Drinkers, Smokers Less Likely to Adhere to Chemoprevention

Alcohol use, smoking tied to low chemoprevention adherence in women at high risk of breast cancer

TUESDAY, Aug. 23 (HealthDay News) -- Women at high risk of breast cancer who drink alcohol each day are less likely to adhere fully to chemoprevention at one month, and cigarette smokers are less likely to adhere adequately at 36 months, according to a study published online Aug. 23 in Cancer Prevention Research.

Stephanie R. Land, Ph.D., from the National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Centers in Pittsburgh, and colleagues investigated predictors of chemoprevention adherence in 13,338 women at high risk of breast cancer. Participants were allocated to receive either 20 mg/d tamoxifen or placebo and were followed for three years. Full drug adherence at one and 36 months and adequate adherence were the primary and secondary end points, respectively.

The investigators found a total of 91 and 79 percent of the patients were adequately adherent at one and 36 months, respectively. Alcohol use and college education were significantly associated with reduced full adherence at one month (odds ratio [OR], 0.79 for more than one drink/day versus no drinks and OR, 0.78 versus high school, respectively). Age (OR, 1.4 for aged 60 or older), and household income (OR, 1.2 per $30,000 per capita) were significantly associated with increased adherence. Current smoking (OR, 0.75) and tamoxifen assignment were associated with reduced adequate adherence at 36 months (OR, 0.75 and 0.84, respectively), while age (OR, 1.1), college education (OR, 1.4), and breast cancer risk (OR, 1.5 for high versus low) significantly predicted adequate adherence at 36 months. Obesity and physical activity had no significant association.

"Heavy alcohol users were less likely to adhere fully in the short term and cigarette smokers were less likely to adhere adequately in the long term," the authors write.

One of the study authors disclosed financial ties to the pharmaceutical industry.

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