknowledge that previous research has been inconclusive, with some studies reporting no increased risk while others have found a significantly increased risk.

Nevertheless, women and healthcare professionals should be aware of the potential risks, they conclude.

Previous abortion and the risk of low birth weight and preterm births
Journal of Epidemiology and Community Health 2007; 62: 16-22

Research into Compulsory Drugs Testing (CDT) of UK service personnel has identified a rise in positive tests for illegal substances in the British Army from 517 individual cases in 2003, to 795 in 2005 (and 769 in 2006), and also a 4-fold increase in soldiers testing positive for the class-A drug cocaine. The study is published in the Journal of the Royal United Services Institute (RUSI).

Professor Sheila Bird, senior scientist at the Medical Research Council Biostatistics Unit said: “What is worrying from our study of compulsory drug testing (CDT) figures for the armed services is the sharp increase in the proportion of soldiers testing positive for cocaine, a sharper increase than in 16-24 year olds in society at large.”

“It’s vital that we find out what lies behind this the rise in positive tests for cocaine from 1.4 per thousand in 2003 to 4 per thousand in early 2006 and 5.7 per thousand in early 2007. The interim period coincides with major combats in both Afghanistan and Iraq and there is natural concern that the rise in cocaine use may be a direct result of increased combat stress.

“We need to know more about how the tests were conducted and whether methods have remained the same over that period to assess the scale of the problem. However, our work looking at CDT in prisons has shown that testing can under-estimate the number of sporadic users dramatically. This could just be the tip of the iceberg.”

Other factors may be playing a part in increased levels of positive tests. A change in the sensitivity of the tests used or in the weekdays of testing could be to blame. Soldiers could be ‘switching’ from cannabis to cocaine in a perverse attempt to avoid testing positive as cocaine disappears from the system in just 2-3 days. This last theory seems unlikely, because irrational: ecstasy would be a much less harmful option as a ‘drug of evasion’.

“Even if the rise could be accounted for in other ways, this would still leave us with high numbers of soldiers testing positive for cocaine, with potentially even higher numbers using the drug sporadically. Our duty of care towards these young men and women fighting in very difficult conditions means we must get to the bottom of their drugs use and the reasons behind it,” continues Professor Bird.

Traces of cocaine are found in urine for only two to three days after use. By contrast, cannabis remains in urine for two to three weeks. In 2003, cannabis accounted for half (50 per cent) of all CDT positive tests, whereas cocaine was 22 per cent. By 2006, around 50 per cent of all positive tests registered cocaine use, with cannabis around 30 per cent.

Professor Bird’s analysis counters claims that this trend is a ‘reflection of society more generally’, when placed in societal context alongside the declared ‘drug use in the last month’ of respondents to the British Crime Survey. The self-reported survey of some 6000 respondents aged between 16-24 years notes cocaine was 28 per 1000 in 2003/04, 30 per 1000 2005/06, and 32 per 1000 in 2006/07. Military cocaine-positive rates, 20 times lower in 2003, were only 6 times lower in 2006/07.

Notes:

1. This study is published in the Journal of the Royal United Services Institute (RUSI). Published six times a year, it is an internationally recognised authority on defence and security issues. Embargoed copies of the articles are attached and can also be viewed online here.

2. Professor Sheila Bird is Senior Scientist with the Medical Research Council (MRC), Biostatistics Unit, Cambridge. Sheila chaired the Royal Statistical Society’s Working Party on Performance Monitoring in the Public Services.

3. CDT is carried out unannounced, unpredictable and at random with respect to weekday or weekend within all three services having been introduced fully in the Army on 2 May 1995, in the Royal Navy on 1 April 1997 and in the RAF on 1 November 1998.

Medical Research Council