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1. Public health lessons from the French 2012 soda tax and insights on the modifications enacted in 2018

Author: Yann Le Bodo, Fabrice Etilé, Chantal Julia, Marine Friant-Perrot, Eric Breton, Sébastien Lecocq, Christine Boizot-Szantai, Céline Bergeran, Françoise Jabot, École des Hautes Études en Santé Publique [EHESP] (EHESP), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), Paris School of Economics (PSE), Université Paris 1 Panthéon-Sorbonne (UP1)-École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École des hautes études en sciences sociales (EHESS)-École des Ponts ParisTech (ENPC)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Paris Jourdan Sciences Economiques (PJSE), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université Sorbonne Paris Nord, Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Sorbonne Paris Nord-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Droit et changement social (DCS), Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR Droit et Sciences Politiques (Nantes Univ - UFR DSP), Nantes Université - pôle Sociétés, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Sociétés, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Département des sciences humaines et sociales (SHS), Paris-Saclay Applied Economics (UMR PSAE), AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), The Soda-Tax project is co-funded by the French League against cancer (Convention n° RI/Fj/02) through the 2018 General Grant Cycle of the prevention and health promotion section of the Institute for Public Health Research (IReSP) (LI-JABOT-AAP18-PREV-006). The sponsors had no role in the study design, data collection, analysis and interpretation, manuscript writing, revision or approval., and Bauer, Caroline
Subjects: Public health, Health Policy, Prevention, Tax, Commerce, Carbonated Beverages, Sugar-sweetened beverages, Taxes, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, Beverages, Policy, Humans, Sugars, [SHS.ECO] Humanities and Social Sciences/Economics and Finance, Nutrition
Abstract: International audience; In 2016, the World Health Organization officially recommended sugar-sweetened beverage (SSB) taxation as a strategy to reduce purchases, stimulate product reformulation and generate revenues for health-related programmes. Four years before, France had been one of the first countries to tax SSBs. However, the design of this tax was not considered optimal: its rate was flat, low, identical for SSBs and artificially-sweetened drinks containing no added sugars, and its initial public health justification was set aside in favour of budgetary concerns. In 2018, a new taxation scheme was enacted. Integrated in the Social Security Finance Bill, the tax on SSBs is now linearly indexed to the quantity of added sugars in the drink. In this article, we summarize the lessons learnt from the 2012 soda tax and offer insights on the potential public health benefits of the new tax enacted in 2018. A multidimensional framework aimed at gathering evidence about SSB taxation for public health drove our rational so that we address: (1) the soda tax policy-change process; (2) its impact on price and purchases; (3) the consumer receptiveness to the tax and; (4) its legal framework. We also discuss the potential application of the tax to other foods/nutrients.
Published: 2022
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2. Monitoring the proportion of the population infected by SARS-CoV-2 using age-stratified hospitalisation and serological data: a modelling study

Author: Hozé, Nathanaël, Paireau, Juliette, Lapidus, Nathanaël, Tran Kiem, Cécile, Salje, Henrik, Severi, Gianluca, Touvier, Mathilde, Zins, Marie, De Lamballerie, Xavier, Lévy-Bruhl, Daniel, Carrat, Fabrice, Cauchemez, Simon, Modélisation mathématique des maladies infectieuses - Mathematical modelling of Infectious Diseases, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université - Département de santé publique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Collège doctoral [Sorbonne universités], Sorbonne Université (SU), University of Cambridge [UK] (CAM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Università degli Studi di Firenze = University of Florence [Firenze] (UNIFI), Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Sorbonne Paris Nord-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Sorbonne Université - Faculté de Médecine (SU FM), Unité des Virus Emergents (UVE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Support for this study was provided by Agence Nationale de la Recherche (ANR, ANR-20-COVI-000, #ANR-10-COHO-06), Fondation pour la Recherche Médicale (#20RR052-00), Institut National de la Santé et de la Recherche Médicale (Inserm, C20-26). We acknowledge financial support from the Investissement d'Avenir programme, the Laboratoire d'Excellence Integrative Biology of Emerging Infectious Diseases programme (grant ANR-10-LABX-62-IBEID), Santé Publique France, the INCEPTION project (PIA/ANR-16-CONV-0005), the EU Horizon 2020 research and innovation programme under grants 101003589 (RECOVER) and 874735 (VEO), AXA, and Groupama. The CONSTANCES Cohort Study is supported by the Caisse Nationale d'Assurance Maladie, the French Ministry of Health, the Ministry of Research, and Inserm. CONSTANCES benefits from a grant from the French National Research Agency (grant number ANR-11-INBS-0002) and is also partly funded by Merck Sharp & Dohme, AstraZeneca, Lundbeck, and L'Oreal. The E3N-E4N cohort is supported by the following institutions: Ministère de l'Enseignement Supérieur, de la Recherche et de l'Innovation, Inserm, University Paris-Saclay, Gustave Roussy, the Mutuelle générale de l'Éducation nationale, and the French League Against Cancer. The NutriNet-Santé study is supported by the following public institutions: Ministère de la Santé, Santé Publique France, Inserm, Institut National de la Recherche Agronomique, Conservatoire National des Arts et Métiers, and Sorbonne Paris Nord. The CEPH-Biobank is supported by the Ministère de l'Enseignement Supérieur, de la Recherche et de l'Innovation., ANR-10-COHO-0006,E4N,Etude Epidémiologique des Enfants de femmes de l'Education Nationale(2010), ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-16-CONV-0005,INCEPTION,Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs(2016), European Project: 101003589, H2020-SC1-PHE-CORONAVIRUS-2020,RECOVER(2020), European Project: 874735,VEO, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Collège Doctoral, Università degli Studi di Firenze = University of Florence (UniFI), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), European Project: 874735,H2020-SC1-2019-Single-Stage-RTD,VEO(2020), Salje, Henrik [0000-0003-3626-4254], Apollo - University of Cambridge Repository, Gestionnaire, HAL Sorbonne Université 5, Cohortes - Etude Epidémiologique des Enfants de femmes de l'Education Nationale - - E4N2010 - ANR-10-COHO-0006 - COHO - VALID, Integrative Biology of Emerging Infectious Diseases - - IBEID2010 - ANR-10-LABX-0062 - LABX - VALID, Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs - - INCEPTION2016 - ANR-16-CONV-0005 - CONV - VALID, Rapid European COVID-19 Emergency Response research - RECOVER - - H2020-SC1-PHE-CORONAVIRUS-20202020-02-14 - 2022-02-13 - 101003589 - VALID, and Versatile Emerging infectious disease Observatory - VEO - - H2020-SC1-2019-Single-Stage-RTD2020-01-01 - 2024-12-31 - 874735 - VALID
Subjects: Adult, Models, Statistical, COVID-19, Articles, Middle Aged, Hospitalization, Young Adult, Age Distribution, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Seroepidemiologic Studies, Humans, Public Health Surveillance, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Aged
Abstract: BACKGROUND: Regional monitoring of the proportion of the population who have been infected by SARS-CoV-2 is important to guide local management of the epidemic, but is difficult in the absence of regular nationwide serosurveys. We aimed to estimate in near real time the proportion of adults who have been infected by SARS-CoV-2. METHODS: In this modelling study, we developed a method to reconstruct the proportion of adults who have been infected by SARS-CoV-2 and the proportion of infections being detected, using the joint analysis of age-stratified seroprevalence, hospitalisation, and case data, with deconvolution methods. We developed our method on a dataset consisting of seroprevalence estimates from 9782 participants (aged ≥20 years) in the two worst affected regions of France in May, 2020, and applied our approach to the 13 French metropolitan regions over the period March, 2020, to January, 2021. We validated our method externally using data from a national seroprevalence study done between May and June, 2020. FINDINGS: We estimate that 5·7% (95% CI 5·1-6·4) of adults in metropolitan France had been infected with SARS-CoV-2 by May 11, 2020. This proportion remained stable until August, 2020, and increased to 14·9% (13·2-16·9) by Jan 15, 2021. With 26·5% (23·4-29·8) of adult residents having been infected in Île-de-France (Paris region) compared with 5·1% (4·5-5·8) in Brittany by January, 2021, regional variations remained large (coefficient of variation [CV] 0·50) although less so than in May, 2020 (CV 0·74). The proportion infected was twice as high (20·4%, 15·6-26·3) in 20-49-year-olds than in individuals aged 50 years or older (9·7%, 6·9-14·1). 40·2% (34·3-46·3) of infections in adults were detected in June to August, 2020, compared with 49·3% (42·9-55·9) in November, 2020, to January, 2021. Our regional estimates of seroprevalence were strongly correlated with the external validation dataset (coefficient of correlation 0·89). INTERPRETATION: Our simple approach to estimate the proportion of adults that have been infected with SARS-CoV-2 can help to characterise the burden of SARS-CoV-2 infection, epidemic dynamics, and the performance of surveillance in different regions. FUNDING: EU RECOVER, Agence Nationale de la Recherche, Fondation pour la Recherche Médicale, Institut National de la Santé et de la Recherche Médicale (Inserm).
Published: 2021
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3. Blood Metal Levels and Amyotrophic Lateral Sclerosis Risk: A Prospective Cohort

Author: Broberg, Karin E., Kippler, Maria J., Veldink, Jan Herman, Van Den Berg, Leonard H., Middleton, Lefkos T., Travis, Ruth C., Bergmann, Manuela M., Mancini, Francesca Romana, Katzke, Verena Andrea, Agudo, Antonio T., Gómez, Jesús Humberto, Rodríguez-Barranco, Miguel A., Trichopoulou, Antonia D., Vermeulen, Roel C.H., Peters, Susan, Broberg, Karin, Gallo, Valentina, Levi, Michael, Kippler, Maria, Vineis, Paolo, Veldink, Jan, Berg, Leonard, Middleton, Lefkos, Travis, Ruth, Bergmann, Manuela, Palli, Domenico, Grioni, Sara, Tumino, Rosario, Elbaz, Alexis, Vlaar, Tim, Mancini, Francesca, Kühn, Tilman, Katzke, Verena, Agudo, Antonio, Goñi, Fernando, Gómez, Jesús‐humberto, Rodríguez‐barranco, Miguel, Merino, Susana, Barricarte, Aurelio, Trichopoulou, Antonia, Jenab, Mazda, Weiderpass, Elisabete, Vermeulen, Roel, Santé publique France - French National Public Health Agency [Saint-Maurice, France], Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Institut Gustave Roussy (IGR), Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), FOOD‐CT‐2005‐513943 Ministry of National Education and Religious Affairs Cancer Research UK, CRUK Wellcome Trust, WT German Cancer Research Center, DKFZ Department of Health, Australian Government Institut National de la Santé et de la Recherche Médicale, Inserm Kræftens Bekæmpelse, DCS Instituto de Salud Carlos III, ISCIII: C03/09 Stichting Diabetes Onderzoek Nederland British Heart Foundation, BHF Norges Forskningsråd QLK4CT199900927 Stroke Association European Commission, EC Deutsche Krebshilfe World Cancer Research Fund, WCRF Kreftforeningen, NCS Medical Research Council, MRC, The EPIC study is funded by a number of grants, however, no funding source had any role in the preparation of this article. The EPIC study was funded by the Europe against Cancer program of the European Commission (SANCO), Italian Association for Research on Cancer, and Italian National Research Council. In addition, the authors thank the following for their financial support: the Environmental Cancer Risk, Nutrition, and Individual Susceptibility Network of Excellence, operating within the European Union Sixth Framework Program, Priority 5: Food Quality and Safety (FOOD‐CT‐2005‐513943), European Community Fifth Framework Program (grant QLK4CT199900927), ISCIII, Red de Centros RCESP (C03/09), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, German Federal Ministry of Education and Research, Danish Cancer Society, Health Research Fund of the Spanish Ministry of Health, Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia, and Navarra, Cancer Research UK, Medical Research Council, UK, Stroke Association, UK, British Heart Foundation, Department of Health, UK, Food Standards Agency, UK, Wellcome Trust, UK, Greek Ministry of Health, Greek Ministry of Education, Italian Association for Research on Cancer, Italian National Research Council, Dutch Ministry of Public Health, Welfare, and Sports, Netherlands Cancer Registry, LK Research Funds, Dutch Prevention Funds, Zorg Onderzoek Nederland, World Cancer Research Fund, Statistics Netherlands, Swedish Cancer, Swedish Scientific Council, Regional Government of Skåne and Västerbotten, Sweden, Norwegian Cancer Society, Research Council of Norway, French League against Cancer, INSERM, Mutuelle Generale l'Education National, and IGR. The EPIC‐Norfolk study (DOI 10.22025/2019.10.105.00004) has received funding from the Medical Research Council (MR/N003284/1 and MC‐UU_12015/1) and Cancer Research UK (C864/A14136)., and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Subjects: 0301 basic medicine, Adult, Male, Risk, medicine.medical_specialty, Clinical Neurology, Gastroenterology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, LEAD-EXPOSURE, Internal medicine, medicine, Humans, Prospective Studies, Prospective cohort study, Research Articles, POPULATION, Aged, Retrospective Studies, Science & Technology, Neurology & Neurosurgery, business.industry, Amyotrophic Lateral Sclerosis, Neurosciences, 1103 Clinical Sciences, Retrospective cohort study, Odds ratio, Environmental exposure, Environmental Exposure, Mercury, Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, 030104 developmental biology, Neurology, Cohort, Population study, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Neurosciences & Neurology, Neurology (clinical), SMOKING, 1109 Neurosciences, business, Life Sciences & Biomedicine, 030217 neurology & neurosurgery, Research Article, Cohort study
Abstract: International audience; Objective: Metals have been suggested as a risk factor for amyotrophic lateral sclerosis (ALS), but only retrospective studies are available to date. We compared metal levels in prospectively collected blood samples from ALS patients and controls, to explore whether metals are associated with ALS mortality. Methods: A nested ALS case–control study was conducted within the prospective EPIC (European Prospective Investigation into Cancer and Nutrition) cohort. Cases were identified through death certificates. We analyzed metal levels in erythrocyte samples obtained at recruitment, as a biomarker for metal exposure from any source. Arsenic, cadmium, copper, lead, manganese, mercury, selenium, and zinc concentrations were measured by inductively coupled plasma–mass spectrometry. To estimate ALS risk, we applied conditional logistic regression models. Results: The study population comprised 107 cases (65% female) and 319 controls matched for age, sex, and study center. Median time between blood collection and ALS death was 8 years (range = 1–15). Comparing the highest with the lowest tertile, cadmium (odds ratio [OR] = 2.04, 95% confidence interval [CI] = 1.08–3.87) and lead (OR = 1.89, 95% CI = 0.97–3.67) concentrations suggest associations with increased ALS risk. Zinc was associated with a decreased risk (OR = 0.50, 95% CI = 0.27–0.94). Associations for cadmium and lead remained when limiting analyses to noncurrent smokers. Interpretation: This is the first study to compare metal levels before disease onset, minimizing reverse causation. The observed associations suggest that cadmium, lead, and zinc may play a role in ALS etiology. Cadmium and lead possibly act as intermediates on the pathway from smoking to ALS. ANN NEUROL 20209999:n/a–n/a.
Published: 2021
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4. Dietary exposure to polychlorinated biphenyls (PCB) and risk of Non-Hodgkin's lymphoma: Evidence from the French E3N prospective cohort

Author: Francesca Mancini, Pauline Frenoy, Thibault Fiolet, Caroline Besson, Marine Lemaitre, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Mutuelle Générale de l'Education Nationale, MGEN Institut Gustave-Roussy Mutuelle Générale de l'Education Nationale, MGEN Institut National de la Santé et de la Recherche Médicale, Inserm, This work was realized with the data of the E3N cohort of the Inserm and supported by the Mutuelle Générale de l’Education Nationale ( MGEN ), the Gustave Roussy Institute, and the French League against Cancer for the constitution and maintenance of the cohort. This work has benefited from State aid managed by the Nation Research Agency under the program 'Investment in the future' bearing the reference ANR-10-COHO-0006 as well as subsidy from the Ministry of Higher Education, Research and Innovation for public service charges bearing the reference n°2102918823., and ANR-10-COHO-0006,E4N,Etude Epidémiologique des Enfants de femmes de l'Education Nationale(2010)
Subjects: Population, Food Contamination, 010501 environmental sciences, Polychlorinated biphenyls (PCB), 01 natural sciences, Biochemistry, Dietary exposure, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Non-hodgkin's lymphomas (NHL), Humans, Medicine, Prospective Studies, 030212 general & internal medicine, education, Prospective cohort study, 0105 earth and related environmental sciences, General Environmental Science, 2. Zero hunger, education.field_of_study, business.industry, Proportional hazards model, Lymphoma, Non-Hodgkin, Hazard ratio, Confounding, Prospective cohort, medicine.disease, Polychlorinated Biphenyls, Confidence interval, 3. Good health, Non-Hodgkin's lymphoma, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Diffuse large B-cell lymphoma
Abstract: International audience; Introduction: Polychlorinated biphenyls (PCB) are persistent and bioaccumulative lipophilic substances, mostly used in the past by industry. Known to be cancerogenic, PCB are suspected to increase Non-Hodgkin's Lymphoma (NHL) risk in the general population mainly due to evidence from cases-controls studies. Since their interdiction in 1987, diet represents the main route of exposure for the general population, nevertheless no study has assessed the relationship between PCB dietary exposure and NHL risk. The aim of this study was to analyze the association between dietary exposures to dioxin like PCB (DL PCB) and non-dioxin like PCB (NDL PCB) and NHL risk in the E3N prospective cohort of French women. Materials and methods: Among 67,879 women included in this study, 457 cases of NHL were confirmed during 21 years of follow-up. Dietary exposure to PCB was estimated combining food consumption data collected in E3N and food contamination data provided by French Agency for Food, Environmental and Occupational Health & Safety (ANSES) in the second French total diet study. Cox regression models, adjusted for potential confounders, were used to estimate hazard ratio (HR) and 95% confidence intervals (CI). Results: Average age at diagnosis was 67 years. The median dietary exposure to DL PCB and NDL PCB was, 18.5 pg TEQ/d and 138,843.2 pg/d, respectively. While no association was found between dietary exposure to DL PCB or NDL PCB and overall NHL risk, analyses by NHL histological subgroups showed a positive association between dietary exposures to DL PCB and Diffuse Large B Cell Lymphoma (OR3vs1 1.90, 95%CI [1.03–3.51], ptrend 0.02). Nevertheless these findings were no longer statistically significant when the models were adjusted for fish and dairy products consumption. In addition, an inverse association was found between dietary exposure to NDL PCB and the risk of follicular lymphoma (OR3vs1 0.46, 95%CI [0.24–0.87], ptrend 0.01). Conclusion: This is the first study to evaluate the association between dietary exposure to DL and NDL PCB and the risk of NHL in a prospective cohort study. Overall, the findings suggest a lack of association between dietary exposure to DL or NDL PCB and NHL risk. Additional studies are needed to reproduce these findings.
Published: 2021
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5. Associations between early-life food deprivation during World War II and risk of hypertension and type 2 diabetes at adulthood

Author: Guy Fagherazzi, Marie-Aline Charles, Julia Mink, Olivier Allais, Marie-Christine Boutron-Ruault, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Bodescot, Myriam, Cohortes - Etude Epidémiologique des Enfants de femmes de l'Education Nationale - - E4N2010 - ANR-10-COHO-0006 - COHO - VALID, Département d'économie (Sciences Po) (ECON), Sciences Po (Sciences Po)-Centre National de la Recherche Scientifique (CNRS), Alimentation et sciences sociales (ALISS), Université Paris-Saclay, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Luxembourg Institute of Health (LIH), The E3N cohort is being carried out with the financial support of the 'Mutuelle Générale de l’Education Nationale', European Community, French League against Cancer, Gustave Roussy, and French Institute of Health and Medical Research. This present study was also supported by the French Research Agency (Agence Nationale de la Recherche) via an 'Investissement d’Avenir' grant (investment for the future grant, ANR-10-COHO-0006) that supports the E4N study and by the Strategic Research Initiative NutriPerso from the University Paris-Saclay., ANR-10-COHO-0006,E4N,Etude Epidémiologique des Enfants de femmes de l'Education Nationale(2010), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Male, Food deprivation, World War II, Hunger, Diseases, Disease, Type 2 diabetes, First world war, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Child, 2. Zero hunger, [SDV.MHEP.EM] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Multidisciplinary, Age Factors, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, Early life, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Child, Preschool, Hypertension, Female, Adolescent, Science, 030209 endocrinology & metabolism, Affect (psychology), Article, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Humans, Adult health, business.industry, Infant, Newborn, Infant, medicine.disease, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Risk factors, Diabetes Mellitus, Type 2, Starvation, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Demography
Abstract: The Developmental Origins of Health and Disease (DOHaD) framework suggests that early-life experiences affect long-term health outcomes. We tested this hypothesis by estimating the long-run effects of exposure to World War II-related food deprivation during childhood and adolescence on the risk of suffering from hypertension and type 2 diabetes at adulthood for 90,226 women from the French prospective cohort study E3N. We found that the experience of food deprivation during early-life was associated with a higher risk of developing type 2 diabetes (+0.7%, 95% CI: 0.073–1.37%) and hypertension (+2.6%, 95% CI: 0.81–4.45%). Effects were stronger for individuals exposed at younger ages. Exposed individuals also achieved lower levels of education, slept less, and were more frequently smokers than unexposed individuals. These results are compatible with both the latency and the pathway models proposed in the DOHaD framework which theorise the association between early life exposure and adult health through both a direct link and an indirect link where changes in health determinants mediate health outcomes.
Published: 2020
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6. Plasma concentration of brominated flame retardants and postmenopausal breast cancer risk: A nested case-control study in the French E3N cohort

Author: Mancini, Francesca Romana, Cano-Sancho, German, Mohamed, Oceane, Cervenka, Iris, Omichessan, Hanane, Marchand, Philippe, Boutron-Ruault, Marie-Christine, Arveux, Patrick, Severi, Gianluca, Antignac, Jean-Philippe, Kvaskoff, Marina, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Institut Gustave Roussy (IGR), Laboratoire d'étude des Résidus et Contaminants dans les Aliments (LABERCA), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Université de Florence, Università degli Studi di Firenze = University of Florence [Firenze] (UNIFI), Institut National Du Cancer, INCa Mutuelle Générale de l'Education Nationale, MGEN Institut National de la Santé et de la Recherche Médicale, Inserm Institut National Du Cancer, INCa, and This work was realized with the data of the E3N cohort of the Inserm and supported by the Mutuelle G?n?rale de l'Education Nationale (MGEN), the Gustave Roussy Institute, and the French League against Cancer for the constitution and maintenance of the cohort. The work was also supported by the grant EQ. 9-C17014LS from the Cancer ITMO of the French National Alliance for Life and Health Sciences (AVIESAN), in collaboration with the Institut National du Cancer (French National Cancer Institute) and Inserm.
Subjects: lcsh:Public aspects of medicine, Research, Polybrominated Biphenyls, lcsh:RA1-1270, Breast Neoplasms, Pentabromodiphenyl ethers (PBDEs), Endocrine Disruptors, Middle Aged, Brominated flame retardants (BFRs), Polybrominated biphenyls (PBBs), Postmenopause, lcsh:RC963-969, Breast cancer, Risk Factors, Case-Control Studies, Biomonitoring, lcsh:Industrial medicine. Industrial hygiene, Halogenated Diphenyl Ethers, E3N cohort, Humans, Environmental Pollutants, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Flame Retardants
Abstract: International audience; Background: Brominated flame retardants (BFRs) are lipophilic substances with endocrine-disrupting properties. To date, only few investigations, mainly retrospective case-control studies, have explored the link between internal levels of BFRs and the risk of breast cancer, leading to conflicting results. We investigated the associations between plasma concentrations of two main groups of BFRs, PBDEs (pentabromodiphenyl ethers) and PBBs (polybrominated biphenyls), and the risk of breast cancer in a nested case-control study. Methods: A total of 197 incident breast cancer cases and 197 controls with a blood sample collected in 1994-1999 were included. Plasma levels of PBDE congeners (BDE-28, BDE-47, BDE-99, BDE-100, BDE153, BDE-154) and of PBB-153 were measured by gas chromatography coupled to high-resolution mass spectrometry. Conditional logistic regression models, adjusted for potential confounders, were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Women were aged 56 years on average at blood draw. All cases, except for one, were diagnosed after menopause, with an average age at diagnosis of 68 years. Overall, we found no evidence of an association between plasma levels of PBDEs and PBB-153 and postmenopausal breast cancer risk (log-concentrations of BFRs yielding non-statistically significant ORs of 0.87 to 1.07). The analysis showed a non-linear inverse association for BDE-100 and BDE-153 and postmenopausal breast cancer risk; nevertheless, these findings were statistically significant only when the exposure was modeled as ng/L plasma (third vs. first quintile: OR = 0.42, 95%CI = 0.19-0.93 and OR = 0.42, 95%CI = 0.18-0.98, respectively) and not when modeled as ng/gr of lipids (OR = 0.58, 95%CI = 0.27-1.25 and OR = 0.53, 95%CI = 0.25-1.17). These results were unchanged in stratified analyses by tumor hormone receptor expression or body mass index. Conclusions: Our results suggest no clear association between internal levels of PBDEs and PBB-153 and the risk of breast cancer in postmenopausal women. However, these findings need to be carefully interpreted, taking into account limitations due to the limited number of women included in the study, the lack of information concerning genetic susceptibility of cases, and the unavailability of exposure assessment during critical windows of susceptibility for breast cancer. More studies are warranted to further investigate the relationships between PBDE and PBB exposure and breast cancer risk.
Published: 2020
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7. Use of nonsteroidal anti-inflammatory drugs and breast cancer risk in a prospective cohort of postmenopausal women

Author: Agnès Fournier, Marc J. Gunter, Gianluca Severi, Manon Cairat, Laure Dossus, Marie Al Rahmoun, Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France, International Agency for Cancer Research (IACR), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut Gustave Roussy (IGR), Università degli Studi di Firenze = University of Florence [Firenze] (UNIFI), Ligue Contre le Cancer Mutuelle Générale de l'Education Nationale, MGEN Institut Gustave-Roussy Institut National de la Santé et de la Recherche Médicale, Inserm, Ligue Contre le Cancer (support for the E3N cohort and PhD fellowship to Manon Cairat). Acknowledgements Disclaimer, and The research was carried out using data from the Inserm (French National Institutes for Health and Medical Research) E3N cohort, which was established and maintained with the support of the Mutuelle Générale de l’Education Nationale (MGEN), Gustave Roussy, and the French League against Cancer (LNCC). We are grateful to the study participants for their continued participation and to medical practitioners for providing pathology reports. We also thank all members of the E3N-EPIC study group, in particular Rafika Chaït, Ghizlane Esselma, Marie Fangon, Pascale Gerbouin-Rérolle, Lyan Hoang, Roselyn Gomes and the data management team, and Amandine Gelot for data management and/or technical assistance. The work reported in this paper was performed during Agnès Fournier’s term as a Visiting Scientist at the International Agency for Research on Cancer.
Subjects: medicine.medical_specialty, Proton pump inhibitors, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Comorbidity, Lower risk, lcsh:RC254-282, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Risk Factors, Surveys and Questionnaires, Internal medicine, medicine, Humans, Medical history, Prospective Studies, Prospective cohort study, Aged, Proportional Hazards Models, 030304 developmental biology, 0303 health sciences, Aspirin, business.industry, Proportional hazards model, Incidence, Incidence (epidemiology), Anti-Inflammatory Agents, Non-Steroidal, Hazard ratio, Nonsteroidal anti-inflammatory drugs, Middle Aged, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Postmenopausal women, 3. Good health, Postmenopause, 030220 oncology & carcinogenesis, Female, France, business, Research Article, Cohort study
Abstract: BackgroundAlthough anti-inflammatory agents could theoretically have anticancer properties, results from cohort studies on nonsteroidal anti-inflammatory drugs (NSAIDs) and breast cancer (BC) risk are inconsistent.MethodsWe investigated the association between NSAID use and BC incidence in the French E3N prospective cohort, which includes 98,995 women born between 1925 and 1950 and insured by a health insurance plan that covers mostly teachers. Self-reported information on lifestyle and medical history has been collected biennially by questionnaires and matched with data from a drug reimbursement database covering the period 2004–2014. Women who self-reported current NSAID use in the 2000 or 2002 questionnaires or with at least two reimbursements in any previous 3-month period were defined as exposed to NSAIDs. Multivariable Cox regression models were used to estimate hazard ratios (HRs) for the association of NSAID use with BC risk.ResultsIn the current analysis, 62,512 postmenopausal women were followed between 2004 and 2014 (9 years on average, starting at a mean age of 63 years; 2864 incident BC). In multivariable models, there was no statistically significant association between NSAID use and BC risk [HR = 1.00 (0.92–1.08), compared with non-exposed women]. The NSAID-BC associations did not differ by NSAID types, BC subtypes, risk factors, and comorbidities, nor by duration and dose of use. However, a statistically significant interaction was observed by proton pump inhibitor (PPI) drug use (Pinteraction = 0.01) whereby a decreased risk of BC with NSAID use was only observed among women who also used PPI before.ConclusionOnly women who used NSAIDs after having used PPI had a lower risk of BC. This result is novel and requires replication in other studies.
Published: 2020
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8. Allergic conditions and risk of glioma and meningioma in the CERENAT case-control study

Author: Camille Carles, Camille Pouchieu, Hugues Loiseau, Pascale Fabbro-Perray, Pierre Lebailly, Jean-Sébastien Guillamo, Clément Piel, Lucile Migault, Chantal Raherison, Isabelle Baldi, Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), BESPIM, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service de Neurologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, The CERENAT study received funding from the following French public research agencies: French National Institute of Health and Medical Research (INSERM), the French agency for Food, Environmental and Occupational Health Safety (ANSES), French Cancer Research Association (ARC - réseau ARECA) and the French League against Cancer (Ligue contre le Cancer - Comité Aquitaine Charentes)., Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Bodescot, Myriam, and UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: 0301 basic medicine, Male, Cancer Research, medicine.medical_specialty, Inverse Association, Allergy, [SDV.IMM] Life Sciences [q-bio]/Immunology, Primary central nervous system neoplasm, [SDV.CAN]Life Sciences [q-bio]/Cancer, Meningioma, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, [SDV.CAN] Life Sciences [q-bio]/Cancer, Risk Factors, Glioma, Internal medicine, Epidemiology, medicine, Hypersensitivity, Meningeal Neoplasms, Prevalence, Humans, neoplasms, business.industry, Brain Neoplasms, Confounding, Case-control study, Middle Aged, medicine.disease, 3. Good health, nervous system diseases, 030104 developmental biology, Neurology, Oncology, 030220 oncology & carcinogenesis, Case-Control Studies, Hay fever, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Neurology (clinical), France, business
Abstract: International audience; Inverse association between allergic conditions and glioma risk has been consistently reported in epidemiological studies with little attention paid to potential environmental confounders; the association with meningioma risk is less consistent. We examined the association between allergy history and risk of glioma and meningioma in adults using data from the CERENAT (CEREbral tumors: a NATional study) multicenter case-control study carried out in 4 areas in France in 2004-2010. Participants' histories of doctor-diagnosed allergic asthma, eczema, rhinitis/hay fever and other allergic conditions were collected at onset through a detailed questionnaire delivered in a face-to-face interview. Conditional logistic regression for matched sets was adjusted for participants' educational level and mobile phone use. A total of 273 glioma cases, 218 meningioma cases and 982 matched controls selected from the local electoral rolls were analyzed. A significant inverse association was found between glioma and a history of any allergy (OR 0.52, 95% CI 0.36-0.75), with a dose-effect relationship with the number of allergic conditions reported (p-trend = 0.001) and a particularly strong association with hay fever/allergic rhinitis (OR 0.46, 95% CI 0.30-0.72). Interestingly, associations with glioma risk were more pronounced in women. For meningioma, no association was observed with overall or specific allergic conditions. Our findings confirmed the inverse association between allergic conditions and glioma risk but questioned the role of allergy in meningioma risk. Future research is needed to clarify the biological mechanism of overall allergy and allergic rhinitis on glioma and to confirm the different effect by gender.
Published: 2018
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9. Multimorbidity medications and poor asthma prognosis

Author: Margaux Sanchez, Marie-Christine Boutron-Ruault, Sébastien Chanoine, Sofia Temam, Pierrick Bedouch, Jean Bousquet, Valérie Siroux, Raphaëlle Varraso, Christophe Pison, Isabelle Pin, Agnès Fournier, Nicole Le Moual, Pôle Pharmacie [CHU Grenoble Alpes], Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Centre Hospitalier Universitaire Grenoble Alpes (CHU Grenoble Alpes), Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health (IAB - INSERM U1209 - CNRS UMR5309), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Clinique Universitaire de Pédiatrie [CHU Grenoble Alpes], Hôpital Sud, CHU de Grenoble-Hôpital Couple Enfant de Grenoble, Université Paris-Sud [Le Kremlin-Bicêtre] (Faculté de Médecine), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut Gustave Roussy (IGR), Service Hospitalier Universitaire Pneumologie-Physiologie [CHU Grenoble Alpes] (Pôle Thorax et Vaisseaux), Centre Hospitalier Universitaire Grenoble Alpes (CHU Grenoble Alpes), Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Clinique de pneumologie, CHU Grenoble, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), This work was supported by a grant of the Institut pour la Recherche en Santé Publique (IReSP), and of the joint support of Direction Générale de la Santé (DGS), Mission recherche de la Direction de la recherche, des études, de l’évaluation et des statistiques (Mire-DREES), Caisse nationale d’assurance maladie des travailleurs salariés (CNAMTS), Régime Social des Indépendants (RSI), and Caisse nationale de solidarité pour l’autonomie (CNSA). In addition, the work was supported by a state grant ANR-10-COHO-0006 from the Agence Nationale de la Recherche within the Investissement d’Avenir program. The research was performed using data from the Inserm E3N cohort and support from the Mutuelle Générale de l’Education Nationale (MGEN), the Gustave Roussy Institute (IGR), the French League against Cancer (LNCC), and the National Institute for Health and Medical Research (Inserm) for setting up and maintaining the cohort., Centre Hospitalier Universitaire Grenoble Alpes ( CHU Grenoble Alpes ) -Université Grenoble Alpes ( UGA ), Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health ( IAB - INSERM U1209 - CNRS UMR5309 ), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) ( IAB ), Centre Hospitalier Universitaire [Grenoble] ( CHU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Etablissement français du sang - Auvergne-Rhône-Alpes ( EFS ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Centre Hospitalier Universitaire [Grenoble] ( CHU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Etablissement français du sang - Auvergne-Rhône-Alpes ( EFS ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique ( VIMA ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris-Sud [Le Kremlin-Bicêtre] ( Faculté de Médecine ), Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut Gustave Roussy [Villejuif], Service Hospitalier Universitaire Pneumologie-Physiologie [CHU Grenoble Alpes] ( Pôle Thorax et Vaisseaux ), Centre Hospitalier Universitaire Grenoble Alpes ( CHU Grenoble Alpes ), Laboratoire de bioénergétique fondamentale et appliquée ( LBFA ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Grenoble Alpes ( UGA ), Contre les Maladies Chroniques pour un VIeillissement Actif en France ( MACVIA-France ), Centre Hospitalier Universitaire de Montpellier ( CHU Montpellier ), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( TIMC-IMAG ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ), Centre Hospitalier Universitaire [Grenoble] (CHU)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire [Grenoble] (CHU), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), and Faraldo, Beatrice
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Databases, Factual, multimorbidity, [SDV]Life Sciences [q-bio], MEDLINE, 03 medical and health sciences, 0302 clinical medicine, medications, Quality of life, immune system diseases, Internal medicine, Surveys and Questionnaires, Medicine, Multimorbidity, Cluster Analysis, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Adverse effect, Asthma, Aged, Polypharmacy, Aged, 80 and over, [ SDV ] Life Sciences [q-bio], business.industry, Case-control study, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Original Articles, Middle Aged, asthma, medicine.disease, Prognosis, adverse events, 3. Good health, respiratory tract diseases, [SDV] Life Sciences [q-bio], 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, Quality of Life, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business
Abstract: Multimedication related to multimorbidity is common in the elderly with asthma. We aimed at comprehensively characterising medications used by elderly women and assessing how multimedication impacts on asthma prognosis. We performed network-based analyses on drug administrative databases to visualise the prevalence of drug classes and their interconnections among 17 458 elderly women from the Asthma-E3N study, including 4328 women with asthma. Asthma groups sharing similar medication profiles were identified by a clustering method relying on all medications and were studied in association with adverse asthma events (uncontrolled asthma, attacks/exacerbations and poor asthma-related quality of life). The network-based analysis showed more multimedication in women with asthma than in those without asthma. The clustering method identified three multimedication profiles in asthma: “Few multimorbidity-related medications” (43.5%), “Predominantly allergic multimorbidity-related medications” (32.8%) and “Predominantly metabolic multimorbidity-related medications” (23.7%). Compared with women belonging to the “Few multimorbidity-related medications” profile, women belonging to the two other profiles had an increased risk of uncontrolled asthma and asthma attacks/exacerbations, and had lower asthma-related quality of life. The integrative data-driven approach on drug administrative databases identified specific multimorbidity-related medication profiles that were associated with poor asthma prognosis. These findings support the importance of multimorbidity in the unmet needs in asthma management., Asthma phenotypes identified by multimorbidity medications are associated with asthma prognosis http://ow.ly/Phfq30iR1Qh
Published: 2018
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10. Does freedom make a difference?

Author: Tessier, Philippe, Thuilliez, Josselin, MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Centre d'économie de la Sorbonne (CES), Université Paris 1 Panthéon-Sorbonne (UP1)-Centre National de la Recherche Scientifique (CNRS), Philippe Tessier benefited from a fellowship from La Ligue contre le cancer (French league against Cancer). Josselin Thuilliez benefited from a Fulbright grant and a Princeton fellowship at Princeton University., Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN)-Université de Tours (UT), and Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques
Subjects: JEL: I - Health, Education, and Welfare/I.I3 - Welfare, Well-Being, and Poverty/I.I3.I31 - General Welfare, Well-Being, JEL: D - Microeconomics/D.D6 - Welfare Economics/D.D6.D63 - Equity, Justice, Inequality, and Other Normative Criteria and Measurement, [SHS.ECO]Humanities and Social Sciences/Economics and Finance
Abstract: International audience; Perceived capabilities—a subjective operationalization of Sen’s concept of capability—and subjective well-being are increasingly regarded as relevant information about individual well-being to guide resources allocation in healthcare. Although they refer to different notions, both types of measures rely on self-reported information and little is known as to how they compare together empirically. The aim of this paper is to investigate differences between measures of subjective well-being and of perceived capabilities in terms of their correlation with dimensions of health-related quality of life using panel data concerning a sample of 293 breast cancer and melanoma patients. Regression analyses suggest that the measures capture quite different aspects of the patients’ welfare. Differences in the correlation with dimensions of health also seem consistent with the underlying notions to which these measures refer. However, our findings also suggest that future researches should aim at determining how measures of perceived capabilities may be influenced by individual personality traits.
Published: 2018
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11. Nonlinear associations between dietary exposures to perfluorooctanoic acid (PFOA) or perfluorooctane sulfonate (PFOS) and type 2 diabetes risk in women: Findings from the E3N cohort study

Author: Gianluca Severi, Jean-Philippe Antignac, Courtney Dow, Fabrice Bonnet, Marina Kvaskoff, Guy Fagherazzi, Kalina Rajaobelina, Marie-Christine Boutron-Ruault, Francesca Mancini, Delphine Praud, Université Paris Saclay (COmUE), Institut Gustave Roussy (IGR), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Mode de vie, génétique et santé : études intégratives et transgénérationnelles (U1018 (Équipe 9)), Institut Gustave Roussy (IGR)-Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Département cancer et environnement, Centre Léon Bérard, Laboratoire d'étude des Résidus et Contaminants dans les Aliments (LABERCA), Institut National de la Recherche Agronomique (INRA)-École nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS), CHU Pontchaillou [Rennes], Université de Rennes (UR), MGEN (Mutuelle Generale de l'Education Nationale), Gustave Roussy Institute, French League against Cancer, European Union [LSHM-CT-2006-037197], French Research Agency (ANR) [ANR-10-COHO-0006], Idex Paris Saclay Nutriperso project, ANR-10-COHO-0006,E4N,Etude Epidémiologique des Enfants de femmes de l'Education Nationale(2010), Institut National de la Recherche Agronomique (INRA)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)
Subjects: Adult, [SDV]Life Sciences [q-bio], 030209 endocrinology & metabolism, Food Contamination, Type 2 diabetes, 010501 environmental sciences, Endocrine Disruptors, 01 natural sciences, Dietary exposure, Decile, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, Environmental health, Medicine, Humans, Risk factor, Prospective cohort study, 0105 earth and related environmental sciences, 2. Zero hunger, Fluorocarbons, business.industry, Public Health, Environmental and Occupational Health, Middle Aged, medicine.disease, 3. Good health, Perfluorooctane, chemistry, Alkanesulfonic Acids, Diabetes Mellitus, Type 2, Perfluorooctanoic acid, Environmental Pollutants, Female, France, Perfluorooctane sulfonate (PFOS), Caprylates, Perfluorooctanoic acid (PFOA), business, Body mass index, Cohort study
Abstract: International audience; The incidence of type 2 diabetes (T2D) is steadily rising worldwide since the past 30 years. There is increasing interest in understanding the contribution of exposure to endocrine disrupting chemicals (EDCs) to T2D trend. Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) are stable, persistent, and bioaccumulative synthetic compounds, suspected to act as EDCs and for which the diet is the main route of exposure. We investigated associations between estimated dietary exposure to PFOS and PFOA and the risk of T2D in the large E3N prospective cohort study. Among 71 270 women included in this study, 2680 cases of incident type 2 diabetes were validated during follow-up (1993-2012). Dietary exposure was estimated combining dietary consumption data collected in E3N and food contamination data provided by ANSES in the 2nd French Total Diet Study. The estimated mean dietary exposure to PFOS and PFOA was 0.50 ng/kg (body weight)/day and 0.86 ng/kg body weight/day respectively. An inverse U-shape association was found when considering PFOA and T2D: women in the 4th, 5th, and 6th decile groups had a HR [95%CI] of 1.21 [1.06-1.46], 1.35 [1.15-1.59], and 1.33 [1.05-1.41], respectively, when compared to women of the 1st decile group, while the other decile groups were not associated to the risk of T2D. The positive association had the strongest effect size for non-obese women (body mass index (BMI)
Published: 2018
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12. High iodine dietary intake is associated with type 2 diabetes among women of the E3N-EPIC cohort study

Author: Courtney Dow, Tina Habbal, Francesca Mancini, Kalina Rajaobelina, Aurélie Affret, Guy Fagherazzi, Marie-Christine Boutron-Ruault, Fabrice Bonnet, Beverley Balkau, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Université de Rennes (UR), The Inserm E3N-EPIC cohort, was established and maintained with the support of the MGEN (Mutuelle Générale de l’Education Nationale), the Gustave Roussy Institute, and the French League against Cancer. The validation of potential diabetes cases was supported by the European Union (Integrated Project LSHM-CT-2006-037197 in the 6th European Community Framework Programme) InterAct project. The study is also supported by the French Research Agency (ANR grant, ANR-10-COHO-0006)., ANR-10-COHO-0006,E4N,Etude Epidémiologique des Enfants de femmes de l'Education Nationale(2010), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)
Subjects: 0301 basic medicine, chemistry.chemical_element, 030209 endocrinology & metabolism, Type 2 diabetes, Critical Care and Intensive Care Medicine, Iodine, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Environmental health, Diabetes mellitus, Medicine, Humans, 030109 nutrition & dietetics, Nutrition and Dietetics, business.industry, Hazard ratio, Middle Aged, Micronutrient, medicine.disease, E3N-Epic, 3. Good health, Diet, chemistry, Diabetes Mellitus, Type 2, Cohort, Female, France, Thyroid function, business, Cohort study, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Abstract: Summary Background Iodine is an essential micronutrient needed for the production of thyroid hormones. Consequently, iodine insufficient and excessive intakes are associated with thyroid disorders. Despite the increase in diabetes prevalence worldwide and the close relationship between thyroid function and the risk of diabetes, the relationship between iodine intake and diabetes has been overlooked. The objective of the present study is to investigate the link between iodine intake and the risk of type 2 diabetes. Methods Cox proportional hazards regression models adjusted on potential confounders were used to calculate the hazard ratios and 95% confidence intervals for the associations between dietary iodine intake and type 2 diabetes risk among 71,264 women of the E3N-EPIC cohort. Results The average iodine intake in the study population was 155.6 μg/day (±47.1 μg/day). After adjusting for the main risk factors for diabetes, for hypo/hyperthyroidism, as well as for phosphorus intakes and consumption of dairy products and seafood, the hazard ratios (95% CI) for type 2 diabetes of women in the 4th (160.7–190.5 μg/day) and 5th (190.6–596.8 μg/day) quintiles groups of iodine intake were 1.27 (1.10–1.47) and 1.28 (1.07–1.53), respectively, compared to women with iodine intake below the 1st quintile (29.3–116.9 μg/day). Conclusion This is the first study to investigate the relationship between dietary iodine intake and the risk of developing type 2 diabetes. More studies are warranted to further investigate the health effects of chronic high iodine intake, and in particular to investigate the biological mechanisms that underlie the association between iodine intake and type 2 diabetes.
Published: 2018
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13. Nevi, Ambient Ultraviolet Radiation, and Thyroid Cancer Risk: A French Prospective Study

Author: Sylvie Mesrine, Françoise Clavel-Chapelon, Lucien Wald, Thierno Bah, Marie-Christine Boutron-Ruault, Marina Kvaskoff, Institut Gustave Roussy (IGR), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Observation, Impacts, Énergie (O.I.E.), Mines Paris - PSL (École nationale supérieure des mines de Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Mutuelle Générale de l’Education Nationale (MGEN), the European Community, the French League against Cancer (LNCC), Gustave Roussy, and the French National Institutes for Health and Medical Research (Inserm). French National Cancer Institute (InCA) (#2009-139)., European Project: PIOF-GA-2011-302078,Marie Curie Fellowship, FP7, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), MINES ParisTech - École nationale supérieure des mines de Paris, and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)
Subjects: 0301 basic medicine, Oncology, medicine.medical_specialty, Goiter, Skin Neoplasms, Epidemiology, Ultraviolet Rays, Skin Pigmentation, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, Prospective Studies, Thyroid Neoplasms, Prospective cohort study, Thyroid cancer, Nevus, Proportional Hazards Models, Proportional hazards model, business.industry, Melanoma, Thyroid, Hazard ratio, Middle Aged, medicine.disease, 030104 developmental biology, Endocrinology, medicine.anatomical_structure, Logistic Models, 030220 oncology & carcinogenesis, Cohort, Female, France, business
Abstract: International audience; Background: Incidence rates have increased considerably worldwide for both differentiated thyroid cancer and cutaneous melanoma, and two-way associations between these neoplasms have been described. Whether melanoma risk factors are associated with thyroid cancer risk remains unknown.Methods: Using Cox regression modeling, we prospectively analyzed the relationship between self-reported pigmentary traits, baseline residential ultraviolet (UV) exposure, and thyroid cancer risk in 86,960 women from the E3N cohort, followed-up over 1990–2008 through biennial questionnaires. We assessed associations of pigmentary traits and UV exposure with personal history of benign thyroid diseases using logistic regression modeling. All statistical tests were two sided.Results: In models adjusted for age and thyroid cancer risk factors, number of nevi was positively associated with thyroid cancer risk (“very many” vs. “none”: hazards ratio [HR] = 1.7, 95% confidence interval [CI] = 1.0, 2.8; Ptrend= 0.01), independently of residential UV exposure or iodine intake. Risk was inversely associated with latitude and positively associated with mean daily UV level at baseline (HRs for the fourth vs. first quartile of latitude and spring/summer UVB level = 0.7, 95% CI = 0.5, 0.9; Ptrend = 0.03, and HR = 1.9, 95% CI = 1.4, 2.7; Ptrend = 0.02, respectively); associations were restricted to women with dietary iodine below the median intake. Number of nevi and UV level were also associated with personal histories of dysthyroidism and of goiter/nodules, although more weakly so.Conclusions: Our results suggest that number of nevi and residential UV exposure are associated with the risks of thyroid cancer and benign conditions. They point to novel pathways in thyroid cancer or melanoma etiologies and warrant replication.
Published: 2017
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14. Educational level and family structure influence the dietary changes after the diagnosis of type 2 diabetes: evidence from the E3N study

Author: Françoise Clavel-Chapelon, Courtney Dow, Fabrice Bonnet, Guy Fagherazzi, Aurélie Affret, Hélène Bihan, Beverley Balkau, Francesca Mancini, Marie-Christine Boutron-Ruault, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'endocrinologie, diabétologie, maladies métaboliques [Avicenne], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pontchaillou [Rennes], The E3N cohort is being carried out with the financial support of the 'Mutuelle Générale de l'Education Nationale', European Community, French League against Cancer, Gustave Roussy, and French Institute of Health and Medical Research. This present work was supported by a grant from the World Cancer Research Fund. The validation of potential diabetes cases was supported by the European Union (Integrated Project LSHM-CT-2006-037197 in the 6th European Community Framework Programme) Interaction of Genetic and Lifestyle Factors on the Incidence of Type 2 Diabetes project., Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and Jonchère, Laurent
Subjects: Gerontology, Blood Glucose, endocrine system diseases, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Type 2 diabetes, Socioeconomic factors, E3N study, White People, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Diabetes mellitus, Environmental health, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Dietary change, Socioeconomic status, Exercise, Life Style, Family Characteristics, Nutrition and Dietetics, Evidence-Based Medicine, Food frequency, Family structure, business.industry, nutritional and metabolic diseases, Middle Aged, medicine.disease, 3. Good health, Diet, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Diabetes Mellitus, Type 2, Food frequency questionnaires, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Educational Status, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Follow-Up Studies
Abstract: International audience; Type 2 diabetes (T2D) has no cure but can be controlled by medication, diet, and lifestyle changes. It has been suggested that diabetes dietary self-management is more difficult for people with socioeconomic difficulties. The objective of our study was to test the hypothesis that socioeconomic factors impact the change of diet after T2D diagnosis. The 57 304 French women included in the present study answered food frequency questionnaires in 1993 and 2005 and questionnaires on socioeconomic factors, and were free from T2D in 1993. Between 1993 and 2005, 1249 women developed T2D. Linear regression models evaluated whether having T2D diagnosed had an impact on energy and nutrient intakes and whether socioeconomic factors were implicated. T2D was associated with a reduction of energy (β = -312.54 kJ/d, P < .001), carbohydrate (β = −9.29 g/d, P < .001), lipid (β = −2.01 g/d, P < .001), and alcohol (β = −2.74 g/d, P = .002) intakes, whereas there was no association with changes in protein or fiber intakes. The main socioeconomic factors that had an impact on dietary change were the level of education of T2D patients and whether or not they had a family (having a partner and/or children). The present study provides evidence that socioeconomic factors impact the way people with T2D change their dietary habits after diagnosis. Furthermore, the family plays a crucial role in dietary self-management, probably encouraging T2D patients to follow dietary recommendations.
Published: 2017
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15. Dietary and alcohol intake and central nervous system tumors in adults: results of the CERENAT multicenter case-control study

Author: Hugues Loiseau, Camille Pouchieu, Isabelle Baldi, Benjamin Allès, Pierre Lebailly, Anne Gruber, Luc Letenneur, Pascale Fabbro-Peray, Université de Bordeaux (UB), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Cancers et préventions, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Université de Caen Normandie (UNICAEN), Normandie Université (NU), CHU Bordeaux [Bordeaux], BESPIM, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), French public research agency: French National Institute of Health and Medical Research (INSERM), French public research agency: French agency for Food, Environmental and Occupational Health Safety (ANSES), French public research agency: French Cancer Research Association (ARC - reseau ARECA), and French public research agency: French League against Cancer (Ligue contre le Cancer - Comite Aquitaine Charentes)
Subjects: Adult, Male, medicine.medical_specialty, Food intake, Pathology, Meat, Alcohol Drinking, Epidemiology, [SDV]Life Sciences [q-bio], Central nervous system, Physiology, Meningiomas, Nervous system neoplasms, Central Nervous System Neoplasms, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Vegetables, medicine, Humans, Neuroepithelial tumors, business.industry, Case-control study, Neoplasms, Neuroepithelial, 3. Good health, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Case-Control Studies, Fruit, Alcoholic beverages, Alcohol intake, Female, Neurology (clinical), business, Meningioma, diet, 030217 neurology & neurosurgery
Abstract: Background: Little is known about the relationship between diet and central nervous system (CNS) tumors, especially in terms of their histological subtypes. This study investigated the overall associations between food groups, alcohol intake and CNS tumors, and in particular about the associations between neuroepithelial tumors and meningiomas. Methods: Data were collected through the CERENAT (CEREbral tumors: a NATional study) case-control study conducted in France during the period 2004-2010. Data were available for 1,479 subjects (494 cases, including 201 neuroepithelial tumors, 193 meningiomas, 100 other CNS tumors, and their 985 matched controls). Conditional logistic regressions for matched sets were adjusted based on the participants' educational level, occupation, smoking status and frequency of food group consumption. Results: A heavy consumption of grilled meat and poultry was associated with neuroepithelial tumors in a dose-related relationship (ORQ4vsQ1 = 3.72, 95% CI 1.62-8.52, p = 0.005). Higher fruit and vegetable intake was inversely associated with meningiomas (for fruits: ORQ4vsQ1 = 0.38, 95% CI 0.17-0.87, p = 0.06, for vegetables ORQ4vsQ1 = 0.26, 95% CI 0.11-0.62, p = 0.007). Consumption of alcohol on a daily basis was inversely associated with CNS tumors especially for meningiomas (ORQ4vsQ1 = 0.33, 95% CI 0.18-0.61, p = 0.001). Conclusions: Results obtained in terms of grilled meat, fruits and vegetables consumption were in line with those published in epidemiological literature. Contradictions in results between neuroepithelial tumors and meningiomas confirmed the need to analyze the effects of dietary factors on the basis of the histological subtypes of CNS tumors.
Published: 2016
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16. Heme iron intake, dietary antioxidant capacity, and risk of colorectal adenomas in a large cohort study of french women

Author: Marie-Christine Boutron-Ruault, Laure Dossus, Françoise Clavel-Chapelon, Claire Cadeau, Sophie Morois, Gaëlle Gusto, Fabrice Pierre, Suvi Kangas, Nadia Bastide, Mauro Serafini, ProdInra, Migration, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Gustave Roussy (IGR), National Research Institute for Food and Nutrition, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Prévention et promotion de la cancérogénèse par les aliments (ToxAlim-PPCA), ToxAlim (ToxAlim), Institut National de la Recherche Agronomique (INRA)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Recherche Agronomique (INRA)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Mutuelle Generale de l'Education Nationale (MGEN), European Community, French League against Cancer (LNCC), Gustave Roussy Institute (IGR), French Institute of Health and Medical Research (INSERM), Fondation de France, French National Cancer Institute (INCa), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Subjects: 0301 basic medicine, Pathology, cancer incidence, Epidemiology, [SDV]Life Sciences [q-bio], Gastroenterology, Antioxidants, colon carcinogenesis, Cohort Studies, chemistry.chemical_compound, 0302 clinical medicine, prevention, Risk Factors, Surveys and Questionnaires, plant foods, Prospective Studies, Prospective cohort study, Heme, 2. Zero hunger, red wine, Middle Aged, inhibition, 3. Good health, [SDV] Life Sciences [q-bio], Oncology, 030220 oncology & carcinogenesis, Female, Adenoma, Colorectal Neoplasms, France, Humans, Iron, Dietary, Cohort study, medicine.medical_specialty, Colon Adenoma, Iron, meat intake, Dietary, Colorectal adenoma, 03 medical and health sciences, Internal medicine, medicine, polyphenols, business.industry, Proportional hazards model, Cancer, medicine.disease, peroxidation, 030104 developmental biology, chemistry, in-vitro assays, business
Abstract: Background: Nitrosylated and non-nitrosylated heme iron from red processed and nonprocessed meat have been associated with increased colorectal carcinogenesis. Mechanisms include oxidative processes. It has been hypothesized that dietary antioxidants could counteract the effects of heme iron. We investigated the relationships between heme iron intake and the risk of colorectal adenomas, and a potential interaction with the dietary antioxidant capacity, in the E3N prospective cohort study. Methods: The study included 17,397 women, who underwent at least one colonoscopy. Among them, 1,409 were diagnosed with at least one first colorectal adenoma during the 103,253 person-years of follow-up. Dietary intake was measured by a semiquantitative food history questionnaire. HR estimates and 95% confidence intervals (CI) were obtained from Cox proportional hazards models, adjusted for potential confounders. Results: Heme iron intake was positively associated with colorectal and colon adenoma risks [HR for the fourth vs. first quartile: HR4 = 1.36 (1.13–1.65), Ptrend = 0.001 and HR4 = 1.49; 95% CI, 1.19–1.87; Ptrend = 0.0003, respectively]. Nonnitrosylated and nitrosylated heme iron intakes were, respectively, associated with advanced distal and proximal adenoma risks. There was a dose–effect relationship between the heme iron to total dietary antioxidant capacity ratio and colorectal adenoma risk. Conclusion: In this prospective cohort study, the association between heme iron and colorectal adenoma risk was found to depend on site, nitrosylation or not, and the ratio with the NEAC. Impact: These results emphasize the need for a global assessment of diet when considering nutritional prevention of colorectal carcinogenesis. Cancer Epidemiol Biomarkers Prev; 25(4); 640–7. ©2016 AACR.
Published: 2016
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17. Confirmatory Factor Analysis Compared with Principal Component Analysis to Derive Dietary Patterns: A Longitudinal Study in Adult Women

Author: Nicole Le Moual, Jean Maccario, Raphaëlle Varraso, Margaux Sanchez, Françoise Clavel-Chapelon, Judith Garcia-Aymerich, Marie-Christine Boutron-Ruault, Annabelle Bédard, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre for Research in Environmental Epidemiology (CREAL), CIBER de Epidemiología y Salud Pública (CIBERESP), IMIM-Hospital del Mar, Generalitat de Catalunya, Universitat Pompeu Fabra [Barcelona] (UPF), Mode de vie, génétique et santé : études intégratives et transgénérationnelles (U1018 (Équipe 9)), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut Gustave Roussy (IGR), The E3N study is supported by the Mutuelle Générale de l’Education Nationale (MGEN), the French League against Cancer (LNCC), the Gustave Roussy Institute (IGR) and the National Institute for Health and Medical Research (Inserm), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR), and Faraldo, Beatrice
Subjects: Longitudinal study, Multivariate statistics, MESH: Asthma, 030309 nutrition & dietetics, Epidemiology, Medicine (miscellaneous), MESH: Energy Intake, Body Mass Index, Food group, MESH: Proportional Hazards Models, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, Surveys and Questionnaires, Medicine, Longitudinal Studies, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, MESH: Longitudinal Studies, 2. Zero hunger, Principal Component Analysis, 0303 health sciences, Nutrition and Dietetics, MESH: Middle Aged, MESH: Follow-Up Studies, Middle Aged, Confirmatory factor analysis, MESH: Motor Activity, MESH: Reproducibility of Results, Principal component analysis, Female, France, MESH: Factor Analysis, Statistical, Context (language use), Motor Activity, MESH: Body Mass Index, 03 medical and health sciences, MESH: Diet, A posteriori dietary patterns, Humans, MESH: Surveys and Questionnaires, Proportional Hazards Models, MESH: Principal Component Analysis, MESH: Humans, business.industry, Proportional hazards model, Methodology, Reproducibility of Results, Asthma, MESH: Prospective Studies, Diet, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Energy Intake, Factor Analysis, Statistical, business, MESH: Female, Follow-Up Studies, Demography
Abstract: International audience; Principal component analysis (PCA) has been used extensively to derive dietary patterns. We proposed to use confirmatory factor analysis (CFA) in the same context as PCA--as a one-step approach--to derive dietary patterns. The first aim of this study was methodologic and was to compare dietary patterns derived with the use of PCA and CFA, used as equivalent one-step approaches. The second aim of this study was to study these patterns in association with individual characteristics and new adult-onset asthma. We included 30,589 French women from the E3N (epidemiologic prospective cohort study of women from the MGEN national insurance plan) with 1177 reported cases of adult-onset asthma between 1993 and 2005. PCA and CFA were used in the same context, on 27 food groups, to derive dietary patterns. Associations between dietary patterns and adult-onset asthma were assessed by Cox proportional hazards models. Whether we used PCA or CFA, 3 similar factors were found and labeled "Prudent," "Western," and "Aperitif." Correlations between patterns derived with the use of PCA and CFA were high. For the "Prudent" and "Aperitif" patterns, we observed comparable patterns in terms of associations with food groups, individual characteristics, and the onset of asthma. For the "Western" patterns, the one derived with the use of CFA was more related to an unhealthy diet than the one derived with the use of PCA, with higher correlations with the food groups "processed meat" (0.73 vs. 0.51) and "dough and pastry" (0.63 vs. 0.40), and negative associations with physical activity and with having parents who were farmers. Regarding associations with adult-onset asthma, a significant positive association was observed for the "Western" pattern derived with the use of CFA [multivariate RR for highest vs. lowest quintile: 1.30 (1.02, 1.67), P-trend: 0.03], whereas no association was reported when using PCA [RR: 1.14 (0.89, 1.47), P-trend: 0.40]. Although quite similar dietary patterns were derived with the use of PCA and CFA, this study supports the alternative use of CFA to PCA for the identification of dietary patterns in epidemiologic studies.
Published: 2015
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18. Overexpression and promoter mutation of the TERT gene in malignant pleural mesothelioma

Author: M.C. Copin, Françoise Galateau-Sallé, Jessica Zucman-Rossi, J-C Nault, Ilir Hysi, Paul Hofman, Anne Tallet, Pascal Andujar, Didier Jean, A Renier, F. Le Pimpec-Barthes, M-C Jaurand, Aurélie Cazes, Génomique fonctionnelle des tumeurs solides (U674), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Labex Immuno-oncology, Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité, Service de chirurgie cardiaque [CHRU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire d'Anatomie Pathologique [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Institut de Pathologie [CHU Lille], Pôle de Biologie Pathologie Génétique [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire de Nice (CHU Nice), CHI Créteil, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Chirurgie Thoracique, Paris, This work was supported by funds and grants from INSERM, the University of Paris-Descartes, the French League against Cancer (Ligue Nationale Contre le Cancer, 'Carte d’Identité des Tumeurs' CIT1 and CIT2 programs and the Comité de l’Oise), and the Chancellerie des Universités de Paris (Legs POIX)., Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jean, Didier
Subjects: telomerase reverse transcriptase (TERT), Cancer Research, Telomerase, Lung Neoplasms, Thoracic neoplasm, [SDV.BBM.BM] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, medicine.disease_cause, Bioinformatics, 0302 clinical medicine, Gene expression, CDKN2A Gene Inactivation, Promoter Regions, Genetic, Regulation of gene expression, 0303 health sciences, telomere, MESH: Telomerase, MESH: Gene Expression Regulation, Gene Expression Regulation, Neoplastic, 030220 oncology & carcinogenesis, mesothelioma, [SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], MESH: Mutation, MESH: Neoplastic, Pleural Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, [SDV.GEN.GH] Life Sciences [q-bio]/Genetics/Human genetics, Biology, MESH: Pleural Neoplasms, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], MESH: Promoter Regions, Genetic, Genetics, medicine, Humans, Telomerase reverse transcriptase, RNA, Messenger, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, Molecular Biology, 030304 developmental biology, MESH: RNA, Messenger, MESH: Humans, MESH: Mesothelioma, Mesothelioma, Malignant, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, asbestos, Telomere, MESH: Lung Neoplasms, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, Cancer cell, Cancer research, mutation, Carcinogenesis
Abstract: International audience; Malignant pleural mesothelioma (MPM) is a very aggressive tumor with no known curative treatment. Better knowledge of the molecular mechanisms of mesothelial carcinogenesis is required to develop new therapeutic strategies. MPM, like all cancer cells, needs to maintain telomere length to prevent senescence. Previous studies suggested that the telomere lengthening mechanism in MPM is based mainly on telomerase activity. For this reason, we focused on the key catalytic enzyme, TERT (telomerase reverse transcriptase), by analyzing its gene expression in MPM and by studying the mechanism underlying its upregulation. We used our large collection of MPM composed of 61 MPM in culture and 71 frozen MPM tumor samples. Evaluation of TERT mRNA expression by quantitative RT-PCR showed overexpression in MPM in culture compared with normal mesothelial cells, and in MPM tumor samples compared with normal pleura. We identified a 'hot spot' of mutations in the TERT gene core promoter in both MPM in culture and in MPM tumor samples with an overall frequency of 15%. Furthermore, data clearly identified mutation in the TERT promoter as a mechanism of TERT mRNA upregulation in MPM. In contrast, gene copy number amplification was not associated with TERT overexpression. Then, we analyzed the clinicopathological, etiological and genetic characteristics of MPM with mutations in the TERT promoter. TERT promoter mutations were more frequent in MPM with sarcomatoid histologic subtype (P
Published: 2014
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19. Epigenomic Alterations in Breast Carcinoma from Primary Tumor to Locoregional Recurrences

Author: Brigitte Sigal-Zafrani, Nicolas Servant, Alain Fourquet, Fabien Reyal, Alice Pinheiro, Véronique Stoven, Matahi Moarii, Martial Caly, Jean-Philippe Vert, Cancer et génome: Bioinformatique, biostatistiques et épidémiologie d'un système complexe, MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Bioinformatique (CBIO), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Compartimentation et dynamique cellulaires (CDC), Centre National de la Recherche Scientifique (CNRS)-Institut Curie [Paris]-Université Pierre et Marie Curie - Paris 6 (UPMC), Département de Biologie des Tumeurs, Institut Curie [Paris], Service de Radiothérapie, Service de Chirurgie Oncologique, MM was supported by the French league against cancer (www.ligue-cancer.net). JPV was supported by the European Research Council (SMAC-ERC- 280032, url: erc.europa.eu). AF was supported by the hospital program for clinical research (AOM 06 149, url: http://www.sante.gouv.fr/le-progra mme-hospitalier- de-recherche-clinique-phrc.html). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of th e manuscript., Mines Paris - PSL (École nationale supérieure des mines de Paris), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut Curie [Paris]-Centre National de la Recherche Scientifique (CNRS), and MINES ParisTech, Bibliothèque
Subjects: Epigenomics, Oncology, Pathology, Carcinogenesis, Allelic Imbalance, Biochemistry, Epigenesis, Genetic, Metastasis, 0302 clinical medicine, Medicine and Health Sciences, Neoplasm Metastasis, [INFO.INFO-BI] Computer Science [cs]/Bioinformatics [q-bio.QM], Cancer, 0303 health sciences, [SDV.BIBS] Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], Multidisciplinary, Cancer Risk Factors, DNA, Neoplasm, Middle Aged, Primary tumor, [SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], Survival Rate, 030220 oncology & carcinogenesis, DNA methylation, Medicine, Epigenetics, Female, DNA modification, Breast carcinoma, Research Article, Adult, Conserving Therapy, medicine.medical_specialty, Science, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Biology, Disease-Free Survival, 03 medical and health sciences, Breast cancer, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, Genetics, Cancer Detection and Diagnosis, medicine, Humans, Survival rate, 030304 developmental biology, Biology and life sciences, Computational Biology, DNA, DNA Methylation, medicine.disease, Neoplasm Recurrence, Local, [INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM]
Abstract: IntroductionEpigenetic modifications such as aberrant DNA methylation has long been associated with tumorogenesis. Little is known, however, about how these modifications appear in cancer progression. Comparing the methylome of breast carcinomas and locoregional evolutions could shed light on this process.MethodsThe methylome profiles of 48 primary breast carcinomas (PT) and their matched axillary metastases (PT/AM pairs, 20 cases), local recurrences (PT/LR pairs, 17 cases) or contralateral breast carcinomas (PT/CL pairs, 11 cases) were analyzed. Univariate and multivariate analyzes were performed to determine differentially methylated probes (DMPs), and a similarity score was defined to compare methylation profiles. Correlation with copy-number based score was calculated and metastatic-free survival was compared between methods.Results49 DMPs were found for the PT/AM set, but none for the others (FDR < 5%). Hierarchical clustering clustered 75% of the PT/AM, 47% of the PT/LR, and none of the PT/CL pairs together. A methylation-based score (MS) was defined as a clonality measure. The PT/AM set contained a high proportion of clonal pairs while PT/LR pairs were evenly split between high and low MS score, suggesting two groups: true recurrences (TR) and new primary tumors (NP). CL were classified as new tumors. MS score was significantly correlated with copy-number based scores. There was no significant difference between the metastatic-free survival of groups of patients based on different classifications.ConclusionEpigenomic alterations are well suited to study clonality and track cancer progression. Methylation-based classification of TR and NP performed as well as clinical and copy-number based methods suggesting that these phenomenons are tightly linked.
Published: 2014
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20. Processed and Unprocessed Red Meat Consumption and Incident Type 2 Diabetes Among French Women

Author: Martin Lajous, Marie-Christine Boutron-Ruaualt, Françoise Clavel-Chapelon, Blandine de Lauzon-Guillain, Guy Fagherazzi, Laura Tondeur, Harvard School of Public Health, National Institute of Public Health = Instituto Nacional de Salud Pública [Cuernavaca, Mexique] (INSP), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), This E3N cohort was performed with the financial support of the Mutuelle Générale de l’Education Nationale, European Community, French League Against Cancer, Gustave Roussy Institute, French Institute of Health and Medical Research, and several general councils in France. The validation of potential diabetes cases was supported by the European Union (Integrated Project LSHM-CT-2006-037197 in Framework Program 6 of the European Community) InterAct project. The present analysis was conducted thanks to the International Associated Laboratory in Nutrition, Hormones, and Chronic Disease in Women, an ongoing collaboration between the National Institute of Health and Medical Research (INSERM, France) and the National Institute of Public Health (INSP, Mexico). M.L. was supported by the National Council for Science and Technology (Mexico), the INSP, the Ministry of Health (Mexico), the Department of Epidemiology at the Harvard School of Public Health, and the Bernard Lown Fund for Cardiovascular Health in the Developing World. G.F. was funded by the French Ministry of Research., TONDEUR, LAURA, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Subjects: MESH: Meat Products, Calorie, 030309 nutrition & dietetics, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Cohort Studies, 0302 clinical medicine, Surveys and Questionnaires, Prospective Studies, MESH: Incidence, Prospective cohort study, MESH: Cohort Studies, Original Research, 2. Zero hunger, MESH: Meat, 0303 health sciences, MESH: Middle Aged, Incidence, Middle Aged, 3. Good health, Menopause, Meat Products, Red Meat Consumption, Red meat, MESH: Feeding Behavior, Female, France, Cohort study, MESH: Diabetes Mellitus, Type 2, medicine.medical_specialty, Meat, 030209 endocrinology & metabolism, 03 medical and health sciences, Environmental health, Diabetes mellitus, Internal Medicine, medicine, Humans, Epidemiology/Health Services Research, MESH: Surveys and Questionnaires, Advanced and Specialized Nursing, MESH: Humans, business.industry, Feeding Behavior, medicine.disease, MESH: Prospective Studies, Surgery, MESH: France, Diabetes Mellitus, Type 2, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: OBJECTIVE To evaluate the relation of processed and unprocessed red meat and incident type 2 diabetes. RESEARCH DESIGN AND METHODS We conducted a prospective study among 66,118 disease-free French women with dietary information from a validated questionnaire. Between 1993 and 2007, we identified 1,369 cases of incident diabetes. Multivariate analyses were adjusted for age, education, region, smoking, BMI, hypertension, hypercholesterolemia, physical activity, parental history of diabetes, menopause, hormone replacement therapy, alcohol, calories, n-3 fatty acids, carbohydrates, coffee, fiber, and fruits and vegetables. RESULTS Comparing the highest category of processed meat intake, ≥5 servings/week (median, 48 g/day), to the lowest, CONCLUSIONS In this large prospective cohort of French women, a direct association was observed only for processed red meat and type 2 diabetes.
Published: 2012
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21. (188)Re-SSS/Lipiodol: Development of a Potential Treatment for HCC from Bench to Bedside

Author: Lepareur, Nicolas, Ardisson, Valérie, Noiret, Nicolas, Garin, Etienne, Microenvironnement et remodelage, Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université européenne de Bretagne - European University of Brittany (UEB)-Institut des Sciences Chimiques de Rennes (ISCR), Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Ecole Nationale Supérieure de Chimie de Rennes (ENSCR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Ecole Nationale Supérieure de Chimie de Rennes (ENSCR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université européenne de Bretagne - European University of Brittany (UEB), Institut des Sciences Chimiques de Rennes (ISCR), region Brittany, ARC, French League against Cancer, the Cancéropôle Grand-Ouest, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université européenne de Bretagne - European University of Brittany (UEB)-Institut des Sciences Chimiques de Rennes (ISCR), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Ecole Nationale Supérieure de Chimie de Rennes (ENSCR)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Ecole Nationale Supérieure de Chimie de Rennes (ENSCR)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université européenne de Bretagne - European University of Brittany (UEB)
Subjects: [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Research Article
Abstract: International audience; Hepatocellular carcinoma (HCC) is the 5th most common tumour worldwide and has a dark prognosis. For nonoperable cases, metabolic radiotherapy with Lipiodol labelled with β-emitters is a promising therapeutic option. The Comprehensive Cancer Centre Eugène Marquis and the National Graduate School of Chemistry of Rennes (ENSCR) have jointly developed a stable and efficient labelling of Lipiodol with rhenium-188 (E(βmax) = 2.1 MeV) for the treatment of HCC. The major "milestones" of this development, from the first syntheses to the recent first injection in man, are described.
Published: 2012
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22. Birth weight, body silhouette over the life course, and incident diabetes in 91,453 middle-aged women from the French Etude Epidemiologique de Femmes de la Mutuelle Generale de l'Education Nationale (E3N) Cohort

Author: de Lauzon-Guillain, Blandine, Balkau, Beverley, Charles, Marie-Aline, Romieu, Isabelle, Boutron-Ruault, Marie-Christine, Clavel-Chapelon, Françoise, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), National Institute of Public Health = Instituto Nacional de Salud Pública [Cuernavaca, Mexique] (INSP), This work was carried out with the financial support of the 'Mutuelle Générale de l'Education Nationale' (MGEN), European Community, French League against Cancer (LNCC), Gustave Roussy Institute (IGR), French Institute of Health and Medical Research (Inserm), and several General Councils in France. The validation of potential diabetes cases was supported by the European Union (Integrated Project LSHM-CT-2006-037197 in the Framework Program 6 of the European-Community), InterAct project., and De Lauzon-Guillain, Blandine
Subjects: adiposity, MESH: Middle Aged, MESH: Thinness, MESH: Body Size, MESH: Diabetes Mellitus, MESH: Humans, longitudinal, adult, MESH: Questionnaires, MESH: Infant, Newborn, MESH: Adult, MESH: Infant, Low Birth Weight, MESH: Regression Analysis, MESH: Male, MESH: Body Mass Index, MESH: Proportional Hazards Models, MESH: France, MESH: Body Surface Area, MESH: Young Adult, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Weight Gain, epidemiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Birth Weight, MESH: Cohort Studies
Abstract: International audience; OBJECTIVE: Obesity and increases in body weight in adults are considered to be among the most important risk factors for type 2 diabetes. Low birth weight is also associated with a higher diabetes incidence. We aimed to examine to what extent the evolution of body shape, from childhood to adulthood, is related to incident diabetes in late adulthood. RESEARCH DESIGN AND METHODS: Etude Epidemiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) is a cohort study of French women born in 1925-1950 and followed by questionnaire every 2 years. At baseline, in 1990, women were asked to report their current weight, height, and body silhouette at various ages. Birth weight was recorded in 2002. Cases of diabetes were self-reported or obtained by drug reimbursement record linkage and further validated. RESULTS: Of the 91,453 women who were nondiabetic at baseline, 2,534 developed diabetes over the 15 years of follow-up. Birth weight and body silhouette at 8 years, at menarche, and in young adulthood (20-25 years) were inversely associated with the risk of diabetes, independently of adult BMI during follow-up (all P(trend) < 0.001). In mid-adulthood (35-40 years), the association was reversed, with an increase in risk related to a larger body silhouette. An increase in body silhouette from childhood to mid-adulthood amplified the risk of diabetes. CONCLUSIONS: Low birth weight and thinness until young adulthood may increase the risk of diabetes, independently of adult BMI during follow-up. Young women who were lean children should be especially warned against weight gain.
Published: 2010
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23. Dietary patterns and asthma in the E3N study

Author: Varraso, Raphaëlle, Kauffmann, Francine, Leynaert, Bénédicte, Le Moual, Nicole, Boutron-Ruault, Marie Christine, Clavel-Chapelon, Françoise, Romieu, Isabelle, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie et Epidemiologie de l'Insuffisance Respiratoire, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), National Institute of Public Health = Instituto Nacional de Salud Pública [Cuernavaca, Mexique] (INSP), The E3N study is supported by the Mutuelle Générale de l'Education Nationale (MGEN), the European Community, the French League against Cancer (LNCC), the Gustave Roussy Institute (IGR), the National Institute for Health and Medical Research (Inserm), the 3M Company and General Councils of France. IR was supported by the National Center for Environmental Health - Centers for Disease Control and Prevention, Atlanta GA, USA. The GA²LEN project (EU contract FOODCT-2004-506378) and the Spanish Ministry of Education and Science, SAB2004-0192. This project was supported by a grant from the Comité National contre les Maladies Respiratoires (Paris, France)., E3N study, GA²LEN project, IR, and Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR)-Université Paris-Sud - Paris 11 (UP11)
Subjects: MESH: Aged, MESH: Humans, MESH: Middle Aged, MESH: Asthma, incident asthma, MESH: Diet Surveys, MESH: Adult, asthma, respiratory tract diseases, Diet, MESH: Body Mass Index, MESH: France, MESH: Diet, immune system diseases, MESH: Risk Factors, adults, MESH: Feeding Behavior, asthma attacks, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, women, MESH: Incidence, MESH: Cohort Studies, MESH: Female, MESH: Prevalence
Abstract: International audience; The aim of the present study was to determine dietary patterns and investigate their association with asthma incidence, current asthma and frequent asthma exacerbations. Dietary habits and asthma data were collected from the large E3N study (of French females, mostly teachers). Of the 54,672 females followed-up in 2003, 2,634 reported ever-adulthood asthma, 1,063 reported current asthma, 206 reported frequent asthma attacks (one or more a week), and 628 reported asthma onset between 1993 and 2003. Using principal component analysis, three dietary patterns were identified: the "prudent" pattern (fruits and vegetables); the "Western" pattern (pizza/salty pies, dessert and cured meats); and the "nuts and wine" pattern. Pattern scores were categorised into tertiles, and the incidence and prevalence of asthma was compared between tertiles. After adjustment for confounders, no association of dietary patterns was observed with asthma incidence, ever-asthma or current asthma. The Western pattern was associated with an increased risk of reporting frequent asthma attacks (highest versus lowest tertile odds ratio (OR) 1.79, 95% confidence interval (CI) 1.11-3.73). Increasing scores of the nuts and wine pattern were associated with a decreased risk of reporting frequent asthma attacks (highest versus lowest tertile OR 0.65, 95% CI 0.31-0.96). The results of the present study suggest that overall diet could be involved in frequent asthma exacerbations, one aspect of asthma severity.
Published: 2009
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24. Diet and asthma

Author: Varraso, Raphaëlle, Kauffmann, Francine, Leynaert, Bénédicte, Le Moual, Nicole, Boutron-Ruault, Marie Christine, Clavel-Chapelon, Françoise, Romieu, Isabelle, Faraldo, Beatrice, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie et Epidemiologie de l'Insuffisance Respiratoire, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), National Institute of Public Health = Instituto Nacional de Salud Pública [Cuernavaca, Mexique] (INSP), The E3N study is supported by the Mutuelle Générale de l'Education Nationale (MGEN), the European Community, the French League against Cancer (LNCC), the Gustave Roussy Institute (IGR), the National Institute for Health and Medical Research (Inserm), the 3M Company and General Councils of France. IR was supported by the National Center for Environmental Health - Centers for Disease Control and Prevention, Atlanta GA, USA. The GA²LEN project (EU contract FOODCT-2004-506378) and the Spanish Ministry of Education and Science, SAB2004-0192. This project was supported by a grant from the Comité National contre les Maladies Respiratoires (Paris, France)., E3N study, GA²LEN project, and IR
Subjects: MESH: Asthma, incident asthma, MESH: Body Mass Index, MESH: Diet, immune system diseases, MESH: Risk Factors, adults, MESH: Incidence, MESH: Cohort Studies, MESH: Prevalence, MESH: Aged, MESH: Humans, MESH: Middle Aged, MESH: Diet Surveys, MESH: Adult, asthma, respiratory tract diseases, Diet, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Feeding Behavior, asthma attacks, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, women, MESH: Female
Abstract: International audience; The aim of the present study was to determine dietary patterns and investigate their association with asthma incidence, current asthma and frequent asthma exacerbations. Dietary habits and asthma data were collected from the large E3N study (of French females, mostly teachers). Of the 54,672 females followed-up in 2003, 2,634 reported ever-adulthood asthma, 1,063 reported current asthma, 206 reported frequent asthma attacks (one or more a week), and 628 reported asthma onset between 1993 and 2003. Using principal component analysis, three dietary patterns were identified: the "prudent" pattern (fruits and vegetables); the "Western" pattern (pizza/salty pies, dessert and cured meats); and the "nuts and wine" pattern. Pattern scores were categorised into tertiles, and the incidence and prevalence of asthma was compared between tertiles. After adjustment for confounders, no association of dietary patterns was observed with asthma incidence, ever-asthma or current asthma. The Western pattern was associated with an increased risk of reporting frequent asthma attacks (highest versus lowest tertile odds ratio (OR) 1.79, 95% confidence interval (CI) 1.11-3.73). Increasing scores of the nuts and wine pattern were associated with a decreased risk of reporting frequent asthma attacks (highest versus lowest tertile OR 0.65, 95% CI 0.31-0.96). The results of the present study suggest that overall diet could be involved in frequent asthma exacerbations, one aspect of asthma severity.
Published: 2009
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25. Title: Estrogen-progestagen menopausal hormone therapy and breast cancer: does delay from menopause onset to treatment initiation influence risks?

Author: Fournier, Agnès, Mesrine, Sylvie, Boutron-Ruault, Marie-Christine, Clavel-Chapelon, Françoise, Fournier, Agnès, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Supported by Mutuelle Générale de l’Education Nationale, European Community, French League Against Cancer, Gustave Roussy Institute, Institut National de la Santé et de la Recherche Médicale, 3M Company, several General Councils of France, Direction Générale de la Santé, and Agence Française de Sécurité Sanitaire des Produits de Sante
Subjects: [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SDV.CAN] Life Sciences [q-bio]/Cancer, BREAST CANCER, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, ESTROGENS, MENOPAUSAL HORMONE THERAPY, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, PROGESTAGENS
Abstract: International audience; PURPOSETo investigate whether the relation between estrogen-progestagen menopausal hormone therapy (EP-MHT) and breast cancer risk varies according to the delay between menopause onset and treatment initiation.MATERIALS AND METHODSBetween 1992 and 2005, 1,726 invasive breast cancers were identified among 53,310 postmenopausal women from the French E3N cohort (mean duration of follow-up: 8.1 years). Hazard ratios (HRs) and confidence intervals (CI) were estimated using Cox models, with MHT never-users as the reference.RESULTSAmong recent users of EP-MHT, the risk of breast cancer varied according to the timing of treatment initiation. This variation was confined to short durations of use (≤2 years): the HR was 1.54 (95% CI 1.28-1.86) for short treatments initiated in the 3-year period following menopause onset and 1.00 (95% CI 0.68-1.47) for short treatments initiated later (p=0.04 for homogeneity). This pattern of risks was however not observed in users of EP-MHT containing progesterone, among whom there was no significantly increased risk associated with short durations of use (HR 0.87, 95% CI 0.57-1.32 for treatments initiated ≤3 years after menopause and 0.90, 95% CI 0.45-1.81 for treatments initiated later). Longer durations of EP-MHT use were generally associated with increases in breast cancer risk, whatever the gap time.CONCLUSIONOur results suggest that, for some EP-MHT, the timing of treatment initiation transiently modulates the risk of breast cancer; and that, when initiated close to menopause, even short durations of use are associated with an increased breast cancer risk. Estrogen-progesterone combinations might be an exception in this regard.
Published: 2009
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26. Long-term association of food and nutrient intakes with cognitive and functional decline: a 13-year follow-up study of elderly French women

Author: Vercambre, Marie-Noël, Boutron-Ruault, Marie-Christine, Ritchie, Karen, Clavel-Chapelon, Françoise, Berr, Claudine, Villebrun, Dominique, Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and The E3N cohort is supported by the French League against Cancer, the European Community, the 3M Company, the 'Mutuelle Générale de l'Education Nationale', the French Institute of Health and Medical Research, the Gustave Roussy Institute and several general councils in France. MN Vercambre is on a grant from the Statlife Company and the 'Association Nationale de la Recherche Technique'.
Subjects: [SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, MESH: Food Habits, MESH: Logistic Models, MESH: Energy Intake, Cognition, MESH: Aged, 80 and over, MESH: Diet, MESH: Fatty Acids, Omega-3, Women, MESH: Aging, Function, Nutrition, MESH: Aged, MESH: Humans, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, MESH: Vitamin B Complex, Dietary habits, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, MESH: Activities of Daily Living, MESH: Diet Surveys, MESH: Follow-Up Studies, MESH: Vegetables, MESH: Marriage, MESH: France, Ageing, MESH: Cognition Disorders, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, MESH: Dietary Fiber, MESH: Vitamins, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Longitudinal study, MESH: Educational Status, MESH: Female
Abstract: International audience; The objective of the present study was to determine the potential long-term impact of dietary habits on age-related decline among 4809 elderly women (born between 1925 and 1930) in the 'Etude Epidémiologique de Femmes de la Mutuelle Générale de l'Education Nationale' (E3N) study, a French epidemiological cohort. In 1993, an extensive diet history self-administered questionnaire was sent to all participants, and in 2006 another questionnaire on instrumental activities of daily living (IADL) and recent cognitive change was sent to a close relative or friend of each woman. Logistic models adjusted for socio-demographic, lifestyle and health factors were performed to evaluate associations between habitual dietary intakes and two outcomes of interest based on the informant response: recent cognitive decline and IADL impairment. Recent cognitive decline was associated with lower intakes of poultry, fish, and animal fats, as well as higher intakes of dairy desserts and ice-cream. IADL impairment was associated with a lower intake of vegetables. The odds of recent cognitive decline increased significantly with decreasing intake of soluble dietary fibre and n-3 fatty acids but with increasing intake of retinol. The odds of IADL impairment increased significantly with decreasing intakes of vitamins B2, B6 and B12. These results are consistent with a possible long-term neuroprotective effect of dietary fibre, n-3 polyunsaturated fats and B-group vitamins, and support dietary intervention to prevent cognitive decline.
Published: 2009
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27. Cost-Effectiveness Analysis of Trastuzumab (Herceptin) in HER2-Overexpressed Metastatic Breast Cancer

Author: Patrice Viens, Anne-Gaëlle Le Corroller-Soriano, Michel Marty, Henri Roché, Veronique Girre, Jocelyne Jacquemier, Jean-Paul Moatti, Etienne Brain, Anthony Gonçalves, Carole Perez-Ellis, Dupuis, Christine, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d’Oncologie Médicale [IPC, Marseille], Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Université de la Méditerranée - Aix-Marseille 2, Département de Biopathologie [Marseille], Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy (IGR), Département d'Oncologie Médicale [Institut Curie, Paris], Institut Curie [Paris], Département d'oncologie médicale, Institut Claudius Regaud, Institut Curie - Saint Cloud (ICSC), Département d'Oncologie Médicale [Centre René-Huguenin, Saint-Cloud], Hôpital René HUGUENIN (Saint-Cloud), Supported by a grant from the French Ministry of Health STIC 2002 and a fellowship grant from the 'French League against Cancer.', Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and Institut Curie [Saint-Cloud]
Subjects: Oncology, Cancer Research, Receptor, ErbB-2, Cost-Benefit Analysis, 0302 clinical medicine, Trastuzumab, Medicine, 030212 general & internal medicine, Neoplasm Metastasis, skin and connective tissue diseases, health care economics and organizations, education.field_of_study, biology, Cost-effectiveness analysis, Middle Aged, Metastatic breast cancer, 3. Good health, 030220 oncology & carcinogenesis, Female, France, medicine.drug, Adult, medicine.medical_specialty, Population, Antineoplastic Agents, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Antibodies, Monoclonal, Humanized, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, Humans, education, neoplasms, Survival analysis, Aged, Retrospective Studies, Gynecology, business.industry, Euros, Retrospective cohort study, Genes, erbB-2, biology.organism_classification, medicine.disease, Survival Analysis, Confidence interval, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: Objective: In women with Human Epidermal growth Receptor 2 (HER2)-positive metastatic breast cancer (MBC), Trastuzumab has become the standard of care but previous studies have raised doubts about its economic acceptability. We carried out the first cost-effectiveness study for Trastuzumab in MBC patients, in France, that is based on observed resource use and outcomes in clinical practice. Methods: We retrospectively analyzed 47 HER2-positive MBC patients in a before-and-after design study. Nineteen patients did not receive Trastuzumab ("before" Trastuzumab introduction in clinical practice) and 28 patients received Trastuzumab (the "after" population). Direct medical costs were estimated on the basis of the physical quantities reported in the patient medical records, for the period from first metastatic progression until death or date of patient last news. Monetary values (2002 French francs) were attributed to these quantities on the basis of unit costs and incremental cost-effectiveness ratios were calculated. Results: In the Trastuzumab group, median overall survival was significantly higher (37 months vs. 19 months in the non-Ttrastuzumab group, P = 0.001) but total treatment costs were 3 times higher (39,608 Euros vs. 12,795 Euros). The cost per additional life-year saved by Trastuzumab treatment was estimated to be 27,492 Euros (95% confidence interval: *20,964 Euros-34,020 Euros/year of life [bootstrapped estimation]). Conclusions: Our data suggest that despite its high unit price, Trastuzumab should be considered cost-effective in MBC patients to the extent that its incremental cost per life-year saved remains lower than gross domestic product per capita in countries like France.
Published: 2009
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28. Use of different postmenopausal hormone therapies and risk of histology- and hormone receptor-defined invasive breast cancer

Author: Agnès Fournier, Marie-Christine Boutron-Ruault, Françoise Clavel-Chapelon, Franco Berrino, Alban Fabre, Sylvie Mesrine, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Preventive and Predictive Medicine, Istituto Nazionale Tumori, Tis study is supported by Mutuelle Générale de l'Education Nationale, European Community, French League against Cancer, Gustave Roussy Institute, French Institute of Health and Medical Research, 3M Company, several General Councils of France, Fondation pour la Recherche Médicale, Cancéropôle Région Ile-de-France, Direction Générale de la Santé, Agence Française de Sécurité Sanitaire des Produits de Santé., and Clavel-Chapelon, F.
Subjects: Oncology, Cancer Research, medicine.medical_treatment, Dydrogesterone, Cohort Studies, 0302 clinical medicine, Risk Factors, Progesterone, 030219 obstetrics & reproductive medicine, Carcinoma, Ductal, Breast, Middle Aged, 3. Good health, Postmenopause, Receptors, Estrogen, Hormone receptor, 030220 oncology & carcinogenesis, Female, Breast disease, Receptors, Progesterone, medicine.drug, Adult, medicine.medical_specialty, medicine.drug_class, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Article, 03 medical and health sciences, Breast cancer, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Humans, Risk factor, Aged, Gynecology, business.industry, Cancer, Estrogens, medicine.disease, Carcinoma, Lobular, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Estrogen, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Hormone therapy, Progestins, business, SEER Program
Abstract: PurposeWe previously found that the risk of invasive breast cancer varied according to the progestagen component of combined postmenopausal hormone therapy (CHT): progesterone, dydrogesterone, or other progestagens. We conducted the present study to assess how these CHTs were associated with histology- and hormone receptor-defined breast cancer.Patients and MethodsWe used data from the French E3N cohort study, with 80,391 postmenopausal women followed for a mean duration of 8.1 years; 2,265 histologically confirmed invasive breast cancers were identified through biennial self-administered questionnaires completed from 1990 to 2002. The relative risks (RRs) were estimated using Cox proportional hazards models.ResultsCompared with postmenopausal hormone therapy (HT) never-use, ever-use of estrogen+progesterone was not significantly associated with the risk of any breast cancer subtype, but increasing duration of estrogen+progesterone was associated with increasing risks of lobular (P = .06) and estrogen receptor–positive/progesterone receptor–negative (ER+/PR−; P = .02). Estrogen+dydrogesterone was associated with a significant increase in risk of lobular carcinoma (RR, 1.7; 95% CI, 1.1 to 2.6). Estrogen+other progestagens was associated with significant increases in risk of ductal and lobular carcinomas (RR, 1.6; 95% CI, 1.3 to 1.8; and 2.0; 95% CI, 1.5 to 2.7, respectively), of ER+/PR+ and ER+/PR− carcinomas (RR, 1.8; 95% CI, 1.5 to 2.1; and 2.6; 95% CI, 1.9 to 3.5, respectively), but not of ER−/PR+ or ER−/PR− carcinomas (RR, 1.0; 95% CI, 0.5 to 2.1; and 1.4; 95% CI, 0.9 to 2.0, respectively).ConclusionThe increase in risk of breast cancer observed with the use of CHTs other than estrogen+progesterone and estrogen+dydrogesterone seems to apply preferentially to ER+ carcinomas, especially those ER+/PR−, and to affect both ductal and lobular carcinomas.
Published: 2008
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29. Risk of onset of menopausal symptoms in periods surrounding menopause

Author: Séverine Sabia, Sylvie Mesrine, Agnès Fournier, Françoise Clavel-Chapelon, Marie-Christine Boutron-Ruault, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Source of financial support: The French League Against Cancer, 3M Company, the European Community, the Mutuelle Générale de l'Education Nationale medical insurance and the INSERM., Clavel-Chapelon, F., and Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR)-Université Paris-Sud - Paris 11 (UP11)
Subjects: Adult, medicine.medical_specialty, Health Behavior, Menopause, Premature, General Biochemistry, Genetics and Molecular Biology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Epidemiology, Artificial and natural menopause, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Risk factor, Life Style, Climacteric, Proportional Hazards Models, Gynecology, 030219 obstetrics & reproductive medicine, Menopausal symptoms, Proportional hazards model, Obstetrics, business.industry, Hazard ratio, Age Factors, Obstetrics and Gynecology, Age at menopause, Middle Aged, medicine.disease, Health Surveys, Confidence interval, 3. Good health, Menopause, Premenopause, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Age of onset, business, Follow-Up Studies, Cohort study
Abstract: International audience; OBJECTIVE: To assess the risk of onset of menopausal symptoms at different periods surrounding menopause, and variations in this risk according to age at menopause and type of menopause. METHODS: We analyzed the 27,897 women participating in the French E3N cohort study who reached menopause during a 10-year follow-up period (1990-2000). Self-administered questionnaires, completed approximately every 24 months, included questions on the use of hormonal treatments, reproductive factors, personal history of a variety of diseases and the occurrence of personal medical events, including menopausal symptoms. Hazard ratios (HRs) were computed from multivariate Cox models. RESULTS: When compared to the year preceding menopause, the risk of onset of menopausal symptoms was higher in the year following menopause (for natural menopause (n=25,753), HR=1.22, 95% confidence interval: 1.17, 1.27, and for artificial menopause (n=2,147), HR=2.21, 95% CI: 1.93, 2.52). More than one year prior to menopause and more than one year after, HRs were significantly below unity. The risk of onset of menopausal symptoms in the year following menopause was 1.47-fold (95% CI: 1.31, 1.64) higher in women having undergone an artificial menopause than in women who had had a natural menopause. In other periods, the risks did not differ significantly according to type of menopause. Those who experienced menopausal symptoms in the 1-5 year period following menopause were more likely to have reached their menopause before 51 years. CONCLUSIONS: The risk of onset of menopausal symptoms at different time periods surrounding menopause varies according to both type of menopause and age at menopause.
Published: 2007
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30. Personal history of endometriosis and risk of cutaneous melanoma in a large prospective cohort of French women

Author: Marina Kvaskoff, Françoise Clavel-Chapelon, Marie-Christine Boutron-Ruault, Agnès Fournier, Sylvie Mesrine, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), This study was supported by the French League Against Cancer, the European Community, the 3M Company, the Mutuelle Générale de l'Education Nationale, the Institut Gustave Roussy, the Institut National de la Santé et de la Recherche Médicale, and the Fondation de France (Ms Kvaskoff)., Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR)-Université Paris-Sud - Paris 11 (UP11), and Clavel-Chapelon, F.
Subjects: Adult, medicine.medical_specialty, Endometriosis, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Risk Assessment, Article, 03 medical and health sciences, 0302 clinical medicine, Internal Medicine, medicine, Humans, Medical history, Prospective Studies, Risk factor, Prospective cohort study, Melanoma, Aged, Proportional Hazards Models, Gynecology, 030219 obstetrics & reproductive medicine, Obstetrics, business.industry, [SDV.MHEP.DERM] Life Sciences [q-bio]/Human health and pathology/Dermatology, Middle Aged, medicine.disease, 3. Good health, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 030220 oncology & carcinogenesis, Relative risk, Cutaneous melanoma, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Risk assessment, [SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology, Cohort study
Abstract: International audience; BACKGROUND: An association between melanoma and endometriosis has been reported, but most findings relied on case-control studies or a limited number of melanoma cases, and therefore the available evidence is weak. Moreover, the effect of other benign gynecological diseases on melanoma risk is unknown. METHODS: We prospectively studied data from the Etude Epid?ologique aupr?de femmes de la Mutuelle G?rale de l'Education Nationale cohort, which includes 98 995 French women, insured by a national health scheme mostly covering teachers, aged 40 to 65 years at inclusion. Data on history of endometriosis and other benign gynecological diseases were regularly collected, starting in 1990. Relative risks and 95% confidence intervals were computed using Cox proportional hazards regression models. RESULTS: During 12 years of follow-up, 363 melanoma cases were ascertained among 91 965 subjects. A history of endometriosis (n = 5949) was significantly associated with a higher risk of melanoma (relative risk, 1.62; 95% confidence interval, 1.15-2.29). There was also a significantly increased risk among women with a history of fibroma (n = 24 375), compared with those who had no such history (relative risk, 1.33; 95% confidence interval, 1.06-1.67). A history of ovarian cyst, uterine polyp, breast adenoma/fibroadenoma, or breast fibrocystic disease was not significantly associated with risk. CONCLUSIONS: These data provide the strongest evidence to date of a positive association between a history of endometriosis and melanoma risk. The association between fibroma and melanoma, which has not been previously described, warrants further investigation.
Published: 2007
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31. Oral progestagens before menopause and breast cancer risk

Author: Françoise Clavel-Chapelon, Sylvie Mesrine, Joëlle Desreux, Marie-Christine Boutron-Ruault, Anne Gompel, Agnès Fournier, Alban Fabre, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Panthéon-Sorbonne (UP1) - Université Paris-Sud - Paris 11 (UP11) - École des hautes études en sciences sociales (EHESS) - Assistance publique - Hôpitaux de Paris (AP-HP) - Université Paris Descartes - Paris 5 (UPD5) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Centre National de la Recherche Scientifique (CNRS) - Université Panthéon-Sorbonne (UP1) - Université Paris-Sud - Paris 11 (UP11) - École des hautes études en sciences sociales (EHESS) - Assistance publique - Hôpitaux de Paris (AP-HP) - Université Paris Descartes - Paris 5 (UPD5) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Centre National de la Recherche Scientifique (CNRS) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Institut Gustave Roussy (IGR) - Université Paris-Sud - Paris 11 (UP11), Service de sénologie, Département universitaire de gynécologie-obstétrique, CHR Citadelle, Unité de Gynécologie, Assistance publique - Hôpitaux de Paris (AP-HP) - Université Paris Descartes - Paris 5 (UPD5) - Hôpital Hôtel-Dieu [Paris], The E3N study is being carried out with financial support from the French League Against Cancer, the European Community, the 3M Company, the Mutuelle Générale de l'Education Nationale, the Institut Gustave Roussy and the Institut National de la Santé et de la Recherche Médicale., Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR)-Université Paris-Sud - Paris 11 (UP11), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Clavel-Chapelon, F.
Subjects: Adult, Cancer Research, medicine.medical_specialty, Time Factors, Epidemiology, menopause, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, breast cancer, [SDV.CAN] Life Sciences [q-bio]/Cancer, Risk Factors, medicine, Humans, Risk factor, Gynecology, 030219 obstetrics & reproductive medicine, Obstetrics, Proportional hazards model, business.industry, Middle Aged, medicine.disease, Confidence interval, 3. Good health, Menopause, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Premenopause, Oncology, progestagen, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 030220 oncology & carcinogenesis, Relative risk, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Progestins, business, Cohort study
Abstract: We examined the relationship between use of progestagen-only before menopause (except for mini-pills) after the age of 40 and invasive breast cancer risk in 73 664 women from the French E3N cohort study (mean age at start of follow-up, 51.8 years; mean duration of follow-up, 9.1 years). A total of 2390 cases of invasive breast cancer were diagnosed during follow-up. Risk estimates were calculated using the Cox proportional hazard model. Overall, ever use of progestagen before menopause was not significantly associated with risk (relative risk (RR): 1.01, 95% confidence interval: 0.93–1.11). However, we observed a significant increase in risk associated with the duration of use (P-value for trend: 0.012), current use of progestagens for longer than 4.5 years being significantly associated with risk (RR: 1.44, 95% confidence interval: 1.03–2.00). Prolonged use of progestagens after the age of 40 may be associated with an increased risk of breast cancer and the subject needs to be investigated further.
Published: 2007
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32. Folate, vitamin B12 and postmenopausal breast cancer in a prospective study of French women

Author: Françoise Clavel-Chapelon, Marie-Christine Boutron-Ruault, Martin Lajous, Séverine Sabia, Isabelle Romieu, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Center for Population Health Research, Insituto Nacional de Salud Publica, The E3N study is financially supported by the French League against Cancer, the European Community, the 3M Company, the Mutuelle Générale de l'Education Nationale, the Institut Gustave Roussy and the Institut National de la Santé et de la Recherche Médicale., and Clavel-Chapelon, F.
Subjects: Oncology, Cancer Research, Folate Metabolism, Riboflavin, MESH: Energy Intake, MESH: Eating, MESH: Proportional Hazards Models, Eating, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Epidemiology, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, MESH: Middle Aged, MESH: Research Design, MESH: Follow-Up Studies, Middle Aged, 3. Good health, Postmenopause, Vitamin B 12, Research Design, 030220 oncology & carcinogenesis, Vitamin B Complex, Female, France, MESH: Postmenopause, Adult, medicine.medical_specialty, Alcohol Drinking, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Folic Acid, Article, MESH: Multivariate Analysis, 03 medical and health sciences, Breast cancer, Folic Acid, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Humans, Vitamin B12, Proportional Hazards Models, MESH: Humans, Proportional hazards model, business.industry, MESH: Questionnaires, MESH: Adult, medicine.disease, MESH: Prospective Studies, MESH: France, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Endocrinology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Multivariate Analysis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Energy Intake, MESH: Female, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, MESH: Alcohol Drinking, MESH: Breast Neoplasms, Vitamin b2, Follow-Up Studies
Abstract: International audience; OBJECTIVE: Adequate folate intake may be important for breast cancer prevention. Its protective effect may be influenced by factors associated with folate metabolism. We sought to evaluate folate intake in relation to breast cancer risk and examine whether the relation is affected by alcohol and intake of vitamin B(2) and B(12). METHODS: A prospective cohort analysis of folate intake was conducted among 62,739 postmenopausal women in the French E3N cohort who had completed a validated food frequency questionnaire in 1993. During nine years' follow-up, 1,812 cases of pathology-confirmed breast cancer were documented through follow-up questionnaires. Nutrients were categorized in quintiles and energy-adjusted using the regression-residual method. Cox model-derived relative risks (RRs) were adjusted for known breast cancer determinants. RESULTS: The multivariate RR for extreme quintiles of folate intake was 0.78 (95% CI: 0.67-0.90; p-trend = 0.001) [Median intake for Q(1) = 296 microg/day and Q(5) = 522 microg/day]. There was no evidence to support effect modification by alcohol or B(2) intake. The decreasing trend was most marked in women with higher folate and vitamin B(12 )intake. However, test for interaction was not statistically significant (p = 0.29). CONCLUSIONS: High folate intake was associated with decreased breast cancer risk. Vitamin B(12) intake may modify this association.
Published: 2006
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33. Several anthropometric measurements and breast cancer risk: results of the E3N cohort study

Author: Bertrand Tehard, Françoise Clavel-Chapelon, Clavel-Chapelon, F., Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and The E3N study is supporting financially by the French League against Cancer, the European Community, the 3M Company, the Mutuelle Générale de l'Education Nationale, the Gustave Roussy Institute and the French National Institute of Health and Medical Research.
Subjects: MESH: Reproductive History, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Medicine (miscellaneous), Overweight, MESH: Epidemiologic Methods, Body Mass Index, 0302 clinical medicine, Medicine, MESH: Obesity, 030212 general & internal medicine, Prospective cohort study, skin and connective tissue diseases, Reproductive History, Adiposity, 2. Zero hunger, MESH: Aged, Nutrition and Dietetics, MESH: Middle Aged, Anthropometry, Obstetrics, Hormone replacement therapy (menopause), Middle Aged, 3. Good health, Postmenopause, MESH: Premenopause, 030220 oncology & carcinogenesis, Female, medicine.symptom, MESH: Postmenopause, Cohort study, medicine.medical_specialty, Waist, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Article, MESH: Body Mass Index, 03 medical and health sciences, Breast cancer, [SDV.CAN] Life Sciences [q-bio]/Cancer, MESH: Anthropometry, MESH: Body Height, Humans, Obesity, MESH: Body Constitution, Risk factor, Aged, MESH: Adiposity, Gynecology, MESH: Humans, business.industry, nutritional and metabolic diseases, medicine.disease, Body Height, Premenopause, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Body Constitution, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Epidemiologic Methods, business, Body mass index, MESH: Female, MESH: Breast Neoplasms
Abstract: Objective: To investigate the association between various anthropometric characteristics and breast cancer. Design: Longitudinal prospective cohort study. Follow-up between 1995 and 2000. Subjects: In total, 69 116 women (age: 45–70 years; mean follow-up: 3.6 years), 275 premenopausal and 860 postmenopausal incident invasive breast cancers. Measurements: Self-reported height, weight, breast, thorax, waist and hip circumferences and calculated body mass index (BMI) and waist-to-hip ratio (WHR) at baseline. Results: A slight increase in risk with increasing height was found. Weight, BMI, thorax and waist circumferences and WHR were negatively related to breast cancer risk among premenopausal women. The relationships became non significant after additional adjustment for BMI. An increased risk of premenopausal breast cancer with an android body shape (WHR>0.87) might possibly be confined to obese women. Among postmenopausal women, all anthropometric measurements of corpulence were positively associated with breast cancer risk but became non significant after additional adjustment for BMI. No difference in risk of postmenopausal breast cancer according to HRT use was observed. Conclusion: The study confirmed that adiposity was negatively associated to premenopausal breast cancer risk and positively associated to postmenopausal breast cancer risk. Further studies will be needed to specify clearly the association between WHR and breast cancer risk, particularly before menopause.
Published: 2006
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34. Dual Association of beta-carotene with risk of tobacco-related cancers in a cohort of French women

Author: Mathilde Touvier, Emmanuelle Kesse, Marie-Christine Boutron-Ruault, FranÃ§oise Clavel-Chapelon, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), The study was funded by the French League against Cancer, the European Community, the 3M Company, the Mutuelle Générale de l'Education Nationale, the Institut Gustave Roussy, the Institut National de la Santé et de la Recherche Médicale, and the French Food Safety Agency., and Clavel-Chapelon, F.
Subjects: Cancer Research, Lung Neoplasms, MESH: Dietary Supplements, MESH: Food Habits, Antioxidants, MESH: Carcinogens, MESH: Proportional Hazards Models, 0302 clinical medicine, Risk Factors, Neoplasms, Odds Ratio, MESH: Neoplasms, Prospective Studies, Prospective cohort study, 0303 health sciences, education.field_of_study, MESH: Middle Aged, Hazard ratio, Smoking, MESH: Research Support, N, MESH: Follow-Up Studies, Middle Aged, beta Carotene, 3. Good health, Oncology, 030220 oncology & carcinogenesis, Cohort, Female, France, Cohort study, Adult, medicine.medical_specialty, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, Risk Assessment, Article, MESH: Multivariate Analysis, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Humans, Risk factor, education, 030304 developmental biology, Proportional Hazards Models, MESH: Humans, business.industry, Proportional hazards model, MESH: Antioxidants, MESH: Adult, Odds ratio, Feeding Behavior, MESH: Odds Ratio, MESH: Prospective Studies, Surgery, MESH: Lung Neoplasms, MESH: France, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Dietary Supplements, Multivariate Analysis, Carcinogens, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Follow-Up Studies
Abstract: Background: Intervention studies have demonstrated that, in smokers, β-carotene supplements had a deleterious effect on risk of lung cancer and may have a deleterious effect on digestive cancers as well. We investigated a potential interaction between β-carotene intake and smoking on the risk of tobacco-related cancers in women. Methods: A total of 59 910 women from the French Etude Epidemiologique de Femmes de la Mutuelle Generale de l’Education Nationale (E3N) prospective investigation were studied from 1994. After a median follow-up of 7.4 years, 700 women had developed cancers known to be associated with smoking. Diet, supplement use, and smoking status at baseline were assessed by self-report. β-carotene intake was classifi ed into four groups: fi rst (low intake), second, and third tertiles of dietary intake, and use of supplements (high intake). Unadjusted and multivariable Cox proportional hazards models were used to calculate hazard ratios and 95% confi dence intervals (CIs) for cancer risk. All statistical tests were two-sided. Results: Among never smokers, multivariable hazard ratios of all smoking-related cancers were 0.72 (95% CI = 0.57 to 0.92), 0.80 (95% CI = 0.64 to 1.01), and 0.44 (95% CI = 0.18 to 1.07) for the second and third tertiles of dietary intake, and high β-carotene intake, respectively, compared with low intake ( P trend = .03). Among ever smokers, multivariable hazard ratios were 1.43 (95% CI = 1.05 to 1.96), 1.20 (95% CI = 0.86 to 1.67), and 2.14 (95% CI = 1.16 to 3.97) for the second and third tertiles of dietary intake, and high β-carotene intake, respectively, compared with low intake ( P trend = .09). Tests for interaction between β-carotene intake and smoking were statistically signifi cant ( P trend =.017). In this population, the absolute rates over 10 years in those with low and high β-carotene intake were 181.8 and 81.7 cases per 10 000 women in never smokers and 174.0 and 368.3 cases per 10 000 women in ever smokers. Conclusions: β-carotene intake was inversely associated with risk of tobacco-related cancers among nonsmokers with a statistically signifi cant dose-dependent relationship, whereas high β-carotene intake was directly associated with risk among smokers. [J Natl Cancer Inst 2005;97:1338 – 44]
Published: 2005
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35. Previous oral contraceptive use and breast cancer risk according to hormone replacement therapy use among postmenopausal women

Author: Françoise Clavel-Chapelon, Agnès Fournier, Eiliv Lund, Vanessa Dumeaux, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute of Community Medicine, University of Tromsø (UiT), The E3N study is supporting financially by the French League against Cancer, the European Community, the 3M Company, the Mutuelle Générale de l'Education Nationale, the Institut Gustave-Roussy and the Institut National de la Santé et de la Recherche Médicale., and Clavel-Chapelon, F.
Subjects: patterns of use, Cancer Research, Time Factors, medicine.medical_treatment, postmenopausal women, MESH: Risk Assessment, Cohort Studies, MESH: Proportional Hazards Models, 0302 clinical medicine, Surveys and Questionnaires, 030212 general & internal medicine, MESH: Cohort Studies, oral contraceptives, education.field_of_study, MESH: Middle Aged, Obstetrics, MESH: Hormone Replacement Therapy, Hormone replacement therapy (menopause), MESH: Follow-Up Studies, Middle Aged, 3. Good health, Postmenopause, hormone replacement therapy, Oncology, 030220 oncology & carcinogenesis, Cohort, Female, France, MESH: Contraceptives, Oral, Hormonal, Risk assessment, MESH: Postmenopause, Cohort study, Adult, medicine.medical_specialty, Population, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Risk Assessment, Article, Contraceptives, Oral, Hormonal, 03 medical and health sciences, Breast cancer, breast cancer, [SDV.CAN] Life Sciences [q-bio]/Cancer, medicine, Humans, education, Proportional Hazards Models, Gynecology, MESH: Humans, business.industry, Proportional hazards model, MESH: Questionnaires, MESH: Time Factors, Cancer, MESH: Adult, medicine.disease, MESH: France, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, MESH: Breast Neoplasms, Follow-Up Studies
Abstract: Objective: To assess postmenopausal breast cancer risk in relation to particular patterns of oral contraceptive (OC) use according to hormone replacement therapy (HRT) exposure. Methods: Time-dependent Cox regression models were used to analyse information on postmenopausal women from a large-scale French cohort. Among a total of 68,670 women born between 1925 and 1950, 1405 primary invasive postmenopausal breast cancer cases were identified from 1992 to 2000. Results: A non-significant decrease in risk of around 10% was associated with ever OC use as compared to never OC use in postmenopausal women. No significant interaction was found between OC and HRT use on postmenopausal breast cancer risk. Breast cancer risk decreased significantly with increasing time since first OC use (test for trend: p = 0.01); this was consistent after adjustment for duration of use or for time since last use. Conclusion: No increase in breast cancer risk was associated with previous OC exposure among postmenopausal women, probably because the induction window had closed. Some women may develop breast cancer soon after exposure to OCs, leading to a deficit of cases of older women. Further investigation is therefore required to identify young women at high risk.
Published: 2005
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36. Anthropometry, breast cancer and menopausal status: use of repeated measurements over 10 years of follow-up-results of the French E3N women's cohort study

Author: Françoise Clavel-Chapelon, Petra H. Lahmann, Bertrand Tehard, Elio Riboli, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Epidemiology, German Institute of Human Nutrition, Unit of Nutrition and Cancer, International Agency for Cancer Research (IACR), Grant sponsor: F. Clavel-Chapelon, French League against Cancer, Grant sponsor: European Community, Grant sponsor: 3M Company, Grant sponsor: Mutuelle Générale de l'Education Nationale, and Clavel-Chapelon, F.
Subjects: Cancer Research, MESH: Risk Assessment, Cohort Studies, 0302 clinical medicine, 030212 general & internal medicine, MESH: Incidence, MESH: Cohort Studies, MESH: Aged, MESH: Middle Aged, Anthropometry, Obstetrics, Incidence, MESH: Follow-Up Studies, Middle Aged, 3. Good health, Postmenopause, Menopause, MESH: Reproducibility of Results, Oncology, 030220 oncology & carcinogenesis, Cohort, Female, France, MESH: Postmenopause, Cohort study, Adult, medicine.medical_specialty, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Risk Assessment, MESH: Multivariate Analysis, 03 medical and health sciences, Breast cancer, [SDV.CAN] Life Sciences [q-bio]/Cancer, MESH: Anthropometry, medicine, Humans, Risk factor, Aged, Gynecology, MESH: Humans, Proportional hazards model, business.industry, Body Weight, Reproducibility of Results, MESH: Adult, medicine.disease, MESH: Body Weight, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Multivariate Analysis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Body mass index, MESH: Female, MESH: Breast Neoplasms, Follow-Up Studies
Abstract: The association between weight, BMI and breast cancer was analyzed on 94,805 women of the E3N cohort according to their menopausal status. Seven hundred eighty-six incident invasive premenopausal breast cancers and 1,522 incident invasive postmenopausal breast cancers occurred during a mean follow-up of 9.7 years. Weight and BMI were updated every 24 months and considered as time-dependent variables. Data were analyzed using multivariate Cox proportional hazards models. Trend RRs of premenopausal breast cancer were 0.97 (0.92-1.01) for a 5 kg increase in weight and 0.96 (0.91-1.01) for a 2 kg/m(2) increase in BMI, adjusted for other known risk factors. Opposite trend RRs were found after menopause: 1.05 (1.02-1.08) for weight and 1.06 (1.02-1.09) for BMI, respectively, for similar increases. Women with a BMI of over 30 kg/m(2) had a RR of premenopausal breast cancer of 0.66 (0.40-1.10) compared to those with a BMI of between 18.5 and 25 kg/m(2). Postmenopausal women with a BMI of over 30 kg/m(2) had a RR of breast cancer of 1.23 (1.00-1.59). The increase in risk of postmenopausal breast cancer with increased weight or BMI was similar whatever the HRT used, although the point estimates were higher in HRT users. We strongly recommend to use anthropometric measurements updated during follow-up to assess the effect of weight, BMI on breast cancer risk.
Published: 2004
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37. Induced and spontaneous abortion and breast cancer risk: results from the E3N cohort study

Author: Xavier Paoletti, Françoise Clavel-Chapelon, Clavel-Chapelon, F., Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Grant sponsor: French League against Cancer, Grant sponsor: European Community, Grant sponsor: 3M Company, Grant sponsor: the Mutuelle Générale de l'Education Nationale, Grant sponsor: Institut Gustave-Roussy, and Grant sponsor: Institut National de la Santé et de la Recherche Médicale.
Subjects: Cancer Research, MESH: Abortion, Spontaneous, Abortion, Cohort Studies, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, Risk Factors, MESH: Child, MESH: Data Collection, 030212 general & internal medicine, Prospective Studies, MESH: Incidence, Prospective cohort study, Child, MESH: Cohort Studies, MESH: Ri, MESH: Aged, education.field_of_study, MESH: Middle Aged, Data Collection, Incidence, Middle Aged, MESH: Case-Control Studies, 3. Good health, Parity, Oncology, 030220 oncology & carcinogenesis, Female, MESH: Abortion, Induced, France, Cohort study, Adult, medicine.medical_specialty, Adolescent, Population, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, 03 medical and health sciences, Breast cancer, Age Distribution, [SDV.CAN] Life Sciences [q-bio]/Cancer, medicine, Humans, Risk factor, education, MESH: Age Distribution, [SDV.BDLR] Life Sciences [q-bio]/Reproductive Biology, Aged, Gynecology, MESH: Adolescent, MESH: Humans, business.industry, MESH: Parity, Case-control study, Abortion, Induced, MESH: Adult, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, medicine.disease, MESH: Prospective Studies, Abortion, Spontaneous, MESH: France, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Relative risk, Case-Control Studies, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, MESH: Breast Neoplasms
Abstract: Recent reviews reach conflicting conclusions on breast cancer risk after spontaneous or induced abortion. E3N is a large-scale cohort study collecting detailed information on environmental and reproductive factors. We investigated the relation between breast cancer and a history of induced and/or spontaneous abortion, using the data from the 100,000 women aged 40-65 at entrance in 1990. Among them, over 2,600 new invasive breast cancers had been diagnosed by June 2000. Multivariate analysis, adjusted for known potential confounders, showed no association between a history of induced abortion and breast cancer risk either in the whole population (relative risk [RR] = 0.91, 95% confidence interval [CI] 0.82-0.99) or in subgroups defined by parity or by menopausal status. Overall, the association between spontaneous abortion and breast cancer was not significant (RR = 1.05, 95% CI 0.95-1.15). However, there is a suggestion of increased risk with increased number of miscarriages (RR = 1.20, 95% CI 0.92-1.56 after 3 or more). Moreover, an interaction with menopausal status was observed. In premenopause, the risk decreased with increasing number of spontaneous abortions, whereas it increased in postmenopause. Among nulliparous and parous women, the relative risk estimates were respectively equal to 1.16 (95% CI 1.04-1.30, p trend < 0.0008) and 1.14 (95% CI 1.01-1.28, p trend = 0.005). Premenopausal breast cancer, on the other hand, appeared to be less frequent in women who had had repeated miscarriages. We conclude that there is no relationship between breast cancer and induced abortion but that an association with spontaneous abortion is possible and may depend on menopausal status.
Published: 2003
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38. Anthropometric measurements and body silhouette of women: validity and perception

Author: Tehard, Bertrand, Van Liere, Marti, Com Nougué, Catherine, Clavel-Chapelon, Françoise, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR)-Université Paris-Sud - Paris 11 (UP11), Epidémiologie des cancers, Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Health Care and Disease Control, The Royal Tropical Institute (KIT), Service de biostatistique et d'épidémiologie (SBE), Direction de la recherche clinique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), The E3N study is financially supporting by the French League against Cancer, the European Community, the 3M company, the ‘Mutuelle Générale de l'Education Nationale' and the Institut National de la Santé et de la Recherche Médicale., Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Clavel-Chapelon, F.
Subjects: body mass index, MESH: Logistic Models, Article, MESH: Body Mass Index, MESH: Anthropometry, Surveys and Questionnaires, MESH: Body Height, Body Image, Humans, Prospective Studies, MESH: Body Image, Aged, MESH: Aged, MESH: Middle Aged, MESH: Humans, Anthropometry, MESH: Questionnaires, Body Weight, Reproducibility of Results, weight, Middle Aged, body silhouettes, Body Height, MESH: Prospective Studies, MESH: Body Weight, Europe, MESH: Reproducibility of Results, Logistic Models, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Educational Status, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Europe, MESH: Educational Status, anthropometric measurements, MESH: Female, height
Abstract: International audience; OBJECTIVE: To examine the validity of self-reported values for current anthropometric measurements and factors related to misreporting. DESIGN: E3N, a prospective cohort study of cancer risk factors, conducted in France and part of the European Prospective Investigation on Cancer. E3N comprises 100,000 women, born between 1925 and 1950, followed with self-administered questionnaires sent every 18 to 24 months starting in 1990. SUBJECTS: 152 women for the validation study of self-reported anthropometric measurements, and 91,815 women selected to evaluate factors affecting misreporting of body silhouette. STATISTICAL ANALYSIS: Paired t tests, Pearson and Spearman correlations were applied to evaluate the validity of self-reported measures, and analysis of variance and logistic regression were used to assess the factors influencing misreporting of silhouette. RESULTS: The correlation coefficients between self- and external measurements were high. All but sitting height (r = 0.56) were more than 0.80, with weight and bust (nipples) measurement correlation coefficients attaining 0.94. The correlation between body mass index (BMI), measured by the technician and the self-reported silhouette, was 0.78. Small height was always associated with misclassification. Specific factors related to a more favorable perception of body silhouette were: being overweight, small height, younger age, and a lower level of education. These women were also more frequently unmarried, more physically active, and had had a slender body shape during adolescence. Results denoting a less favorable perception of body shape were reversed. CONCLUSION/APPLICATIONS: Self-reported measurements (made with or without help) are valid measures in epidemiological studies. Body silhouettes are simple and useful indicators of body mass index. However they should be interpreted with caution in certain instances, especially for overweight subjects.
Published: 2002

39. Cumulative number of menstrual cycles and breast cancer risk: results from the E3N cohort study of French women

Author: Clavel-Chapelon, Françoise, E3N Group, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), The E3N study is supporting financially by the French League against Cancer, the European Community, the 3M Company, the Mutuelle Générale de l'Education Nationale, the Institut Gustave-Roussy, and the Institut National de la Santé et de la Recherche Médicale., and Clavel-Chapelon, F.
Subjects: Adult, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Article, MESH: Multivariate Analysis, Cohort Studies, MESH: Proportional Hazards Models, [SDV.CAN] Life Sciences [q-bio]/Cancer, Risk Factors, Surveys and Questionnaires, Confidence Intervals, Humans, Prospective Studies, MESH: Cohort Studies, [SDV.BDLR] Life Sciences [q-bio]/Reproductive Biology, Menstrual Cycle, Aged, Proportional Hazards Models, MESH: Aged, MESH: Middle Aged, MESH: Humans, MESH: Questionnaires, MESH: Confounding Factors (Epidemiology), Confounding Factors, Epidemiologic, MESH: Adult, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, Middle Aged, MESH: Confidence Intervals, MESH: Prospective Studies, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Multivariate Analysis, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, MESH: Female, MESH: Breast Neoplasms, MESH: Risk Fa, MESH: Menstrual Cycle
Abstract: OBJECTIVE: To examine the relationship between breast cancer risk and the cumulative number of cycles before a first full-term pregnancy (FTP) and lifetime, taking age at menarche and at onset of regular cycling, periodicity and regularity of cycles, duration of periods of pregnancy, and lactation, oral contraceptive (OC) use, and age at menopause into account. METHODS: The data were taken from the E3N prospective cohort study of women aged 40-65 years in 1990. A total of 1718 breast cancer cases were identified during the 579,525 person-years of follow-up. RESULTS: There was a highly significant linear relationship between breast cancer risk and both the cumulative number of cycles before a first FTP (p for trend < 0.0001) and lifetime (p for trend < 0.001), with multivariate relative risk (RR) of a similar magnitude for both variables. Compared to women with a lifetime number of cycles or =521 cycles were 0.95 (0.75-1.21), 1.21 (0.97-1.52), 1.23 (0.96-1.58), and 1.60 (1.25-2.04), respectively. Results restricted to never OC users were similar. CONCLUSIONS: Further investigation is needed to clarify whether the underlying factor is repeated exposure to fluctuating hormones, the number of anovular/ovular cycles, or the relative importance of the follicular and luteal phases.
Published: 2002

40. Differential effects of reproductive factors on the risk of pre- and postmenopausal breast cancer. Results from a large cohort of French women

Author: Françoise Clavel-Chapelon, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie des cancers, Institut National de la Santé et de la Recherche Médicale (INSERM), The E3N study is financially supporting by the French League against Cancer, the European Community, the 3M Company, the Mutuelle Générale de l'Education Nationale and the Institut National de la Santé et de la Recherche Médicale., and Clavel-Chapelon, F.
Subjects: Cancer Research, MESH: Abortion, Spontaneous, Epidemiology, Abortion, Cohort Studies, 0302 clinical medicine, MESH: Pregnancy, 5. Gender equality, Pregnancy, MESH: Risk Factors, MESH: Child, Medicine, risk factors, Prospective Studies, 030212 general & internal medicine, Age of Onset, Child, Prospective cohort study, MESH: Cohort Studies, MESH: Aged, MESH: Middle Aged, Middle Aged, 3. Good health, Postmenopause, Menopause, Parity, MESH: Premenopause, Oncology, MESH: Menarche, 030220 oncology & carcinogenesis, Menarche, Female, France, reproductive factors, MESH: Postmenopause, Cohort study, Adult, medicine.medical_specialty, Adolescent, MESH: Age of Onset, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, 03 medical and health sciences, Breast cancer, breast cancer, [SDV.CAN] Life Sciences [q-bio]/Cancer, cohort study, Humans, Aged, Gynecology, MESH: Adolescent, MESH: Humans, business.industry, MESH: Parity, MESH: Adult, medicine.disease, MESH: Prospective Studies, Abortion, Spontaneous, MESH: France, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Premenopause, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Age of onset, business, MESH: Female, MESH: Breast Neoplasms
Abstract: The aim of this study was to obtain a better understanding of the role of hormonal factors in breast cancer risk and to determine whether the effect of reproductive events differs according to age at diagnosis. It analysed the effect of age at menarche, age at first full-term pregnancy, number of full-term pregnancies and number of spontaneous abortions both on the overall risk of breast cancer and on its pre- or postmenopausal onset, using the data on 1718 breast cancer cases, obtained from a large sample of around 100 000 French women participating in the E3N cohort study. The results provide further evidence that the overall risk of breast cancer increases with decreasing age at menarche, increasing age at first pregnancy and low parity. No overall effect of spontaneous abortions was observed. The effect of these reproductive factors differed according to menopausal status. Age at menarche had an effect on premenopausal breast cancer risk, with a decrease in risk with increasing age of 7% per year (P
Published: 2002
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41. Evolution of age at menarche and at onset of regular cycling in a large cohort of French women

Author: Françoise Clavel-Chapelon, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), The E3N study is supporting financially bt the French League against Cancer, the European Community, the 3M Company, the Mutuelle Générale de l'Education Nationale, the Institut Gustave-Roussy and the Institut National de la Santé et de la Recherche Médicale., E3N-EPIC group, Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR)-Université Paris-Sud - Paris 11 (UP11), and Clavel-Chapelon, F.
Subjects: Time Factors, Menstruation, Cohort Studies, 0302 clinical medicine, Surveys and Questionnaires, Medicine, 030212 general & internal medicine, MESH: Cohort Studies, media_common, MESH: Aged, MESH: Middle Aged, Incidence (epidemiology), Rehabilitation, Age Factors, Obstetrics and Gynecology, Middle Aged, MESH: Menarche, 030220 oncology & carcinogenesis, Menarche, Female, France, Cohort study, Adult, medicine.medical_specialty, media_common.quotation_subject, Physical exercise, Article, menstrual cycle, 03 medical and health sciences, evolution, cohort study, Humans, Risk factor, [SDV.BDLR] Life Sciences [q-bio]/Reproductive Biology, Menstrual cycle, Aged, Gynecology, MESH: Age Factors, MESH: Humans, business.industry, menarche, MESH: Questionnaires, MESH: Time Factors, MESH: Adult, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, MESH: France, Reproductive Medicine, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Age of onset, business, MESH: Female, Demography, MESH: Menstrual Cycle
Abstract: Background Early exposure to ovarian hormones is considered to increase breast cancer incidence. The age at which the ovaries become functional is thus important. Methods We explored the evolution of age at first menstruation and at onset of regular cycling in 86 031 women participating in the E3N-EPIC cohort study, part of the European Prospective Investigation into Cancer. Results We observed an increase in mean age at menarche among women born between 1925 and 1930, followed by a steady decrease in the youngest birth cohorts. In contrast, age at onset of regular cycling increased gradually from 1925 onwards. There was thus a steady increase in the interval between age at menarche and at onset of regular cycling, mainly due to an increase in the percentage of women in whom regular cycling started at least 5 years after menarche (from 9.0% among women born in 1925-1929 to 20.8% in those born in 1945-1950). The increase in the interval between menarche and onset of regular cycling was even greater among women with a late menarche. Conclusions This increase might be due to a change in dietary intake and/or physical exercise aimed at achieving the slim silhouette desired by the younger generations.
Published: 2002

42. Do eating habits differ according to alcohol consumption? Results of a study of the French cohort of the European Prospective Investigation into Cancer and Nutrition (E3N-EPIC)

Author: Emmanuelle Kesse, Françoise Clavel-Chapelon, Nadia Slimani, Marti van Liere, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), International Agency for Cancer Research (IACR), KIT Health, The Royal Tropical Institute (KIT), The study is supported by the French League against Cancer, the European Community, the 3M Company, the Mutuelle Générale de l'Education Nationale, Institut Gustave Roussy, and the Institut National de la Santé et de la Recherche Médicale. E Kesse is supported by a grant from the Association for Research on Cancer., and Clavel-Chapelon, F.
Subjects: Gerontology, 030309 nutrition & dietetics, Cross-sectional study, Health Behavior, Medicine (miscellaneous), Coronary Disease, MESH: Food Habits, MESH: Energy Intake, Cohort Studies, 0302 clinical medicine, Alcohol and health, Neoplasms, Surveys and Questionnaires, Medicine, MESH: Neoplasms, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, MESH: Cohort Studies, 2. Zero hunger, MESH: Aged, 0303 health sciences, education.field_of_study, Nutrition and Dietetics, MESH: Middle Aged, Smoking, Confounding Factors, Epidemiologic, Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, MESH: Dietary Fats, Cohort, Female, France, Cohort study, Adult, Alcohol Drinking, MESH: Health Behavior, Population, 03 medical and health sciences, MESH: Cross-Sectional Studies, Environmental health, Humans, education, Aged, Consumption (economics), MESH: Humans, business.industry, MESH: Confounding Factors (Epidemiology), MESH: Adult, Feeding Behavior, Dietary Fats, MESH: Prospective Studies, MESH: France, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Coronary Disease, Energy Intake, business, MESH: Female, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, MESH: Alcohol Drinking
Abstract: Background The potential of dietary habits to confound the association between alcohol consumption and health needs further study. Objective We examined whether eating habits differed according to alcohol consumption in a large cohort of French women. Design This was a cross-sectional study of the French cohort of the European Prospective Investigation into Cancer and Nutrition (E3N-EPIC). The cohort was established in 1990 and includes 100000 women born between 1925 and 1950. Dietary data were obtained between 1993 and 1995 by using self-administered food-frequency questionnaires. About 73000 questionnaires were analyzed, and women were placed into 7 categories of alcohol consumption. Results After adjustment for energy derived from alcohol, increasing alcohol consumption was associated with a higher total energy intake, a higher percentage of energy intake as protein and lipids, and higher intakes of cholesterol, fatty acids, retinol, iron, and vitamin E. Conversely, energy provided by carbohydrates decreased with increasing alcohol consumption, as did beta-carotene intake. Increasing alcohol consumption was associated with higher consumption of animal products, cheese, potatoes, oil, bread, and breakfast cereals and with lower consumption of vegetables and dairy products. Conclusion In this population of middle-aged, highly educated French women, marked differences in dietary patterns and nutrient intakes were found according to alcohol consumption. Part of the detrimental effect of alcohol on health may be due to the less healthy dietary habits of drinkers. This points to a confounding role of eating habits and nutrient intakes in the relation between alcohol and health.
Published: 2001

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