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1. Consumption of vegetables and fruit and the risk of bladder cancer in the European Prospective Investigation into Cancer and Nutrition

Author

Anne Tjønneland, Carlos González, Ole Raaschou-Nielsen, Marina Touillaud, Sabina Sieri, Françoise Clavel-Chapelon, Salvatore Panico, Lambertus A. Kiemeney, Jonas Manjer, Pagona Lagiou, Rudolf Kaaks, Dimitrios Trichopoulos, Nina Roswall, Andrew W. Roddam, Carla H. van Gils, Inger T. Gram, Steffen Weikert, Frederike L. Büchner, Kim Overvad, Paolo Vineis, Roy Ehrnström, Eva Ardanaz, Nadia Slimani, Martine M. Ros, H. Bas Bueno-de-Mesquita, Sheila Bingham, Traci Mouw, Eiliv Lund, Antonia Trichopoulou, Laudina Rodríguez, Göran Hallmans, Lars Egevad, Ellen Kampman, Rosario Tumino, Carmen Enid Martínez, Heiner Boeing, Kay-Tee Khaw, Marie-Christine Boutron-Ruault, Domenico Palli, Dagrun Engeset, Jenny Chang-Claude, Mazda Jenab, Dominique S. Michaud, Carmen Navarro, Naomi E. Allen, Petra H.M. Peeters, Nerea Larrañaga, Elio Riboli, Alina Vrieling, Börje Ljungberg, Paolo Boffetta, Büchner, F.L., Bueno-De-Mesquita, H.B., Ros, M.M., Kampman, E., Egevad, L., Overvad, K., Raaschou-Nielsen, O., Tjønneland, A., Roswall, N., Clavel-Chapelon, F., Boutron-Ruault, M.-C., Touillaud, M., Chang-Claude, J., Kaaks, R., Boeing, H., Weikert, S., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Palli, D., Sieri, S., Vineis, P., Tumino, R., Panico, S., Vrieling, A., Peeters, P.H.M., Van Gils, C.H., Lund, E., Gram, I.T., Engeset, D., Martinez, C., Gonzalez, C.A., Larrañaga, N., Ardanaz, E., Navarro, C., Rodríguez, L., Manjer, J., Ehrnström, R.A., Hallmans, G., Ljungberg, B., Allen, N.E., Roddam, A.W., Bingham, S., Khaw, K.-T., Slimani, N., Boffetta, P., Jenab, M., Mouw, T., Michaud, D.S., Kiemeney, L.A.L.M., Riboli, E., Büchner, Fl, Bueno de Mesquita, Hb, Ros, Mm, Kampman, E, Egevad, L, Overvad, K, Raaschou Nielsen, O, Tjønneland, A, Roswall, N, Clavel Chapelon, F, Boutron Ruault, Mc, Touillaud, M, Chang Claude, J, Kaaks, R, Boeing, H, Weikert, S, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Palli, D, Sieri, S, Vineis, P, Tumino, R, Panico, Salvatore, Vrieling, A, Peeters, Ph, van Gils, Ch, Lund, E, Gram, It, Engeset, D, Martinez, C, Gonzalez, Ca, Larrañaga, N, Ardanaz, E, Navarro, C, Rodríguez, L, Manjer, J, Ehrnström, Ra, Hallmans, G, Ljungberg, B, Allen, Ne, Roddam, Aw, Bingham, S, Khaw, Kt, Slimani, N, Boffetta, P, Jenab, M, Mouw, T, Michaud, D, and Kiemeney, La

Subjects
Male, Cancer Research, Nutrition and Disease, Aetiology, screening and detection [ONCOL 5], Cohort Studies, 0302 clinical medicine, Risk Factors, Voeding en Ziekte, Vegetables, Epidemiology, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, 2. Zero hunger, carotenoids, Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Oncology, 030220 oncology & carcinogenesis, Female, epidemiology, vitamin-c, Cohort study, Adult, medicine.medical_specialty, prospective cohort, consumption vegetables fruit risk bladder cancer European Prospective Investigation Cancer Nutrition, folate, Molecular epidemiology [NCEBP 1], 03 medical and health sciences, Translational research [ONCOL 3], Environmental health, medicine, Humans, Risk factor, Aged, VLAG, Consumption (economics), Gynecology, Bladder cancer, Hereditary cancer and cancer-related syndromes [ONCOL 1], cigarette-smoking, business.industry, food, Cancer, medicine.disease, Urinary Bladder Neoplasms, Fruit, diet, business, Follow-Up Studies
Abstract

Contains fulltext : 81056.pdf (Publisher’s version ) (Closed access) Previous epidemiologic studies found inconsistent associations between vegetables and fruit consumption and the risk of bladder cancer. We therefore investigated the association between vegetable and fruit consumption and the risk of bladder cancer among participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Data on food consumption and complete follow-up for cancer occurrence was available for a total of 478,533 participants, who were recruited in 10 European countries. Estimates of rate ratios were obtained by Cox proportional hazard models, stratified by age at recruitment, gender and study centre, and adjusted for total energy intake, smoking status, duration of smoking and lifetime intensity of smoking. A calibration study in a subsample was used to control for dietary measurement errors. After a mean follow-up of 8.7 years, 1015 participants were newly diagnosed with bladder cancer. Increments of 100 g/day in fruit and vegetable consumption combined did not affect bladder cancer risk (i.e., calibrated HR = 0.98; 95%CI: 0.95-1.01). Borderline statistically significant lower bladder cancer risks were found among never smokers with increased consumption of fruit and vegetables combined (HR = 0.94 95%CI: 0.87-1.00 with increments of 100 g/day; calibrated HR = 0.92 95%CI 0.79-1.06) and increased consumption of apples and pears (hard fruit; calibrated HR = 0.90 95%CI: 0.82-0.98 with increments of 25 g/day). For none of the associations a statistically significant interaction with smoking status was found. Our findings do not support an effect of fruit and vegetable consumption, combined or separately, on bladder cancer risk.

Published
2009

2. Fruits and vegetables consumption and the risk of histological subtypes of lung cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author

Petra H.M. Peeters, C. Navarro, Françoise Clavel-Chapelon, H. B. Bueno-De-Mesquita, Tonje Braaten, Kim Overvad, Salvatore Panico, Teresa Norat, Marina Touillaud, E. Wirfält, Eva Ardanaz, M. C. Boutron-Ruault, Rudolf Kaaks, Sabina Sieri, Inger T. Gram, Sabine Rohrmann, Martine M. Ros, Carlos Martinez, Elio Riboli, Sheila Bingham, Domenico Palli, Antonia Trichopoulou, Timothy J. Key, Jonas Manjer, Lambertus A. Kiemeney, Andrew W. Roddam, Antonio Agudo, Rosario Tumino, Louise Hansen, Torgny Rasmuson, C. H. van Gils, K-T Khaw, Paolo Vineis, Dominique S. Michaud, Heiner Boeing, Jakob Linseisen, Dimosthenis Zylis, Eiliv Lund, Nadia Slimani, Graham Byrnes, Anne Tjønneland, Ole Raaschou-Nielsen, U. Nöthlings, Hendriek C. Boshuizen, Göran Hallmans, L. Arriola, P. Bofetta, Frederike L. Büchner, Vardis Dilis, L. Rodríguez, Büchner, Fl, Bueno de Mesquita, Hb, Linseisen, J, Boshuizen, Hc, Kiemeney, La, Rosmm, Overvad, K, Hansen, L, Tjonneland, A, Raaschou Nielsen, O, Clavel Chapelon, F, Boutron Ruault, Mc, Touillaud, M, Kaaks, R, Rohrmann, S, Boeing, H, Nöthlings, U, Trichopoulou, A, Zylis, D, Dilis, V, Palli, D, Sieri, S, Vineis, P, Tumino, R, Panico, Salvatore, Peeters, Ph, van Gils, Ch, Lund, E, Gram, It, Braaten, T, Martinez, C, Agudo, A, Arriolal, Ardanaz, E, Navarro, C, Rodríguez, L, Manjer, J, Wirfält, E, Hallmans, G, Rasmusont, Key, Tj, Roddam, Aw, Bingham, S, Khaw, Kt, Slimani, N, Bofetta, P, Byrnes, G, Noratt, Michaud, D, and Riboli, E.

Subjects
Oncology, Male, Cancer Research, Pathology, Lung Neoplasms, Aetiology, screening and detection [ONCOL 5], Antioxidants, 0302 clinical medicine, Carcinoma, Non-Small-Cell Lung, Vegetables, Odds Ratio, Medicine, Non-small-cell lung carcinoma, Prospective Studies, Carcinoma, Small Cell, Prospective cohort study, Public, Environmental & Occupational Health, 2. Zero hunger, 0303 health sciences, Smoking, WOMEN, MEN, Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Large cell carcinoma, Research Design, 030220 oncology & carcinogenesis, Adenocarcinoma, Female, Small Cell Lung Carcinoma, Risk assessment, Life Sciences & Biomedicine, Adult, medicine.medical_specialty, DIET, Fruits, Molecular epidemiology [NCEBP 1], 03 medical and health sciences, Young Adult, Internal medicine, Humans, COHORT, Small cell lung carcinoma, ddc:610, Lung cancer, 030304 developmental biology, Proportional Hazards Models, Original Paper, Science & Technology, business.industry, Large cell, Odds ratio, medicine.disease, ONCOLOGY, Evaluation of complex medical interventions [NCEBP 2], Fruit, PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH, SCI, Multivariate Analysis, business
Abstract

Contains fulltext : 88547.pdf (Publisher’s version ) (Closed access) OBJECTIVE: To examine the association between fruit and vegetable consumption and risk of different histological subtypes of lung cancer among participants of the European Prospective Investigation into Cancer and Nutrition study. METHODS: Multivariable Cox proportional hazard models were used to analyze the data. A calibration study in a subsample was used to reduce dietary measurement errors. RESULTS: During a mean follow-up of 8.7 years, 1,830 incident cases of lung cancer (574 adenocarcinoma, 286 small cell, 137 large cell, 363 squamous cell, 470 other histologies) were identified. In line with our previous conclusions, we found that after calibration a 100 g/day increase in fruit and vegetables consumption was associated with a reduced lung cancer risk (HR 0.94; 95% CI 0.89-0.99). This was also seen among current smokers (HR 0.93; 95% CI 0.90-0.97). Risks of squamous cell carcinomas in current smokers were reduced for an increase of 100 g/day of fruit and vegetables combined (HR 0.85; 95% CI 0.76-0.94), while no clear effects were seen for the other histological subtypes. CONCLUSION: We observed inverse associations between the consumption of vegetables and fruits and risk of lung cancer without a clear effect on specific histological subtypes of lung cancer. In current smokers, consumption of vegetables and fruits may reduce lung cancer risk, in particular the risk of squamous cell carcinomas. 01 maart 2010

Published
2009

3. Meat consumption and prospective weight change in participants of the EPIC-PANACEA study

Author

Claudia Agnoli, Eiliv Lund, Jytte Halkjær, Paolo Vineis, Nadia Slimani, Laudina Rodríguez, Ingegerd Johansson, Anne M. May, Pilar Amiano, Bas Bueno-de-Mesquita, José María Huerta, Dagrun Engeset, Anne Tjønneland, Françoise Clavel-Chapelon, Heiner Boeing, Marie-Christine Boutron-Ruault, Dora Romaguera, Rosario Tumino, Traci Mouw, Androniki Naska, Marianne Uhre Jakobsen, Nicholas J. Wareham, Elisabeth Couto, Anne-Claire Vergnaud, Frederike L. Büchner, Teresa Norat, Kim Overvad, Philippos Orfanos, Silke Hermann, Timothy J. Key, Vanessa Cottet, Elisabet Wirfält, Salvatore Panico, Jian'an Luan, Antonia Trichopoulou, Veronica Hellstrom, Aurelio Barricarte, Antonio Agudo, Sabina Rinaldi, Jonas Manjer, Noémie Travier, Andreani D. Odysseos, Domenico Palli, Brian Buijsse, María José Sánchez, Tonje Braaten, Sabine Rohrmann, Petra H.M. Peeters, Elio Riboli, E. A. Spencer, Vergnaud, Ac, Norat, T, Romaguera, D, Mouw, T, May, Am, Travier, N, Luan, J, Wareham, N, Slimani, N, Rinaldi, S, Couto, E, Clavel Chapelon, F, Boutron Ruault, Mc, Cottet, V, Palli, D, Agnoli, C, Panico, Salvatore, Tumino, R, Vineis, P, Agudo, A, Rodriguez, L, Sanchez, Mj, Amiano, P, Barricarte, A, Huerta, Jm, Key, Tj, Spencer, Ea, Bueno de Mesquita, B, Büchner, Fl, Orfanos, P, Naska, A, Trichopoulou, A, Rohrmann, S, Hermann, S, Boeing, H, Buijsse, B, Johansson, I, Hellstrom, V, Manjer, J, Wirfält, E, Jakobsen, Mu, Overvad, K, Tjonneland, A, Halkjaer, J, Lund, E, Braaten, T, Engeset, D, Odysseos, A, Riboli, E, and Peeters, Ph

Subjects
Adult, Male, Calorie, Meat, 030309 nutrition & dietetics, Medicine (miscellaneous), 030209 endocrinology & metabolism, Overweight, Weight Gain, Diet Surveys, Molecular epidemiology [NCEBP 1], 03 medical and health sciences, 0302 clinical medicine, Reference Values, Risk Factors, Environmental health, Surveys and Questionnaires, Weight management, medicine, Humans, Food science, Obesity, Prospective Studies, Prospective cohort study, Aged, 2. Zero hunger, 0303 health sciences, Nutrition and Dietetics, business.industry, Weight change, Smoking, food and beverages, Middle Aged, medicine.disease, 3. Good health, Diet, Red meat, Female, medicine.symptom, business, Energy Intake, Weight gain, Follow-Up Studies
Abstract

Contains fulltext : 87610.pdf (Publisher’s version ) (Closed access) BACKGROUND: Meat intake may be related to weight gain because of its high energy and fat content. Some observational studies have shown that meat consumption is positively associated with weight gain, but intervention studies have shown mixed results. OBJECTIVE: Our objective was to assess the association between consumption of total meat, red meat, poultry, and processed meat and weight gain after 5 y of follow-up, on average, in the large European population who participated in the European Prospective Investigation into Cancer and Nutrition-Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating Out of Home and Obesity (EPIC-PANACEA) project. DESIGN: A total of 103,455 men and 270,348 women aged 25-70 y were recruited between 1992 and 2000 in 10 European countries. Diet was assessed at baseline with the use of country-specific validated questionnaires. A dietary calibration study was conducted in a representative subsample of the cohort. Weight and height were measured at baseline and self-reported at follow-up in most centers. Associations between energy from meat (kcal/d) and annual weight change (g/y) were assessed with the use of linear mixed models, controlled for age, sex, total energy intake, physical activity, dietary patterns, and other potential confounders. RESULTS: Total meat consumption was positively associated with weight gain in men and women, in normal-weight and overweight subjects, and in smokers and nonsmokers. With adjustment for estimated energy intake, an increase in meat intake of 250 g/d (eg, one steak at approximately 450 kcal) would lead to a 2-kg higher weight gain after 5 y (95% CI: 1.5, 2.7 kg). Positive associations were observed for red meat, poultry, and processed meat. CONCLUSION: Our results suggest that a decrease in meat consumption may improve weight management. 01 augustus 2010

Published
2010

4. Vitamins B2 and B6 and genetic polymorphisms related to one-carbon metabolism as risk factors for gastric adenocarcinoma in the European prospective investigation into cancer and nutrition

Author

Laudina Rodríguez, Steinar Hustad, Carlos A. González, Jonas Manjer, Frederike L. Büchner, Petra H.M. Peeters, Franco Berrino, Kim Overvad, Antonio Agudo, Mario Plebani, Gabriel Capellá, Göran Berglund, Paolo Vineis, Heiner Boeing, Rudolf Kaaks, Fátima Carneiro, Sheila Bingham, Cornelia Weikert, Antonia Trichopoulou, H. Bas Bueno-de-Mesquita, Carmen Enid Martínez, Stein Emil Vollset, Åse Fredriksen, Giuseppe Del Giudice, Simone J. P. M. Eussen, Roger Stenling, Rosario Tumino, Pietro Ferrari, Françoise Clavel-Chapelon, Göran Hallmans, Aurelio Barricarte, Marie-Christine Boutron-Ruault, Nadia Slimani, Sophie Morois, Eiliv Lund, Núria Sala, Elio Riboli, Klaus Meyer, Øivind Midttun, Salvatore Panico, Carmen Navarro, Mattijs E. Numans, Mazda Jenab, Per Magne Ueland, Anne Tjønneland, Larraitz Arrizola, Jakob Linseisen, Domenico Palli, University of Groningen, Eussen, Sj, Vollset, Se, Hustad, S, Midttun, Ø, Meyer, K, Fredriksen, A, Ueland, Pm, Jenab, M, Slimani, N, Ferrari, P, Agudo, A, Sala, N, Capellá, G, Del Giudice, G, Pallid, Boeing, H, Weikert, C, Bueno de Mesquita, Hb, Büchner, Fl, Carneiro, F, Berrino, F, Vineis, P, Tumino, R, Panico, Salvatore, Berglund, G, Manjer, J, Stenling, R, Hallmans, G, Martínez, C, Arrizola, L, Barricarte, A, Navarro, C, Rodriguez, L, Bingham, S, Linseisen, J, Kaaks, R, Overvad, K, Tjønneland, A, Peeters, Ph, Numans, Me, Clavel Chapelon, F, Boutron Ruault, Mc, Morois, S, Trichopoulou, A, Lund, E, Plebanim, Riboli, E, and González, Ca

Subjects
Male, Epidemiology, Atrophic gastritis, Riboflavin, Physiology, Mass Spectrometry, chemistry.chemical_compound, Risk Factors, biology, Middle Aged, FOLATE-DEFICIENCY, European Prospective Investigation into Cancer and Nutrition, Oncology, PERNICIOUS-ANEMIA, METHYLENETETRAHYDROFOLATE-REDUCTASE, Female, medicine.medical_specialty, NUTRIENT INTAKE, UPPER GASTROINTESTINAL-TRACT, Adenocarcinoma, Polymorphism, Single Nucleotide, Molecular epidemiology [NCEBP 1], Stomach Neoplasms, Internal medicine, medicine, Humans, Genetic Predisposition to Disease, Polymorphism, Pyridoxal, One-Carbon Group Transferases, ATROPHIC GASTRITIS, business.industry, Case-control study, medicine.disease, HELICOBACTER-PYLORI INFECTION, Vitamin B 6, B vitamins, STOMACH-CANCER, Endocrinology, chemistry, Case-Control Studies, Relative risk, Methylenetetrahydrofolate reductase, HOMOCYSTEINE METABOLISM, MTHFR POLYMORPHISMS, biology.protein, business, Chromatography, Liquid, Blood sampling
Abstract

Contains fulltext : 87498.pdf (Publisher’s version ) (Closed access) B vitamins and polymorphisms in genes coding for enzymes involved in one-carbon metabolism may affect DNA synthesis and methylation and thereby be implicated in carcinogenesis. Previous data on vitamins B2 and B6 and genetic polymorphisms other than those involving MTHFR as risk factors for gastric cancer (GC) are sparse and inconsistent. In this case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort, cases (n = 235) and controls (n = 601) were matched for study center, age, sex, and time of blood sampling. B2 and B6 species were measured in plasma, and the sum of riboflavin and flavin mononucleotide was used as the main exposure variable for vitamin B2 status, whereas the sum of pyridoxal 5'-phosphate, pyridoxal, and 4-pyridoxic acid was used to define vitamin B6 status. In addition, we determined eight polymorphisms related to one-carbon metabolism. Relative risks for GC risk were calculated with conditional logistic regression, adjusted for Helicobacter pylori infection status and smoking status. Adjusted relative risks per quartile (95% confidence interval, P(trend)) were 0.85 (0.72-1.01, 0.06) for vitamin B2 and 0.78 (0.65-0.93

Published
2010

5. Variety in Fruit and Vegetable Consumption and the Risk of Lung Cancer in the European Prospective Investigation into Cancer and Nutrition

Author

Sabina Sieri, Antonio Agudo, Petra H.M. Peeters, Françoise Clavel-Chapelon, Kim Overvad, H. Bas Bueno-de-Mesquita, Timothy J. Key, Elio Riboli, Louise Hansen, Lambertus A. Kiemeney, María José Sánchez, Paolo Vineis, Ute Nöthlings, Nerea Larrañaga, Dimosthenis Zylis, Domenico Palli, Wei W. Xun, Rosario Tumino, Eva Ardanaz, Torgny Rasmuson, Carla H. van Gils, Kay-Tee Khaw, Martine M. Ros, Inger T. Gram, Sabine Rohrmann, Marcial Argüelles, Elisabet Wirfält, Salvatore Panico, Tonje Braaten, Carmen Navarro, Frederike L. Büchner, Marie-Christine Boutron-Ruault, Vardis Dilis, Anne-Claire Vergnaud, Eiliv Lund, Marina Touillaud, Rudolf Kaaks, Jonas Manjer, Göran Hallmans, Nicholas J. Wareham, Heiner Boeing, Nadia Slimani, Antonia Trichopoulou, Anne Tjønneland, Christina C. Dahm, Büchner, Fl, Bueno de Mesquita, Hb, Ros, Mm, Overvad, K, Dahm, Cc, Hansen, L, Tjønneland, A, Clavel Chapelon, F, Boutron Ruault, Mc, Touillaud, M, Kaaks, R, Rohrmann, S, Boeing, H, Nöthlings, U, Trichopoulou, A, Zylis, D, Dilis, V, Palli, D, Sieri, S, Vineis, P, Tumino, R, Panico, Salvatore, Peeters, Ph, van Gils, Ch, Lund, E, Gram, It, Braaten, T, Sánchez, Mj, Agudo, A, Larrañaga, N, Ardanaz, E, Navarro, C, Argüelles, Mv, Manjer, J, Wirfält, E, Hallmans, G, Rasmuson, T, Key, Tj, Khaw, Kt, Wareham, N, Slimani, N, Vergnaud, Ac, Xun, Ww, Kiemeney, La, and Riboli, E.

Subjects
Male, medicine.medical_specialty, Lung Neoplasms, Epidemiology, Cohort Studies, Molecular epidemiology [NCEBP 1], Risk Factors, Surveys and Questionnaires, Environmental health, Vegetables, Humans, Medicine, Prospective Studies, Risk factor, Lung cancer, Prospective cohort study, Proportional Hazards Models, business.industry, Proportional hazards model, Incidence, Hazard ratio, Cancer, Middle Aged, Nutrition Surveys, medicine.disease, Diet, Surgery, European Prospective Investigation into Cancer and Nutrition, Europe, Oncology, Quartile, Fruit, Carcinoma, Squamous Cell, Female, business
Abstract

Background: We investigated whether a varied consumption of vegetables and fruits is associated with lower lung cancer risk in the European Prospective Investigation into Cancer and Nutrition study. Methods: After a mean follow-up of 8.7 years, 1,613 of 452,187 participants with complete information were diagnosed with lung cancer. Diet diversity scores (DDS) were used to quantify the variety in fruit and vegetable consumption. Multivariable proportional hazards models were used to assess the associations between DDS and lung cancer risk. All models were adjusted for smoking behavior and the total consumption of fruit and vegetables. Results: With increasing variety in vegetable subgroups, risk of lung cancer decreases [hazard ratios (HR), 0.77; 95% confidence interval (CI), 0.64-0.94 highest versus lowest quartile; P trend = 0.02]. This inverse association is restricted to current smokers (HR, 0.73; 95% CI, 0.57-0.93 highest versus lowest quartile; P trend = 0.03). In continuous analyses, in current smokers, lower risks were observed for squamous cell carcinomas with more variety in fruit and vegetable products combined (HR/two products, 0.88; 95% CI, 0.82-0.95), vegetable subgroups (HR/subgroup, 0.88; 95% CI, 0.79-0.97), vegetable products (HR/two products, 0.87; 95% CI, 0.79-0.96), and fruit products (HR/two products, 0.84; 95% CI, 0.72-0.97). Conclusion: Variety in vegetable consumption was inversely associated with lung cancer risk among current smokers. Risk of squamous cell carcinomas was reduced with increasing variety in fruit and/or vegetable consumption, which was mainly driven by the effect in current smokers. Impact: Independent from quantity of consumption, variety in fruit and vegetable consumption may decrease lung cancer risk. Cancer Epidemiol Biomarkers Prev; 19(9); 2278–86. ©2010 AACR.

Published
2010

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

Author

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

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

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

Published
2010

7. The Role of Smoking and Diet in Explaining Educational Inequalities in Lung Cancer Incidence

Author

Elisabet Wirfält, Salvatore Panico, Jonas Manjer, Jakob Linseisen, Kay-Tee Khaw, Sheila Bingham, Rosario Tumino, María José Tormo, Petra H.M. Peeters, H. Bas Bueno-de-Mesquita, Naomi E. Allen, Anne Tjønneland, Torgny Rasmuson, Antonia Trichopoulou, Gwenn Menvielle, Pietro Ferrari, Nadia Slimani, Paolo Boffetta, Valentina Gallo, Ole Raaschou-Nielsen, Domenico Palli, Timothy J. Key, Elio Riboli, Hendriek Boshuizen, Antonio Agudo, Anton E. Kunst, Susanne Oksbjerg Dalton, Eric J. Duell, Paolo Vineis, Tonje Braaten, Silke Hermann, Maria Kosti, Carla H. van Gils, Vardis Dilis, Göran Hallmans, Eva Ardanaz, Manuela M. Bergmann, María José Sánchez, Inger T. Gram, Vittorio Krogh, Eiliv Lund, Laudina Rodríguez, Frederike L. Büchner, Rudolf Kaaks, Kaniewski, Nadine, Department of Public Health, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), National Institute for Public Health and the Environment [Bilthoven] (RIVM), Institute of Cancer Epidemiology, Danish Cancer Society, University of Torino and CPO-Piemonte, Università degli studi di Torino = University of Turin (UNITO), Department of Epidemiology, German Institute of Human Nutrition, Division of Cancer Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Unit of Nutrition, Environment, and Cancer, Catalan Institute of Oncology, Molecular and Nutritional Epidemiology Unit, CSPO-Scientific Institute of Tuscany, Department of Preventive & Predictive Medicine, Italian National Center Institute, Department of Clinical and Experimental Medicine, Frederico II University, Cancer Registry Azienda, Civile - M.P.Arezzo Hospital, Julius Center for Health Sciences and Primary Care, VU University Medical Center [Amsterdam], Institute of Community Medicine, University of Tromsø (UiT), Public Health Directorate, Unit of Nutrition, Environment and Cancer, Andalusian School of Public Health [Granada], CIBER Epidemiologia y Salud Publica, CIBER de Epidemiología y Salud Pública (CIBERESP), Murcia Health Council, Public Health Institute of Navarra, Department of surgery, Lund University [Lund]-Malmö University Hospital, Department of Clinical Sciences, Nutrition Epidemiology, Lund University [Lund], Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Department of Radiation Sciences, Oncology, MRC Centrer for Nutritional Epidemiology and Cancer Prevention and Survival, University of Cambridge [UK] (CAM), Cancer Epidemiology Unit, University of Oxford, Departement of Epidemiolgy and Public Health, Imperial College London, Menvielle, G, Boshuizen, H, Kunst, Ae, Dalton, So, Vineis, P, Bergmann, Mm, Hermann, S, Ferrari, P, Raaschou Nielsen, O, Tjønneland, A, Kaaks, R, Linseisen, J, Kosti, M, Trichopoulou, A, Dilis, V, Palli, D, Krogh, V, Panico, Salvatore, Tumino, R, Büchner, Fl, van Gils, Ch, Peeters, Ph, Braaten, T, Gram, It, Lund, E, Rodriguez, L, Agudo, A, Sánchez, Mj, Tormo, Mj, Ardanaz, E, Manjer, J, Wirfält, E, Hallmans, G, Rasmuson, T, Bingham, S, Khaw, Kt, Allen, N, Key, T, Boffetta, P, Duell, Ej, Slimani, N, Gallo, V, Riboli, E, Bueno de Mesquita, Hb, Public and occupational health, Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Università degli studi di Torino (UNITO), University of Oxford [Oxford], Malmö University Hospital-Lund University [Lund], Public Health, Cell biology, Menvielle, G., Boshuizen, H., Kunst, A.E., Dalton, S.O., Vineis, P., Bergmann, M.M., Hermann, S., Ferrari, P., Raaschou-Nielsen, O., Tjønneland, A., Kaaks, R., Linseisen, J., Kosti, M., Trichopoulou, A., Dilis, V., Palli, D., Krogh, V., Panico, S., Tumino, R., Büchner, F.L., Van Gils, C.H., Peeters, P.H.M., Braaten, T., Gram, I.T., Lund, E., Rodriguez, L., Agudo, A., Sánchez, M.-J., Tormo, M.-J., Ardanaz, E., Manjer, J., Wirfält, E., Hallmans, G., Rasmuson, T., Bingham, S., Khaw, K.-T., Allen, N., Key, T., Boffetta, P., Duell, E.J., Slimani, N., Gallo, V., Riboli, E., and Bueno-De-Mesquita, H.B.

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

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

Published
2009

8. Adherence to the Mediterranean diet is associated with lower abdominal adiposity in European men and women

Author

Anne M. May, Petra H.M. Peeters, Hervé Besson, Aurelio Barricarte, Vanessa Cottet, Ingegerd Johansson, Françoise Clavel-Chapelon, Kim Overvad, Heiner Boeing, Marianne Uhre Jacobsen, Eiliv Lund, Nadia Slimani, Elisabeth Couto, Dragun Engeset, Paolo Vineis, Pilar Amiano, Claudia Agnoli, Jian'an Luan, Rudolf Kaaks, Christina Bamia, Domenico Palli, Frederike L. Büchner, Jytte Halkjær, Laudina Rodríguez, Nicholas J. Wareham, Anne Tjønneland, Elio Riboli, Toni Braaten, María José Sánchez, E. A. Spencer, Jonas Manjer, Sabine Rohrmann, Veronica Hellstrom, Antonio Agudo, José María Huerta, H. Bas Bueno-de-Mesquita, Traci Mouw, Teresa Norat, Timothy J. Key, Manuela M. Bergmann, Sabina Rinaldi, Noémie Travier, Andreani D. Odysseos, Elisabet Wirfält, Salvatore Panico, Philippos Orfanos, Marie-Christine Boutron-Ruault, Antonia Trichopoulou, Dora Romaguera, Rosario Tumino, Androniki Naska, Romaguera, D, Norat, T, Mouw, T, May, Am, Bamia, C, Slimani, N, Travier, N, Besson, H, Luan, J, Wareham, N, Rinaldi, S, Couto, E, Clavel Chapelon, F, Boutron Ruault, Mc, Cottet, V, Palli, D, Agnoli, C, Panico, Salvatore, Tumino, R, Vineis, P, Agudo, A, Rodriguez, L, Sanchez, Mj, Amiano, P, Barricarte, A, Huerta, Jm, Key, Tj, Spencer, Ea, Bueno de Mesquita, Hb, Büchner, Fl, Orfanos, P, Naska, A, Trichopoulou, A, Rohrmann, S, Kaaks, R, Bergmann, M, Boeing, H, Johansson, I, Hellstrom, V, Manjer, J, Wirfält, E, Uhre Jacobsen, M, Overvad, K, Tjonneland, A, Halkjaer, J, Lund, E, Braaten, T, Engeset, D, Odysseos, A, Riboli, E, and Peeters, P. H.

Subjects
Adult, Male, Waist, Mediterranean diet, 030309 nutrition & dietetics, Cross-sectional study, Abdominal Fat, Medicine (miscellaneous), 030209 endocrinology & metabolism, Aetiology, screening and detection [ONCOL 5], Diet, Mediterranean, Body Mass Index, Cohort Studies, Molecular epidemiology [NCEBP 1], 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Obesity, Prospective Studies, Food science, Prospective cohort study, Adiposity, Aged, 2. Zero hunger, 0303 health sciences, Nutrition and Dietetics, Geography, Confounding, Middle Aged, medicine.disease, Diet, Europe, Cross-Sectional Studies, Linear Models, Female, Waist Circumference, Body mass index, Demography, Cohort study
Abstract

Contains fulltext : 79873.pdf (Publisher’s version ) (Closed access) Given the lack of consistent evidence of the relationship between Mediterranean dietary patterns and body fat, we assessed the cross-sectional association between adherence to a modified Mediterranean diet, BMI, and waist circumference (WC). A total of 497,308 individuals (70.7% women) aged 25-70 y from 10 European countries participated in this study. Diet was assessed at baseline using detailed validated country-specific questionnaires, and anthropometrical measurements were collected using standardized procedures. The association between the degree of adherence to the modified-Mediterranean Diet Score (mMDS) (including high consumption of vegetables, legumes, fruits and nuts, cereals, fish and seafood, and unsaturated:saturated fatty acids ratio; moderate alcohol intake; and low consumption of meat and meat products and dairy products) and BMI (kg.m(-2)) or WC (cm) was modeled through mixed-effects linear regression, controlling for potential confounders. Overall, the mMDS was not significantly associated with BMI. Higher adherence to the Mediterranean diet was significantly associated with lower WC, for a given BMI, in both men (-0.09; 95% CI -0.14 to -0.04) and women (-0.06; 95% CI -0.10 to -0.01). The association was stronger in men (-0.20; 95% CI -0.23 to -0.17) and women (-0.17; 95% CI -0.21 to -0.13) from Northern European countries. Despite the observed heterogeneity among regions, results of this study suggest that adherence to a modified Mediterranean diet, high in foods of vegetable origin and unsaturated fatty acids, is associated with lower abdominal adiposity measured by WC in European men and women.

Published
2009

9. The association of gastric cancer risk with plasma folate, cobalamin, and methylenetetrahydrofolate reductase polymorphisms in the European Prospective Investigation into Cancer and Nutrition

Author

Kim Overvad, Jonas Manjer, Domenico Palli, José Ramón Quirós, Françoise Clavel-Chapelon, Simone J. P. M. Eussen, Marie-Christine Boutron-Ruault, Rudolf Kaaks, Carmen Navarro, Aurelio Barricarte, Per Magne Ueland, Åse Fredriksen, Klaus Meyer, Guillem Pera, Anne Tjønneland, Valeria Pala, Eiliv Lund, Pietro Ferrari, Rosario Tumino, Carmen Martinez, Timothy J. Key, Frederike L. Büchner, Paolo Vineis, Jakob Linseisen, Carlos A. González, Salvatore Panico, Elio Riboli, Cornelia Weikert, Göran Hallmans, Göran Berglund, Mattijs E. Numans, Mazda Jenab, Fátima Carneiro, Stein Emil Vollset, Giuseppe Del Giudice, Roger Stenling, Antonio Agudo, Jannicke Igland, Naomi E. Allen, Sheila Bingham, Antonia Trichopoulou, H. Bas Bueno-de-Mesquita, Håkon K. Gjessing, Núria Sala, Petra H.M. Peeters, Gabriel Capellá, Heiner Boeing, Miren Dorronsoro, Nadia Slimani, University of Groningen, Vollset, Se, Igland, J, Jenab, M, Fredriksen, A, Meyer, K, Eussen, S, Gjessing, Hk, Ueland, Pm, Pera, G, Sala, N, Agudo, A, Capella, G, Del Giudice, G, Palli, D, Boeing, H, Weikert, C, Bueno de Mesquita, Hb, Carneiro, F, Pala, V, Vineis, P, Tumino, R, Panico, Salvatore, Berglund, G, Manjer, J, Stenling, R, Hallmans, G, Martínez, C, Dorronsoro, M, Barricarte, A, Navarro, C, Quirós, Jr, Allen, N, Key, Tj, Bingham, S, Linseisen, J, Kaaks, R, Overvad, K, Tjønneland, A, Büchner, Fl, Peeters, Ph, Numans, Me, Clavel Chapelon, F, Boutron Ruault, Mc, Trichopoulou, A, Lund, E, Slimani, N, Ferrari, P, Riboli, E, and González, C. A.

Subjects
Male, Epidemiology, Atrophic gastritis, C677T POLYMORPHISM, EPIC-EURGAST, Gastroenterology, Cohort Studies, chemistry.chemical_compound, Risk Factors, Prospective Studies, GENETIC POLYMORPHISMS, Prospective cohort study, Stomach cancer, Homocysteine, biology, Middle Aged, European Prospective Investigation into Cancer and Nutrition, Europe, Vitamin B 12, MICROBIOLOGICAL ASSAY, Oncology, MENDELIAN RANDOMIZATION, Female, Adult, Gastritis, Atrophic, medicine.medical_specialty, Polymorphism, Single Nucleotide, Cobalamin, Folic Acid, Stomach Neoplasms, Interventional oncology [UMCN 1.5], Internal medicine, 10-METHYLENETETRAHYDROFOLATE REDUCTASE, medicine, Humans, Methylenetetrahydrofolate Reductase (NADPH2), Aged, CHINESE POPULATION, business.industry, Cancer, medicine.disease, HELICOBACTER-PYLORI INFECTION, digestive system diseases, Surgery, 5,10-METHYLENETETRAHYDROFOLATE REDUCTASE, STOMACH-CANCER, chemistry, Case-Control Studies, Methylenetetrahydrofolate reductase, biology.protein, MTHFR POLYMORPHISMS, business, Methylmalonic Acid, Blood sampling
Abstract

Previous studies have shown inconsistent associations of folate intake and polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene with gastric cancer risk. Our nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort is the first prospective study of blood folate levels and gastric cancer. Gastric cancer cases (n = 247) and controls (n = 631) were matched for study center, age, sex, and time of blood donation. Two common single nucleotide polymorphisms of the MTHFR gene were determined, as were plasma concentrations of folate, cobalamin (vitamin B12), total homocysteine, and methylmalonic acid (cobalamin deficiency marker) in prediagnostic plasma. Risk measures were calculated with conditional logistic regression. Although no relations were observed between plasma folate or total homocysteine concentrations and gastric cancer, we observed a trend toward lower risk of gastric cancer with increasing cobalamin concentrations (odds ratio, 0.79 per SD increase in cobalamin; P = 0.01). Further analyses showed that the inverse association between cobalamin and gastric cancer was confined to cancer cases with low pepsinogen A levels (marker of severe chronic atrophic gastritis) at the time of blood sampling. The 677 C→T MTHFR polymorphism was not associated with gastric cancer, but we observed an increased risk with the variant genotype of the 1298 A→C polymorphism (odds ratio, 1.47 for CC versus AA; P = 0.04). In conclusion, we found no evidence of a role of folate in gastric cancer etiology. However, we observed increased gastric cancer risk at low cobalamin levels that was most likely due to compromised cobalamin status in atrophic gastritis preceding gastric cancer. (Cancer Epidemiol Biomarkers Prev 2007;16(11):2416–24)

Published
2007

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