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Studies Warn Against Even Moderate Drinking by Older
Women
Raises danger of breast cancer, brain damage
 May
16, 2005 – Two new studies both raise red flags about dangers of even
moderate alcohol consumption for women. One found that postmenopausal
women who consume even moderate amounts of alcohol may face an increased
risk of breast cancer and, the second says women develop alcohol-related
brain damage more readily than men.
The study of postmenopausal women who consume even
moderate amounts of alcohol says they may face an increased risk of
breast cancer, particularly if their cancer is fueled by the hormones
estrogen or progesterone. This study was by researchers at Boston's
Dana-Farber Cancer Institute, Brigham and Women's Hospital, and Harvard
School of Public Health.
"Women need to consider the possible effects of
alcohol on breast cancer risk when weighing the risks and benefits of
alcohol consumption," says Wendy Chen, MD, PhD. "Our findings indicate
that in some postmenopausal women, even modest levels of alcohol
consumption may elevate their risk of breast cancer."
Using data from the Nurses' Health Study –– a
project led by Boston's Brigham and Women's Hospital that has tracked
the health of 122,000 registered nurses since 1976 –– Chen and her
colleagues focused on breast cancer rates in women who reported drinking
small amounts of alcohol (averaging less than a glass of beer or wine a
day).
Chen, who is also an instructor in medicine at
Harvard Medical School, said that although the women's overall risk of
breast cancer was low, they developed the disease at a higher rate than
women who were non-drinkers. The elevated risk was most pronounced in
those whose tumor growth was stimulated by the hormones estrogen or
progesterone. The results were consistent regardless of the women's body
mass index, type of alcoholic beverage consumed, or use of hormone
replacement therapy.
Chen discussed the study's findings at the annual
meeting of the American Society of Clinical Oncology on Sunday, May 15.
Study on brain damage
The second study says women appear to be more
vulnerable to chronic drinking than men, yet few studies have looked at
gender differences in alcohol's effects on the brain. The study in the
May issue of Alcoholism: Clinical & Experimental Research addresses this
gap in research, using computed tomography (CT) to examine brain atrophy
in the brains of alcoholic men and women.
The findings support and build upon a prior
hypothesis that women develop alcohol-related brain damage more readily
than men.
> Women appear to be more vulnerable to chronic
drinking than men are.
> New research uses computed tomography to examine alcohol's effects
on the brains of alcoholic men and women.
> Results show that women develop alcohol-related brain damage more
readily than men.
"Studies using brain-imaging techniques are
time-consuming and expensive," said Karl Mann, full professor in the
department for addictive behavior and addiction medicine at the
University of Heidelberg and first author of the study. "Women have
generally not been considered in brain-imaging studies, or samples have
not been large enough to differentiate between women and men.
Conversely, male patients with alcohol dependence have historically been
easier to recruit because the majority of alcoholic patients are male
and the first evaluations of larger samples were carried out in
soldiers. Furthermore, study results were thought to be generally
applicable to both genders. Yet gender differences in the development,
course and consequences of alcohol dependence have to be considered in
early diagnosis as this probably will lead to different therapeutic
strategies."
"Not only is the prevalence of alcoholism somewhat
higher in men than women, thus increasing the chances of recruiting men
over women in research programs," added Edith Sullivan, a professor in
the department of psychiatry and behavioral sciences at Stanford
University School of Medicine, "but some speculate that women, with
household and motherly responsibilities, have greater difficulty in
finding time to participate in studies."
"Telescoping" is a term that refers to the later
onset and possibly accelerated negative effects that chronic alcohol
consumption may have on the brain's structural and functional systems in
women.
"Epidemiological studies have demonstrated gender
differences in alcohol-consumption behavior and the course of alcohol
dependence," said Mann.
"Women typically start to drink later in life,
consume less per occasion and are, in general, less likely to develop
alcohol dependence. One could reason that women are less affected by
alcohol. But there is, in fact, evidence for a faster progression of the
developmental events leading to dependence among female alcoholics and
an earlier onset of adverse consequences of alcoholism. This suggests
that women may be more vulnerable to chronic alcohol consumption," Mann
added.
For this study, researchers examined 158 subjects:
76 women (42 patients, 34 healthy "controls"), and 82 age-matched men
(34 patients, 48 healthy "controls"). All of the alcoholics were
recruited from a six-week inpatient treatment program, and met
Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition
and International Classification of Diseases 10 criteria for alcohol
dependence. Control subjects were recruited by advertisement. CT scans
were performed twice among the patients – at the beginning and end of
their six-week program – and once among the controls.
Results confirm gender-specific differences in the
onset of alcohol dependence.
"We were able to confirm the telescoping course of
alcohol dependence in women," said Mann, "meaning faster progression of
the developmental events leading to dependence among female alcoholics
and an earlier onset of adverse consequences."
Results also show that brain atrophy seems to
develop faster in women.
"We confirmed greater brain atrophy in alcoholic
women and men compared to healthy controls," said Mann. "Furthermore,
the women developed equal brain-volume reductions as the men after a
significantly shorter period of alcohol dependence than the men. These
results corroborate previous studies that have found other
gender-related consequences of alcohol, such as cognitive deficits,
alcoholic cardiomyopathy, myopathy of skeletal muscle, and alcoholic
liver disease - all of which occur earlier in women than in men despite
a significantly shorter exposure to alcohol."
"The higher depression index in alcoholic women
than men was also of interest," added Sullivan, "and may actually serve
as a useful trigger to family members that 'something is wrong' with the
affected individual.
The good news is that abstinence seems to
partially reverse the brain atrophy, for both genders.
"Because of the 'telescoping' effect," said Mann,
"early diagnosis and early prevention are even more important for women
with alcohol problems than for men. Despite the fact that men, in
general, drink more alcohol and are more likely to develop alcohol
dependence, it is those women who consume alcohol who probably develop
alcohol dependence and adverse consequences more readily than men."
Notes on Sources:
In addition to Chen, the study's other authors are
Walter Willett, MD, MPH, DrPh, Harvard School of Public Health, and
Bernard Rosner, PhD, and Graham Colditz, MD, MPH, DrPh, Brigham and
Women's Hospital.
Dana-Farber Cancer Institute (www.danafarber.org)
is a principal teaching affiliate of the Harvard Medical School and is
among the leading cancer research and care centers in the United States.
It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC),
designated a comprehensive cancer center by the National Cancer
Institute.
Alcoholism: Clinical & Experimental Research (ACER)
is the official journal of the Research Society on Alcoholism and the
International Society for Biomedical Research on Alcoholism. Co-authors
of the ACER paper, "Neuroimaging of gender differences in alcoholism:
Are women more vulnerable?," were: Klaus Ackermann, Bernhard Croissant,
Helmut Nakovics, and Alexander Diehl of the Central Institute of Mental
Health at the University of Heidelberg; and Goetz Mundle of the
Department of Psychiatry and Psychotherapy at the University of
Tuebingen. The study was supported by the German Ministry of Education
and Research.
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