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1. 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, Chajès, V, IRAS OH Epidemiology Chemical Agents, Apollo - University of Cambridge Repository, Wareham, Nicholas [0000-0003-1422-2993], IRAS OH Epidemiology Chemical Agents, Schulze, M B [0000-0002-0830-5277], and Overvad, K [0000-0001-6429-7921]

Subjects
Cancer Research, Epidemiology, DATABASE, OMEGA-3, Endometrial cancer, MARKERS, Àcids grassos en la nutrició, Risk Factors, Genetics, Humans, Animals, Prospective Studies, gamma-Linolenic Acid, Fatty acids, Epidemiologia, Cancer och onkologi, Fatty acids in human nutrition, Endometrial Neoplasms, Diet, Oncology, Càncer d'endometri, Cancer and Oncology, OBESITY, Female, FISH CONSUMPTION, HEALTH
Abstract

We would like to thank ‘the National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands’ for their contribution and ongoing support to the EPIC Study., This work was undertaken during the tenure of a doctoral Fellowship supported by INCa (INCa 2016 − 184), by Fondation ARC pour la recherche sur le cancer (ARC 2019-DOC4) and by IARC. The coordination of EPIC is financially supported by International Agency for Research on Cancer (IARC) and by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are supported by: Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition PotsdamRehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, Compagnia di SanPaolo and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (C864/A 14136 to EPIC- Norfolk (DOI https://doi.org/10.22025/2019.10.105.00004); C8221/A29017 to EPIC-Oxford), Medical Research Council (MR/N003284/1 and MC_UU_00006/1 to EPIC-Norfolk; MR/M012190/1 to EPIC-Oxford). (United Kingdom)., Data Availability For information on how to submit an application for gaining access to EPIC data and/or biospecimens, please follow the instructions at http://epic.iarc.fr/access/index.php., Background: Diet may impact important risk factors for endometrial cancer such as obesity and inflammation. However, evidence on the role of specific dietary factors is limited. We investigated associations between dietary fatty acids and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: This analysis includes 1,886 incident endometrial cancer cases and 297,432 non-cases. All participants were followed up for a mean of 8.8 years. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of endometrial cancer across quintiles of individual fatty acids estimated from various food sources quantified through food frequency questionnaires in the entire EPIC cohort. The false discovery rate (q-values) was computed to control for multiple comparisons. Results: Consumption of n-6 γ-linolenic acid was inversely associated with endometrial cancer risk (HR comparing 5th with 1st quintileQ5-Q1=0.77, 95% CI = 0.64; 0.92, ptrend=0.01, q-value = 0.15). This association was mainly driven by γ-linolenic acid derived from plant sources (HRper unit increment=0.94, 95%CI= (0.90;0.98), p = 0.01) but not from animal sources (HRper unit increment= 1.00, 95%CI = (0.92; 1.07), p = 0.92). In addition, an inverse association was found between consumption of n-3 α-linolenic acid from vegetable sources and endometrial cancer risk (HRper unit increment= 0.93, 95%CI = (0.87; 0.99), p = 0.04). No significant association was found between any other fatty acids (individual or grouped) and endometrial cancer risk. Conclusion: Our results suggest that higher consumption of γ-linolenic acid and α-linoleic acid from plant sources may be associated with lower risk of endometrial cancer., Institut National du Cancer (INCA) France C864/A 14136, Fondation ARC pour la Recherche sur le Cancer ARC 2019-DOC4, IARC, World Health Organization. International Agency for Research on Cancer (IARC), Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, NIHR Imperial Biomedical Research Centre (BRC), Danish Cancer Society, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (Inserm), Deutsche Krebshilfe. German Cancer Aid, Helmholtz Association, German Institute of Human Nutrition PotsdamRehbruecke (DIfE), Federal Ministry of Education & Research (BMBF), Fondazione AIRC per la ricerca sul cancro, Compagnia di San Paolo, Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund International (WCRF), Netherlands Government, Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Skane and Vaesterbotten (Sweden), Cancer Research UK C8221/A29017 MR/N003284/1, UK Research & Innovation (UKRI) Medical Research Council UK (MRC) MC_UU_00006/1 MR/M012190/1 2016 - 184

Published
2023

2. Prevalent diabetes and risk of total, colorectal, prostate and breast cancers in an ageing population: meta-analysis of individual participant data from cohorts of the CHANCES consortium

Author

Amadou, A., Freisling, H., Jenab, M., Tsilidis, K.K., Trichopoulou, A., Boffetta, P., Van Guelpen, B., Mokoroa, O., Wilsgaard, T., Kee, F., Schöttker, B., Ordóñez-Mena, J.M., Männistö, S., Söderberg, S., Vermeulen, R.C.H., Quirós, J.R., Liao, L.M., Sinha, R., Kuulasmaa, K., Brenner, H., Romieu, I., IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Sub Algemeen Theoretical Physics, IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Sub Algemeen Theoretical Physics, Amadou A., Freisling H., Jenab M., Tsilidis K.K., Trichopoulou A., Boffetta P., Van Guelpen B., Mokoroa O., Wilsgaard T., Kee F., Schottker B., Ordonez-Mena J.M., Mannisto S., Soderberg S., Vermeulen R.C.H., Quiros J.R., Liao L.M., Sinha R., Kuulasmaa K., Brenner H., and Romieu I.

Subjects
Male, Aging, Cancer Research, medicine.medical_specialty, Colorectal cancer, Breast Neoplasms, Colorectal Neoplasm, Overweight, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Risk Factors, Neoplasms, Internal medicine, Diabetes Mellitus, Prevalence, medicine, Humans, Prospective cohort study, Aged, Aged, 80 and over, business.industry, Risk Factor, Hazard ratio, Prostatic Neoplasms, Cancer, Diabetes Mellitu, Middle Aged, medicine.disease, Obesity, United States, Confidence interval, Europe, Oncology, 030220 oncology & carcinogenesis, Prostatic Neoplasm, Neoplasm, Female, Cohort Studie, medicine.symptom, Colorectal Neoplasms, business, Breast Neoplasm, Human
Abstract

BACKGROUND: We investigated whether associations between prevalent diabetes and cancer risk are pertinent to older adults and whether associations differ across subgroups of age, body weight status or levels of physical activity. METHODS: We harmonised data from seven prospective cohort studies of older individuals in Europe and the United States participating in the CHANCES consortium. Cox proportional hazard regression was used to estimate the associations of prevalent diabetes with cancer risk (all cancers combined, and for colorectum, prostate and breast). We calculated summary risk estimates across cohorts using pooled analysis and random-effects meta-analysis. RESULTS: A total of 667,916 individuals were included with an overall median (P25–P75) age at recruitment of 62.3 (57–67) years. During a median follow-up time of 10.5 years, 114,404 total cancer cases were ascertained. Diabetes was not associated with the risk of all cancers combined (hazard ratio (HR) = 0.94; 95% confidence interval (CI): 0.86–1.04; I(2) = 63.3%). Diabetes was positively associated with colorectal cancer risk in men (HR = 1.17; 95% CI: 1.08–1.26; I(2) = 0%) and a similar HR in women (1.13; 95% CI: 0.82–1.56; I(2) = 46%), but with a confidence interval including the null. Diabetes was inversely associated with prostate cancer risk (HR = 0.81; 95% CI: 0.77–0.85; I(2) = 0%), but not with postmenopausal breast cancer (HR = 0.96; 95% CI: 0.89–1.03; I(2) = 0%). In exploratory subgroup analyses, diabetes was inversely associated with prostate cancer risk only in men with overweight or obesity. CONCLUSIONS: Prevalent diabetes was positively associated with colorectal cancer risk and inversely associated with prostate cancer risk in older Europeans and Americans.

Published
2021

3. Association of CRP genetic variants with blood concentrations of C-reactive protein and colorectal cancer risk

Author

Nimptsch, K, Aleksandrova, K, Boeing, H, Janke, J, Lee, YA, Jenab, M, Bueno-de-Mesquita, HB, Jansen, EH, Tsilidis, KK, Trichopoulou, A, Weiderpass, E, Wu, C, Overvad, K, Tjønneland, A, Boutron-Ruault, MC, Dossus, L, Racine, A, Kaaks, R, Canzian, F, Lagiou, P, Trichopoulos, D, Palli, D, Agnoli, C, Tumino, R, Vineis, P, Panico, S, Johansson, A, Van Guelpen, B, Khaw, KT, Wareham, N, Peeters, PH, Quirós, JR, Venceslá García, A, Molina-Montes, E, Dorronsoro, M, Chirlaque, MD, Barricarte Gurrea, A, Key, TJ, Duarte-Salles, T, Stepien, M, Gunter, MJ, Riboli, E, Pischon, T, Nimptsch, K, Aleksandrova, K, Boeing, H, Janke, J, Lee, Ya, Jenab, M, Bueno De Mesquita, Bh, Jansen, Eh, Tsilidis, Kk, Trichopoulou, A, Weiderpass, E, Wu, C, Overvad, K, Tj?nneland, A, Boutron Ruault, Mc, Dossus, L, Racine, A, Kaaks, R, Canzian, F, Lagiou, P, Trichopoulos, D, Palli, D, Agnoli, C, Tumino, R, Vineis, P, Panico, Salvatore, Johansson, A, Van Guelpen, B, Khaw, Kt, Wareham, N, Peeters, Ph, Quir?s, Jr, Vencesl? Garc?a, A, Molina Montes, E, Dorronsoro, M, Chirlaque, Md, Barricarte Gurrea, A, Key, Tj, Duarte Salles, T, Stepien, M, Gunter, Mj, Riboli, E, and Pischon, T.

Subjects
Adult, Male, Genotype, colorectal cancer, INFLAMMATORY MARKERS, Polymorphism, Single Nucleotide, Article, C-reactive protein, Risk Factors, COLON, Biomarkers, Tumor, Journal Article, Humans, COHORT, Comparative Study, Prospective Studies, Aged, CRP genetic variants, Research Support, Non-U.S. Gov't, WOMEN, Middle Aged, Prognosis, Cardiovascular and Metabolic Diseases, Case-Control Studies, Randomized Controlled Trial, MENDELIAN RANDOMIZATION, POPULATIONS, Female, NUTRITION, HEALTH, Colorectal Neoplasms, Follow-Up Studies
Abstract

High blood concentrations of C-reactive protein (CRP) have been associated with elevated risk of colorectal cancer in several prospective studies including the European Prospective Investigation into Cancer and Nutrition (EPIC), but it is unknown whether these observations reflect a causal relationship. We aimed to investigate whether CRP genetic variants associated with lifelong higher CRP concentrations translate into higher colorectal cancer risk. We conducted a prospective nested case-control study within EPIC including 727 cases diagnosed between 1992 and 2003 and 727 matched controls selected according to an incidence-density sampling protocol. Baseline CRP concentrations were measured in plasma samples by a high sensitivity assay. Tagging single nucleotide polymorphisms (SNPs) in the CRP gene (rs1205, rs1800947, rs1130864, rs2808630, rs3093077) were identified via HapMap. The causal effect of CRP on colorectal cancer risk was examined in a Mendelian Randomization approach utilizing multiple CRP genetic variants as instrumental variables. The SNPs rs1205, rs1800947, rs1130864 and rs3093077 were significantly associated with CRP concentrations and were incorporated in a CRP allele score which was associated with 13% higher CRP concentrations per allele count (95% confidence interval 8%, 19%). Using the CRP-score as instrumental variable, genetically 2-fold higher CRP concentrations were associated with higher risk of colorectal cancer (odds ratio 1.74, 95% confidence interval 1.06, 2.85). Similar observations were made using alternative definitions of instrumental variables. Our findings give support to the hypothesis that elevated circulating CRP may play a direct role in the etiology of colorectal cancer.

Published
2016

4. Subtypes of fruit and vegetables, variety in consumption and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition

Author

Leenders, M., Siersema, P. D., Overvad, K., Tjonneland, A., Olsen, A., Boutron-Ruault, M. -C., Bastide, N., Fagherazzi, G., Katzke, V., Kuhn, T., Boeing, H., Aleksandrova, K., Trichopoulou, A., Lagiou, P., Klinaki, E., Masala, G., Grioni, S., Santucci De Magistris, M., Tumino, R., Ricceri, F., Peeters, P. H. M., Lund, E., Skeie, G., Weiderpass, E., Quiros, J. R., Agudo, A., Sanchez, M. -J., Dorronsoro, M., Navarro, C., Ardanaz, E., Ohlsson, B., Jirstrom, K., Van Guelpen, B., Wennberg, M., Khaw, K. -T., Wareham, N., Key, T. J., Romieu, I., Huybrechts, I., Cross, A. J., Murphy, N., Riboli, E., Bueno-De-Mesquita, H., Risk Assessment, Infection & Immunity, dIRAS RA-I&I RA, LS IRAS EEPI GRA (Gezh.risico-analyse), and Imperial College Trust

Subjects
DIET DIVERSITY, Adult, Male, Risk, Cancer Research, CRUCIFEROUS VEGETABLES, Nutritional Status, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], fruits and vegetables, colorectal cancer, variety, Colorectal Neoplasms, Diet, Europe, Feeding Behavior, Female, Fruit, Humans, Middle Aged, Prospective Studies, Risk Factors, Vegetables, COLORECTAL-CANCER, COHORT, Oncology & Carcinogenesis, Science & Technology, JAPAN, MUSHROOMS, food and beverages, Oncology, Food Habits, Life Sciences & Biomedicine, 1112 Oncology And Carcinogenesis
Abstract

Previously, a lower risk of colorectal cancer was observed with fruit and vegetable consumption in the European Prospective Investigation into Cancer and Nutrition within a follow-up period of 9 years which was not fully supported by a recent meta-analysis. Therefore, we were interested in the relation with extended follow-up, also focusing on single subtypes and a variety of intake of fruit and vegetables. Fruit and vegetable consumption was assessed at baseline. After an average of 13 years of follow-up, 3,370 participants were diagnosed with colon or rectal cancer. Diet diversity scores were constructed to quantify variety in fruit and vegetable consumption. A lower risk of colon cancer was observed with higher self-reported consumption of fruit and vegetable combined (HR Q4 vs. Q1 0.87, 95% CI 0.75-1.01, p for trend 0.02), but no consistent association was observed for separate consumption of fruits and vegetables. No associations with risk of rectal cancer were observed. The few observed associations for some fruit and vegetable subtypes with colon cancer risk may have been due to chance. Variety in consumption of fruits and vegetables was not associated with a lower risk of colon or rectal cancer. Although a lower risk of colon cancer is suggested with high consumption of fruit and vegetables, this study does not support a clear inverse association between fruit and vegetable consumption and colon or rectal cancer beyond a follow-up of more than 10 years. Attenuation of the risk estimates from dietary changes over time cannot be excluded, but appears unlikely. What's new? Eating a healthy diet loaded with fruits and vegetables will help you stave off cancer - that's the conventional wisdom. But the relationship between diet and cancer is complex. This study probed the effects of fruits and vegetables on colorectal cancer risk. The authors combed through data from the European Prospective Investigation into Cancer and Nutrition (EPIC) and analyzed total fruit and vegetable consumption as well as individual subtypes. Contrary to earlier results, they found no correlation between fruit and vegetable intake and colorectal cancer risk over a period of more than ten years.

Published
2015

5. Development and validation of a lifestyle-based model for colorectal cancer risk prediction: the LiFeCRC score

Author

Amanda J. Cross, Kristin Benjaminsen Borch, Anne Kirstine Eriksen, Elio Riboli, José María Huerta, H. Bas Bueno-de-Mesquita, Giovanna Masala, Núria Sala, Anne Tjønneland, Anika Hüsing, Rudolf Kaaks, Sara Grioni, Anne M. May, Fanny Artaud, Antonia Trichopoulou, Pilar Amiano, Eleni Peppa, Marc J. Gunter, Timothy J. Key, Aurelio Barricarte Gurrea, Jonna Berntsson, Anna Karakatsani, Mazda Jenab, Elisabete Weiderpass, Isabel Drake, Christina C. Dahm, Torkjel M. Sandanger, Bethany Van Guelpen, Robin Reichmann, María José Sánchez, Guri Skeie, Konstantinos K. Tsilidis, Gianluca Severi, Carlotta Sacerdote, Sjoerd G. Elias, José Ramón Quirós, Marie-Christine Boutron-Ruault, Salvatore Panico, Krasimira Aleksandrova, Rosario Tumino, Sophia Harlid, Elom K. Aglago, [Aleksandrova,K, Reichmann,R] Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany. [Aleksandrova,K, Reichmann,R] Institute of Nutritional Science, University of Potsdam, Potsdam, Germany. [Aleksandrova,K] Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany. [Kaaks,R, Hüsing,A] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Jenab,M, Weiderpass,E, Aglago,EK, Gunter,MJ] International Agency for Research on Cancer, World Health Organization, Lyon, France. [Bueno-de-Mesquita,HB] National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. [Bueno-de-Mesquita,HB, Cross,AJ, Tsilidis,KK, Riboli,E] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. [Dahm,CC] Department of Public Health, Aarhus University, Aarhus, Denmark. [Eriksen,AK, Tjønneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Artaud,F, Boutron-Ruault,MC, Severi,G] CESP, Faculté de Medicine, Université Paris-Saclay, Villejuif, France. [Artaud,F, Severi,G] Institut Gustave Roussy, Villejuif, France. [Severi,G] Dipartimento di Statistica, Informatica e Applicazioni 'G. Parenti' (DISIA), University of Florence, Florence, Italy. [Trichopoulou,A, Karakatsani,A, Peppa,E] Hellenic Health Foundation, Athens, Greece. [Karakatsani,A] 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, 'ATTIKON' University Hospital, Haidari, Greece. [Panico,S] EPIC Centre of Naples, Dipartimento di Medicina Clinica e Chirurgia, University of Naples Federico II, Naples, Italy. [Masala,G] 1Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network – ISPRO, Florence, Italy. [Grioni,S] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy. [Sacerdote,C] Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy. [Tumino,R] Cancer Registry and Histopathology Department, Provincial Health Authority (ASP), Ragusa, Italy. [Elias,SG, May,AM] Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. [Borch,KB, Sandanger,TM, Skeie,G] Department of Community Medicine, Health Faculty, UiT-the Arctic university of Norway, Tromsø, Norway. [Sánchez,MJ] Escuela Andaluza de Salud Pública (EASP), Granada, Spain. [Sánchez,MJ] Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain. [Sánchez,MJ, Huerta,JM, Gurrea,AB, Amiano,P] Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Sánchez,MJ] Universidad de Granada, Granada, Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. [Sala,N] Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Translational Research Laboratory, Catalan Institute of Oncology (ICO), Barcelona, Spain. [Sala,N] Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain. [Gurrea,AB] Navarra Public Health Institute, Pamplona, Spain. [Gurrea,AB] Navarra Institute for Health Research (IdiSNA), Pamplona, Spain. [Quirós,JR] Public Health Directorate, Asturias, Spain. [Amiano,P] Ministry of Health of the Basque Government, Public Health Division of Gipuzkoa, Biodonostia Health Research Institute, Donostia-San Sebastian, Spain. [Berntsson,J] Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden. [Drake,I] Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden. [van Guelpen,B, Harlid,S] Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden. [van Guelpen,B] Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden. [Key,T] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. [Tsilidis,KK] Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece., This work was supported by the German Research Foundation (DFG) (grant AL 1784/3-1), which funded the research position of Dr. Aleksandrova for organizing study conduct and analysis. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum (DKFZ) and Federal Ministry of Education and Research (BMBF) (Germany), Hellenic Health Foundation (Greece), Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands), Health Research Fund (FIS), Instituto de salud Carlos III PI13/00061 to Granada, PI13/ 01162 to EPIC-Murcia, Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236), Navarra and Catalonia (Catalan Institute of Oncology – ICO-IDIBELL) (Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden), and Cancer Research UK (C864/A14136 to EPIC-Norfolk and C8221/A19170 to EPICOxford), Medical Research Council (MR/N003284/1 and MC-UU_12015/1 to EPIC-Norfolk and MR/M012190/1 to EPIC-Oxford) (United Kingdom). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. Open Access funding enabled and organized by Projekt DEAL.

Subjects
Male, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Probability::Risk::Risk Assessment [Medical Subject Headings], lcsh:Medicine, Cancer prevention, Cohort Studies, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Calibration [Medical Subject Headings], 0302 clinical medicine, Risk Factors, Neoplasias colorrectales, Medicine, 030212 general & internal medicine, Prospective Studies, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Nutritional Status [Medical Subject Headings], 10. No inequality, Prospective cohort study, 11 Medical and Health Sciences, Framingham Risk Score, Risk screening, Lifestyle behaviour, Risk prediction, Colorectal cancer, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, 030220 oncology & carcinogenesis, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Prospective Studies [Medical Subject Headings], Female, Risk assessment, Colorectal Neoplasms, Research Article, Cohort study, Estils de vida, Waist, Lifestyles, Nutritional Status, Check Tags::Male [Medical Subject Headings], Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], Estil de vida, Risk Assessment, Riesgo, Estilo de vida, 03 medical and health sciences, Càncer colorectal, General & Internal Medicine, Humans, Life Style, business.industry, lcsh:R, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Probability::Risk [Medical Subject Headings], Technology and Food and Beverages::Food and Beverages::Food::Vegetables [Medical Subject Headings], Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [Medical Subject Headings], Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], Nomogram, Lifestyle, Diet, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Check Tags::Female [Medical Subject Headings], Phenomena and Processes::Musculoskeletal and Neural Physiological Phenomena::Musculoskeletal Physiological Phenomena::Musculoskeletal Physiological Processes::Movement::Motor Activity::Exercise [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], business, Prevención de Enfermedades, Demography
Abstract

Background: Nutrition and lifestyle have been long established as risk factors for colorectal cancer (CRC). Modifiable lifestyle behaviours bear potential to minimize long-term CRC risk; however, translation of lifestyle information into individualized CRC risk assessment has not been implemented. Lifestyle-based risk models may aid the identification of high-risk individuals, guide referral to screening and motivate behaviour change. We therefore developed and validated a lifestyle-based CRC risk prediction algorithm in an asymptomatic European population. Methods: The model was based on data from 255,482 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study aged 19 to 70 years who were free of cancer at study baseline (1992–2000) and were followed up to 31 September 2010. The model was validated in a sample comprising 74,403 participants selected among five EPIC centres. Over a median follow-up time of 15 years, there were 3645 and 981 colorectal cancer cases in the derivation and validation samples, respectively. Variable selection algorithms in Cox proportional hazard regression and random survival forest (RSF) were used to identify the best predictors among plausible predictor variables. Measures of discrimination and calibration were calculated in derivation and validation samples. To facilitate model communication, a nomogram and a web-based application were developed. Results: The final selection model included age, waist circumference, height, smoking, alcohol consumption, physical activity, vegetables, dairy products, processed meat, and sugar and confectionary. The risk score demonstrated good discrimination overall and in sex-specific models. Harrell’s C-index was 0.710 in the derivation cohort and 0.714 in the validation cohort. The model was well calibrated and showed strong agreement between predicted and observed risk. Random survival forest analysis suggested high model robustness. Beyond age, lifestyle data led to improved model performance overall (continuous net reclassification improvement = 0.307 (95% CI 0.264–0.352)), and especially for young individuals below 45 years (continuous net reclassification improvement = 0.364 (95% CI 0.084–0.575)). Conclusions: LiFeCRC score based on age and lifestyle data accurately identifies individuals at risk for incident colorectal cancer in European populations and could contribute to improved prevention through motivating lifestyle change at an individual level., German Research Foundation (DFG) AL 1784/3-1, European Commission European Commission Joint Research Centre, International Agency for Research on Cancer, Danish Cancer Society, Ligue Contre le Cancer (France), Institut Gustave Roussy (France), Mutuelle Generale de l'Education Nationale (France), Institut National de la Sante et de la Recherche Medicale (Inserm), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum (DKFZ) (Germany), Federal Ministry of Education & Research (BMBF), Hellenic Health Foundation (Greece), Associazione Italiana per la Ricerca sul Cancro (AIRC), Consiglio Nazionale delle Ricerche (CNR), Netherlands Government, World Cancer Research Fund International (WCRF), Instituto de Salud Carlos III PI13/00061 PI13/01162, Junta de Andalucia, Regional Government of Asturias (Spain), Regional Government of Basque Country (Spain), Regional Government of Murcia (Spain) 6236, Regional Government of Navarra (Spain), Regional Government of Catalonia (Catalan Institute of Oncology -ICO-IDIBELL) (Spain), Swedish Cancer Society, Swedish Research Council, County Council of Skane (Sweden), County Council of Vasterbotten (Sweden), Cancer Research UK C864/A14136 C8221/A19170, UK Research & Innovation (UKRI) Medical Research Council UK (MRC) MR/N003284/1 MC-UU_12015/1 MR/M012190/1, Projekt DEAL

Published
2021

6. Physical activity and risks of breast and colorectal cancer : a Mendelian randomisation analysis

Author

Michael O. Woods, Fränzel J.B. van Duijnhoven, Tilman Kühn, Graham G. Giles, Temitope O. Keku, Konstantinos K. Tsilidis, Andrew T. Chan, Mingyang Song, Michael Hoffmeister, Gad Rennert, Tabitha A. Harrison, Anna H. Wu, Kenneth Offit, Mark A. Jenkins, Elizabeth A Platz, Sabina Sieri, Noralane M Lindor, John D. Potter, D Timothy Bishop, Barbara L. Banbury, Anne M. May, Sonja I. Berndt, José María Huerta, Antonia Trichopoulou, Paul D.P. Pharoah, Niki Dimou, Christopher I. Li, Roger L. Milne, Marc J. Gunter, Hermann Brenner, Martha L. Slattery, Catherine M. Tangen, Gianluca Severi, Richard M. Martin, Nabila Kazmi, Ruth C. Travis, Sanford D. Markowitz, Jeroen R. Huyghe, Heather Hampel, Ulrike Peters, John L. Hopper, Brigid M. Lynch, Krasimira Aleksandrova, Alicja Wolk, Merete Ellingjord-Dale, Li Li, Bethany Van Guelpen, Sergi Castellví-Bel, Edward Giovannucci, Steven J Gallinger, Annika Lindblom, Cornelia M. Ulrich, Stephen B. Gruber, Stephanie L. Schmit, Jenny Chang-Claude, Lorena Moreno, Victor Moreno, Nikos Papadimitriou, Stephen N. Thibodeau, Elio Riboli, Sophia Harlid, Polly A. Newcomb, Pavel Vodicka, Demetrius Albanes, Bas Bueno-de-Mesquita, Maria J. Sánchez, Sarah J Lewis, Timothy Robinson, Daniel D Buchanan, Loic Le Marchand, Carlo La Vecchia, Robert E Schoen, Neil Murphy, Giovanna Masala, Evelyn M. Monninkhof, Jane C. Figueiredo, Andrea Gsur, Jochen Hampe, Vittorio Perduca, Li Hsu, Emily White, Peter T. Campbell, School of Public Health - Department of Epidemiology and Biostatistics, Imperial College London, University of Bristol [Bristol], National Cancer Institute [Bethesda] (NCI-NIH), National Institutes of Health [Bethesda] (NIH), Department of Epidemiology, German Institute of Human Nutrition, Division of Cancer Epidemiology and Genetics [Bethesda, MD, États-Unis], National Institutes of Health [Bethesda] (NIH)-National Institutes of Health [Bethesda] (NIH), Division of Clinical Epidemiology and Aging Research, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment [Bilthoven] (RIVM), The Cancer, Ageing and Somatic Mutation Programme [Cambridgeshire, UK], The Wellcome Trust Sanger Institute [Cambridge], Division of Cancer Epidemiology, Samuel Lunenfeld Research Institute, Mount Sinai Hospital [Toronto, Canada] (MSH), University of Melbourne, Harvard School of Public Health, Department of Internal Medicine, Epidemiology, Human Genetics, University of Michigan [Ann Arbor], University of Michigan System-University of Michigan System, Medical Department 1 [Dresden, Germany], Technische Universität Dresden = Dresden University of Technology (TU Dresden), Ohio State University [Columbus] (OSU), FESTO, Universität Stuttgart [Stuttgart], Centre for MEGA Epidemiology, The University of Melbourne, Victoria, Australia, CIBER de Epidemiología y Salud Pública (CIBERESP), Department of Medical Genetics, HMNC Brain Health, Department of Clinical Sciences and Community Health [Milan, Italy], Università degli Studi di Milano [Milano] (UNIMI), University of Hawai‘i [Mānoa] (UHM), Chinese Center for Disease Control and Prevention, Department of Clinical Genetics, Karolinska University Hospital [Stockholm], Mayo Clinic, Case Western Reserve University [Cleveland], Cancer Risk Factors and LifeStyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Julius Center for Health Sciences and Primary Care, University Medical Center [Utrecht], Cancer Epidemiology Centre, Cancer Council Victoria, Biomedical Research Centre Network for Rare Diseases, CIBER de Enfermedades Raras (CIBERER), Memorial Sloane Kettering Cancer Center [New York], Mathématiques Appliquées Paris 5 (MAP5 - UMR 8145), Université Paris Descartes - Paris 5 (UPD5)-Institut National des Sciences Mathématiques et de leurs Interactions (INSMI)-Centre National de la Recherche Scientifique (CNRS), Department of Oncology, University of Cambridge [UK] (CAM), Johns Hopkins Bloomberg School of Public Health [Baltimore], Johns Hopkins University (JHU), Department of Community Medicine and Epidemiology, CHS National Cancer Control Center, School of Public Health [London, UK] (Faculty of Medicine), Andalusian School of Public Health [Granada], Istituto Nazionale dei Tumori, Fred Hutchinson Cancer Research Center [Seattle] (FHCRC), Mayo Clinic [Rochester], University of Oxford [Oxford], WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School [Athens]-University of Athens Medical School [Athens], Helmholtz Centre for Ocean Research [Kiel] (GEOMAR), Department of Medical Biosciences and Pathology, Umeå University, Institute of Experimental Medicine, Czech Academy of Sciences [Prague] (CAS), Karolinska Institutet [Stockholm], Nutrition and Metabolism Section, International Agency for Research on Cancer, [Papadimitriou,N, Dimou,N, Gunter,MJ, Murphy,N] Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France. [Tsilidis,KK] Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. [Tsilidis,KK, Ellingjord-Dale,M, Riboli,E] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. [Banbury,B, Harrison,TA, Hsu,L, Huyghe,JR, Li,CI, Newcomb,PA, Potter,JD, White,E, Peters,U] Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. [Martin,RM, Kazmi,N] MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. [Martin,RM, Lewis,SJ, Robinson,TM] Bristol Medical School, Department of Population Health Sciences, University of Bristol, Bristol, UK. [Martin,RM] National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK. [Albanes,D, Berndt,SI] Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MA, USA. [Aleksandrova,K] German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany. [Bishop,DT] Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK. [Brenner,H, Hoffmeister,M] Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Brenner,H] Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany. [Brenner,H] German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany. [Buchanan,DD, Giles,GG, Hopper,JL, Jenkins,MA, Lynch,B, Milne,R] Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. [Buchanan,DD] Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, VIC, Australia. [Buchanan,DD] Genetic Medicine and Family Cancer Clinic, The Royal Melbourne Hospital, Parkville, VIC, Australia [Bueno-de-Mesquita,B] Former senior scientist, Dept. for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), BA Bilthoven, Netherlands. [Bueno-de-Mesquita,B] Former associate professor, Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, Netherlands. [Bueno-de-Mesquita,B] ormer visiting professor, Dept. of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, St Mary’s Campus, Norfolk Place, London, London, UK. [Bueno-de-Mesquita,B] Former academic Icon / visiting professor, Dept. of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, Kuala Lumpur, Malaysia. [Campbell,PT] Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA, USA. [Castellví-Bel,S, Moreno,L] Gastroenterology Department, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain. [Chan,AT, Song,M] Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. [Chan,AT, Song,M] Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. [Chang-Claude,J, Kühn,T] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Chang-Claude,J] University Medical Centre Hamburg-Eppendorf, University Cancer Centre Hamburg (UCCH), Hamburg, Germany. [Figueiredo,JC] Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. [Figueiredo,JC] Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. [Gallinger,SJ] Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada. [Giles,GG, Milne,R] Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia. [Giovannucci,E, Song,M] Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA. [Giovannucci,E, Song,M] Department of Nutrition, T.H. H, Chan School of Public Health, Boston, MA, USA. [Giovannucci,E] Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA. [Gruber,SB, Schmit,SL] Department of Preventive Medicine, USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. [Gsur,A] Institute of Cancer Research, Department of Medicine I, Medical University Vienna, Vienna, Austria. [Hampe,J] Department of Medicine I, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany. [Hampel,H] Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA. [Harlid,S] Department of Radiation Sciences, Oncology, Umea University, Umea, Sweden. [Hopper,JL] Department of Epidemiology, School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, South Korea. [Hsu,L] Department of Biostatistics, University of Washington, Seattle, WA, USA. [Huerta,JM, Moreno,V, Sánchez,MJ] CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. [Keku,TO] Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA. [La Vecchia,C, Trichopoulou,A] Hellenic Health Foundation, Athens, Greece. [La Vecchia,C] Dept. of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy. [Le Marchand,L] University of Hawaii Cancer Center, Honolulu, HI, USA. [Li,L] Department of Family Medicine, University of Virginia, Charlottesville, VA, USA. [Lindblom,A] Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden. [Lindblom,A] Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. [Lindor,NM] Department of Health Science Research, Mayo Clinic, Scottsdale, AZ, USA. [Lynch,B] Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia. [Markowitz,SD] Departments of Medicine and Genetics, Case Comprehensive Cancer Center, Case Western Reserve University, and University Hospitals of Cleveland, Cleveland, OH, USA. [Masala,G] Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy. [May,AM, Monninkhof,E] Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, GA UTRECHT, Netherlands. [Milne,R] Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, VIC, Australia. [Moreno,V] Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain. [Moreno,V] Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain. [Newcomb,PA] School of Public Health, University of Washington, Seattle, WA, USA. [Offit,K] Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. [Offit,K] Department of Medicine, Weill Cornell Medical College, New York, NY, USA. [Perduca,V, Severi,G] CESP, Fac. de médecine - Univ. ParisSud, Fac. de médecine - UVSQ I, Université Paris-Saclay, Villejuif, France. [Perduca,V, Severi,G] Gustave Roussy, Villejuif, France. [Perduca,V] Laboratoire de Mathématiques Appliquées MAP5 (UMR CNRS 8145), Université Paris Descartes, Paris, France. [Pharoah,PDP] Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. [Platz,EA] Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. [Rennert,G] Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel. [Rennert,G] 7Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. [Rennert,G] Clalit National Cancer Control Center, Haifa, Israel. [Sánchez,MJ] Andalusian School of Public Health, Biomedical Research Institute ibs.GRANADA, University of Granada, Granada, Spain. [Schmit,SL] Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA. [Schoen,RE] Department of Medicine and Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. [Sieri,S] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Slattery,ML] Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA. [Tangen,CM] SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. [Thibodeau,SN] Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA. [Travis,RC] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. [Ulrich,CM] Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA. [van Duijnhoven,FJB] Division of Human Nutrition, Wageningen University and Research, Wageningen, Netherlands. [Van Guelpen,B] Department of Radiation Sciences, Oncology Unit, Umeå University, Umeå, Sweden. [Van Guelpen,B] Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden. [Vodicka,P] Department of Molecular Biology of Cancer, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czech Republic. [Vodicka,P] Faculty of Medicine and Biomedical Center in Pilsen, Charles University, Pilsen, Czech Republic. [Vodicka,P] Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Prague, Czech Republic. [White,E, Peters,U] Department of Epidemiology, University of Washington, Seattle, WA, USA. [Wolk,A] Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. [Woods,MO] Memorial University of Newfoundland, Discipline of Genetics, St. John’s, Canada. [Wu,AH] University of Southern California, Preventative Medicine, Los Angeles, CA, USA., This work was supported by the National Cancer Institute, the International Agency for Research on Cancer and a Cancer Research UK program grant (C18281/A19169 to RMM, SJL & NK). RMM was supported by the National Institute for Health Research (NIHR) Bristol Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funding sources for BCAC, CCFR, GECCO, and CORECT consortia are presented in detail in the appendix in the Supplementary material., Tsilidis, Konstantinos K [0000-0002-8452-8472], Martin, Richard M [0000-0002-7992-7719], Lewis, Sarah J [0000-0003-4311-6890], Robinson, Timothy M [0000-0003-0933-646X], Timothy Bishop, D [0000-0002-8752-8785], Buchanan, Daniel D [0000-0003-2225-6675], Chan, Andrew T [0000-0001-7284-6767], Giles, Graham G [0000-0003-4946-9099], Gsur, Andrea [0000-0002-9795-1528], Hampe, Jochen [0000-0002-2421-6127], Hampel, Heather [0000-0001-7558-9794], Harlid, Sophia [0000-0001-8540-6891], Harrison, Tabitha A [0000-0002-4173-7530], María Huerta, José [0000-0002-9637-3869], Huyghe, Jeroen R [0000-0001-6027-9806], Jenkins, Mark A [0000-0002-8964-6160], La Vecchia, Carlo [0000-0003-1441-897X], Masala, Giovanna [0000-0002-5758-9069], Milne, Roger [0000-0001-5764-7268], Moreno, Victor [0000-0002-2818-5487], Newcomb, Polly A [0000-0001-8786-0043], Perduca, Vittorio [0000-0003-0339-0473], Pharoah, Paul D P [0000-0001-8494-732X], Potter, John D [0000-0001-5439-1500], Rennert, Gad [0000-0002-8512-068X], Riboli, Elio [0000-0001-6795-6080], Schmit, Stephanie L [0000-0001-5931-1194], Schoen, Robert E [0000-0001-7153-2766], Van Guelpen, Bethany [0000-0002-9692-101X], Wolk, Alicja [0000-0001-7387-6845], Peters, Ulrike [0000-0001-5666-9318], Murphy, Neil [0000-0003-3347-8249], Apollo - University of Cambridge Repository, Tsilidis, Konstantinos K. [0000-0002-8452-8472], Martin, Richard M. [0000-0002-7992-7719], Lewis, Sarah J. [0000-0003-4311-6890], Timothy Bishop, D. [0000-0002-8752-8785], Buchanan, Daniel D. [0000-0003-2225-6675], Chan, Andrew T. [0000-0001-7284-6767], Giles, Graham G. [0000-0003-4946-9099], Harrison, Tabitha A. [0000-0002-4173-7530], Huyghe, Jeroen R. [0000-0001-6027-9806], Jenkins, Mark A. [0000-0002-8964-6160], Newcomb, Polly A. [0000-0001-8786-0043], Pharoah, Paul D. P. [0000-0001-8494-732X], Potter, John D. [0000-0001-5439-1500], Schmit, Stephanie L. [0000-0001-5931-1194], Schoen, Robert E. [0000-0001-7153-2766], and Pharoah, Paul DP [0000-0001-8494-732X]

Subjects
Oncology, Epidemiology, Colorectal cancer, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Accelerometry [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Molecular Epidemiology::Mendelian Randomization Analysis [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Breast cancer, Epidemiology of cancer, Accelerometry, Odds Ratio, lcsh:Science, skin and connective tissue diseases, Cancer genetics, ComputingMilieux_MISCELLANEOUS, Cancer, 0303 health sciences, Biobank, 3. Good health, 030220 oncology & carcinogenesis, ICEP, Factores de riesgo, medicine.medical_specialty, Science, 631/67/2324, Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms::Colorectal Neoplasms, Hereditary Nonpolyposis [Medical Subject Headings], Breast Neoplasms/genetics, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Càncer colorectal, Anthropology, Education, Sociology and Social Phenomena::Human Activities::Exercise [Medical Subject Headings], Humans, Epidemiologia, Exercise, VLAG, Cancer och onkologi, 45, 631/67/1347, Odds ratio, Mendelian Randomization Analysis, medicine.disease, Colorectal Neoplasms/genetics, 030104 developmental biology, Analyses, Risk factors, Check Tags::Female [Medical Subject Headings], Cancer and Oncology, lcsh:Q, Breast neoplasms, 0301 basic medicine, 631/67/1504/1885, Nutrition and Disease, General Physics and Astronomy, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings], Risk Factors, Neoplasias colorrectales, Voeding en Ziekte, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Odds Ratio [Medical Subject Headings], Multidisciplinary, article, Public Health, Global Health, Social Medicine and Epidemiology, Polymorphism, Single Nucleotide/genetics, Ejercicio físico, Neoplasias de la mama, Female, Colorectal Neoplasms, 631/67, 141, Breast Neoplasms, 45/23, Polymorphism, Single Nucleotide, Colorectal neoplasms, Càncer de mama, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Disease Susceptibility::Genetic Predisposition to Disease [Medical Subject Headings], Cancer epidemiology, 631/67/68, Internal medicine, Mendelian randomization, medicine, Journal Article, Life Science, Genetic Predisposition to Disease, Diseases::Neoplasms::Neoplasms by Site::Breast Neoplasms [Medical Subject Headings], 030304 developmental biology, Phenomena and Processes::Genetic Phenomena::Genetic Variation::Polymorphism, Genetic::Polymorphism, Single Nucleotide [Medical Subject Headings], business.industry, General Chemistry, Physical fitness, Confidence interval, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Condició física
Abstract

Physical activity has been associated with lower risks of breast and colorectal cancer in epidemiological studies; however, it is unknown if these associations are causal or confounded. In two-sample Mendelian randomisation analyses, using summary genetic data from the UK Biobank and GWA consortia, we found that a one standard deviation increment in average acceleration was associated with lower risks of breast cancer (odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.27 to 0.98, P-value = 0.04) and colorectal cancer (OR: 0.66, 95% CI: 0.48 to 0.90, P-value = 0.01). We found similar magnitude inverse associations for estrogen positive (ER+ve) breast cancer and for colon cancer. Our results support a potentially causal relationship between higher physical activity levels and lower risks of breast cancer and colorectal cancer. Based on these data, the promotion of physical activity is probably an effective strategy in the primary prevention of these commonly diagnosed cancers., United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Cancer Institute (NCI), International Agency for Research on Cancer, Cancer Research UK C18281/A19169, National Institute for Health Research (NIHR)

Published
2020

7. Modified Mediterranean diet and survival after myocardial infarction

Author

Y. T. van der Schouw, Philippos Orfanos, B. Van Guelpen, V. Pala, C. A. Gonzalez, Petra H.M. Peeters, Anne Tjønneland, María José Sánchez, Antonia Trichopoulou, Vassiliki Benetou, S Bingham, Timothy J. Key, S. Rohrmann, Theodora Psaltopoulou, Kay-Tee Khaw, Christina Bamia, Kim Overvad, Erik Berg Schmidt, Concha Moreno, Nerea Larrañaga, F. Clavel-Chapelon, J. Linseisen, Salvatore Panico, J. H. Jansson, M. C. Boutron-Ruault, M-D Chirlaque, Teresa Norat, Giovanna Masala, Jytte Halkjær, Cornelia Weikert, H. Boeing, Paolo Boffetta, Dimitrios Trichopoulos, R. Tumino, Carlotta Sacerdote, Marga C. Ocké, Marie-Noël Vercambre, H. B. Bueno-De-Mesquita, Elio Riboli, E. A. Spencer, Trichopoulou, A, Bamia, C, Norat, T, Overvad, K, Schmidt, Eb, Tjonneland, A, Halkjaer, J, CLAVEL CHAPELON, F, Vercambre, Mn, BOUTRON RUAULT, Mc, Linseisen, J, Rohrmann, S, Boeing, H, Weikert, C, Benetou, V, Psaltopoulou, T, Orfanos, P, Boffetta, P, Masala, G, Pala, V, Panico, Salvatore, Tumino, R, Sacerdote, C, BUENO DE MESQUITA, Hb, Ocke, Mc, Peeters, Ph, VAN DER SCHOUW, Yt, Gonzalez, C, Sanchez, Mj, Chirlaque, Md, Moreno, C, Larranaga, N, VAN GUELPEN, B, Jansson, Jh, Bingham, S, Khaw, Kt, Spencer, Ea, Key, T, Riboli, E, Trichopoulos, D., Trichopoulou, A., Bamia, C., Norat, T., Overvad, K., Schmidt, E.B., Tjønneland, A., Halkjær, J., Clavel-Chapelon, F., Vercambre, M.-N., Boutron-Ruault, M.-C., Linseisen, J., Rohrmann, S., Boeing, H., Weikert, C., Benetou, V., Psaltopoulou, T., Orfanos, P., Boffetta, P., Masala, G., Pala, V., Panico, S., Tumino, R., Sacerdote, C., Bueno-De-Mesquita, H.B., Ocke, M.C., Peeters, P.H., Van Der Schouw, Y.T., González, C., Sanchez, M.J., Chirlaque, M.D., Moreno, C., Larrañaga, N., Van Guelpen, B., Jansson, J.-H., Bingham, S., Khaw, K.-T., Spencer, E.A., Key, T., Riboli, E., and University of Groningen

Subjects
Male, COUNTRIES, medicine.medical_specialty, Mediterranean diet, Epidemiology, ALCOHOL, Diet, Mediterranean, survival, elderly, Modified Mediterranean diet survival myocardial infarction EPIC-Elderly study, Food group, PEOPLE, medicine, Humans, CORONARY-HEART-DISEASE, COHORT, Prospective Studies, Myocardial infarction, ddc:610, Survival rate, Aged, Proportional Hazards Models, RISK, business.industry, Proportional hazards model, Mortality rate, MORTALITY, Middle Aged, Nutrition Surveys, medicine.disease, CANCER, European Prospective Investigation into Cancer and Nutrition, Surgery, Europe, Survival Rate, Standardized mortality ratio, myocardial infarction, Female, NUTRITION, business, FOLLOW-UP, Demography
Abstract

Mediterranean diet is associated with lower incidence of coronary heart disease, and two randomised trials indicated that it improves prognosis of coronary patients. These trials, however, relied on a total of 100 deaths and evaluated designer diets in the clinical context. We have evaluated the association of adherence to the modified Mediterranean diet, in which unsaturates were substituted for monounsaturates, with survival among elderly with previous myocardial infarction within the European Prospective Investigation into Cancer and nutrition (EPIC) study. As of December 2003, after a median follow-up of 6.7 years, 2671 EPIC participants from nine countries were 60 years or older and had prevalent myocardial infarction but no stroke or cancer at enrolment, complete information on dietary intakes and important covariates and known survival status. Adherence to the modified Mediterranean diet was assessed through a 10-unit-scale. Mortality ratio in relation to modified Mediterranean diet was estimated through Cox regression controlling for possible confounding. Increased adherence to modified Mediterranean diet by two units was associated with 18% lower overall mortality rate (95% confidence interval 7-27%, fixed effects model). There was no significant heterogeneity by sex, age at enrolment, or country, although the association tended to be less evident among northern Europeans. Associations between food groups contributing to the modified Mediterranean diet and mortality were generally weak. A diet inspired by the Mediterranean pattern that can be easily adopted by Western populations is associated with substantial reduction of total mortality of coronary patients in the community. © 2007 Springer Science+Business Media B.V.

Published
2007

8. Polymorphisms in fatty acid metabolism-related genes are associated with colorectal cancer risk

Author

Yvoni Koumantaki, Elio Riboli, Bethany Van Guelpen, Nicholas J. Wareham, Paolo Vineis, Birgit Hoeft, Karin Jirström, Elizabeth A Spencer, Jonas Manjer, Göran Hallmans, H. B. Bueno-De-Mesquita, Ulla Vogel, Veronique Chajes, Carla H. van Gils, Paolo Boffetta, Heiner Boeing, Lars Beckmann, Kim Overvad, Rikke Dalgaard Hansen, Marianne Uhre Jakobsen, Laudina Rodríguez, Franco Berrino, Eiliv Lund, Mazda Jenab, Petra H.M. Peeters, Sophie Morois, Traci Mouw, Jakob Linseisen, Teresa Norat, Aurelio Barricarte, F. Clavel-Chapelon, Karin Müller-Decker, Fränzel J.B. Van Duijnhoven, Francesca L. Crowe, José María Huerta Castaño, Dimitrios Trichopoulos, Antonia Trichopoulou, Sven Knüppel, Rudolf Kaaks, Federico Canzian, Domenico Palli, Vanessa Dumeaux, Alexandra Nieters, Kay-Tee Khaw, Anika Hüsing, Xavier Muñoz, Rosario Tumino, Marie-Christine Boutron-Ruault, Salvatore Panico, Hoeft, B, Linseisen, J, Beckmann, L, Müller Decker, K, Canzian, F, Hüsing, A, Kaaksr, Vogel, U, Jakobsen, Mu, Overvad, K, Hansen, Rd, Knüppel, S, Boeing, H, Trichopoulou, A, Koumantaki, Y, Trichopoulos, D, Berrino, F, Palli, D, Panico, Salvatore, Tumino, R, Bueno de Mesquita, Hb, van Duijnhoven, Fj, van Gils, Ch, Peeters, Ph, Dumeaux, V, Lunde, Huerta Castaño, Jm, Muñoz, X, Rodriguez, L, Barricarte, A, Manjer, J, Jirström, K, Van Guelpen, B, Hallmans, G, Spencer, Ea, Crowe, Fl, Khaw, Kt, Wareham, N, Morois, S, Boutron Ruault, Mc, Clavel Chapelon, F, Chajes, V, Jenab, M, Boffetta, P, Vineis, P, Mouw, T, Norat, T, Riboli, E, Nieters, A., Hoeft, B., Linseisen, J., Beckmann, L., Müller-Decker, K., Canzian, F., Hüsing, A., Kaaks, R., Vogel, U., Jakobsen, M.U., Overvad, K., Hansen, R.D., Knüppel, S., Boeing, H., Trichopoulou, A., Koumantaki, Y., Trichopoulos, D., Berrino, F., Palli, D., Panico, S., Tumino, R., Buenode-Mesquita, H.B., van Duijnhoven, F.J.B., van Gils, C.H., Peeters, P.H., Dumeaux, V., Lund, E., Huerta Castaño, J.M., Muñoz, X., Rodriguez, L., Barricarte, A., Manjer, J., Jirström, K., van Guelpen, B., Hallmans, G., Spencer, E.A., Crowe, F.L., Khaw, K.-T., Wareham, N., Morois, S., Boutron-Ruault, M.-C., Clavel-Chapelon, F., Chajes, V., Jenab, M., Boffetta, P., Vineis, P., Mouw, T., Norat, T., and Riboli, E.

Subjects
Oncology, Male, Cancer Research, Colorectal cancer, Cohort Studies, 0302 clinical medicine, Genetics, 0303 health sciences, Group III Phospholipases A2, Fatty Acids, Smoking, General Medicine, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Neoplasm Proteins, Europe, 030220 oncology & carcinogenesis, Hydroxyprostaglandin Dehydrogenases, Female, Colorectal Neoplasms, medicine.medical_specialty, Genotype, TRPV Cation Channels, colorectal cancer, Single-nucleotide polymorphism, Biology, Adenocarcinoma, Polymorphism, Single Nucleotide, Group VI Phospholipases A2, 03 medical and health sciences, Internal medicine, medicine, Humans, Receptors, Prostaglandin E, ddc:610, Polymorphism, Allele frequency, Alleles, Genetic Association Studies, 030304 developmental biology, Haplotype, Cancer, Odds ratio, Receptors, Prostaglandin E, EP2 Subtype, medicine.disease, Minor allele frequency, Haplotypes, Case-Control Studies, fatty acid, metabolism
Abstract

Colorectal cancer (CRC) is the third most common malignant tumor and the fourth leading cause of cancer death worldwide. The crucial role of fatty acids for a number of important biological processes suggests a more in-depth analysis of inter-individual differences in fatty acid metabolizing genes as contributing factor to colon carcinogenesis. We examined the association between genetic variability in 43 fatty acid metabolism-related genes and colorectal risk in 1225 CRC cases and 2032 controls participating in the European Prospective Investigation into Cancer and Nutrition study. Three hundred and ninety two single-nucleotide polymorphisms were selected using pairwise tagging with an r2 cutoff of 0.8 and a minor allele frequency of >5%. Conditional logistic regression models were used to estimate odds ratios and corresponding 95% confidence intervals. Haplotype analysis was performed using a generalized linear model framework. On the genotype level, hydroxyprostaglandin dehydrogenase 15-(NAD) (HPGD), phospholipase A2 group VI (PLA2G6) and transient receptor potential vanilloid 3 were associated with higher risk for CRC, whereas prostaglandin E receptor 2 (PTGER2) was associated with lower CRC risk. A significant inverse association (P < 0.006) was found for PTGER2 GGG haplotype, whereas HPGD AGGAG and PLA2G3 CT haplotypes were significantly (P < 0.001 and P = 0.003, respectively) associated with higher risk of CRC. Based on these data, we present for the first time the association of HPGD variants with CRC risk. Our results support the key role of prostanoid signaling in colon carcinogenesis and suggest a relevance of genetic variation in fatty acid metabolism-related genes and CRC risk. © The Author 2009. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org.

Published
2010

9. Plasma folate, related genetic variants, and colorectal cancer risk in EPIC

Author

Elio Riboli, Klaus Meyer, Rudolf Kaaks, Eiliv Lund, Salvatore Panico, Françoise Clavel-Chapelon, Åse Fredriksen, Laudina Rodríguez, H. Bas Bueno-de-Mesquita, Sophie Morois, Richard Palmqvist, Guri Skeie, Teresa Norat, Carmen Navarro, Inger T. Gram, Kim Overvad, Jakob Linseisen, Stein Emil Vollset, Jannicke Igland, Miren Dorronsoro, Demosthenes Zilis, Nadia Slimani, Mazda Jenab, Bethany Van Guelpen, Paolo Vineis, Paolo Boffetta, Ulrika Ericson, Carlos A. González, Petra H.M. Peeters, Marie-Christine Boutron-Ruault, Franco Berrino, Eva Ardanaz, Fränzel J.B. Van Duijnhoven, Sheila Bingham, Anja Olsen, Antonia Trichopoulou, Rosario Tumino, Jonas Manjer, Kay-Tee Khaw, Cornelia Weikert, Carmen Enid Martínez, Simone J. P. M. Eussen, Tobias Pischon, Domenico Palli, Per Magne Ueland, Michael Katsoulis, Anne Tjønneland, Eussen, Sj, Vollset, Se, Igland, J, Meyer, K, Fredriksen, A, Ueland, Pm, Jenab, M, Slimani, N, Boffetta, P, Overvad, K, Tjønneland, A, Olsen, A, Clavel Chapelon, F, Boutron Ruault, Mc, Morois, S, Weikert, C, Pischon, T, Linseisen, J, Kaaks, R, Trichopoulou, A, Zilis, D, Katsoulis, M, Palli, D, Berrino, F, Vineis, P, Tumino, R, Panico, Salvatore, Peeters, Ph, Bueno de Mesquita, Hb, van Duijnhoven, Fj, Gram, It, Skeie, G, Lund, E, González, Ca, Martínez, C, Dorronsoro, M, Ardanaz, E, Navarro, C, Rodríguez, L, Van Guelpen, B, Palmqvist, R, Manjer, J, Ericson, U, Bingham, S, Khaw, Kt, Norat, T, Riboli, E., Eussen, S.J.P.M., Vollset, S.E., Igland, J., Meyer, K., Fredriksen, Å., Ueland, P.M., Jenab, M., Slimani, N., Boffetta, P., Overvad, K., Tjønneland, A., Olsen, A., Clavel-Chapelon, F., Boutron-Ruault, M.-C., Morois, S., Weikert, C., Pischon, T., Linseisen, J., Kaaks, R., Trichopoulou, A., Zilis, D., Katsoulis, M., Palli, D., Berrino, F., Vineis, P., Tumino, R., Panico, S., Peeters, P.H.M., Bueno-de-Mesquita, H.B., Van Duijnhoven, F.J.B., Gram, I.T., Skeie, G., Lund, E., González, C.A., Martínez, C., Dorronsoro, M., Ardanaz, E., Navarro, C., Rodríguez, L., Van Guelpen, B., Palmqvist, R., Manjer, J., Ericson, U., Bingham, S., Khaw, K.-T., and Norat, T.

Subjects
Adult, Male, Oncology, medicine.medical_specialty, Epidemiology, Colorectal cancer, colorectal cancer, Biology, medicine.disease_cause, Polymorphism, Single Nucleotide, Article, Methylenetetrahydrofolate reductase polymorphism, Nested case-control, Human methionine synthase, Carbon metabolic pathway, C677T MTHFR polymorphism, Colon-cancer, Folic-acid, Mass-spectrometry, Dietary patterns, Common mutation, Folic Acid, Risk Factors, Molecular genetics, Internal medicine, Genetic variation, medicine, Humans, Genetic Predisposition to Disease, Prospective Studies, Prospective cohort study, Methylenetetrahydrofolate Reductase (NADPH2), Aged, Aged, 80 and over, Genetics, Plasma folate, Case-control study, Middle Aged, Prognosis, medicine.disease, digestive system diseases, Survival Rate, Case-Control Studies, Methylenetetrahydrofolate reductase, Nested case-control study, biology.protein, Female, EPIC, Colorectal Neoplasms, Carcinogenesis
Abstract

Background: A potential dual role of folate in colorectal cancer (CRC) is currently subject to debate. We investigate the associations between plasma folate, several relevant folate-related polymorphisms, and CRC risk within the large European Prospective Investigation into Cancer and Nutrition cohort.Methods: In this nested case-control study, 1,367 incident CRC cases were matched to 2,325 controls for study center, age, and sex. Risk ratios (RR) were estimated with conditional logistic regression and adjusted for smoking, education, physical activity, and intake of alcohol and fiber.Results: Overall analyses did not reveal associations of plasma folate with CRC. The RR (95% confidence interval; Ptrend) for the fifth versus the first quintile of folate status was 0.94 (0.74-1.20; 0.44). The polymorphisms MTHFR677C→T, MTHFR1298A→C, MTR2756A→G, MTRR66A→G, and MTHFD11958G→A were not associated with CRC risk. However, in individuals with the lowest plasma folate concentrations, the MTHFR 677TT genotype showed a statistically nonsignificant increased CRC risk [RR (95% CI; Ptrend) TT versus CC = 1.39 (0.87-2.21); 0.12], whereas those with the highest folate concentrations showed a nonsignificant decreased CRC risk [RR TT versus CC = 0.74 (0.39-1.37); 0.34]. The SLC19A180G→A showed a positive association with CRC risk [RR AA versus GG 1.30 (1.06-1.59); Conclusions: This large European prospective multicenter study did not show an association of CRC risk with plasma folate status nor with MTHFR polymorphisms.Impact: Findings of the present study tend to weaken the evidence that folate plays an important role in CRC carcinogenesis. However, larger sample sizes are needed to adequately address potential gene-environment interactions. Cancer Epidemiol Biomarkers Prev; 19(5); 1328–40. ©2010 AACR.

Published
2010

10. Oral contraceptives, reproductive history and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition

Author

Yvoni Koumantaki, Eiliv Lund, Anne Tjønneland, Elio Riboli, Giovanna Tagliabue, F. J. B. van Duijnhoven, Paolo Vineis, M. C. Boutron-Ruault, Rudolf Kaaks, Salvatore Panico, M-J Sanchez, Aurelio Barricarte, B. Van Guelpen, V. Chajes, G. Stasinopoulou, Françoise Clavel-Chapelon, Teresa Norat, P. H. M. Peeters, Franco Berrino, M-D Chirlaque, Konstantinos K. Tsilidis, Graham Byrnes, Signe Borgquist, Domenico Palli, Kjersti Bakken, Kim Overvad, A. Olsen, M. Dorronsoro, Dora Romaguera, Jonas Manjer, Rosario Tumino, Timothy J. Key, Antonia Trichopoulou, M. Bergmann, L. Rodríguez, Agnès Fournier, Göran Hallmans, S. Rinaldi, K-T Khaw, Jenny Chang-Claude, C. H. van Gils, C. A. Gonzalez, H. B. Bueno-de-Mesquita, Heiner Boeing, Naomi E. Allen, Sheila A. Rodwell, Tsilidis, Kk, Allen, Ne, Key, Tj, Bakken, K, Lund, E, Berrino, F, Fournier, A, Olsen, A, Tjønneland, A, Overvad, K, Boutron Ruault, Mc, Clavel Chapelon, F, Byrnes, G, Chajes, V, Rinaldi, S, Chang Claude, J, Kaaks, R, Bergmann, M, Boeing, H, Koumantaki, Y, Stasinopoulou, G, Trichopoulou, A, Palli, D, Tagliabue, G, Panico, Salvatore, Tumino, R, Vineis, P, Bueno de Mesquita, Hb, van Duijnhoven, Fj, van Gils, Ch, Peeters, Ph, Rodríguez, L, González, Ca, Sánchez, Mj, Chirlaque, Md, Barricarte, A, Dorronsoro, M, Borgquist, S, Manjer, J, van Guelpen, B, Hallmans, G, Rodwell, Sa, Khaw, Kt, Norat, T, Romaguera, D, and Riboli, E.

Subjects
Cancer Research, Colorectal cancer, Epidemiology, medicine.medical_treatment, SERUM, 0302 clinical medicine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, oral contraceptives, reproductive history, 2. Zero hunger, education.field_of_study, Obstetrics, Reproduction, COLON-CANCER, HORMONE-REPLACEMENT-THERAPY, WOMEN, Hormone replacement therapy (menopause), Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, LARGE BOWEL, Family planning, 030220 oncology & carcinogenesis, Female, Colorectal Neoplasms, Life Sciences & Biomedicine, Adult, Risk, medicine.medical_specialty, Population, UNITED-STATES, colorectal cancer, EXOGENOUS HORMONES, 03 medical and health sciences, ADENOMAS, medicine, cohort study, Humans, COHORT, Risk factor, education, Aged, Gynecology, Science & Technology, business.industry, Cancer, medicine.disease, ONCOLOGY, sense organs, business, Contraceptives, Oral
Abstract

Udgivelsesdato: 2010-Nov-2 Background:Oral contraceptive use and reproductive factors may initiate long-term changes to the hormonal milieu and thereby, possibly influence colorectal cancer risk.Methods:We examined the association of hormonal and reproductive factors with risk of colorectal cancer among 337 802 women in the European Prospective Investigation into Cancer and Nutrition, of whom 1878 developed colorectal cancer.Results:After stratification for center and age, and adjustment for body mass index, smoking, diabetes mellitus, physical activity and alcohol consumption, ever use of oral contraceptives was marginally inversely associated with colorectal cancer risk (hazard ratio (HR), 0.92; 95% confidence interval (CI), 0.83-1.02), although this association was stronger among post-menopausal women (HR, 0.84; 95% CI: 0.74-0.95). Duration of oral contraceptive use and reproductive factors, including age at menarche, age at menopause, type of menopause, ever having an abortion, parity, age at first full-term pregnancy and breastfeeding, were not associated with colorectal cancer risk.Conclusion:Our findings provide limited support for a potential inverse association between oral contraceptives and colorectal cancer risk.British Journal of Cancer advance online publication, 2 November 2010; doi:10.1038/sj.bjc.6605965 www.bjcancer.com.

Published
2016

11. Dietary folate intake and breast cancer risk:European prospective investigation into cancer and nutrition

Author

M. C. Boutron-Ruault, Rudolf Kaaks, A. Barricarte Gurrea, Paolo Vineis, Emily Sonestedt, B. Van Guelpen, Timothy J. Key, M-J Sanchez, Françoise Clavel-Chapelon, Jin Young Park, M-D Chirlaque, Salvatore Panico, Jörn Schneede, Noémie Travier, Rosario Tumino, Dagrun Engeset, Anette Hjartåker, N. Roswall, Sabina Sieri, Michael Bergmann, Anne Tjønneland, V. Chajes, Pilar Amiano, Ulrika Ericson, H. B. Bueno-de-Mesquita, Isabelle Romieu, Soledad Sánchez, J. D. De Batlle, Dimitrios Trichopoulos, Guy Fagherazzi, Verena Katzke, Antonia Trichopoulou, Kathryn E. Bradbury, Elisabete Weiderpass, P. H. Peeters, Pagona Lagiou, Elio Riboli, Kim Overvad, Domenico Palli, Fiona McKenzie, Kay-Tee Khaw, Pamela Ferrari, Nadia Slimani, de Batlle, J, Ferrari, P, Chajes, V, Park, Jy, Slimani, N, Mckenzie, F, Overvad, K, Roswall, N, Tjønneland, A, Boutron Ruault, Mc, Clavel Chapelon, F, Fagherazzi, G, Katzke, V, Kaaks, R, Bergmann, Mm, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Palli, D, Sieri, S, Panico, Salvatore, Tumino, R, Vineis, P, Bueno de Mesquita, Hb, Peeters, Ph, Hjartåker, A, Engeset, D, Weiderpass, E, Sánchez, S, Travier, N, Sánchez, Mj, Amiano, P, Chirlaque, Md, Barricarte Gurrea, A, Khaw, Kt, Key, Tj, Bradbury, Ke, Ericson, U, Sonestedt, E, Van Guelpen, B, Schneede, J, Riboli, E, and Romieu, I.

Subjects
Adult, Cancer Research, medicine.medical_specialty, Physiology, Breast Neoplasms, Lower risk, Breast cancer, Folic Acid, medicine, Odds Ratio, Humans, Prospective Studies, Prospective cohort study, Aged, Gynecology, business.industry, Hazard ratio, Odds ratio, Middle Aged, medicine.disease, European Prospective Investigation into Cancer and Nutrition, Menopause, Europe, B vitamins, Oncology, Premenopause, Receptors, Estrogen, Vitamin B Complex, Female, business, Follow-Up Studies
Abstract

There is limited evidence on the association between dietary folate intake and the risk of breast cancer (BC) by hormone receptor expression in the tumors. We investigated the relationship between dietary folate and BC risk using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). A total of 367993 women age 35 to 70 years were recruited in 10 European countries. During a median follow-up of 11.5 years, 11575 women with BC were identified. Dietary folate intake was estimated from country-specific dietary questionnaires. Cox proportional hazards regression models were used to quantify the association between dietary variables and BC risk. BC tumors were classified by receptor status. Subgroup analyses were performed by menopausal status and alcohol intake. Intake of other B vitamins was considered. All statistical tests were two-sided. A borderline inverse association was observed between dietary folate and BC risk (hazard ratio comparing top vs bottom quintile [HRQ5-Q1] = 0.92, 95% CI = 0.83 to 1.01, P (trend) = .037). In premenopausal women, we observed a statistically significant trend towards lower risk in estrogen receptor-negative BC (HRQ5-Q1 = 0.66, 95% CI = 0.45 to 0.96, P (trend) = .042) and progesterone receptor-negative BC (HRQ5-Q1 = 0.70, 95% CI = 0.51 to 0.97, P (trend) = .021). No associations were found in postmenopausal women. A 14% reduction in BC risk was observed when comparing the highest with the lowest dietary folate tertiles in women having a high (> 12 alcoholic drinks/week) alcohol intake (HRT3-T1 = 0.86, 95% CI = 0.75 to 0.98, P (interaction) = .035). Higher dietary folate intake may be associated with a lower risk of sex hormone receptor-negative BC in premenopausal women.

Published
2015

12. The association of education with body mass index and waist circumference in the EPIC-PANACEA study

Author

Amalia Mattiello, Marianne Uhre Jakobsen, Noémie Travier, Dora Romaguera, Rosario Tumino, Jakob Linseisen, Kim Overvad, Giovanna Masala, Rudolf Kaaks, Aurelio Barricarte, Petra H.M. Peeters, Sabina Rinaldi, Silke Hermann, Petra G. Van Boeckel, Jytte Halkjær, Miren Dorronsoro, Bethany Van Guelpen, Esther Molina, Ingegerd Johansson, Francesca L. Crowe, Anne M. May, Paolo Vineis, Anton E. Kunst, Nadia Slimani, Claudia Agnoli, Signe Borgquist, Philippos Orfanos, H. Bas Bueno-de-Mesquita, Traci Mouw, Antonia Trichopoulou, Françoise Clavel-Chapelon, Elio Riboli, Teresa Norat, Manuela M. Bergmann, Kay-Tee Khaw, Tonje Braaten, Androniki Naska, Laudina Rodríguez, Sabine Rohrmann, Hervé Besson, Guy Fagherazzi, Annika Steffen, Anne Tjønneland, María José Tormo, Jonas Manjer, Nicholas J. Wareham, Division of Cancer Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Social and Preventive Medicine Institute, Universität Zürich [Zürich] = University of Zurich (UZH), Institute of Epidemiology, Helmholtz Centre Munich, Julius Centre for Health Sciences and Primary Care, University Medical Center [Utrecht], National Institute for Public Health and the Environment [Bilthoven] (RIVM), Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA), Medical Research Council, Institute of Metabolic Science-Epidemiology Unit, Department of Epidemiology & Public Health, Imperial College London, Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology-Environment and Cancer, Epidemiology Service, Murcia Health Council, Preventive Medicine and Public Health Unit, Murcia Medical School, CIBER Epidemiología y Salud Pública (CIBERESP), CIBER de Epidemiología y Salud Pública (CIBERESP), Andalusian School of Public Health [Granada], Public Health Department of Gipuzkoa, Public Health Institute of Navarra, Public Health and Participation Directorate, Health and Health Care Services Council, Cancer Epidemiology Unit, University of Oxford, Department of Public Health and Primary Care, University of Cambridge [UK] (CAM), Department of Cardiology, Aarhus University Hospital, Department of Clinical Epidemiology, Danish Cancer Society, Institute of Cancer Epidemiology, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Clinical and Experimental Medicine, University of Naples Federico II = Università degli studi di Napoli Federico II, Cancer Registry and Histopathology Unit, Department of Oncology-Civile - M.P.Arezzo Hospital, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), ISI Foundation Institute for Scientific Interchange, Environmental Epidemiology, Department of Hygiene and Epidemiology, University of Athens Medical School [Athens], Hellenic Health Foundation, Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke (DifE), Leibniz Association, Department of Medical Biosciences and Pathology, Umeå University, Department of Odontology, Department of Oncology, Lund University Hospital, Department of Surgery, Malmö University Hospital, Institute of Community Medicine, University of Tromsø (UiT), 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), 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), The work was further financially supported by the European Commission: Public Health and Consumer Protection Directorate 1993-2004, Research Directorate-General 2005-.', Ligue contre le Cancer, Societé 3M, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center, Federal Ministry of Education and Research (Germany), Danish Cancer Society (Denmark), Health Research Fund (FIS) of the Spanish Ministry of Health, The participating regional governments and institutions (Spain), Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, the Wellcome Trust (United Kingdom), Greek Ministry of Health and Social Solidarity, Hellenic Health Foundation and Stavros Niarchos Foundation (Greece), Italian Association for Research on Cancer, National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports, Dutch Ministry of Health, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) (the Netherlands), Swedish Cancer Society, Swedish Scientific Council, Regional Government of Skane (Sweden), Norwegian Cancer Society (Norway)., BMC, Ed., University of Zurich, Rohrmann, S, University of Oxford [Oxford], Università degli studi di Napoli Federico II, [Hermann,S, Rohrmann,S, Linseisen,J, Kaaks,R] German Canc Res Ctr, Div Canc Epidemiol, D-6900 Heidelberg, Germany. [Linseisen,J] Helmholtz Ctr Munich, Inst Epidemiol, Neuherberg, Germany. [May,AM., Besson,H, Peeters,PH.M.] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. [May,AM., van Boeckel,PG.A., Bueno-de-Mesquita,H.B] Natl Inst Publ Hlth & Environm RIVM, Bilthoven, Netherlands. [Kunst,A] Univ Amsterdam, Acad Med Ctr, Amsterdam, Netherlands. [Besson,H, Wareham,NJ.] MRC, Inst Metab Sci, Epidemiol Unit, Cambridge, England. [Romaguera,D, Mouw,T, Norat,T, Riboli,E] Univ London Imperial Coll Sci Technol & Med, Dept Epidemiol & Publ Hlth, London, England. [Travier,N] IDIBELL, Catalan Inst Oncol, Unit Nutr Environm & Canc, Barcelona, Spain. [Tormo,MJ] Murcia Hlth Council, Epidemiol Serv, Murcia, Spain. [Tormo,MJ] Murcia Med Sch, Prevent Med & Publ Hlth Unit, Murcia, Spain. [Molina,E] Andalusian Sch Publ Hlth, Granada, Spain. [Dorronsoro,M] Publ Hlth Dept Gipuzkoa, San Sebastian, Spain. [Barricarte,A] Publ Hlth Inst Navarra, Pamplona, Spain. [Rodriguez,L] Hlth & Hlth Care Serv Council, Publ Hlth & Participat Directorate, Asturias, Spain. [Crowe,FL.] Univ Oxford, Canc Epidemiol Unit, Oxford, England. [Khaw,K-T] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England. [Overvad,K] Aarhus Univ Hosp, Aalborg Hosp, Dept Cardiol, Aalborg, Denmark. [Overvad,K, Jakobsen,MU] Aarhus Univ Hosp, Dept Clin Epidemiol, Aalborg, Denmark. [Tjonneland,A, Halkjaer,J] Danish Canc Soc, Inst Canc Epidemiol, Copenhagen, Denmark. [Agnoli,C] Fdn IRCCS Ist Nazl Tumori, Nutr Epidemiol Unit, Milan, Italy. [Mattiello,A] Univ Naples Federico 2, Dept Clin & Expt Med, Naples, Italy. [Tumino,R] Civile MP Arezzo Hosp, Dept Oncol, Canc Registry & Histopathol Unit, Ragusa, Italy. [Masala,G] Canc Res & Prevent Inst ISPO, Mol & Nutr Epidemiol Unit, Florence, Italy. [Vineis,P] ISI Fdn, Turin, Italy. [Naska,A, Orfanos,P, Trichopoulou,A] Univ Athens, Sch Med, Dept Hyg & Epidemiol, Athens, Greece. [Bergmann,MM., Steffen,A] German Inst Human Nutr Potsdam Rehbrucke, Nuthetal, Germany. [Van Guelpen,B] Umea Univ, Dept Med Biosci, Umea, Sweden. [Johansson,I] Umea Univ, Dept Odontol, Umea, Sweden. [Borgquist,S] Univ Lund Hosp, Dept Oncol, Lund, Sweden. [Manjer,J] Malmo Univ Hosp, Dept Surg, Malmo, Sweden. [Braaten,T] Univ Tromso, Inst Community Med, Tromso, Norway. [Fagherazzi,G, Clavel-Chapelon,F] Paris S Univ, Inst Gustave Roussy, Villejuif, France. [Fagherazzi,G, Clavel-Chapelon,F] INSERM, ERI20, Villejuif, France. [Besson,H, Rinaldi,S, Slimani,N] Int Agcy Res Canc, Lyon, France. [Rohrmann,S] Univ Zurich, Inst Social & Prevent Med, Zurich, Switzerland, European Commission: Grant no DG Sanco, project number: 2005328. The work was further financially supported by the European Commission: Public Health and Consumer Protection Directorate 1993-2004, Khaw, Kay-Tee [0000-0002-8802-2903], Wareham, Nicholas [0000-0003-1422-2993], Apollo - University of Cambridge Repository, Faculteit der Geneeskunde, APH - Amsterdam Public Health, and Public and occupational health

Subjects
Male, Epidemiology, Body Mass Index, VDP::Medical disciplines: 700::Health sciences: 800::Nutrition: 811, 0302 clinical medicine, Prospective Studies, Public, Environmental & Occupational Health, MESH: Middle Aged, 3. Good health, MESH: Health Status Disparities, MESH: Waist Circumference, Socioeconomic status, Waist circumference, Public Health, Waist Circumference, Cohort study, VDP::Medisinske Fag: 700::Helsefag: 800::Medisinsk/odontologisk etikk, atferdsfag, historie: 805, Waist, Pes corporal, Education, MESH: Body Mass Index, VDP::Medisinske Fag: 700::Helsefag: 800::Ernæring: 811, 03 medical and health sciences, MESH: Sex Factors, cohort study, Humans, Aged, Science & Technology, MESH: Humans, Prevention, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, MESH: Adult, Body weight, medicine.disease, Obesity, Health Care::Environment and Public Health::Public Health::Epidemiologic Measurements::Biometry::Anthropometry::Body Mass Index [Medical Subject Headings], Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Prospective Studies [Medical Subject Headings], ENERGY-INTAKE, OXFORD PARTICIPANTS, PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH, SCI, Educació, MESH: Educational Status, Body mass index, MESH: Female, Demography, Gerontology, Overweight, SOCIOECONOMIC-STATUS, 030212 general & internal medicine, 2. Zero hunger, MESH: Aged, education, Bmi, Cohort Study, Epic, Socioeconomic Status, lcsh:Public aspects of medicine, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, Circumference, CANCER, PREVALENCE, European Prospective Investigation into Cancer and Nutrition, Europe, OBESITY, Educational Status, Female, medicine.symptom, Life Sciences & Biomedicine, Research Article, Adult, VDP::Medical disciplines: 700::Health sciences: 800::Medical/dental ethics, behavioural sciences, history: 805, 030209 endocrinology & metabolism, 610 Medicine & health, socioeconomic status, BMI, Sex Factors, Eating disorders and obesity, Phenomena and Processes::Physiological Phenomena::Body Constitution::Body Weights and Measures::Body Size::Waist Circumference [Medical Subject Headings], medicine, ddc:610, Nutrition, OVERWEIGHT, business.industry, Health Care::Environment and Public Health::Public Health::Epidemiologic Measurements::Demography::Health Status::Health Status Disparities [Medical Subject Headings], Health Status Disparities, ADULTS, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), 2739 Public Health, Environmental and Occupational Health, MESH: Prospective Studies, MESH: Male, PHYSICAL-ACTIVITY, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, WEIGHT STATUS, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Europe, EPIC, business
Abstract

Background To examine the association of education with body mass index (BMI) and waist circumference (WC) in the European Prospective Investigation into Cancer and Nutrition (EPIC). Method This study included 141,230 male and 336,637 female EPIC-participants, who were recruited between 1992 and 2000. Education, which was assessed by questionnaire, was classified into four categories; BMI and WC, measured by trained personnel in most participating centers, were modeled as continuous dependent variables. Associations were estimated using multilevel mixed effects linear regression models. Results Compared with the lowest education level, BMI and WC were significantly lower for all three higher education categories, which was consistent for all countries. Women with university degree had a 2.1 kg/m2 lower BMI compared with women with lowest education level. For men, a statistically significant, but less pronounced difference was observed (1.3 kg/m2). The association between WC and education level was also of greater magnitude for women: compared with the lowest education level, average WC of women was lower by 5.2 cm for women in the highest category. For men the difference was 2.9 cm. Conclusion In this European cohort, there is an inverse association between higher BMI as well as higher WC and lower education level. Public Health Programs that aim to reduce overweight and obesity should primarily focus on the lower educated population.

Published
2011

13. Anthropometry, physical activity and hip fractures in the elderly

Author

Valeria Pala, Yvonne T. van der Schouw, Graziella Frasca, Petra H.M. Peeters, H. Bas Bueno-de-Mesquita, Ioannis S. Benetos, Jone M. Altzibar, Vassiliki Benetou, Alberto Evangelista, Heiner Boeing, Maria Concetta Giurdanella, Ulrika Pettersson, Paolo Boffetta, Bethany Van Guelpen, Sabine Rohrmann, Jakob Linseisen, Cornelia Weikert, Philippos Orfanos, Antonia Trichopoulou, Benetou, V., Orfanos, P., Benetos, I.S., Pala, V., Evangelista, A., Frasca, G., Giurdanella, M.C., Peeters, P.H.M., Van Der Schouw, Y.T., Rohrmann, S., Linseisen, J., Boeing, H., Weikert, C., Pettersson, U., Van Guelpen, B., Bueno-De-Mesquita, H.B., Altzibar, J., Boffetta, P., and Trichopoulou, A.

Subjects
Male, musculoskeletal diseases, medicine.medical_specialty, Poison control, Motor Activity, Hip fracture, Waist–hip ratio, Elderly, Bone Density, Risk Factors, Surveys and Questionnaires, Humans, Medicine, Prospective Studies, Body mass index, Aged, General Environmental Science, Anthropometry, Hip Fractures, Waist-Hip Ratio, business.industry, Physical activity, Incidence, Public health, Waist-to-hip ratio, Human factors and ergonomics, Middle Aged, medicine.disease, Diet, Europe, EPIC study, Body height, Orthopedic surgery, Physical therapy, General Earth and Planetary Sciences, Female, business
Abstract

Introduction: Hip fractures constitute a major and growing public health problem amongst the elderly worldwide. We examined the association of anthropometry and physical activity with hip fracture incidence in a cohort of elderly Europeans, participants in the European Prospective Investigation into Cancer and nutrition (EPIC) study. Materials and methods: The study population consisted of 27 982 volunteers (10 553 men and 17 429 women) aged 60 years and above from five European countries. Information on anthropometry, physical activity, medical history and other characteristics was collected at baseline. During a median follow-up of 8 years, 261 incident hip fractures (203 women and 58 men) were recorded. Data were analysed through Cox proportional hazard regression with adjustment for potential confounders. Results: A higher body mass index (BMI) was associated with lower hip fracture risk (hazard ratio (HR) per increasing sex-specific-quintile: 0.85, 95% confidence interval (95% CI): 0.77-0.94). Body height was associated with increased hip fracture risk (HR per 5 cm: 1.13, 95% CI: 1.01-1.25). Waist-to-hip ratio was not related to hip fracture risk. Increasing levels of leisure-time physical activity were related to lower risk (HR per increasing tertile: 0.84, 95% CI: 0.70-0.99, p for trend: 0.039). Conclusions: In a prospective cohort study of elderly Europeans, we found evidence that high body stature increased and high BMI decreased the incidence of hip fractures. After adjustment for BMI, waist-to-hip ratio was not associated with hip fracture risk. Leisure-time physical activity appears to play a beneficial role in the prevention of hip fractures. © 2010 Elsevier Ltd. All rights reserved.

Published
2011

14. Lifetime and baseline alcohol intake and risk of colon and rectal cancers in the European prospective investigation into cancer and nutrition (EPIC)

Author

Salvatore Panico, Marga C. Ocké, H. Bas Bueno-de-Mesquita, Carla H. van Gils, Teresa Norat, Antonio Agudo, Pilar Amiano, Göran Berglund, Mazda Jenab, Eva Ardanaz, Rudolf Kaaks, Jonas Manjer, Pietro Ferrari, Dolores C. López, Jakob Linseisen, Elio Riboli, Françoise Clavel-Chapelon, Sophie Morois, María José Sánchez, Mathieu Mazuir, Heiner Boeing, Rosario Tumino, Majken K. Jensen, Christina Kassapa, Marie-Christine Boutron-Ruault, Petra H.M. Peeters, Eiliv Lund, Paolo Vineis, Kim Overvad, Anja Olsen, Timothy J. Key, Paolo Boffetta, Giovanna Masala, Manuela M. Bergmann, Sabine Rohrmann, Vittorio Krogh, Nadia Slimani, Guri Skeie, Naomi E. Allen, Aurelie Moskal, José Ramón Quirós, Bethany Van Guelpen, Richard Palmqvist, Dimitra Kontopoulou, Anne Tjønneland, Sheila Bingham, Antonia Trichopoulou, Ferrari, P, Jenab, M, Norat, T, Moskal, A, Slimani, N, Olsen, A, Tjonneland, A, Overvad, K, Jensen, Mk, BOUTRON RUAULT, Mc, CLAVEL CHAPELON, F, Morois, S, Rohrmann, S, Linseisen, J, Boeing, H, Bergmann, M, Kontopoulou, D, Trichopoulou, A, Kassapa, C, Masala, G, Krogh, V, Vineis, P, Panico, Salvatore, Tumino, R, Gils, Ch, Peeters, P, BUENO DE MESQUITA, Hb, Ocke, Mc, Skeie, G, Lund, E, Agudo, A, Ardanaz, E, Lopez, Dc, Sanchez, Mj, Quiros, Jr, Amiano, P, Berglund, G, Manjer, J, Palmqvist, R, Guelpen, Bv, Allen, N, Key, T, Bingham, S, Mazuir, M, Boffetta, P, Kaaks, R, Riboli, E., Ferrari, P., Jenab, M., Norat, T., Moskal, A., Slimani, N., Olsen, A., Tjønneland, A., Overvad, K., Jensen, M.K., Boutron-Ruault, M.-C., Clavel-Chapelon, F., Morois, S., Rohrmann, S., Linseisen, J., Boeing, H., Bergmann, M., Kontopoulou, D., Trichopoulou, A., Kassapa, C., Masala, G., Krogh, V., Vineis, P., Panico, S., Tumino, R., Van Gils, C.H., Peeters, P., Bueno-de-Mesquita, H.B., Ocké, M.C., Skeie, G., Lund, E., Agudo, A., Ardanaz, E., López, D.C., Sanchez, M.-J., Quirós, J.R., Amiano, P., Berglund, G., Manjer, J., Palmqvist, R., Van Guelpen, B., Allen, N., Key, T., Bingham, S., Mazuir, M., Boffetta, P., and Kaaks, R.

Subjects
Oncology, Male, Cancer Research, medicine.medical_specialty, Time Factors, Alcohol intake and risk of colon and rectal cancers, Alcohol Drinking, Colorectal cancer, alcohol, lifetime exposure, colorectal cancer, prospective study, EPIC, Gastroenterology, Risk Factors, Internal medicine, Epidemiology, medicine, Humans, ddc:610, Risk factor, Prospective cohort study, Colonic disease, Sex Characteristics, business.industry, Rectal Neoplasms, Middle Aged, medicine.disease, European Prospective Investigation into Cancer and Nutrition, Europe, Nutrition Assessment, Colonic Neoplasms, Alcohol intake, Female, business
Abstract

Alcohol consumption may be associated with risk of colorectal cancer (CRC), but the epidemiological evidence for an association with specific anatomical subsites, types of alcoholic beverages and current vs. lifetime alcohol intake is inconsistent. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), 478,732 study subjects free of cancer at enrolment between 1992 and 2000 were followed up for an average of 6.2 years, during which 1,833 CRC cases were observed. Detailed information on consumption of alcoholic beverages at baseline (all cases) and during lifetime (1,447 CRC cases, 69% of the cohort) was collected from questionnaires. Cox proportional hazard models were used to examine the alcohol-CRC association. After adjustment for potential confounding factors, lifetime alcohol intake was significantly positively associated to CRC risk (hazard ratio, HR = 1.08, 95%CI = 1.04-1.12 for 15 g/day increase), with higher cancer risks observed in the rectum (HR = 1.12, 95%CI = 1.06-1.18) than distal colon (HR = 1.08, 95%CI = 1.01-1.16), and proximal colon (HR = 1.02, 95%CI = 0.92-1.12). Similar results were observed for baseline alcohol intake. When assessed by alcoholic beverages at baseline, the CRC risk for beer (HR = 1.38, 95%CI = 1.08-1.77 for 20-39.9 vs. 0.1-2.9 g/day) was higher than wine (HR = 1.21, 95%CI = 1.02-1.44), although the two risk estimates were not significantly different from each other. Higher HRs for baseline alcohol were observed for low levels of folate intake (1.13, 95%CI = 1.06-1.20 for 15 g/day increase) compared to high folate intake (1.03, 95%CI = 0.98-1.09). In this large European cohort, both lifetime and baseline alcohol consumption increase colon and rectum cancer risk, with more apparent risk increases for alcohol intakes greater than 30 g/day. © 2007 Wiley-Liss, Inc.

Published
2007

15. Body size and risk of colon and rectal cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC)

Author

J. Ramón Quirós, Christine M. Friedenreich, Göran Berglund, Sheila Bingham, H. Bas Bueno-de-Mesquita, Antonia Trichopoulou, Teresa Norat, Rudolf Kaaks, Jakob Linseisen, Carmen Martinez, Françoise Clavel-Chapelon, Kim Overvad, Carmen Navarro, Petra H. Lahmann, Jytte Halkjær, Sabina Sieri, Miren Dorronsoro, Bethany Van Guelpen, Dimitrios Trichopoulos, Elio Riboli, Anne Tjønneland, Richard Palmqvist, Nadia Slimani, Hendriek C. Boshuizen, Petra H.M. Peeters, Manuela M. Bergmann, Tobias Pischon, Kay-Tee Khaw, Domenico Palli, Naomi E. Allen, Heiner Boeing, Rosario Tumino, Aurelio Barricarte, Paolo Vineis, Nikolaus Becker, Marie-Christine Boutron-Ruault, Salvatore Panico, Gregory Guernec, Carlos A. González, Pietro Ferrari, Andrew W. Roddam, Pischon, T, Lahmann, Ph, Boeing, H, Friedenreich, C, Norat, T, Tjonneland, A, Halkjaer, J, Overvad, K, CLAVEL CHAPELON, F, BOUTRON RUAULT, Mc, Guernec, G, Bergmann, Mm, Linseisen, J, Becker, N, Trichopoulou, A, Trichopoulos, D, Sieri, S, Palli, D, Tumino, R, Vineis, P, Panico, Salvatore, Peeters, Ph, BUENO DE MESQUITA, Hb, Boshuizen, Hc, VAN GUELPEN, B, Palmqvist, R, Berglund, G, Gonzalez, Ca, Dorronsoro, M, Barricarte, A, Navarro, C, Martinez, C, Quiros, Jr, Roddam, A, Allen, N, Bingham, S, Khaw, Kt, Ferrari, P, Kaaks, R, Slimani, N, and Riboli, E.

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Colorectal cancer, Population, Abdominal Fat, Risk Assessment, Body Mass Index, Waist–hip ratio, Sex Factors, Risk Factors, medicine, Body Fat Distribution, Body Size, Humans, Obesity, Prospective Studies, ddc:610, Risk factor, Sex Distribution, education, Life Style, Aged, Proportional Hazards Models, Gynecology, education.field_of_study, Obstetrics, business.industry, Rectal Neoplasms, Waist-Hip Ratio, Estrogen Replacement Therapy, Absolute risk reduction, Cancer, Confounding Factors, Epidemiologic, Feeding Behavior, Middle Aged, medicine.disease, European Prospective Investigation into Cancer and Nutrition, Europe, Postmenopause, Oncology, Colonic Neoplasms, Multivariate Analysis, Female, business, Body mass index, Follow-Up Studies
Abstract

BACKGROUND: Body weight and body mass index (BMI) are positively related to risk of colon cancer in men, whereas weak or no associations exist in women. This discrepancy may be related to differences in fat distribution between sexes or to the use of hormone replacement therapy (HRT) in women. METHODS: We used multivariable adjusted Cox proportional hazards models to examine the association between anthropometric measures and risks of colon and rectal cancer among 368 277 men and women who were free of cancer at baseline from nine countries of the European Prospective Investigation Into Cancer and Nutrition. All statistical tests were two-sided. RESULTS: During 6.1 years of follow-up, we identified 984 and 586 patients with colon and rectal cancer, respectively. Body weight and BMI were statistically significantly associated with colon cancer risk in men (highest versus lowest quintile of BMI, relative risk [RR] = 1.55, 95% confidence interval [CI] = 1.12 to 2.15; P(trend) = .006) but not in women. In contrast, comparisons of the highest to the lowest quintile showed that several anthropometric measures, including waist circumference (men, RR = 1.39, 95% CI = 1.01 to 1.93; P(trend) = .001; women, RR = 1.48, 95% CI = 1.08 to 2.03; P(trend) = .008), waist-to-hip ratio (WHR; men, RR = 1.51, 95% CI = 1.06 to 2.15; P(trend) = .006; women, RR = 1.52, 95% CI = 1.12 to 2.05; P(trend) = .002), and height (men, RR = 1.40, 95% CI = 0.99 to 1.98; P(trend) = .04; women, RR = 1.79, 95% CI = 1.30 to 2.46; P(trend)

Published
2006

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