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1. Meal patterns across ten European countries - results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.

Author

Huseinovic E, Winkvist A, Slimani N, Park MK, Freisling H, Boeing H, Buckland G, Schwingshackl L, Weiderpass E, Rostgaard-Hansen AL, Tjønneland A, Affret A, Boutron-Ruault MC, Fagherazzi G, Katzke V, Kühn T, Naska A, Orfanos P, Trichopoulou A, Pala V, Palli D, Ricceri F, Santucci de Magistris M, Tumino R, Engeset D, Enget T, Skeie G, Barricarte A, Bonet CB, Chirlaque MD, Amiano P, Quirós JR, Sánchez MJ, Dias JA, Drake I, Wennberg M, Boer J, Ocké MC, Verschuren W, Lassale C, Perez-Cornago A, Riboli E, Ward H, and Forslund HB

Subjects
Adult, Aged, Cross-Sectional Studies, Energy Intake, Europe, Female, Humans, Male, Meals, Middle Aged, Prospective Studies, Snacks, Diet, Diet Surveys, Feeding Behavior
Abstract

Objective: To characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study., Design: Cross-sectional study utilizing dietary data collected through a standardized 24 h diet recall during 1995-2000. Eleven predefined intake occasions across a 24 h period were assessed during the interview. In the present descriptive report, meal patterns were analysed in terms of daily number of intake occasions, the proportion reporting each intake occasion and the energy contributions from each intake occasion., Setting: Twenty-seven centres across ten European countries., Subjects: Women (64 %) and men (36 %) aged 35-74 years (n 36 020)., Results: Pronounced differences in meal patterns emerged both across centres within the same country and across different countries, with a trend for fewer intake occasions per day in Mediterranean countries compared with central and northern Europe. Differences were also found for daily energy intake provided by lunch, with 38-43 % for women and 41-45 % for men within Mediterranean countries compared with 16-27 % for women and 20-26 % for men in central and northern European countries. Likewise, a south-north gradient was found for daily energy intake from snacks, with 13-20 % (women) and 10-17 % (men) in Mediterranean countries compared with 24-34 % (women) and 23-35 % (men) in central/northern Europe., Conclusions: We found distinct differences in meal patterns with marked diversity for intake frequency and lunch and snack consumption between Mediterranean and central/northern European countries. Monitoring of meal patterns across various cultures and populations could provide critical context to the research efforts to characterize relationships between dietary intake and health.

Published
2016
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2. Consumption of fatty foods and incident type 2 diabetes in populations from eight European countries.

Author

Buijsse B, Boeing H, Drogan D, Schulze MB, Feskens EJ, Amiano P, Barricarte A, Clavel-Chapelon F, de Lauzon-Guillain B, Fagherazzi G, Fonseca-Nunes A, Franks PW, Huerta JM, Jakobsen MU, Kaaks R, Key TJ, Khaw KT, Masala G, Moskal A, Nilsson PM, Overvad K, Pala V, Panico S, Redondo ML, Ricceri F, Rolandsson O, Sánchez MJ, Sluijs I, Spijkerman AM, Tjonneland A, Tumino R, van der A DL, van der Schouw YT, Langenberg C, Sharp SJ, Forouhi NG, Riboli E, and Wareham NJ

Subjects
Adult, Body Mass Index, Butter, Case-Control Studies, Energy Intake, Energy Metabolism, Europe epidemiology, Female, Follow-Up Studies, Humans, Incidence, Life Style, Male, Margarine, Mental Recall, Nutrition Assessment, Nuts, Plant Oils, Proportional Hazards Models, Prospective Studies, Risk Factors, Surveys and Questionnaires, Diabetes Mellitus, Type 2 epidemiology, Diet, Dietary Fats administration & dosage
Abstract

Background/objectives: Diets high in saturated and trans fat and low in unsaturated fat may increase type 2 diabetes (T2D) risk, but studies on foods high in fat per unit weight are sparse. We assessed whether the intake of vegetable oil, butter, margarine, nuts and seeds and cakes and cookies is related to incident T2D., Subjects/methods: A case-cohort study was conducted, nested within eight countries of the European Prospective Investigation into Cancer (EPIC), with 12,403 incident T2D cases and a subcohort of 16,835 people, identified from a cohort of 340,234 people. Diet was assessed at baseline (1991-1999) by country-specific questionnaires. Country-specific hazard ratios (HRs) across four categories of fatty foods (nonconsumers and tertiles among consumers) were combined with random-effects meta-analysis., Results: After adjustment not including body mass index (BMI), nonconsumers of butter, nuts and seeds and cakes and cookies were at higher T2D risk compared with the middle tertile of consumption. Among consumers, cakes and cookies were inversely related to T2D (HRs across increasing tertiles 1.14, 1.00 and 0.92, respectively; P-trend <0.0001). All these associations attenuated upon adjustment for BMI, except the higher risk of nonconsumers of cakes and cookies (HR 1.57). Higher consumption of margarine became positively associated after BMI adjustment (HRs across increasing consumption tertiles: 0.93, 1.00 and 1.12; P-trend 0.03). Within consumers, vegetable oil, butter and nuts and seeds were unrelated to T2D., Conclusions: Fatty foods were generally not associated with T2D, apart from weak positive association for margarine. The higher risk among nonconsumers of cakes and cookies needs further explanation.

Published
2015
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3. Dietary intake of acrylamide and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

Author

Obón-Santacana M, Slimani N, Lujan-Barroso L, Travier N, Hallmans G, Freisling H, Ferrari P, Boutron-Ruault MC, Racine A, Clavel F, Saieva C, Pala V, Tumino R, Mattiello A, Vineis P, Argüelles M, Ardanaz E, Amiano P, Navarro C, Sánchez MJ, Molina Montes E, Key T, Khaw KT, Wareham N, Peeters PH, Trichopoulou A, Bamia C, Trichopoulos D, Boeing H, Kaaks R, Katzke V, Ye W, Sund M, Ericson U, Wirfält E, Overvad K, Tjønneland A, Olsen A, Skeie G, Åsli LA, Weiderpass E, Riboli E, Bueno-de-Mesquita HB, and Duell EJ

Subjects
Adult, Aged, Body Mass Index, Cohort Studies, Eating, Europe, Female, Humans, Male, Middle Aged, Nutritional Status, Obesity, Prospective Studies, Risk, Risk Factors, Surveys and Questionnaires, Waist Circumference, Acrylamide toxicity, Carcinoma, Pancreatic Ductal chemically induced, Carcinoma, Pancreatic Ductal epidemiology, Diet adverse effects, Pancreatic Neoplasms chemically induced, Pancreatic Neoplasms epidemiology
Abstract

Background: In 1994, acrylamide (AA) was classified as a probable human carcinogen by the International Agency for Research on Cancer. In 2002, AA was discovered at relatively high concentrations in some starchy, plant-based foods cooked at high temperatures., Patients and Methods: A prospective analysis was conducted to evaluate the association between the dietary intake of AA and ductal adenocarcinoma of the exocrine pancreatic cancer (PC) risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort using Cox regression modeling. EPIC includes >500,000 men and women aged 35-75 at enrollment from 10 European countries. AA intake was estimated for each participant by combining questionnaire-based food consumption data with a harmonized AA database derived from the EU monitoring database of AA levels in foods, and evaluated in quintiles and continuously., Results: After a mean follow-up of 11 years, 865 first incident adenocarcinomas of the exocrine pancreas were observed and included in the present analysis. At baseline, the mean dietary AA intake in EPIC was 26.22 µg/day. No overall association was found between continuous or quintiles of dietary AA intake and PC risk in EPIC (HR:0.95, 95%CI:0.89-1.01 per 10 µg/day). There was no effect measure modification by smoking status, sex, diabetes, alcohol intake or geographic region. However, there was an inverse association (HR: 0.73, 95% CI: 0.61-0.88 per 10 µg/day) between AA intake and PC risk in obese persons as defined using the body mass index (BMI, ≥ 30 kg/m(2)), but not when body fatness was defined using waist and hip circumference or their ratio., Conclusions: Dietary intake of AA was not associated with an increased risk of PC in the EPIC cohort.

Published
2013
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4. Association between dietary meat consumption and incident type 2 diabetes: the EPIC-InterAct study.

Author

Bendinelli B, Palli D, Masala G, Sharp SJ, Schulze MB, Guevara M, van der AD, Sera F, Amiano P, Balkau B, Barricarte A, Boeing H, Crowe FL, Dahm CC, Dalmeijer G, de Lauzon-Guillain B, Egeberg R, Fagherazzi G, Franks PW, Krogh V, Huerta JM, Jakszyn P, Khaw KT, Li K, Mattiello A, Nilsson PM, Overvad K, Ricceri F, Rolandsson O, Sánchez MJ, Slimani N, Sluijs I, Spijkerman AM, Teucher B, Tjonneland A, Tumino R, van den Berg SW, Forouhi NG, Langeberg C, Feskens EJ, Riboli E, and Wareham NJ

Subjects
Adult, Aged, Aged, 80 and over, Case-Control Studies, Cohort Studies, Cross-Sectional Studies, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 ethnology, Diet ethnology, Europe epidemiology, Female, Follow-Up Studies, Humans, Incidence, Iron, Dietary administration & dosage, Iron, Dietary adverse effects, Male, Meat analysis, Meat Products adverse effects, Meat Products analysis, Middle Aged, Prospective Studies, Risk, Sex Characteristics, Young Adult, Diabetes Mellitus, Type 2 etiology, Diet adverse effects, Meat adverse effects
Abstract

Aims/hypothesis: A diet rich in meat has been reported to contribute to the risk of type 2 diabetes. The present study aims to investigate the association between meat consumption and incident type 2 diabetes in the EPIC-InterAct study, a large prospective case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study., Methods: During 11.7 years of follow-up, 12,403 incident cases of type 2 diabetes were identified among 340,234 adults from eight European countries. A centre-stratified random subsample of 16,835 individuals was selected in order to perform a case-cohort design. Prentice-weighted Cox regression analyses were used to estimate HR and 95% CI for incident diabetes according to meat consumption., Results: Overall, multivariate analyses showed significant positive associations with incident type 2 diabetes for increasing consumption of total meat (50 g increments: HR 1.08; 95% CI 1.05, 1.12), red meat (HR 1.08; 95% CI 1.03, 1.13) and processed meat (HR 1.12; 95% CI 1.05, 1.19), and a borderline positive association with meat iron intake. Effect modifications by sex and class of BMI were observed. In men, the results of the overall analyses were confirmed. In women, the association with total and red meat persisted, although attenuated, while an association with poultry consumption also emerged (HR 1.20; 95% CI 1.07, 1.34). These associations were not evident among obese participants., Conclusions/interpretation: This prospective study confirms a positive association between high consumption of total and red meat and incident type 2 diabetes in a large cohort of European adults.

Published
2013
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5. Compliance with dietary and nutrient recommendations in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Granada cohort at recruitment.

Author

Molina-Montes E, Sánchez-Cantalejo E, Martínez C, Contreras JM, Molina E, and Sánchez MJ

Subjects
Adult, Aged, Body Mass Index, Cohort Studies, Energy Intake, Female, Humans, Male, Middle Aged, Nutrition Assessment, Smoking epidemiology, Socioeconomic Factors, Spain epidemiology, Surveys and Questionnaires, Vitamin D Deficiency epidemiology, Young Adult, Diet, Guideline Adherence statistics & numerical data, Guidelines as Topic, Neoplasms, Patient Compliance statistics & numerical data
Abstract

Background: The overall intake of energy and nutrients in the Granada EPIC-cohort (European Prospective Investigation into Cancer and Nutrition) is examined in order to assess compliance with the Spanish Nutritional Objectives (NO) and the Recommended Intakes (RI)., Methods: During recruitment (1992-1996), 7,789 participants, aged 35-69, were asked about diet through a validated diet history questionnaire. Nutrient intake is compared to the NO and RI that were valid at that time. Risk of inadequate intake is estimated as the percentage of the sample with intakes: ≤ 1/3 RI (high risk), ≤ 2/3 RI- > 1/3 RI (moderate risk), ≤ RI- > 2/3 RI, > RI. Differences in intakes have been analyzed by sex and age, and by smoking status and BMI., Results: The daily intake of nutrients did not meet the NO as the total contribution of energy from proteins and fats exceeded these guidelines. Whilst intake of most nutrients was above the RI, the amount of iron, magnesium and vitamins D and E provided by the diet was not enough to meet the RI: in women aged 20-49 years, about 55% were at moderate risk for iron inadequacy, and a 20% of women for magnesium. Both sexes were at high risk of inadequacy for vitamin D, although sunlight exposure may supply adequate amounts. Never smokers showed a higher compliance to the NO., Conclusion: At recruitment, the nutrient profile of the diet was unbalanced. The observed nutrient inadequacy for iron, magnesium and vitamin E might be attributed to inappropriate dietary habits, and may have implications for future disease risk.

Published
2012
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6. Dietary beta-carotene, vitamin C and E intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Author

Nagel G, Linseisen J, van Gils CH, Peeters PH, Boutron-Ruault MC, Clavel-Chapelon F, Romieu I, Tjønneland A, Olsen A, Roswall N, Witt PM, Overvad K, Rohrmann S, Kaaks R, Drogan D, Boeing H, Trichopoulou A, Stratigakou V, Zylis D, Engeset D, Lund E, Skeie G, Berrino F, Grioni S, Mattiello A, Masala G, Tumino R, Zanetti R, Ros MM, Bueno-de-Mesquita HB, Ardanaz E, Sánchez MJ, Huerta JM, Amiano P, Rodríguez L, Manjer J, Wirfält E, Lenner P, Hallmans G, Spencer EA, Key TJ, Bingham S, Khaw KT, Rinaldi S, Slimani N, Boffetta P, Gallo V, Norat T, and Riboli E

Subjects
Adult, Aged, Europe, Female, Humans, Middle Aged, Postmenopause, Premenopause, Proportional Hazards Models, Risk, Surveys and Questionnaires, Antioxidants administration & dosage, Ascorbic Acid administration & dosage, Breast Neoplasms epidemiology, Diet, Vitamin E administration & dosage, beta Carotene administration & dosage
Abstract

So far, studies on dietary antioxidant intake, including beta-carotene, vitamin C and vitamin E, and breast cancer risk are inconclusive. Thus, we addressed this question in the European Prospective Investigation into Cancer and Nutrition. During a median follow-up time of 8.8 years, 7,502 primary invasive breast cancer cases were identified. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). All analyses were run stratified by menopausal status at recruitment and, additionally, by smoking status, alcohol intake, use of exogenous hormones and use of dietary supplements. In the multivariate analyses, dietary intake of beta-carotene, vitamin C and E was not associated with breast cancer risk in premenopausal [highest vs. lowest quintile: HR, 1.04 (95% CI, 0.85-1.27), 1.12 (0.92-1.36) and 1.11 (0.84-1.46), respectively] and postmenopausal women [0.93 (0.82-1.04), 0.98 (0.87-1.11) and 0.92 (0.77-1.11), respectively]. However, in postmenopausal women using exogenous hormones, high intake of beta-carotene [highest vs. lowest quintile; HR 0.79 (95% CI, 0.66-0.96), P (trend) 0.06] and vitamin C [0.88 (0.72-1.07), P (trend) 0.05] was associated with reduced breast cancer risk. In addition, dietary beta-carotene was associated with a decreased risk in postmenopausal women with high alcohol intake. Overall, dietary intake of beta-carotene, vitamin C and E was not related to breast cancer risk in neither pre- nor postmenopausal women. However, in subgroups of postmenopausal women, a weak protective effect between beta-carotene and vitamin E from food and breast cancer risk cannot be excluded.

Published
2010
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7. Plasma phyto-oestrogens and prostate cancer in the European Prospective Investigation into Cancer and Nutrition.

Author

Travis RC, Spencer EA, Allen NE, Appleby PN, Roddam AW, Overvad K, Johnsen NF, Olsen A, Kaaks R, Linseisen J, Boeing H, Nöthlings U, Bueno-de-Mesquita HB, Ros MM, Sacerdote C, Palli D, Tumino R, Berrino F, Trichopoulou A, Dilis V, Trichopoulos D, Chirlaque MD, Ardanaz E, Larranaga N, Gonzalez C, Suárez LR, Sánchez MJ, Bingham S, Khaw KT, Hallmans G, Stattin P, Rinaldi S, Slimani N, Jenab M, Riboli E, and Key TJ

Subjects
Case-Control Studies, Europe, Genistein blood, Humans, Male, Middle Aged, Risk Factors, Diet, Phytoestrogens blood, Prostatic Neoplasms blood, Prostatic Neoplasms epidemiology
Abstract

We examined plasma concentrations of phyto-oestrogens in relation to risk for subsequent prostate cancer in a case-control study nested in the European Prospective Investigation into Cancer and Nutrition. Concentrations of isoflavones genistein, daidzein and equol, and that of lignans enterolactone and enterodiol, were measured in plasma samples for 950 prostate cancer cases and 1042 matched control participants. Relative risks (RRs) for prostate cancer in relation to plasma concentrations of these phyto-oestrogens were estimated by conditional logistic regression. Higher plasma concentrations of genistein were associated with lower risk of prostate cancer: RR among men in the highest vs the lowest fifth, 0.71 (95% confidence interval (CI) 0.53-0.96, P trend=0.03). After adjustment for potential confounders this RR was 0.74 (95% CI 0.54-1.00, P trend=0.05). No statistically significant associations were observed for circulating concentrations of daidzein, equol, enterolactone or enterodiol in relation to overall risk for prostate cancer. There was no evidence of heterogeneity in these results by age at blood collection or country of recruitment, nor by cancer stage or grade. These results suggest that higher concentrations of circulating genistein may reduce the risk of prostate cancer but do not support an association with plasma lignans.

Published
2009
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8. Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition.

Author

Jenab M, Riboli E, Ferrari P, Friesen M, Sabate J, Norat T, Slimani N, Tjønneland A, Olsen A, Overvad K, Boutron-Ruault MC, Clavel-Chapelon F, Boeing H, Schulz M, Linseisen J, Nagel G, Trichopoulou A, Naska A, Oikonomou E, Berrino F, Panico S, Palli D, Sacerdote C, Tumino R, Peeters PH, Numans ME, Bueno-de-Mesquita HB, Büchner FL, Lund E, Pera G, Chirlaque MD, Sánchez MJ, Arriola L, Barricarte A, Quirós JR, Johansson I, Johansson A, Berglund G, Bingham S, Khaw KT, Allen N, Key T, Carneiro F, Save V, Del Giudice G, Plebani M, Kaaks R, and Gonzalez CA

Subjects
Adenocarcinoma blood, Adenocarcinoma diagnosis, Adult, Aged, Carotenoids blood, Case-Control Studies, Europe epidemiology, Follow-Up Studies, Humans, Middle Aged, Nutritional Physiological Phenomena, Prospective Studies, Risk Factors, Stomach Neoplasms blood, Stomach Neoplasms diagnosis, Tocopherols blood, Vitamin A blood, Adenocarcinoma epidemiology, Carotenoids administration & dosage, Diet, Stomach Neoplasms epidemiology, Tocopherols administration & dosage, Vitamin A administration & dosage
Abstract

Despite declining incidence rates, gastric cancer (GC) is a major cause of death worldwide. Its aetiology may involve dietary antioxidant micronutrients such as carotenoids and tocopherols. The objective of this study was to determine the association of plasma levels of seven common carotenoids, their total plasma concentration, retinol and alpha- and gamma-tocopherol, with the risk of gastric adenocarcinoma in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 countries. A secondary objective was to determine the association of total sum of carotenoids, retinol and alpha-tocopherol on GCs by anatomical subsite (cardia/noncardia) and histological subtype (diffuse/intestinal). Analytes were measured by high-performance liquid chromatography in prediagnostic plasma from 244 GC cases and 645 controls matched by age, gender, study centre and date of blood donation. Conditional logistic regression models adjusted by body mass index, total energy intake, smoking and Helicobacter pylori infection status were used to estimate relative cancer risks. After an average 3.2 years of follow-up, a negative association with GC risk was observed in the highest vs the lowest quartiles of plasma beta-cryptoxanthin (odds ratio (OR) = 0.53, 95% confidence intervals (CI) = 0.30-0.94, P(trend) = 0.006), zeaxanthin (OR = 0.39, 95% CI = 0.22-0.69, P(trend) = 0.005), retinol (OR = 0.55, 95% CI = 0.33-0.93, P(trend) = 0.005) and lipid-unadjusted alpha-tocopherol (OR = 0.59, 95% CI = 0.37-0.94, P(trend) = 0.022). For all analytes, no heterogeneity of risk estimates or significant associations were observed by anatomical subsite. In the diffuse histological subtype, an inverse association was observed with the highest vs lowest quartile of lipid-unadjusted alpha-tocopherol (OR = 0.26, 95% CI = 0.11-0.65, P(trend) = 0.003). These results show that higher plasma concentrations of some carotenoids, retinol and alpha-tocopherol are associated with reduced risk of GC.

Published
2006
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9. Oral and oropharyngeal cancer in Spain: influence of dietary patterns.

Author

Sánchez MJ, Martínez C, Nieto A, Castellsagué X, Quintana MJ, Bosch FX, Muñoz N, Herrero R, and Franceschi S

Subjects
Adult, Aged, Aged, 80 and over, Alcohol Drinking adverse effects, Case-Control Studies, Female, Fruit, Humans, Male, Middle Aged, Odds Ratio, Risk Factors, Smoking adverse effects, Spain epidemiology, Vegetables, Diet, Mouth Neoplasms epidemiology, Mouth Neoplasms etiology, Oropharyngeal Neoplasms epidemiology, Oropharyngeal Neoplasms etiology
Abstract

Cancer of the oral cavity and oropharynx is a major public health problem in Spain. Tobacco and alcohol have been identified as the two major risk factors for oral cancer in most western populations. Other risk factors include diets low in fruits and vegetables, but the impact of dietary habits on the risk of these cancers has never been assessed in Spain. The objective of this study was to elucidate the role of dietary habits in oral and oropharyngeal cancer, a multicentric case-control study was conducted in three areas of Spain (Barcelona, Granada and Sevilla) between 1996 and 1999. Cases were 375 patients (71 women), with incident, histologically confirmed cancer of the oral cavity or oropharynx, and controls were 375 subjects (71 women) admitted to hospitals for conditions unrelated to smoking or alcohol drinking. Data were analysed using multivariate logistic regression procedures. After allowance for education, tobacco and alcohol use, a significant inverse association with the risk of oral and oropharyngeal cancer was found for total consumption of total green vegetables (OR 0.54, 95% CI = 0.34-0.87) and total fruit (OR 0.52, 95% CI = 0.34-0.79) with significant trends in risk. We found that the protective effect of each of these food items was consistently larger among current smokers and among heavy alcohol drinkers, following a multiplicative effect model. In conclusion, this study provides further support to the beneficial effect of high intake of vegetables and fruits on the risk of developing cancers of the oral cavity and oropharynx in Spain, particularly among current smokers and heavy alcohol drinkers.

Published
2003
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10. BMI throughout life, intake of vitamin supplements and oral cancer in Spain.

Author

Nieto A, Sánchez MJ, Quintana MJ, Castellsagué X, Martínez C, Muñoz J, Bosch FX, Muñoz N, Herrero R, and Franceschi S

Subjects
Age Distribution, Alcohol Drinking adverse effects, Case-Control Studies, Confidence Intervals, Dietary Supplements, Female, Fruit, Humans, Interviews as Topic, Life Style, Male, Middle Aged, Mouth Neoplasms etiology, Mouth Neoplasms prevention & control, Odds Ratio, Oropharyngeal Neoplasms etiology, Oropharyngeal Neoplasms prevention & control, Risk Factors, Sex Distribution, Smoking adverse effects, Spain epidemiology, Vegetables, Body Mass Index, Diet, Mouth Neoplasms epidemiology, Oropharyngeal Neoplasms epidemiology, Vitamins administration & dosage
Published
2002

11. Dietary fatty acids and endometrial cancer risk within the European Prospective Investigation into Cancer and Nutrition

Author

Yammine, S. G., Huybrechts, I., Biessy, C., Dossus, L., Panico, S., Sánchez, M. J., Benetou, V., Turzanski-Fortner, R., Katzke, V., Idahl, A., Skeie, G., Olsen, K. Standahl, Tjønneland, A., Halkjaer, J., Colorado-Yohar, S., Heath, A. K., Sonestedt, E., Sartor, H., Schulze, M. B., Palli, D., Crous-Bou, M., Dorronsoro, A., Overvad, K., Gurrea, A. Barricarte, Severi, G., Vermeulen, R. C.H., Sandanger, T. M., Travis, R. C., Key, T., Amiano, P., Van Guelpen, B., Johansson, M., Sund, M., Tumino, R., Wareham, N., Sacerdote, C., Krogh, V., Brennan, P., Riboli, E., Weiderpass, E., Gunter, M. J., and Chajès, V.

Published
2023
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12. Biomarkers of folate and vitamin B12 and breast cancer risk: report from the EPIC cohort

Author

Matejcic, M., de Batlle, J., Ricci, C., Biessy, C., Perrier, F., Huybrechts, I., Weiderpass, E., Boutron-Ruault, M. C., Cadeau, C., His, M., Cox, D. G., Boeing, H., Fortner, R. T., Kaaks, R., Lagiou, P., Trichopoulou, A., Benetou, V., Tumino, R., Panico, S., Sieri, S., Palli, D., Ricceri, F., Bueno-de-Mesquita, H. Bas, Skeie, G., Amiano, P., Sánchez, M. J., Chirlaque, M. D., Barricarte, A., Quirós, J. R., Buckland, G., van Gils, C. H., Peeters, P. H., Key, T. J., Riboli, E., Gylling, B., Zeleniuch-Jacquotte, A., Gunter, M. J., Romieu, I., Chajès, V., Matejcic, M, de Batlle, J, Ricci, C, Biessy, C, Perrier, F, Huybrechts, I, Weiderpass, E, Boutron Ruault, M. C, Cadeau, C, His, M, Cox, D. G, Boeing, H, Fortner, R. T, Kaaks, R, Lagiou, P, Trichopoulou, A, Benetou, V, Tumino, R, Panico, Salvatore, Sieri, S, Palli, D, Ricceri, F, Bueno de Mesquita, H. B. A, Skeie, G, Amiano, P, Sánchez, M. J, Chirlaque, M. D, Barricarte, A, Quirós, J. R, Buckland, G, van Gils, C. H, Peeters, P. H, Key, T. J, Riboli, E, Gylling, B, Zeleniuch Jacquotte, A, Gunter, M. J, Romieu, I, Chajès, V., University Medical Center Utrecht, and Imperial College Trust

Subjects
hormone receptor status, Cancer Research, MTHFR polymorphism, Risk Factors, Neoplasms, Progesterone, Medicine(all), alcohol, plasma biomarker, Single Nucleotide, vitamin B12, Middle Aged, Multicenter Study, Europe, Vitamin B 12, Oncology, Female, breast cancer, folate, plasma biomarkers, Adult, Aged, Alcohol Drinking, Biomarkers, Breast Neoplasms, Case-Control Studies, Diet, Estrogens, Folic Acid, Folic Acid Deficiency, Follow-Up Studies, Genes, erbB-2, Humans, Life Style, Methylenetetrahydrofolate Reductase (NADPH2), Neoplasms, Hormone-Dependent, Polymorphism, Single Nucleotide, Vitamin B 12 Deficiency, Journal Article, Oncology & Carcinogenesis, Hormone-Dependent, Polymorphism, erbB-2, hormone receptor statu, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Oncology: 762, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Onkologi: 762, Genes, 1112 Oncology And Carcinogenesis
Abstract

This is the peer reviewed version of the following article: Matejcic, M., De Batlle, J., Ricci, C., Biessy, C., Perrier, F., Huybrechts, I., ... Chajès, V. (2017). Biomarkers of folate and vitamin B12 and breast cancer risk: report from the EPIC cohort. International Journal of Cancer, 140(6), 1246-1259. https://doi.org/10.1002/ijc.30536, which has been published in final form at https://doi.org/10.1002/ijc.30536. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Epidemiological studies have reported inconsistent findings for the association between B vitamins and breast cancer (BC) risk. We investigated the relationship between biomarkers of folate and vitamin B12 and the risk of BC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Plasma concentrations of folate and vitamin B12 were determined in 2,491 BC cases individually matched to 2,521 controls among women who provided baseline blood samples. Multivariable logistic regression models were used to estimate odds ratios by quartiles of either plasma B vitamin. Subgroup analyses by menopausal status, hormone receptor status of breast tumors (estrogen receptor [ER], progesterone receptor [PR] and human epidermal growth factor receptor 2 [HER2]), alcohol intake and MTHFR polymorphisms (677C > T and 1298A > C) were also performed. Plasma levels of folate and vitamin B12 were not significantly associated with the overall risk of BC or by hormone receptor status. A marginally positive association was found between vitamin B12 status and BC risk in women consuming above the median level of alcohol (ORQ4‐Q1 = 1.26; 95% CI 1.00–1.58; Ptrend = 0.05). Vitamin B12 status was also positively associated with BC risk in women with plasma folate levels below the median value (ORQ4‐Q1 = 1.29; 95% CI 1.02–1.62; Ptrend = 0.03). Overall, folate and vitamin B12 status was not clearly associated with BC risk in this prospective cohort study. However, potential interactions between vitamin B12 and alcohol or folate on the risk of BC deserve further investigation.

Published
2016

13. BMI throughout life, intake of vitamin supplements and oral cancer in Spain

Author

Nieto, A., Sánchez, M. J., Quintana, M. J., Castellsagué, X., Martínez, C., Muñoz, J., Bosch, F. X., Muñoz, N., Herrero, R., and silvia franceschi

Subjects
Male, Alcohol Drinking, Smoking, Vitamins, Middle Aged, Body Mass Index, Diet, Interviews as Topic, Oropharyngeal Neoplasms, Age Distribution, Risk Factors, Spain, Case-Control Studies, Fruit, Dietary Supplements, Vegetables, Confidence Intervals, Odds Ratio, Humans, Female, Mouth Neoplasms, Sex Distribution, Life Style

14. Circulating plasma phospholipid fatty acids and risk of pancreatic cancer in a large European cohort

Author

J. R. Quirós, Weimin Ye, Aurelio Barricarte, Petra H.M. Peeters, Isabelle Romieu, M-D Chirlaque, Hendrik B. Bueno-de-Mesquita, Verena Katzke, K. T. Khaw, Marc J. Gunter, Timothy J. Key, Paolo Vineis, Franck Carbonnel, Bertrand Hémon, H. Boeing, M. C. Boutron-Ruault, Claudia Agnoli, Rudolf Kaaks, Aurora Perez-Cornago, Eric J. Duell, D. Palli, Anne Laure Renault, M-J Sanchez, Salvatore Panico, Pilar Amiano, Marco Matejcic, R. Tumino, Sahar Yammine, Veronique Chajes, Miquel Porta, Tilman Kühn, Carlotta Sacerdote, Vinciane Rebours, Pekka Keski-Rahkonen, Antonia Trichopoulou, Elisabete Weiderpass, Fabienne Lesueur, Carine Biessy, Elio Riboli, Kuanrong Li, Noura Mebirouk, Matejcic, M, Lesueur, F, Biessy, C, Renault, A L, Mebirouk, N, Yammine, S, Keski-Rahkonen, P, Li, K, Hémon, B, Weiderpass, E, Rebours, V, Boutron-Ruault, M C, Carbonnel, F, Kaaks, R, Katzke, V, Kuhn, T, Boeing, H, Trichopoulou, A, Palli, D, Agnoli, C, Panico, S, Tumino, R, Sacerdote, LAURA LEA, Quirós, J R, Duell, E J, Porta, M, Sánchez, M J, Chirlaque, M D, Barricarte, A, Amiano, P, Ye, W, Peeters, P H, Khaw, K T, Perez-Cornago, A, Key, T J, Bueno-de-Mesquita, H B, Riboli, E, Vineis, P, Romieu, I, Gunter, M J, and Chajès, V

Subjects
Male, 0301 basic medicine, FOOD-INTAKE, Cancer Research, pancreatic cancer, Gastroenterology, Cohort Studies, chemistry.chemical_compound, 0302 clinical medicine, Phospholipids, ASSOCIATIONS, chemistry.chemical_classification, INDUCTION, Incidence, Middle Aged, European Prospective Investigation into Cancer and Nutrition, Europe, Oncology, 030220 oncology & carcinogenesis, Cohort, F344 RATS, biomarker, GROWTH, NUTRITION, Female, Heptadecanoic acid, HEALTH, Docosapentaenoic acid, Life Sciences & Biomedicine, Polyunsaturated fatty acid, Adult, Risk, medicine.medical_specialty, CARCINOMA, plasma phospholipids, Lower risk, fatty acids, OVARIAN-CANCER, DIET, 03 medical and health sciences, Pancreatic cancer, Internal medicine, medicine, Humans, 1112 Oncology and Carcinogenesis, Oncology & Carcinogenesis, tobacco smoking, Aged, Science & Technology, 030109 nutrition & dietetics, business.industry, plasma phospholipid, biomarkers, Odds ratio, medicine.disease, Pancreatic Neoplasms, chemistry, Case-Control Studies, fatty acid, business
Abstract

There are both limited and conflicting data on the role of dietary fat and specific fatty acids in the development of pancreatic cancer. In this study, we investigated the association between plasma phospholipid fatty acids and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The fatty acid composition was measured by gas chromatography in plasma samples collected at recruitment from 375 incident pancreatic cancer cases and 375 matched controls. Associations of specific fatty acids with pancreatic cancer risk were evaluated using multivariable conditional logistic regression models with adjustment for established pancreatic cancer risk factors. Statistically significant inverse associations were found between pancreatic cancer incidence and levels of heptadecanoic acid (ORT3-T1 [odds ratio for highest versus lowest tertile] =0.63; 95%CI[confidence interval]=0.41-0.98; Ptrend =0.036), n-3 polyunsaturated α-linolenic acid (ORT3-T1 =0.60; 95%CI=0.39-0.92; Ptrend =0.02) and docosapentaenoic acid (ORT3-T1 =0.52; 95%CI=0.32-0.85; Ptrend =0.008). Industrial trans-fatty acids were positively associated with pancreatic cancer risk among men (ORT3-T1 =3.00; 95%CI=1.13-7.99; Ptrend =0.029), while conjugated linoleic acids were inversely related to pancreatic cancer among women only (ORT3-T1 =0.37; 95%CI=0.17-0.81; Ptrend =0.008). Among current smokers, the long-chain n-6/n-3 polyunsaturated fatty acids ratio was positively associated with pancreatic cancer risk (ORT3-T1 =3.40; 95%CI=1.39-8.34; Ptrend =0.007). Results were robust to a range of sensitivity analyses. Our findings suggest that higher circulating levels of saturated fatty acids with an odd number of carbon atoms and n-3 polyunsaturated fatty acids may be related to lower risk of pancreatic cancer. The influence of some fatty acids on the development of pancreatic cancer may be sex-specific and modulated by smoking. This article is protected by copyright. All rights reserved.

Published
2018

15. Variety in vegetable and fruit consumption and risk of bladder cancer in the European Prospective Investigation into Cancer and Nutrition

Author

Marina Touillaud, Rudolf Kaaks, Antonia Trichopoulou, Inger T. Gram, Roy Ehrnström, Nina Roswall, Paula Jakszyn, Ellen Kampman, Kay-Tee Khaw, Elio Riboli, H. Bas Bueno-de-Mesquita, Nerea Larrañaga, Marie-Christine Boutron-Ruault, Eva Ardanaz, Carmen Navarro, Kim Overvad, Eiliv Lund, Naomi E. Allen, Carla H. van Gils, Timothy J. Key, Laudina Rodríguez, Martine M. Ros, Paolo Vineis, María José Sánchez, Vicky Benetou, Lambertus A. Kiemeney, Sabina Sieri, Françoise Clavel-Chapelon, A. Naska, Frederike L. Büchner, Rosario Tumino, Lars Egevad, Nicholas J. Wareham, Mazda Jenab, Heiner Boeing, Jonas Manjer, Nadia Slimani, Anne Tjønneland, Petra H.M. Peeters, Fränzel J.B. Van Duijnhoven, Börje Ljungberg, Paolo Boffetta, Steffen Weikert, Domenico Palli, Jenny Chang-Claude, Salvatore Panico, Göran Hallmans, Büchner, F.L., Bueno-De-Mesquita, H.B., Ros, M.M., Kampman, E., Egevad, L., Overvad, K., Tjãnneland, A., Roswall, N., Clavel-Chapelon, F., Boutron-Ruault, M.-C., Touillaud, M., Kaaks, R., Chang-Claude, J., Boeing, H., Weikert, S., Trichopoulou, A., Naska, A., Benetou, V., Palli, D., Sieri, S., Vineis, P., Tumino, R., Panico, S., Van Duijnhoven, F.J.B., Peeters, P.H.M., Van Gils, C.H., Lund, E., Gram, I.T., Sánchez, M.-J., Jakszyn, P., Larrañaga, N., Ardanaz, E., Navarro, C., Rodríguez, L., Manjer, J., Ehrnström, R., Hallmans, G., Ljungberg, B., Key, T.J., Allen, N.E., Khaw, K.-T., Wareham, N., Slimani, N., Jenab, M., Boffetta, P., Kiemeney, L.A.L.M., and Riboli, E.

Subjects
Male, Cancer Research, validity, Nutrition and Disease, Colorectal cancer, pharyngeal cancer, Food group, 0302 clinical medicine, Risk Factors, diet diversity, Voeding en Ziekte, Vegetables, vegetable, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, bladder, risk, 2. Zero hunger, Hazard ratio, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Oncology, 030220 oncology & carcinogenesis, food groups, Female, colon-cancer, medicine.medical_specialty, Molecular epidemiology [NCEBP 1], 03 medical and health sciences, Translational research [ONCOL 3], Environmental health, medicine, cancer, Humans, consumption, Risk factor, Life Style, Molecular epidemiology Aetiology, screening and detection [NCEBP 1], VLAG, Gynecology, Bladder cancer, business.industry, cigarette-smoking, questionnaire, colorectal-cancer, Cancer, medicine.disease, Diet, Urinary Bladder Neoplasms, Fruit, business
Abstract

Contains fulltext : 97508.pdf (Publisher’s version ) (Closed access) Recent research does not show an association between fruit and vegetable consumption and bladder cancer risk. None of these studies investigated variety in fruit and vegetable consumption, which may capture different aspects of consumption. We investigated whether a varied consumption of vegetables and fruits is associated with bladder cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Detailed data on food consumption and complete follow-up for cancer incidence were available for 452,185 participants, who were recruited from ten European countries. After a mean follow-up of 8.7 years, 874 participants were diagnosed with bladder cancer. Diet diversity scores (DDSs) were used to quantify the variety in fruit and vegetable consumption. Multivariable Cox proportional hazard models were used to assess the effect of the DDSs on bladder cancer risk. There was no evidence of a statistically significant association between bladder cancer risk and any of the DDSs when these scores were considered as continuous covariates. However, the hazard ratio (HR) for the highest tertile of the DDS for combined fruit and vegetable consumption was marginally significant compared to the lowest (HR = 1.30, 95% confidence interval: 1.00-1.69, p-trend = 0.05). In EPIC, there is no clear association between a varied fruit and vegetable consumption and bladder cancer risk. This finding provides further evidence for the absence of any strong association between fruit and vegetable consumption as measured by a food frequency questionnaire and bladder cancer risk.

Published
2011
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16. Fruit and vegetable consumption and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition

Author

Kim Overvad, H. Bas Bueno-de-Mesquita, Zilis Dimosthenes, Elio Riboli, Dominique S. Michaud, Göran Hallmans, Sabina Sieri, Bas A.J. Verhage, Carla H. van Gils, Rudolf Kaaks, Paolo Boffetta, Eric J. Duell, Laudina Rodríguez Suárez, Domenico Palli, Amalia Mattiello, Françoise Clavel-Chapelon, Jonas Manjer, Petra H.M. Peeters, Eiliv Lund, Dagrun Engeset, Weimin Ye, Alina Vrieling, Mazda Jenab, Fränzel J.B. Van Duijnhoven, Sheila Bingham, Björn Lindkvist, Antonia Trichopoulou, Sabine Rohrmann, Anja Olsen, Eva Ardanaz, María José Sánchez, Heiner Boeing, Nerea Larrañaga, Anne Tjønneland, María Dolores Chirlaque, Kay-Tee Khaw, Tountas John, Rosario Tumino, Ute Nöthlings, Paolo Vineis, Paula Jakszyn, Marie-Christine Boutron-Ruault, Timothy J. Key, Andrew W. Roddam, Vrieling, A., Verhage, B.A.J., Van Duijnhoven, F.J.B., Jenab, M., Overvad, K., Tjønneland, A., Olsen, A., Clavel-Chapelon, F., Boutron-Ruault, M.-C., Kaaks, R., Rohrmann, S., Boeing, H., Nöthlings, U., Trichopoulou, A., John, T., Dimosthenes, Z., Palli, D., Sieri, S., Mattiello, A., Tumino, R., Vineis, P., Van Gils, C.H., Peeters, P.H.M., Engeset, D., Lund, E., Suárez, L.R., Jakszyn, P., Larrañaga, N., Sánchez, M.-J., Chirlaque, M.-D., Ardanaz, E., Manjer, J., Lindkvist, B., Hallmans, G., Ye, W., Bingham, S., Khaw, K.-T., Roddam, A., Key, T., Boffetta, P., Duell, E.J., Michaud, D.S., Riboli, E., and Bueno-de-Mesquita, H.B.

Subjects
Male, Risk, Cancer Research, medicine.medical_specialty, Nutritional Sciences, Lower risk, Cohort Studies, Environmental health, Internal medicine, Vegetables, medicine, Humans, vegetable, Risk factor, Prospective cohort study, Aged, Proportional Hazards Models, business.industry, Smoking, Hazard ratio, pancreatic cancer risk, Cancer, Middle Aged, medicine.disease, Diet, European Prospective Investigation into Cancer and Nutrition, Europe, Pancreatic Neoplasms, Endocrinology, Oncology, Fruit, Exocrine pancreatic cancer, Female, business, Cohort study
Abstract

Udgivelsesdato: 2008-Nov-7 Many case-control studies have suggested that higher consumption of fruit and vegetables is associated with a lower risk of pancreatic cancer, whereas cohort studies do not support such an association. We examined the associations of the consumption of fruits and vegetables and their main subgroups with pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is comprised of over 520,000 subjects recruited from 10 European countries. The present study included 555 exocrine pancreatic cancer cases after an average follow-up of 8.9 years. Estimates of risk were obtained by Cox proportional hazard models, stratified by age at recruitment, gender, and study center, and adjusted for total energy intake, weight, height, history of diabetes mellitus, and smoking status. Total consumption of fruit and vegetables, combined or separately, as well as subgroups of vegetables and fruits were unrelated to risk of pancreatic cancer. Hazard ratios (95% CI) for the highest versus the lowest quartile were 0.92 (0.68-1.25) for total fruit and vegetables combined, 0.99 (0.73-1.33) for total vegetables, and 1.02 (0.77-1.36) for total fruits. Stratification by gender or smoking status, restriction to microscopically verified cases, and exclusion of the first 2 years of follow-up did not materially change the results. These results from a large European prospective cohort suggest that higher consumption of fruit and vegetables is not associated with decreased risk of pancreatic cancer. (c) 2008 Wiley-Liss, Inc.

Published
2009
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17. Red meat, dietary nitrosamines, and heme iron and risk of bladder cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author

Amalia Mattiello, Anne Tjønneland, Leila Lujan-Barroso, Marina Touillaud, Kim Overvad, Roy Ehrnström, Rudolf Kaaks, H. Bas Bueno-de-Mesquita, Ole Raaschou-Nielsen, Traci Mouw, Frederike L. Büchner, Petra H.M. Peeters, Laudina Rodríguez, Martine M. Ros, Domenico Palli, Eva Ardanaz, Guri Skeie, David Ulmert, Nina Roswall, Jenny Chang-Claude, Carlos A. González, Elio Riboli, Timothy J. Key, Naomi E. Allen, Franco Berrino, Andrew W. Roddam, Lars Egevad, Dominique S. Michaud, Börje Ljungberg, Nerea Larrañaga, Carmen Navarro, Paolo Boffetta, Mazda Jenab, Nadia Slimani, Sheila Bingham, Steffen Weikert, Göran Hallmans, Heiner Boeing, María José Sánchez, Antonia Trichopoulou, Inger T. Gram, Paula Jakszyn, Marie-Christine Boutron-Ruault, Françoise Clavel-Chapelon, Paolo Vineis, Christine L. Parr, Lambertus A. Kiemeney, Dimosthenis Zylis, Kay-Tee Khaw, Rosario Tumino, Eleni Oikonomou, Jakszyn, P., González, C.A., Luján-Barroso, L., Ros, M.M., Bueno-de-Mesquita, H.B., Roswall, N., Tjønneland, A.M., Büchner, F.L., Egevad, L., Overvad, K., Raaschou-Nielsen, O., Clavel-Chapelon, F., Boutron-Ruault, M.-C., Touillaud, M.S., Chang-Claude, J., Allen, N.E., Kiemeney, L.A., Key, T.J., Kaaks, R., Boeing, H., Weikert, S., Trichopoulou, A., Oikonomou, E., Zylis, D., Palli, D., Berrino, F., Vineis, P., Tumino, R., Mattiello, A., Peeters, P.H.M., Parr, C.L., Gram, I.T., Skeie, G., Sánchez, M.-J., Larrañaga, N., Ardanaz, E., Navarro, C., Rodríguez, L., Ulmert, D., Ehrnström, R., Hallmans, G., Ljungberg, B., Roddam, A.W., Bingham, S.A., Khaw, K.-T., Slimani, N., Boffetta, P.A., Jenab, M., Mouw, T., Michaud, D.S., and Riboli, E.

Subjects
medicine.medical_specialty, Meat, Nitrosamines, Epidemiology, Aetiology, screening and detection [ONCOL 5], Heme, Gastroenterology, Molecular epidemiology [NCEBP 1], dietary nitrosamine, chemistry.chemical_compound, Risk Factors, Internal medicine, Medicine, Humans, Prospective Studies, Risk factor, Prospective cohort study, Molecular epidemiology Aetiology, screening and detection [NCEBP 1], Bladder cancer, business.industry, red meat, heme iron risk, Cancer, medicine.disease, Surgery, European Prospective Investigation into Cancer and Nutrition, Diet, Europe, Oncology, chemistry, Urinary Bladder Neoplasms, Red Meat Consumption, Nitrosamine, Red meat, bladder cancer, business, Iron, Dietary
Abstract

Background: Previous epidemiologic studies found inconsistent results for the association between red meat intake, nitrosamines [NDMA: N-nitrosodimethylamine, and ENOC (endogenous nitroso compounds)], and the risk of bladder cancer. We investigated the association between red meat consumption, dietary nitrosamines, and heme iron and the risk of bladder cancer among participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Data on food consumption and complete follow-up for cancer occurrence were available for a total of 481,419 participants, recruited in 10 European countries. Estimates of HRs were obtained by proportional hazard models, stratified by age at recruitment, gender, and study center and adjusted for total energy intake, smoking status, lifetime intensity of smoking, duration of smoking, educational level, and BMI. Results: After a mean follow-up of 8.7 years, 1,001 participants were diagnosed with bladder cancer. We found no overall association between intake of red meat (log2 HR: 1.06; 95% CI: 0.99–1.13), nitrosamines (log2 HR: 1.09; 95% CI: 0.92–1.30 and HR: 0.98; 95% CI: 0.92–1.05 for ENOC and NDMA, respectively) or heme iron (log2 HR: 1.05; 95 CI: 0.99–1.12) and bladder cancer risk. The associations did not vary by sex, high- versus low-risk bladder cancers, smoking status, or occupation (high vs. low risk). Conclusions: Our findings do not support an effect of red meat intake, nitrosamines (endogenous or exogenous), or heme iron intake on bladder cancer risk. Cancer Epidemiol Biomarkers Prev; 20(3); 555–9. ©2011 AACR.

Published
2011
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18. Fruit and vegetable intake and overall cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author

Françoise Clavel-Chapelon, Sophie Morois, Carla H. van Gils, Miren Dorronsoro, Nadia Slimani, Paolo Boffetta, Rudolf Kaaks, Aurelio Barricarte, Magritt Brustad, Laudina Rodríguez, Frederike L. Büchner, Sabina Sieri, Naomi E. Allen, Dagrun Engeset, Elio Riboli, Kim Overvad, Sheila Bingham, Göran Hallmans, Carlos González, Heiner Boeing, Eiliv Lund, Antonia Trichopoulou, Dimitrios Trichopoulos, Emily Sonestedt, Ingegerd Johansson, Janine Wichmann, Pagona Lagiou, Mazda Jenab, José María Huerta, Anne Tjønneland, H. Bas Bueno-de-Mesquita, Traci Mouw, Jakob Linseisen, Teresa Norat, Jonas Manjer, Michael Nielsen, Petra H.M. Peeters, Vassiliki Benetou, Fränzel J.B. Van Duijnhoven, Anja Olsen, Elisabeth Couto, Pietro Ferrari, Timothy J. Key, Domenico Palli, Marie-Christine Boutron-Ruault, Salvatore Panico, Ute Nöthlings, Kay-Tee Khaw, Androniki Naska, Paolo Vineis, María José Sánchez, Sabine Rohrmann, 33: Boffetta, P, Couto, E, Wichmann, J, Ferrari, P, Trichopoulos, D, Bueno de Mesquita, Hb, van Duijnhoven, Fj, Büchner, Fl, Key, T, Boeing, H, Nöthlings, U, Linseisen, J, Gonzalez, Ca, Overvad, K, Nielsen, Mr, Tjønneland, A, Olsen, A, Clavel Chapelon, F, Boutron Ruault, Mc, Morois, S, Lagiou, P, Naska, A, Benetou, V, Kaaks, R, Rohrmann, S, Panico, Salvatore, Sieri, S, Vineis, P, Palli, D, van Gils, Ch, Peeters, Ph, Lund, E, Brustad, M, Engeset, D, Huerta, Jm, Rodríguez, L, Sánchez, Mj, Dorronsoro, M, Barricarte, A, Hallmans, G, Ohansson, I, Manjer, J, Sonestedt, E, Allen, Ne, Bingham, S, Khaw, Kt, Slimani, N, Jenab, M, Mouw, T, Norat, T, Riboli, E, Trichopoulou, A., Boffetta, P., Couto, E., Wichmann, J., Ferrari, P., Trichopoulos, D., Bueno-De-Mesquita, H.B., Van Duijnhoven, F.J.B., Büchner, F.L., Key, T., Boeing, H., Nöthlings, U., Linseisen, J., Gonzalez, C.A., Overvad, K., Nielsen, M.R.S., Tjønneland, A., Olsen, A., Clavel-Chapelon, F., Boutron-Ruault, M.-C., Morois, S., Lagiou, P., Naska, A., Benetou, V., Kaaks, R., Rohrmann, S., Panico, S., Sieri, S., Vineis, P., Palli, D., Van Gils, C.H., Peeters, P.H., Lund, E., Brustad, M., Engeset, D., Huerta, J.M., Rodríguez, L., Sánchez, M.-J., Dorronsoro, M., Barricarte, A., Hallmans, G., Johansson, I., Manjer, J., Sonestedt, E., Allen, N.E., Bingham, S., Khaw, K.-T., Slimani, N., Jenab, M., Mouw, T., Norat, T., and Riboli, E.

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Alcohol Drinking, tobacco, Risk Assessment, smoking, Molecular epidemiology [NCEBP 1], nutrition in cancer, Risk Factors, Neoplasms, Surveys and Questionnaires, Environmental health, Vegetables, Epidemiology, follow-up, Odds Ratio, cancer, vegetable, Humans, Medicine, Prospective Studies, Registries, Food science, ddc:610, Prospective cohort study, Life Style, risk, Aged, Observer Variation, Proportional hazards model, business.industry, Incidence, Hazard ratio, Feeding Behavior, Odds ratio, Middle Aged, European Prospective Investigation into Cancer and Nutrition, Europe, Oncology, Research Design, Fruit, Cohort, Female, diet, Risk assessment, business
Abstract

Contains fulltext : 88546.pdf (Publisher’s version ) (Closed access) BACKGROUND: It is widely believed that cancer can be prevented by high intake of fruits and vegetables. However, inconsistent results from many studies have not been able to conclusively establish an inverse association between fruit and vegetable intake and overall cancer risk. METHODS: We conducted a prospective analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to assess relationships between intake of total fruits, total vegetables, and total fruits and vegetables combined and cancer risk during 1992-2000. Detailed information on the dietary habit and lifestyle variables of the cohort was obtained. Cancer incidence and mortality data were ascertained, and hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression models. Analyses were also conducted for cancers associated with tobacco and alcohol after stratification for tobacco smoking and alcohol drinking. RESULTS: Of the initial 142 605 men and 335 873 women included in the study, 9604 men and 21 000 women were identified with cancer after a median follow-up of 8.7 years. The crude cancer incidence rates were 7.9 per 1000 person-years in men and 7.1 per 1000 person-years in women. Associations between reduced cancer risk and increased intake of total fruits and vegetables combined and total vegetables for the entire cohort were similar (200 g/d increased intake of fruits and vegetables combined, HR = 0.97, 95% CI = 0.96 to 0.99; 100 g/d increased intake of total vegetables, HR = 0.98, 95% CI = 0.97 to 0.99); intake of fruits showed a weaker inverse association (100 g/d increased intake of total fruits, HR = 0.99, 95% CI = 0.98 to 1.00). The reduced risk of cancer associated with high vegetable intake was restricted to women (HR = 0.98, 95% CI = 0.97 to 0.99). Stratification by alcohol intake suggested a stronger reduction in risk in heavy drinkers and was confined to cancers caused by smoking and alcohol. CONCLUSIONS: A very small inverse association between intake of total fruits and vegetables and cancer risk was observed in this study. Given the small magnitude of the observed associations, caution should be applied in their interpretation.

Published
2010
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19. A prospective analysis of the association between macronutrient intake and renal cell carcinoma in the European Prospective Investigation into Cancer and Nutrition

Author

Petra H.M. Peeters, Aurelio Barricarte, Domenico Palli, Naomi E. Allen, Laudina Rodríguez, Sheila Bingham, María Dolores Chirlaque, Antonia Trichopoulou, Sabina Sieri, H. Bas Bueno-de-Mesquita, Kim Overvad, Kay-Tee Khaw, Traci Mouw, María José Sánchez, Teresa Norat, Paolo Contiero, Yvoni Koumantaki, Peter Wallström, Sabine Rohrmann, Göran Hallmans, Rosario Tumino, Andrew W. Roddam, Anne Tjønneland, Rudolf Kaaks, Paolo Vineis, Laura Esquius, Börje Ljungberg, Jonas Manjer, Jytte Halkjær, Paolo Boffetta, Amalia Mattiello, Marianne Uhre Jakobsen, Elio Riboli, Miren Dorronsoro, Demosthenes Zilis, Heiner Boeing, Allen, N.E., Roddam, A.W., Sieri, S., Boeing, H., Jakobsen, M.U., Overvad, K., Tjønneland, A., Halkjær, J., Vineis, P., Contiero, P., Palli, D., Tumino, R., Mattiello, A., Kaaks, R., Rohrmann, S., Trichopoulou, A., Zilis, D., Koumantaki, Y., Peeters, P.H., Bueno-de-Mesquita, H.B., Barricarte, A., Rodríguez, L., Dorronsoro, M., Sánchez, M.-J., Chirlaque, M.D., Esquius, L., Manjer, J., Wallström, P., Ljungberg, B., Hallmans, G., Bingham, S., Khaw, K.-T., Boffetta, P., Norat, T., Mouw, T., and Riboli, E.

Subjects
Adult, Male, Questionnaires, Cancer Research, medicine.medical_specialty, renal cell carcinoma, Meat, macronutrient, Physiology, Risk Assessment, Body Mass Index, Cohort Studies, Renal cell carcinoma, Risk Factors, Internal medicine, Surveys and Questionnaires, medicine, Carcinoma, Humans, Prospective Studies, Prospective cohort study, Carcinoma, Renal Cell, Aged, business.industry, Cancer, Confounding Factors, Epidemiologic, Feeding Behavior, prospective, Middle Aged, medicine.disease, Confounding Factors (Epidemiology), Dietary Fats, Kidney Neoplasms, European Prospective Investigation into Cancer and Nutrition, Endocrinology, Oncology, Female, Food Habits, business, diet, EPIC, Kidney cancer, Body mass index, Kidney disease, Follow-Up Studies
Abstract

Udgivelsesdato: 2009-Aug-15 Previous case-control studies have suggested that a high intake of animal foods and its associated nutrients are associated with an increased risk of renal cell carcinoma, although data from prospective studies are limited. We report here on the relationship between macronutrient intake and renal cell carcinoma incidence among 435,293 participants enrolled in the European Prospective Investigation into Cancer and Nutrition. Cox proportional hazard models were used to examine the association of dietary intake of fat, protein, carbohydrate, fiber and cholesterol and risk of renal cell carcinoma adjusted for age, sex, center, height, body mass index, physical activity, education, smoking, menopausal status, alcohol and energy intake. During an average 8.8 years of follow-up, 507 renal cell carcinoma cases occurred. Risk of renal cell carcinoma was not associated with macronutrient intake, including nutrients derived from animal sources. Our results indicate that macronutrient intake is not associated with risk of renal cell carcinoma in this cohort of European men and women.

Published
2009
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20. Fruit, vegetables, and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition

Author

Petra H.M. Peeters, Domenico Palli, Carmen Navarro, Carla H. van Gils, Jonas Manjer, Corinne Casagrande, Mazda Jenab, Jakob Linseisen, Ute Nöthlings, Paolo Vineis, Martine M. Ros, Sheila Bingham, Anja Olsen, Miren Dorronsoro, Elio Riboli, Göran Berglund, Pietro Ferrari, Aurelio Barricarte, Nadia Slimani, Antonia Trichopoulou, Marie-Christine Boutron-Ruault, Dagrun Engeset, Salvatore Panico, Marga C. Ocké, Françoise Clavel-Chapelon, Sabina Sieri, Ole Thorlacius-Ussing, Dimitrios Trichopoulos, Sophie Morois, Timothy J. Key, Kim Overvad, Valentina Gallo, Carlos A. González, Rosario Tumino, Paolo Boffetta, Heiner Boeing, H. Bas Bueno-de-Mesquita, Kay-Tee Khaw, Anne Tjønneland, Teresa Norat, Laudina Rodríguez Suárez, Fränzel J. B. van Duijnhoven, Guri Skeie, Naomi E. Allen, Eiliv Lund, Rudolf Kaaks, Richard Palmqvist, Gesthimani Misirli, María José Sánchez, Göran Hallmans, Hendriek C. Boshuizen, Sabina Rinaldi, Van Duijnhoven, F.J.B., Bueno-De-Mesquita, H.B., Ferrari, P., Jenab, M., Boshuizen, H.C., Ros, M.M., Casagrande, C., Tjønneland, A., Olsen, A., Overvad, K., Thorlacius-Ussing, O., Clavel-Chapelon, F., Boutron-Ruault, M.-C., Morois, S., Kaaks, R., Linseisen, J., Boeing, H., Nöthlings, U., Trichopoulou, A., Trichopoulos, D., Misirli, G., Palli, D., Sieri, S., Panico, S., Tumino, R., Vineis, P., Peeters, P.H.M., Van Gils, C.H., Ocké, M.C., Lund, E., Engeset, D., Skeie, G., Suárez, L.R., González, C.A., Sánchez, M.-J., Dorronsoro, M., Navarro, C., Barricarte, A., Berglund, G., Manjer, J., Hallmans, G., Palmqvist, R., Bingham, S.A., Khaw, K.-T., Key, T.J., Allen, N.E., Boffetta, P., Slimani, N., Rinaldi, S., Gallo, V., Norat, T., Riboli, E., van Duijnhoven, Fj, Bueno De Mesquita, Hb, Ferrari, P, Jenab, M, Boshuizen, Hc, Ros, Mm, Casagrande, C, Tjønneland, A, Olsen, A, Overvad, K, Thorlacius Ussing, O, Clavel Chapelon, F, Boutron Ruault, Mc, Morois, S, Kaaks, R, Linseisen, J, Boeing, H, Nöthlings, U, Trichopoulou, A, Trichopoulos, D, Misirli, G, Palli, D, Sieri, S, Panico, Salvatore, Tumino, R, Vineis, P, Peeters, Ph, van Gils, Ch, Ocké, Mc, Lund, E, Engeset, D, Skeie, G, Suárez, Lr, González, Ca, Sánchez, Mj, Dorronsoro, M, Navarro, C, Barricarte, A, Berglund, G, Manjer, J, Hallmans, G, Palmqvist, R, Bingham, Sa, Khaw, Kt, Key, Tj, Allen, Ne, Boffetta, P, Slimani, N, Rinaldi, S, Gallo, V, and Norat, T

Subjects
Questionnaires, Oncology, Male, medicine.medical_specialty, Time Factors, Colorectal cancer, Medicine (miscellaneous), Environment, Gastroenterology, 03 medical and health sciences, Fruit vegetables colorectal cancer risk The European Prospective Investigation Cancer Nutrition, 0302 clinical medicine, Risk Factors, Internal medicine, Surveys and Questionnaires, Vegetables, medicine, Humans, ddc:610, Prospective Studies, Risk factor, Life Style, 030304 developmental biology, 2. Zero hunger, 0303 health sciences, Nutrition and Dietetics, Proportional hazards model, business.industry, Incidence (epidemiology), Incidence, Patient Selection, Hazard ratio, Smoking, Cancer, Reproducibility of Results, Colonoscopy, medicine.disease, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Diet, Europe, 030220 oncology & carcinogenesis, Fruit, Cohort, Female, business, Colorectal Neoplasms, Demography, Follow-Up Studies
Abstract

Background: A high consumption of fruit and vegetables is possibly associated with a decreased risk of colorectal cancer (CRC). However, the findings to date are inconsistent. Objective: We examined the relation between self-reported usual consumption of fruit and vegetables and the incidence of CRC. Design: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 452,755 subjects (131,985 men and 320,770 women) completed a dietary questionnaire in 1992-2000 and were followed up for cancer incidence and mortality until 2006. A multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HRs) and 95% CIs. Results: After an average follow-up of 8.8 y, 2,819 incident CRC cases were reported. Consumption of fruit and vegetables was inversely associated with CRC in a comparison of the highest with the lowest EPIC-wide quintile of consumption (HR: 0.86; 95% CI: 0.75, 1.00; P for trend = 0.04), particularly with colon cancer risk (HR: 0.76; 95% CI: 0.63, 0.91; P for trend < 0.01). Only after exclusion of the first 2 y of follow-up were these findings corroborated by calibrated continuous analyses for a 100-g increase in consumption: HRs of 0.95 (95% CI: 0.91, 1.00; P = 0.04) and 0.94 (95% CI: 0.89, 0.99; P = 0.02), respectively. The association between fruit and vegetable consumption and CRC risk was inverse in never and former smokers, but positive in current smokers. This modifying effect was found for fruit and vegetables combined and for vegetables alone (P for interaction < 0.01 for both). Conclusions: These findings suggest that a high consumption of fruit and vegetables is associated with a reduced risk of CRC, especially of colon cancer. This effect may depend on smoking status. © 2009 American Society for Nutrition.

Published
2009
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21. The Role of Smoking and Diet in Explaining Educational Inequalities in Lung Cancer Incidence

Author

Elisabet Wirfält, Salvatore Panico, Jonas Manjer, Jakob Linseisen, Kay-Tee Khaw, Sheila Bingham, Rosario Tumino, María José Tormo, Petra H.M. Peeters, H. Bas Bueno-de-Mesquita, Naomi E. Allen, Anne Tjønneland, Torgny Rasmuson, Antonia Trichopoulou, Gwenn Menvielle, Pietro Ferrari, Nadia Slimani, Paolo Boffetta, Valentina Gallo, Ole Raaschou-Nielsen, Domenico Palli, Timothy J. Key, Elio Riboli, Hendriek Boshuizen, Antonio Agudo, Anton E. Kunst, Susanne Oksbjerg Dalton, Eric J. Duell, Paolo Vineis, Tonje Braaten, Silke Hermann, Maria Kosti, Carla H. van Gils, Vardis Dilis, Göran Hallmans, Eva Ardanaz, Manuela M. Bergmann, María José Sánchez, Inger T. Gram, Vittorio Krogh, Eiliv Lund, Laudina Rodríguez, Frederike L. Büchner, Rudolf Kaaks, Kaniewski, Nadine, Department of Public Health, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, 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 de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), National Institute for Public Health and the Environment [Bilthoven] (RIVM), Institute of Cancer Epidemiology, Danish Cancer Society, University of Torino and CPO-Piemonte, Università degli studi di Torino = University of Turin (UNITO), Department of Epidemiology, German Institute of Human Nutrition, Division of Cancer Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Unit of Nutrition, Environment, and Cancer, Catalan Institute of Oncology, Molecular and Nutritional Epidemiology Unit, CSPO-Scientific Institute of Tuscany, Department of Preventive & Predictive Medicine, Italian National Center Institute, Department of Clinical and Experimental Medicine, Frederico II University, Cancer Registry Azienda, Civile - M.P.Arezzo Hospital, Julius Center for Health Sciences and Primary Care, VU University Medical Center [Amsterdam], Institute of Community Medicine, University of Tromsø (UiT), Public Health Directorate, Unit of Nutrition, Environment and Cancer, Andalusian School of Public Health [Granada], CIBER Epidemiologia y Salud Publica, CIBER de Epidemiología y Salud Pública (CIBERESP), Murcia Health Council, Public Health Institute of Navarra, Department of surgery, Lund University [Lund]-Malmö University Hospital, Department of Clinical Sciences, Nutrition Epidemiology, Lund University [Lund], Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Department of Radiation Sciences, Oncology, MRC Centrer for Nutritional Epidemiology and Cancer Prevention and Survival, University of Cambridge [UK] (CAM), Cancer Epidemiology Unit, University of Oxford, Departement of Epidemiolgy and Public Health, Imperial College London, Menvielle, G, Boshuizen, H, Kunst, Ae, Dalton, So, Vineis, P, Bergmann, Mm, Hermann, S, Ferrari, P, Raaschou Nielsen, O, Tjønneland, A, Kaaks, R, Linseisen, J, Kosti, M, Trichopoulou, A, Dilis, V, Palli, D, Krogh, V, Panico, Salvatore, Tumino, R, Büchner, Fl, van Gils, Ch, Peeters, Ph, Braaten, T, Gram, It, Lund, E, Rodriguez, L, Agudo, A, Sánchez, Mj, Tormo, Mj, Ardanaz, E, Manjer, J, Wirfält, E, Hallmans, G, Rasmuson, T, Bingham, S, Khaw, Kt, Allen, N, Key, T, Boffetta, P, Duell, Ej, Slimani, N, Gallo, V, Riboli, E, Bueno de Mesquita, Hb, Public and occupational health, 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)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Università degli studi di Torino (UNITO), University of Oxford [Oxford], Malmö University Hospital-Lund University [Lund], Public Health, Cell biology, Menvielle, G., Boshuizen, H., Kunst, A.E., Dalton, S.O., Vineis, P., Bergmann, M.M., Hermann, S., Ferrari, P., Raaschou-Nielsen, O., Tjønneland, A., Kaaks, R., Linseisen, J., Kosti, M., Trichopoulou, A., Dilis, V., Palli, D., Krogh, V., Panico, S., Tumino, R., Büchner, F.L., Van Gils, C.H., Peeters, P.H.M., Braaten, T., Gram, I.T., Lund, E., Rodriguez, L., Agudo, A., Sánchez, M.-J., Tormo, M.-J., Ardanaz, E., Manjer, J., Wirfält, E., Hallmans, G., Rasmuson, T., Bingham, S., Khaw, K.-T., Allen, N., Key, T., Boffetta, P., Duell, E.J., Slimani, N., Gallo, V., Riboli, E., and Bueno-De-Mesquita, H.B.

Subjects
Male, Cancer Research, Lung Neoplasms, Aetiology, screening and detection [ONCOL 5], 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Vegetables, Odds Ratio, Prospective Studies, 030212 general & internal medicine, 10. No inequality, Prospective cohort study, education, Mediterranean Region, Incidence, Incidence (epidemiology), 1. No poverty, Confounding Factors, Epidemiologic, Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Oncology, Research Design, 030220 oncology & carcinogenesis, Cohort, Educational Status, lung cancer incidence, Female, women, Cohort study, Adult, medicine.medical_specialty, men, Risk Assessment, Article, smoking, Molecular epidemiology [NCEBP 1], 03 medical and health sciences, Sex Factors, SDG 3 - Good Health and Well-being, medicine, cohort study, Humans, ddc:610, Sex Distribution, Risk factor, Lung cancer, Socioeconomic status, Aged, Proportional Hazards Models, business.industry, Feeding Behavior, medicine.disease, Social Mobility, Surgery, Social Class, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Fruit, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, EPIC, diet, Demography
Abstract

Background: Studies in many countries have reported higher lung cancer incidence and mortality in individuals with lower socioeconomic status. Methods: To investigate the role of smoking in these inequalities, we used data from 391 251 participants in the European Prospective Investigation into Cancer and Nutrition study, a cohort of individuals in 10 European countries. We collected information on smoking (history and quantity), fruit and vegetable consumption, and education through questionnaires at study entry and gathered data on lung cancer incidence for a mean of 8.4 years. Socioeconomic status was defined as the highest attained level of education, and participants were grouped by sex and region of residence (Northern Europe, Germany, or Southern Europe). Relative indices of inequality (RIIs) of lung cancer risk unadjusted and adjusted for smoking were estimated using Cox regression models. Additional analyses were performed by histological type. Results: During the study period, 939 men and 692 women developed lung cancer. Inequalities in lung cancer risk (RII men = 3.62, 95% confidence interval [CI] = 2.77 to 4.73, 117 vs 52 per 100 000 person-years for lowest vs highest education level; RII women = 2.39, 95% CI = 1.77 to 3.21, 46 vs 25 per 100 000 person-years) decreased after adjustment for smoking but remained statistically significant (RIImen = 2.29, 95% CI = 1.75 to 3.01; RII women = 1.59, 95% CI = 1.18 to 2.13). Large RIIs were observed among men and women in Northern European countries and among men in Germany, but inequalities in lung cancer risk were reverse (RIIs < 1) among women in Southern European countries. Inequalities differed by histological type. Adjustment for smoking reduced inequalities similarly for all histological types and among men and women in all regions. In all analysis, further adjustment for fruit and vegetable consumption did not change the estimates. Conclusion: Self-reported smoking consistently explains approximately 50% of the inequalities in lung cancer risk due to differences in education. © The Author 2009. Published by Oxford University Press. All rights reserved.

Published
2009
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