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Does dietary folate intake modify effect of alcohol consumption on breast cancer risk? Prospective cohort study

BMJ 2005; 331 doi: (Published 06 October 2005) Cite this as: BMJ 2005;331:807
  1. Laura Baglietto, senior research fellow (laura.baglietto{at},
  2. Dallas R English, associate director1,
  3. Dorota M Gertig, senior research fellow2,
  4. John L Hopper, director2,
  5. Graham G Giles, , director1
  1. 1Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, 100 Drummond Street, Carlton, Victoria 3053, Australia,
  2. 2Centre for Genetic Epidemiology, University of Melbourne, Melbourne
  1. Correspondence to: L Baglietto
  • Accepted 27 June 2005


Abstract Objective To evaluate the effect of dietary folate intake on the relation between alcohol consumption and breast cancer risk.

Design Prospective cohort study.

Setting Melbourne, Australia.

Participants 17 447 Anglo-Australian women resident in Melbourne, aged 40-69 years at recruitment in 1990-4, and followed up until 31 December 2003.

Main outcome measure Invasive breast cancers diagnosed during follow-up and ascertained through the Victorian cancer registry.

Results 537 invasive breast cancers were diagnosed. Compared with lifetime abstainers, the hazard ratio for breast cancer in women who consumed an average of 40 g or more of alcohol daily at baseline was 1.41 (95% confidence interval 0.90 to 2.23). No direct association was found between dietary folate intake and risk of breast cancer, but a high folate intake mitigated the excess risk associated with alcohol. The estimated hazard ratio of an alcohol consumption of 40 g/day or more was 2.00 (1.14 to 3.49) for women with intakes of 200 μg/day of folate and 0.77 (0.33 to 1.80) for 400 μg/day of folate (P = 0.04 for interaction between alcohol and folate).

Conclusions An adequate dietary intake of folate might protect against the increased risk of breast cancer associated with alcohol consumption.


  • Contributors GGG, DMG, and JLH were responsible for the initial study design. DRE and GGG supervised the conduct of the study. LB did the data analysis. All of the authors contributed to the final report. All the authors are guarantors.

  • Funding Cohort recruitment was funded by VicHealth and the Cancer Council Victoria. This analysis was partly funded by grants from the National Health and Medical Research Council (grants No 209057 and 251533), the National Breast Cancer Foundation (grant No: KCF20), and the Australian Brewers Foundation.

  • Competing interests None declared.

  • Ethical approval The Cancer Council Victoria's human research ethics committee approved the study protocol.

  • Accepted 27 June 2005
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