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

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.