101 results on '"Dorronsoro, Miren"'
Search Results
2. Association between plasma phospholipid saturated fatty acids and metabolic markers of lipid, hepatic, inflammation and glycaemic pathways in eight European countries: a cross-sectional analysis in the EPIC-InterAct study.
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Ju-Sheng Zheng, Sharp, Stephen J., Fumiaki Imamura, Koulman, Albert, Schulze, Matthias B., Zheng Ye, Griffin, Jules, Guevara, Marcela, Huerta, José María, Kröger, Janine, Sluijs, Ivonne, Agudo, Antonio, Barricarte, Aurelio, Boeing, Heiner, Colorado-Yohar, Sandra, Dow, Courtney, Dorronsoro, Miren, Dinesen, Pia T., Fagherazzi, Guy, and Franks, Paul W.
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PHOSPHOLIPIDS ,SATURATED fatty acids ,INFLAMMATION ,BODY mass index ,LIPIDS ,BLOOD sugar ,COMPARATIVE studies ,FATTY acids ,FAT content of food ,HIGH density lipoproteins ,LONGITUDINAL method ,LOW density lipoproteins ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,RESEARCH funding ,TRIGLYCERIDES ,EVALUATION research ,CROSS-sectional method - Abstract
Background: Accumulating evidence suggests that individual circulating saturated fatty acids (SFAs) are heterogeneous in their associations with cardio-metabolic diseases, but evidence about associations of SFAs with metabolic markers of different pathogenic pathways is limited. We aimed to examine the associations between plasma phospholipid SFAs and the metabolic markers of lipid, hepatic, glycaemic and inflammation pathways.Methods: We measured nine individual plasma phospholipid SFAs and derived three SFA groups (odd-chain: C15:0 + C17:0, even-chain: C14:0 + C16:0 + C18:0, and very-long-chain: C20:0 + C22:0 + C23:0 + C24:0) in individuals from the subcohort of the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study across eight European countries. Using linear regression in 15,919 subcohort members, adjusted for potential confounders and corrected for multiple testing, we examined cross-sectional associations of SFAs with 13 metabolic markers. Multiplicative interactions of the three SFA groups with pre-specified factors, including body mass index (BMI) and alcohol consumption, were tested.Results: Higher levels of odd-chain SFA group were associated with lower levels of major lipids (total cholesterol (TC), triglycerides, apolipoprotein A-1 (ApoA1), apolipoprotein B (ApoB)) and hepatic markers (alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT)). Higher even-chain SFA group levels were associated with higher levels of low-density lipoprotein cholesterol (LDL-C), TC/high-density lipoprotein cholesterol (HDL-C) ratio, triglycerides, ApoB, ApoB/A1 ratio, ALT, AST, GGT and CRP, and lower levels of HDL-C and ApoA1. Very-long-chain SFA group levels showed inverse associations with triglycerides, ApoA1 and GGT, and positive associations with TC, LDL-C, TC/HDL-C, ApoB and ApoB/A1. Associations were generally stronger at higher levels of BMI or alcohol consumption.Conclusions: Subtypes of SFAs are associated in a differential way with metabolic markers of lipid metabolism, liver function and chronic inflammation, suggesting that odd-chain SFAs are associated with lower metabolic risk and even-chain SFAs with adverse metabolic risk, whereas mixed findings were obtained for very-long-chain SFAs. The clinical and biochemical implications of these findings may vary by adiposity and alcohol intake. [ABSTRACT FROM AUTHOR]- Published
- 2017
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3. Influence of Dopaminergic System Genetic Variation and Lifestyle Factors on Excessive Alcohol Consumption.
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Celorrio, David, Muñoz, Xavier, Amiano, Pilar, Dorronsoro, Miren, Bujanda, Luis, Sánchez, María-José, Molina-Montes, Esther, Navarro, Carmen, Chirlaque, M. Dolores, Huerta, José María, Ardanaz, Eva, Barricarte, Aurelio, Rodriguez, Laudina, Duell, Eric J., Hijona, Elizabeth, Herreros-Villanueva, Marta, Sala, Núria, Alfonso-Sánchez, Miguel A., and de Pancorbo, Marian M.
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ALCOHOLISM ,ALCOHOLS (Chemical class) ,CANNABIS (Genus) ,GENES ,GENETIC polymorphisms ,GENETICS ,LONGITUDINAL method ,EDUCATIONAL attainment ,LIFESTYLES - Abstract
Aims: To examine the role of genetic and environmental factors in the pathogenesis of alcohol dependence in a Spanish cohort of women and men. Methods: We analyzed the relationship between 56 genetic variants in 7 genes associated with the dopaminergic reward pathway and excessive alcohol consumption. The study sample (N= 1533, of which 746 were women) consisted of 653 heavy consumers and 880 very low consumers from the Spanish subcohort of the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Single nucleotide polymorphisms (SNPs) were genotyped using a customized array. Lifestyle variables were also examined to assess associations between genetic and environmental factors. Results: No statistically significant differences were found between cases and controls for the allele frequencies in five genes: TH, SLC18A2, DRD1, DRD3 and COMT. Conversely, some alleles of the 12 SNPs from the DRD2 locus and the 5 from the MAOA locus showed significant associations with excessive alcohol consumption. Namely, rs10891556 (DRD2) proved to be the only SNP positively correlated with excessive alcohol consumption in both sexes. DRD2 rs1800497 and rs877138 were significantly associated in men, whereas DRD2 rs17601612 and rs4936271 and MAOA rs5906898 were associated with excessive alcohol consumption in women. A correspondence analysis provided an overall lifestyle profile of excessive drinkers, who were predominantly men who smoked, had large intakes of meat, small intakes of fruit and vegetables, whose jobs did not require high education levels and who engaged in little physical activity. Conclusions: It has shown the influence of dopaminergic pathway in the genetics of alcohol dependence with differences between men and women and providing a lifestyle profile of excessive drinkers. [ABSTRACT FROM AUTHOR]
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- 2016
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4. A Nested Case-Control Study of Metabolically Defined Body Size Phenotypes and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC).
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Murphy, Neil, Cross, Amanda J., Abubakar, Mustapha, Jenab, Mazda, Aleksandrova, Krasimira, Boutron-Ruault, Marie-Christine, Dossus, Laure, Racine, Antoine, Kühn, Tilman, Katzke, Verena A., Tjønneland, Anne, Petersen, Kristina E. N., Overvad, Kim, Quirós, J. Ramón, Jakszyn, Paula, Molina-Montes, Esther, Dorronsoro, Miren, Huerta, José-María, Barricarte, Aurelio, and Khaw, Kay-Tee
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COLON cancer ,OBESITY ,HYPERINSULINISM ,OVERWEIGHT persons ,CARDIOVASCULAR diseases ,ADIPOSE tissues ,BODY size ,HUMAN body composition ,C-peptide ,CHI-squared test ,COLON tumors ,COMPARATIVE studies ,HEALTH status indicators ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,MULTIVARIATE analysis ,PROBABILITY theory ,RECTUM tumors ,RESEARCH ,RESEARCH funding ,RISK assessment ,PHENOTYPES ,LOGISTIC regression analysis ,EVALUATION research ,BODY mass index ,DISEASE incidence ,CASE-control method ,WAIST circumference ,ODDS ratio ,DIAGNOSIS - Abstract
Background: Obesity is positively associated with colorectal cancer. Recently, body size subtypes categorised by the prevalence of hyperinsulinaemia have been defined, and metabolically healthy overweight/obese individuals (without hyperinsulinaemia) have been suggested to be at lower risk of cardiovascular disease than their metabolically unhealthy (hyperinsulinaemic) overweight/obese counterparts. Whether similarly variable relationships exist for metabolically defined body size phenotypes and colorectal cancer risk is unknown.Methods and Findings: The association of metabolically defined body size phenotypes with colorectal cancer was investigated in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolic health/body size phenotypes were defined according to hyperinsulinaemia status using serum concentrations of C-peptide, a marker of insulin secretion. A total of 737 incident colorectal cancer cases and 737 matched controls were divided into tertiles based on the distribution of C-peptide concentration amongst the control population, and participants were classified as metabolically healthy if below the first tertile of C-peptide and metabolically unhealthy if above the first tertile. These metabolic health definitions were then combined with body mass index (BMI) measurements to create four metabolic health/body size phenotype categories: (1) metabolically healthy/normal weight (BMI < 25 kg/m2), (2) metabolically healthy/overweight (BMI ≥ 25 kg/m2), (3) metabolically unhealthy/normal weight (BMI < 25 kg/m2), and (4) metabolically unhealthy/overweight (BMI ≥ 25 kg/m2). Additionally, in separate models, waist circumference measurements (using the International Diabetes Federation cut-points [≥80 cm for women and ≥94 cm for men]) were used (instead of BMI) to create the four metabolic health/body size phenotype categories. Statistical tests used in the analysis were all two-sided, and a p-value of <0.05 was considered statistically significant. In multivariable-adjusted conditional logistic regression models with BMI used to define adiposity, compared with metabolically healthy/normal weight individuals, we observed a higher colorectal cancer risk among metabolically unhealthy/normal weight (odds ratio [OR] = 1.59, 95% CI 1.10-2.28) and metabolically unhealthy/overweight (OR = 1.40, 95% CI 1.01-1.94) participants, but not among metabolically healthy/overweight individuals (OR = 0.96, 95% CI 0.65-1.42). Among the overweight individuals, lower colorectal cancer risk was observed for metabolically healthy/overweight individuals compared with metabolically unhealthy/overweight individuals (OR = 0.69, 95% CI 0.49-0.96). These associations were generally consistent when waist circumference was used as the measure of adiposity. To our knowledge, there is no universally accepted clinical definition for using C-peptide level as an indication of hyperinsulinaemia. Therefore, a possible limitation of our analysis was that the classification of individuals as being hyperinsulinaemic-based on their C-peptide level-was arbitrary. However, when we used quartiles or the median of C-peptide, instead of tertiles, as the cut-point of hyperinsulinaemia, a similar pattern of associations was observed.Conclusions: These results support the idea that individuals with the metabolically healthy/overweight phenotype (with normal insulin levels) are at lower colorectal cancer risk than those with hyperinsulinaemia. The combination of anthropometric measures with metabolic parameters, such as C-peptide, may be useful for defining strata of the population at greater risk of colorectal cancer. [ABSTRACT FROM AUTHOR]- Published
- 2016
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5. Circulating 25-Hydroxyvitamin D3 in Relation to Renal Cell Carcinoma Incidence and Survival in the EPIC Cohort.
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Muller, David C., Fanidi, Anouar, Midttun, Øivind, Steffen, Annika, Dossus, Laure, Boutron-Ruault, Marie-Christine, Severi, Gianluca, Kühn, Tilman, Katzke, Verena, de la Torre, Ramón Alonso, González, Carlos A., Sánchez, María-José, Dorronsoro, Miren, Santiuste, Carmen, Barricarte, Aurelio, Khaw, Kay-Tee, Wareham, Nick, Travis, Ruth C., Trichopoulou, Antonia, and Giotaki, Maria
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VITAMIN D metabolism ,CONFIDENCE intervals ,STATISTICAL correlation ,CAUSES of death ,LONGITUDINAL method ,MASS spectrometry ,PAIRED comparisons (Mathematics) ,RENAL cell carcinoma ,RESEARCH funding ,SEASONS ,SURVIVAL analysis (Biometry) ,SURVIVAL ,VITAMIN D ,LOGISTIC regression analysis ,SECONDARY analysis ,DISEASE incidence ,PROPORTIONAL hazards models ,DESCRIPTIVE statistics ,ODDS ratio ,CANCER risk factors - Abstract
Normal renal function is essential for vitamin D metabolism, but it is unclear whether circulating vitamin D is associated with risk of renal cell carcinoma (RCC). We assessed whether 25-hydroxyvitamin D3 (25(OH)D3) was associated with risk of RCC and death after RCC diagnosis in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC recruited 385,747 participants with blood samples between 1992 and 2000. The current study included 560 RCC cases, 557 individually matched controls, and 553 additional controls. Circulating 25(OH)D3 was assessed by mass spectrometry. Conditional and unconditional logistic regression models were used to calculate odds ratios and 95% confidence intervals. Death after RCC diagnosis was assessed using Cox proportional hazards models and flexible parametric survival models. A doubling of 25(OH)D3 was associated with 28% lower odds of RCC after adjustment for season of and age at blood collection, sex, and country of recruitment (odds ratio = 0.72, 95% confidence interval: 0.60, 0.86; P = 0.0004). This estimate was attenuated somewhat after additional adjustment for smoking status at baseline, circulating cotinine, body mass index (weight (kg)/height (m)2), and alcohol intake (odds ratio = 0.82, 95% confidence interval: 0.68, 0.99; P = 0.038). There was also some indication that both low and high 25(OH)D3 levels were associated with higher risk of death from any cause among RCC cases. [ABSTRACT FROM PUBLISHER]
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- 2014
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6. Risk of type 2 diabetes according to traditional and emerging anthropometric indices in Spain, a Mediterranean country with high prevalence of obesity: results from a large-scale prospective cohort study.
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Huerta, José María, Tormo, María-José, Chirlaque, María-Dolores, Gavrila, Diana, Amiano, Pilar, Arriola, Larraitz, Ardanaz, Eva, Rodríguez, Laudina, Sánchez, María-José, Mendez, Michelle, Salmerón, Diego, Barricarte, Aurelio, Burgui, Rosana, Dorronsoro, Miren, Larrañaga, Nerea, Molina-Montes, Esther, Moreno-Iribas, Conchi, Quirós, José Ramón, Toledo, Estefanía, and Travier, Noémie
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TYPE 2 diabetes prevention ,TYPE 2 diabetes risk factors ,SMOKING ,OBESITY ,MORBID obesity ,OBESITY complications ,ANTHROPOMETRY ,BODY weight ,CHI-squared test ,ENDOCRINOLOGY ,LONGITUDINAL method ,MENOPAUSE ,QUESTIONNAIRES ,STATURE ,U-statistics ,DATA analysis ,BODY mass index ,WAIST circumference ,DIAGNOSIS - Abstract
Background: Obesity is a major risk factor for type 2 diabetes mellitus (T2DM). A proper anthropometric characterisation of T2DM risk is essential for disease prevention and clinical risk assessment. Methods: Longitudinal study in 37 733 participants (63% women) of the Spanish EPIC (European Prospective Investigation into Cancer and Nutrition) cohort without prevalent diabetes. Detailed questionnaire information was collected at baseline and anthropometric data gathered following standard procedures. A total of 2513 verified incident T2DM cases occurred after 12.1 years of mean follow-up. Multivariable Cox regression was used to calculate hazard ratios of T2DM by levels of anthropometric variables. Results: Overall and central obesity were independently associated with T2DM risk. BMI showed the strongest association with T2DM in men whereas waist-related indices were stronger independent predictors in women. Waist-to-height ratio revealed the largest area under the ROC curve in men and women, with optimal cut-offs at 0.60 and 0.58, respectively. The most discriminative waist circumference (WC) cut-off values were 99.4 cm in men and 90.4 cm in women. Absolute risk of T2DM was higher in men than women for any combination of age, BMI and WC categories, and remained low in normal-waist women. The population risk of T2DM attributable to obesity was 17% in men and 31% in women. Conclusions: Diabetes risk was associated with higher overall and central obesity indices even at normal BMI and WC values. The measurement of waist circumference in the clinical setting is strongly recommended for the evaluation of future T2DM risk in women. [ABSTRACT FROM AUTHOR]
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- 2013
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7. Olive oil intake and CHD in the European Prospective Investigation into Cancer and Nutrition Spanish cohort.
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Buckland, Genevieve, Travier, Noemie, Barricarte, Aurelio, Ardanaz, Eva, Moreno-Iribas, Conchi, Sánchez, María-José, Molina-Montes, Esther, Chirlaque, María Dolores, Huerta, José María, Navarro, Carmen, Redondo, Maria Luisa, Amiano, Pilar, Dorronsoro, Miren, Larrañaga, Nerea, and Gonzalez, Carlos A.
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CHI-squared test ,CONFIDENCE intervals ,CORONARY disease ,EPIDEMIOLOGICAL research ,INTERVIEWING ,LONGITUDINAL method ,OLIVE oil ,PROBABILITY theory ,QUESTIONNAIRES ,REGRESSION analysis ,RESEARCH funding ,STATISTICS ,DISEASE incidence ,PROPORTIONAL hazards models ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Olive oil is well known for its cardioprotective properties; however, epidemiological data showing that olive oil consumption reduces incident CHD events are still limited. Therefore, we studied the association between olive oil and CHD in the European Prospective Investigation into Cancer and Nutrition (EPIC) Spanish cohort study. The analysis included 40 142 participants (38 % male), free of CHD events at baseline, recruited from five EPIC-Spain centres from 1992 to 1996 and followed up until 2004. Baseline dietary and lifestyle information was collected using interview-administered questionnaires. Cox proportional regression models were used to assess the relationship between validated incident CHD events and olive oil intake (energy-adjusted quartiles and each 10 g/d per 8368 kJ (2000 kcal) increment), while adjusting for potential confounders. During a 10·4-year follow-up, 587 (79 % male) CHD events were recorded. Olive oil intake was negatively associated with CHD risk after excluding dietary mis-reporters (hazard ratio (HR) 0·93; 95 % CI 0·87, 1·00 for each 10 g/d per 8368 kJ (2000 kcal) and HR 0·78; 95 % CI 0·59, 1·03 for upper v. lower quartile). The inverse association between olive oil intake (per 10 g/d per 8368 kJ (2000 kcal)) and CHD was more pronounced in never smokers (11 % reduced CHD risk (P = 0·048)), in never/low alcohol drinkers (25 % reduced CHD risk (P < 0·001)) and in virgin olive oil consumers (14 % reduced CHD risk (P = 0·072)). In conclusion, olive oil consumption was related to a reduced risk of incident CHD events. This emphasises the need to conserve the traditional culinary use of olive oil within the Mediterranean diet to reduce the CHD burden. [ABSTRACT FROM PUBLISHER]
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- 2012
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8. Menstrual and Reproductive Factors, Exogenous Hormone Use, and Gastric Cancer Risk in a Cohort of Women From the European Prospective Investigation Into Cancer and Nutrition.
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Duell, Eric J., Travier, Noémie, Lujan-Barroso, Leila, Boutron-Ruault, M. C., Clavel-Chapelon, F., Palli, Domenico, Krogh, Vittorio, Mattiello, Amalia, Tumino, Rosario, Sacerdote, Carlotta, Rodriguez, Laudina, Sanchez-Cantalejo, Emilio, Navarro, Carmen, Barricarte, Aurelio, Dorronsoro, Miren, Khaw, Kay-Tee, Wareham, Nicholas, Allen, Naomi E., Tsilidis, Konstantinos K., and Bueno-de-Mesquita, H. Bas
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HYPOTHESIS ,ANALYSIS of variance ,CONFIDENCE intervals ,HORMONE therapy ,LONGITUDINAL method ,MEDICAL cooperation ,MENSTRUAL cycle ,OVARIECTOMY ,RESEARCH ,STATISTICAL hypothesis testing ,STATISTICS ,STOMACH tumors ,WOMEN ,DATA analysis ,PROPORTIONAL hazards models ,CASE-control method ,REPRODUCTIVE history - Abstract
The worldwide incidence of gastric adenocarcinoma (GC) is lower in women than in men. Furthermore, cancer patients treated with estrogens have been reported to have a lower subsequent risk of GC. The authors conducted a prospective analysis of menstrual and reproductive factors, exogenous hormone use, and GC in 335,216 women from the European Prospective Investigation Into Cancer and Nutrition, a cohort study of individuals aged 35–70 years from 10 European countries. After a mean follow-up of 8.7 years (through 2004), 181 women for whom complete exposure data were available developed GC. Adjusted hazard ratios and 95% confidence intervals were estimated using Cox proportional hazards models. All statistical tests were 2-sided. Women who had ovariectomy had a 79% increased risk of GC (based on 25 cases) compared with women who did not (hazard ratio = 1.79, 95% confidence interval: 1.15, 2.78). Total cumulative years of menstrual cycling was inversely associated with GC risk (fifth vs. first quintile: hazard ratio = 0.55, 95% confidence interval: 0.31, 0.98; Ptrend = 0.06). No other reproductive factors analyzed were associated with risk of GC. The results of this analysis provide some support for the hypothesis that endogenous ovarian sex hormones lower GC incidence in women. [ABSTRACT FROM PUBLISHER]
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- 2010
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9. Dietary Intake of Polycyclic Aromatic Hydrocarbons in a Spanish Population.
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Ibáñez, Raquel, Agudo, Antonio, Berenguer, Antonio, Jakszyn, Paula, Tormo, María José, Sanchéz, María José, José R. Quiró, Pera, Guillem, Navarro, Carmen, Martinez, Carmen, Larrañaga, Nerea, Dorronsoro, Miren, Chirlaque, María Dolores, Barricarte, Aurelio, Ardanaz, Eva, Amlano, Pilar, and González, Carlos A.
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FOOD ,INGESTION ,INTERVIEWING ,POLYCYCLIC aromatic hydrocarbons ,BENZOPYRENE ,MEAT ,GRAIN - Abstract
The objective of the present study was to estimate the dietary intake of polycyclic aromatic hydrocarbons (PAHs), particularly benzo[a]pyrene (B[a]P), as well as to identify the principal dietary sources of such compounds in the Spanish adult population. The study included 40,690 subjects aged 35 to 64 years from five regions of Spain that were included in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain cohort. Usual food intake was estimated by personal interview through a computerized version of a dietary history questionnaire. The estimations of B[a]P and total PAHs were made, taking into account the country where the determinations of content of these compounds in the foods came from and the year of publication. The mean intake of B[a]P in the population was 0.14 μg/day, and the mean intake of total PAHs was 8.57 μg/day. Both for B[a]P and total PAHs, women had a significantly lower mean intake than men, and older people consumed lesser amounts than younger people. Furthermore, the intake was higher in the northern regions. There were no significant differences by smoking status. The food groups of meat and meat products, cereals, and oils and fats contribute 55.5% to the total B[a]P intake, while cereals and meat and meat products contribute 61% to the total PAH consumption. Our estimations of B[a]P intake were lower than in the United Kingdom and The Netherlands, were similar to those found in other studies from Spain and Italy, and were higher than those in the United States and Norway. [ABSTRACT FROM AUTHOR]
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- 2005
10. Smoking and the risk of gastric cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC).
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González, Carlos A., Pera, Guillem, Agudo, Antonio, Palli, Domenico, Krogh, Vittorio, Vineis, Paolo, Tumino, Rosario, Panico, Salvatore, Berglund, Göran, Simán, Henrik, Nyrén, Olof, Agren, Asa, Martinez, Carmen, Dorronsoro, Miren, Barricarte, Aurelio, Tormo, María J., Quiros, Jose R., Allen, Naomi, Bingham, Sheila, and Day, Nicholas
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SMOKING ,STOMACH cancer risk factors ,SMOKING cessation ,CIGARETTE smokers ,EDUCATIONAL attainment ,BODY mass index ,LIFESTYLES ,QUESTIONNAIRES - Abstract
Smoking has recently been recognised as causally associated with the development of gastric cancer (GC). However, evidence on the effect by sex, duration and intensity of smoking, anatomic subsite and cessation of smoking is limited. Our objective was to assess the relation between tobacco use and GC incidence in the European Prospective Investigation into Cancer and Nutrition (EPIC). We studied data from 521,468 individuals recruited from 10 European countries taking part in the EPIC study. Participants completed lifestyle questionnaires that included questions on lifetime consumption of tobacco and diet in 19911998. Participants were followed until September 2002, and during that period 305 cases of stomach cancer were identified. After exclusions, 274 were eligible for the analysis, using the Cox proportional hazard model. After adjustment for educational level, consumption of fresh fruit, vegetables and preserved meat, alcohol intake and body mass index (BMI), there was a significant association between cigarette smoking and gastric cancer risk: the hazard ratio (HR) for ever smokers was 1.45 (95% confidence interval [CI] = 1.081.94). The HR of current cigarette smoking was 1.73 (95% CI = 1.062.83) in males and 1.87 (95% CI = 1.123.12) in females. Hazard ratios increased with intensity and duration of cigarette smoked. A significant decrease of risk was observed after 10 years of quitting smoking. A preliminary analysis of 121 cases with identified anatomic site showed that current cigarette smokers had a higher HR of GC in the cardia (HR = 4.10) than in the distal part of the stomach (HR = 1.94). In this cohort, 17.6 % (95% CI = 10.529.5 %) of GC cases may be attributable to smoking. Findings from this large study support the causal relation between smoking and gastric cancer in this European population. Stomach cancer should be added to the burden of diseases caused by smoking. © 2003 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]
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- 2003
11. Plasma polyphenols associated with lower high-sensitivity C-reactive protein concentrations: a cross-sectional study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.
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Harms LM, Scalbert A, Zamora-Ros R, Rinaldi S, Jenab M, Murphy N, Achaintre D, Tjønneland A, Olsen A, Overvad K, Romana Mancini F, Mahamat-Saleh Y, Boutron-Ruault MC, Kühn T, Katzke V, Trichopoulou A, Martimianaki G, Karakatsani A, Palli D, Panico S, Sieri S, Tumino R, Sacerdote C, Bueno-de-Mesquita B, Vermeulen RCH, Weiderpass E, Nøst TH, Lasheras C, Rodríguez-Barranco M, Huerta JM, Barricarte A, Dorronsoro M, Hultdin J, Schmidt JA, Gunter M, Riboli E, and Aleksandrova K
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- Adult, Aged, Biomarkers blood, Cohort Studies, Cross-Sectional Studies, Diet, Diet Surveys, Europe, Female, Humans, Inflammation epidemiology, Male, Middle Aged, Neoplasms epidemiology, Prospective Studies, Risk Factors, C-Reactive Protein analysis, Inflammation blood, Neoplasms blood, Nutrition Assessment, Polyphenols blood
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Experimental studies have reported on the anti-inflammatory properties of polyphenols. However, results from epidemiological investigations have been inconsistent and especially studies using biomarkers for assessment of polyphenol intake have been scant. We aimed to characterise the association between plasma concentrations of thirty-five polyphenol compounds and low-grade systemic inflammation state as measured by high-sensitivity C-reactive protein (hsCRP). A cross-sectional data analysis was performed based on 315 participants in the European Prospective Investigation into Cancer and Nutrition cohort with available measurements of plasma polyphenols and hsCRP. In logistic regression analysis, the OR and 95 % CI of elevated serum hsCRP (>3 mg/l) were calculated within quartiles and per standard deviation higher level of plasma polyphenol concentrations. In a multivariable-adjusted model, the sum of plasma concentrations of all polyphenols measured (per standard deviation) was associated with 29 (95 % CI 50, 1) % lower odds of elevated hsCRP. In the class of flavonoids, daidzein was inversely associated with elevated hsCRP (OR 0·66, 95 % CI 0·46, 0·96). Among phenolic acids, statistically significant associations were observed for 3,5-dihydroxyphenylpropionic acid (OR 0·58, 95 % CI 0·39, 0·86), 3,4-dihydroxyphenylpropionic acid (OR 0·63, 95 % CI 0·46, 0·87), ferulic acid (OR 0·65, 95 % CI 0·44, 0·96) and caffeic acid (OR 0·69, 95 % CI 0·51, 0·93). The odds of elevated hsCRP were significantly reduced for hydroxytyrosol (OR 0·67, 95 % CI 0·48, 0·93). The present study showed that polyphenol biomarkers are associated with lower odds of elevated hsCRP. Whether diet rich in bioactive polyphenol compounds could be an effective strategy to prevent or modulate deleterious health effects of inflammation should be addressed by further well-powered longitudinal studies.
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- 2020
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12. Gallstones and incident colorectal cancer in a large pan-European cohort study.
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Ward HA, Murphy N, Weiderpass E, Leitzmann MF, Aglago E, Gunter MJ, Freisling H, Jenab M, Boutron-Ruault MC, Severi G, Carbonnel F, Kühn T, Kaaks R, Boeing H, Tjønneland A, Olsen A, Overvad K, Merino S, Zamora-Ros R, Rodríguez-Barranco M, Dorronsoro M, Chirlaque MD, Barricarte A, Perez-Cornago A, Trichopoulou A, Bamia C, Lagiou P, Masala G, Grioni S, Tumino R, Sacerdote C, Mattiello A, Bueno-de-Mesquita B, Vermeulen R, Van Gils C, Nyström H, Rutegård M, Aune D, Riboli E, and Cross AJ
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- Adult, Cohort Studies, Colorectal Neoplasms complications, Europe epidemiology, Female, Gallstones complications, Humans, Incidence, Male, Middle Aged, Proportional Hazards Models, Registries, Risk Factors, Colorectal Neoplasms epidemiology, Gallstones epidemiology
- Abstract
Gallstones, a common gastrointestinal condition, can lead to several digestive complications and can result in inflammation. Risk factors for gallstones include obesity, diabetes, smoking and physical inactivity, all of which are known risk factors for colorectal cancer (CRC), as is inflammation. However, it is unclear whether gallstones are a risk factor for CRC. We examined the association between history of gallstones and CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a prospective cohort of over half a million participants from ten European countries. History of gallstones was assessed at baseline using a self-reported questionnaire. The analytic cohort included 334,986 participants; a history of gallstones was reported by 3,917 men and 19,836 women, and incident CRC was diagnosed among 1,832 men and 2,178 women (mean follow-up: 13.6 years). Hazard ratios (HR) and 95% confidence intervals (CI) for the association between gallstones and CRC were estimated using Cox proportional hazards regression models, stratified by sex, study centre and age at recruitment. The models were adjusted for body mass index, diabetes, alcohol intake and physical activity. A positive, marginally significant association was detected between gallstones and CRC among women in multivariable analyses (HR = 1.14, 95%CI 0.99-1.31, p = 0.077). The relationship between gallstones and CRC among men was inverse but not significant (HR = 0.81, 95%CI 0.63-1.04, p = 0.10). Additional adjustment for details of reproductive history or waist circumference yielded minimal changes to the observed associations. Further research is required to confirm the nature of the association between gallstones and CRC by sex., (© 2018 UICC.)
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- 2019
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13. Dietary folate intake and pancreatic cancer risk: Results from the European prospective investigation into cancer and nutrition.
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Park JY, Bueno-de-Mesquita HB, Ferrari P, Weiderpass E, de Batlle J, Tjønneland A, Kyro C, Rebours V, Boutron-Ruault MC, Mancini FR, Katzke V, Kühn T, Boeing H, Trichopoulou A, La Vecchia C, Kritikou M, Masala G, Pala V, Tumino R, Panico S, Peeters PH, Skeie G, Merino S, Duell EJ, Rodríguez-Barranco M, Dorronsoro M, Chirlaque MD, Ardanaz E, Gylling B, Schneede J, Ericson U, Sternby H, Khaw KT, Bradbury KE, Huybrechts I, Aune D, Vineis P, and Slimani N
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- Adult, Europe epidemiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Nutritional Status, Pancreatic Neoplasms etiology, Proportional Hazards Models, Prospective Studies, Self Report, Smoking adverse effects, Folic Acid administration & dosage, Pancreatic Neoplasms epidemiology, Smoking epidemiology
- Abstract
Pancreatic cancer (PC) has an exceptionally low survival rate and primary prevention strategies are limited. Folate plays an important role in one-carbon metabolism and has been associated with the risk of several cancers, but not consistently with PC risk. We aimed to investigate the association between dietary folate intake and PC risk, using the standardised folate database across 10 European countries. A total of 477,206 participants were followed up for 11 years, during which 865 incident primary PC cases were recorded. Folate intake was energy-adjusted using the residual method. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. In multivariable analyses stratified by age, sex, study centre and adjusted for energy intake, smoking status, BMI, educational level, diabetes status, supplement use and dietary fibre intake, we found no significant association between folate intake and PC risk: the HR of PC risk for those in the highest quartile of folate intake (≥353 μg/day) compared to the lowest (<241 μg/day) was 0.81 (95% CI: 0.51, 1.31; p
trend = 0.38). In current smokers, a positive trend was observed in PC risk across folate quartiles [HR = 4.42 (95% CI: 1.05, 18.62) for ≥353 μg/day vs. <241 μg/day, ptrend = 0.01]. Nonetheless, there was no significant interaction between smoking and dietary folate intake (pinteraction = 0.99). We found no association between dietary folate intake and PC risk in this large European study., (© 2018 UICC.)- Published
- 2019
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14. Comparison of the Dietary Antioxidant Profiles of 21 a priori Defined Mediterranean Diet Indexes.
- Author
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Hernández-Ruiz A, García-Villanova B, Guerra-Hernández E, Amiano P, Sánchez MJ, Dorronsoro M, and Molina-Montes E
- Subjects
- Adult, Cross-Sectional Studies, Europe, Female, Humans, Linear Models, Male, Middle Aged, Prospective Studies, Reproducibility of Results, Statistics, Nonparametric, Antioxidants analysis, Diet Surveys methods, Diet, Healthy statistics & numerical data, Diet, Mediterranean statistics & numerical data
- Abstract
Background: The Mediterranean Diet (MD) is a dietary pattern that features a high quotient of antioxidant-rich foods. Differences in the level of dietary antioxidants intake reflected by different MD indexes has received little research attention., Objective: The purpose of this study was to compare the dietary antioxidant profile of 21 a priori defined indexes of adherence to the MD., Design: A cross-sectional study., Participants/setting: A total of 14,756 participants belonging to two Spanish European Prospective Investigation into Cancer and Nutrition cohorts, aged 32 to 69 years, recruited between 1992 and 1996, were included., Main Outcome Measure: Participants provided information on diet through a validated diet history questionnaire. Antioxidants (vitamin C, beta carotene and α-tocopherol), total antioxidant capacity, total polyphenols, flavonoids, and polyphenol antioxidant content score were estimated using different food composition databases. Twenty-one MD indexes were operationalized., Statistical Analysis: Spearman correlation coefficients between the indexes were calculated and hierarchical clustering was applied to identify cluster groups. Weighted kappa statistic was estimated to value the scoring agreements between indexes. Antioxidant profiles between the MD indexes were compared based on geometric mean intakes. The relationship between each MD index with the components of the antioxidant profile was evaluated using linear multivariable regression analysis., Results: Correlation patterns between the MD indexes showed that about half of the indexes were moderately-to-weakly correlated with each other (rho<0.5). The main cluster groups derived denoted the high-, moderate-, and low-correlated MD indexes. Three MD indexes (MD pattern-2002, Prevention with MD, and Alternate MD index) presented the highest mean intakes of antioxidant vitamins, total antioxidant capacity, total polyphenols, flavonoids, and polyphenol antioxidant content score. These and other indexes (mainly those belonging to the MD Scale group) captured higher intake levels of dietary antioxidants overall., Conclusions: The level of dietary antioxidant intake that is captured through the different MD indexes differed due to the variation in their construction. Study results also suggest that some MD indexes reflect a higher antioxidant profile., (Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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15. Pre-diagnostic circulating insulin-like growth factor-I and bladder cancer risk in the European Prospective Investigation into Cancer and Nutrition.
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Lin C, Travis RC, Appleby PN, Tipper S, Weiderpass E, Chang-Claude J, Gram IT, Kaaks R, Kiemeney LA, Ljungberg B, Tumino R, Tjønneland A, Roswall N, Overvad K, Boutron-Ruault MC, Manciniveri FR, Severi G, Trichopoulou A, Masala G, Sacerdote C, Agnoli C, Panico S, Bueno-de-Mesquita B, Peeters PH, Salamanca-Fernández E, Chirlaque MD, Ardanaz E, Dorronsoro M, Menéndez V, Luján-Barroso L, Liedberg F, Freisling H, Gunter M, Aune D, Cross AJ, Riboli E, Key TJ, and Perez-Cornago A
- Subjects
- Adult, Aged, Case-Control Studies, Europe epidemiology, Female, Humans, Male, Middle Aged, Prospective Studies, Risk, Urinary Bladder Neoplasms epidemiology, Insulin-Like Growth Factor I metabolism, Urinary Bladder Neoplasms blood
- Abstract
Previous in vitro and case-control studies have found an association between the insulin-like growth factor (IGF)-axis and bladder cancer risk. Circulating concentrations of IGF-I have also been found to be associated with an increased risk of several cancer types; however, the relationship between pre-diagnostic circulating IGF-I concentrations and bladder cancer has never been studied prospectively. We investigated the association of pre-diagnostic plasma concentrations of IGF-I with risk of overall bladder cancer and urothelial cell carcinoma (UCC) in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 843 men and women diagnosed with bladder cancer between 1992 and 2005 were matched with 843 controls by recruitment centre, sex, age at recruitment, date of blood collection, duration of follow-up, time of day and fasting status at blood collection using an incidence density sampling protocol. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression with adjustment for smoking status. No association was found between pre-diagnostic circulating IGF-I concentration and overall bladder cancer risk (adjusted OR for highest versus lowest fourth: 0.91, 95% CI: 0.66-1.24, p
trend = 0.40) or UCC (n of cases = 776; 0.91, 0.65-1.26, ptrend = 0.40). There was no significant evidence of heterogeneity in the association of IGF-I with bladder cancer risk by tumour aggressiveness, sex, smoking status, or by time between blood collection and diagnosis (pheterogeneity > 0.05 for all). This first prospective study indicates no evidence of an association between plasma IGF-I concentrations and bladder cancer risk., (© 2018 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)- Published
- 2018
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16. Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE).
- Author
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Nagel G, Stafoggia M, Pedersen M, Andersen ZJ, Galassi C, Munkenast J, Jaensch A, Sommar J, Forsberg B, Olsson D, Oftedal B, Krog NH, Aamodt G, Pyko A, Pershagen G, Korek M, De Faire U, Pedersen NL, Östenson CG, Fratiglioni L, Sørensen M, Tjønneland A, Peeters PH, Bueno-de-Mesquita B, Vermeulen R, Eeftens M, Plusquin M, Key TJ, Concin H, Lang A, Wang M, Tsai MY, Grioni S, Marcon A, Krogh V, Ricceri F, Sacerdote C, Ranzi A, Cesaroni G, Forastiere F, Tamayo-Uria I, Amiano P, Dorronsoro M, de Hoogh K, Beelen R, Vineis P, Brunekreef B, Hoek G, Raaschou-Nielsen O, and Weinmayr G
- Subjects
- Adult, Europe epidemiology, Female, Follow-Up Studies, Head and Neck Neoplasms etiology, Humans, Incidence, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Stomach Neoplasms etiology, Air Pollution adverse effects, Head and Neck Neoplasms epidemiology, Stomach Neoplasms epidemiology
- Abstract
Air pollution has been classified as carcinogenic to humans. However, to date little is known about the relevance for cancers of the stomach and upper aerodigestive tract (UADT). We investigated the association of long-term exposure to ambient air pollution with incidence of gastric and UADT cancer in 11 European cohorts. Air pollution exposure was assigned by land-use regression models for particulate matter (PM) below 10 µm (PM
10 ), below 2.5 µm (PM2.5 ), between 2.5 and 10 µm (PMcoarse ), PM2.5 absorbance and nitrogen oxides (NO2 and NOX ) as well as approximated by traffic indicators. Cox regression models with adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined with random effects meta-analyses. During average follow-up of 14.1 years of 305,551 individuals, 744 incident cases of gastric cancer and 933 of UADT cancer occurred. The hazard ratio for an increase of 5 µg/m3 of PM2.5 was 1.38 (95% CI 0.99; 1.92) for gastric and 1.05 (95% CI 0.62; 1.77) for UADT cancers. No associations were found for any of the other exposures considered. Adjustment for additional confounders and restriction to study participants with stable addresses did not influence markedly the effect estimate for PM2.5 and gastric cancer. Higher estimated risks of gastric cancer associated with PM2.5 was found in men (HR 1.98 [1.30; 3.01]) as compared to women (HR 0.85 [0.5; 1.45]). This large multicentre cohort study shows an association between long-term exposure to PM2.5 and gastric cancer, but not UADT cancers, suggesting that air pollution may contribute to gastric cancer risk., (© 2018 UICC.)- Published
- 2018
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17. Lifetime and baseline alcohol intakes and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition study.
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Naudin S, Li K, Jaouen T, Assi N, Kyrø C, Tjønneland A, Overvad K, Boutron-Ruault MC, Rebours V, Védié AL, Boeing H, Kaaks R, Katzke V, Bamia C, Naska A, Trichopoulou A, Berrino F, Tagliabue G, Palli D, Panico S, Tumino R, Sacerdote C, Peeters PH, Bueno-de-Mesquita HBA, Weiderpass E, Gram IT, Skeie G, Chirlaque MD, Rodríguez-Barranco M, Barricarte A, Quirós JR, Dorronsoro M, Johansson I, Sund M, Sternby H, Bradbury KE, Wareham N, Riboli E, Gunter M, Brennan P, Duell EJ, and Ferrari P
- Subjects
- Adult, Alcohol Drinking adverse effects, Alcoholic Beverages, Alcoholism complications, Alcoholism epidemiology, Confounding Factors, Epidemiologic, Diet, Dose-Response Relationship, Drug, Europe epidemiology, Female, Humans, Life Style, Male, Middle Aged, Pancreatic Neoplasms etiology, Proportional Hazards Models, Prospective Studies, Risk Factors, Smoking adverse effects, Smoking epidemiology, Surveys and Questionnaires, Alcohol Drinking epidemiology, Pancreatic Neoplasms epidemiology
- Abstract
Recent evidence suggested a weak relationship between alcohol consumption and pancreatic cancer (PC) risk. In our study, the association between lifetime and baseline alcohol intakes and the risk of PC was evaluated, including the type of alcoholic beverages and potential interaction with smoking. Within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, 1,283 incident PC (57% women) were diagnosed from 476,106 cancer-free participants, followed up for 14 years. Amounts of lifetime and baseline alcohol were estimated through lifestyle and dietary questionnaires, respectively. Cox proportional hazard models with age as primary time variable were used to estimate PC hazard ratios (HR) and their 95% confidence interval (CI). Alcohol intake was positively associated with PC risk in men. Associations were mainly driven by extreme alcohol levels, with HRs comparing heavy drinkers (>60 g/day) to the reference category (0.1-4.9 g/day) equal to 1.77 (95% CI: 1.06, 2.95) and 1.63 (95% CI: 1.16, 2.29) for lifetime and baseline alcohol, respectively. Baseline alcohol intakes from beer (>40 g/day) and spirits/liquors (>10 g/day) showed HRs equal to 1.58 (95% CI: 1.07, 2.34) and 1.41 (95% CI: 1.03, 1.94), respectively, compared to the reference category (0.1-2.9 g/day). In women, HR estimates did not reach statistically significance. The alcohol and PC risk association was not modified by smoking status. Findings from a large prospective study suggest that baseline and lifetime alcohol intakes were positively associated with PC risk, with more apparent risk estimates for beer and spirits/liquors than wine intake., (© 2018 IARC/WHO.)
- Published
- 2018
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18. Interplay between genetic predisposition, macronutrient intake and type 2 diabetes incidence: analysis within EPIC-InterAct across eight European countries.
- Author
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Li SX, Imamura F, Schulze MB, Zheng J, Ye Z, Agudo A, Ardanaz E, Aune D, Boeing H, Dorronsoro M, Dow C, Fagherazzi G, Grioni S, Gunter MJ, Huerta JM, Ibsen DB, Jakobsen MU, Kaaks R, Key TJ, Khaw KT, Kyrø C, Mancini FR, Molina-Portillo E, Murphy N, Nilsson PM, Onland-Moret NC, Palli D, Panico S, Poveda A, Quirós JR, Ricceri F, Sluijs I, Spijkerman AMW, Tjonneland A, Tumino R, Winkvist A, Langenberg C, Sharp SJ, Riboli E, Scott RA, Forouhi NG, and Wareham NJ
- Subjects
- Adult, Alleles, Body Mass Index, Dietary Fiber, Energy Intake, Europe, Female, Follow-Up Studies, Humans, Insulin Resistance, International Cooperation, Male, Middle Aged, Nutrition Assessment, Polymorphism, Single Nucleotide, Proportional Hazards Models, Prospective Studies, Surveys and Questionnaires, White People, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 genetics, Diet, Genetic Predisposition to Disease, Nutrients administration & dosage
- Abstract
Aims/hypothesis: Gene-macronutrient interactions may contribute to the development of type 2 diabetes but research evidence to date is inconclusive. We aimed to increase our understanding of the aetiology of type 2 diabetes by investigating potential interactions between genes and macronutrient intake and their association with the incidence of type 2 diabetes., Methods: We investigated the influence of interactions between genetic risk scores (GRSs) for type 2 diabetes, insulin resistance and BMI and macronutrient intake on the development of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct, a prospective case-cohort study across eight European countries (N = 21,900 with 9742 incident type 2 diabetes cases). Macronutrient intake was estimated from diets reported in questionnaires, including proportion of energy derived from total carbohydrate, protein, fat, plant and animal protein, saturated, monounsaturated and polyunsaturated fat and dietary fibre. Using multivariable-adjusted Cox regression, we estimated country-specific interaction results on the multiplicative scale, using random-effects meta-analysis. Secondary analysis used isocaloric macronutrient substitution., Results: No interactions were identified between any of the three GRSs and any macronutrient intake, with low-to-moderate heterogeneity between countries (I
2 range 0-51.6%). Results were similar using isocaloric macronutrient substitution analyses and when weighted and unweighted GRSs and individual SNPs were examined., Conclusions/interpretation: Genetic susceptibility to type 2 diabetes, insulin resistance and BMI did not modify the association between macronutrient intake and incident type 2 diabetes. This suggests that macronutrient intake recommendations to prevent type 2 diabetes do not need to account for differences in genetic predisposition to these three metabolic conditions.- Published
- 2018
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19. Is There an Association Between Ambient Air Pollution and Bladder Cancer Incidence? Analysis of 15 European Cohorts.
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Pedersen M, Stafoggia M, Weinmayr G, Andersen ZJ, Galassi C, Sommar J, Forsberg B, Olsson D, Oftedal B, Krog NH, Aamodt G, Pyko A, Pershagen G, Korek M, De Faire U, Pedersen NL, Östenson CG, Fratiglioni L, Sørensen M, Eriksen KT, Tjønneland A, Peeters PH, Bueno-de-Mesquita B, Vermeulen R, Eeftens M, Plusquin M, Key TJ, Jaensch A, Nagel G, Concin H, Wang M, Tsai MY, Grioni S, Marcon A, Krogh V, Ricceri F, Sacerdote C, Ranzi A, Cesaroni G, Forastiere F, Tamayo I, Amiano P, Dorronsoro M, Stayner LT, Kogevinas M, Nieuwenhuijsen MJ, Sokhi R, de Hoogh K, Beelen R, Vineis P, Brunekreef B, Hoek G, and Raaschou-Nielsen O
- Subjects
- Adult, Aged, Cohort Studies, Europe epidemiology, Female, Humans, Incidence, Male, Meta-Analysis as Topic, Middle Aged, Nitrogen Oxides adverse effects, Particulate Matter adverse effects, Prospective Studies, Risk Factors, Urinary Bladder Neoplasms etiology, Air Pollution adverse effects, Carcinogens, Environmental adverse effects, Environmental Exposure adverse effects, Urinary Bladder Neoplasms epidemiology
- Abstract
Background: Ambient air pollution contains low concentrations of carcinogens implicated in the etiology of urinary bladder cancer (BC). Little is known about whether exposure to air pollution influences BC in the general population., Objective: To evaluate the association between long-term exposure to ambient air pollution and BC incidence., Design, Setting, and Participants: We obtained data from 15 population-based cohorts enrolled between 1985 and 2005 in eight European countries (N=303431; mean follow-up 14.1 yr). We estimated exposure to nitrogen oxides (NO
2 and NOx ), particulate matter (PM) with diameter <10μm (PM10 ), <2.5μm (PM2.5 ), between 2.5 and 10μm (PM2.5-10 ), PM2.5 absorbance (soot), elemental constituents of PM, organic carbon, and traffic density at baseline home addresses using standardized land-use regression models from the European Study of Cohorts for Air Pollution Effects project., Outcome Measurements and Statistical Analysis: We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and meta-analyses to estimate summary hazard ratios (HRs) for BC incidence., Results and Limitations: During follow-up, 943 incident BC cases were diagnosed. In the meta-analysis, none of the exposures were associated with BC risk. The summary HRs associated with a 10-μg/m3 increase in NO2 and 5-μg/m3 increase in PM2.5 were 0.98 (95% confidence interval [CI] 0.89-1.08) and 0.86 (95% CI 0.63-1.18), respectively. Limitations include the lack of information about lifetime exposure., Conclusions: There was no evidence of an association between exposure to outdoor air pollution levels at place of residence and risk of BC., Patient Summary: We assessed the link between outdoor air pollution at place of residence and bladder cancer using the largest study population to date and extensive assessment of exposure and comprehensive data on personal risk factors such as smoking. We found no association between the levels of outdoor air pollution at place of residence and bladder cancer risk., (Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.)- Published
- 2018
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20. Dietary flavonoid intake and colorectal cancer risk in the European prospective investigation into cancer and nutrition (EPIC) cohort.
- Author
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Zamora-Ros R, Barupal DK, Rothwell JA, Jenab M, Fedirko V, Romieu I, Aleksandrova K, Overvad K, Kyrø C, Tjønneland A, Affret A, His M, Boutron-Ruault MC, Katzke V, Kühn T, Boeing H, Trichopoulou A, Naska A, Kritikou M, Saieva C, Agnoli C, Santucci de Magistris M, Tumino R, Fasanelli F, Weiderpass E, Skeie G, Merino S, Jakszyn P, Sánchez MJ, Dorronsoro M, Navarro C, Ardanaz E, Sonestedt E, Ericson U, Maria Nilsson L, Bodén S, Bueno-de-Mesquita HB, Peeters PH, Perez-Cornago A, Wareham NJ, Khaw KT, Freisling H, Cross AJ, Riboli E, and Scalbert A
- Subjects
- Adult, Aged, Cell Proliferation drug effects, Colorectal Neoplasms chemically induced, Colorectal Neoplasms epidemiology, Colorectal Neoplasms pathology, Europe, Female, Flavonoids adverse effects, Follow-Up Studies, Humans, Male, Middle Aged, Nutritional Status, Prospective Studies, Risk Factors, Surveys and Questionnaires, White People, Colorectal Neoplasms diet therapy, Diet adverse effects, Dietary Supplements adverse effects, Flavonoids therapeutic use
- Abstract
Flavonoids have been shown to inhibit colon cancer cell proliferation in vitro and protect against colorectal carcinogenesis in animal models. However, epidemiological evidence on the potential role of flavonoid intake in colorectal cancer (CRC) development remains sparse and inconsistent. We evaluated the association between dietary intakes of total flavonoids and their subclasses and risk of development of CRC, within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cohort of 477,312 adult men and women were recruited in 10 European countries. At baseline, dietary intakes of total flavonoids and individual subclasses were estimated using centre-specific validated dietary questionnaires and composition data from the Phenol-Explorer database. During an average of 11 years of follow-up, 4,517 new cases of primary CRC were identified, of which 2,869 were colon (proximal = 1,298 and distal = 1,266) and 1,648 rectal tumours. No association was found between total flavonoid intake and the risk of overall CRC (HR for comparison of extreme quintiles 1.05, 95% CI 0.93-1.18; p-trend = 0.58) or any CRC subtype. No association was also observed with any intake of individual flavonoid subclasses. Similar results were observed for flavonoid intake expressed as glycosides or aglycone equivalents. Intake of total flavonoids and flavonoid subclasses, as estimated from dietary questionnaires, did not show any association with risk of CRC development., (© 2016 UIC.)
- Published
- 2017
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21. Anthropometry and the Risk of Lung Cancer in EPIC.
- Author
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Dewi NU, Boshuizen HC, Johansson M, Vineis P, Kampman E, Steffen A, Tjønneland A, Halkjær J, Overvad K, Severi G, Fagherazzi G, Boutron-Ruault MC, Kaaks R, Li K, Boeing H, Trichopoulou A, Bamia C, Klinaki E, Tumino R, Palli D, Mattiello A, Tagliabue G, Peeters PH, Vermeulen R, Weiderpass E, Torhild Gram I, Huerta JM, Agudo A, Sánchez MJ, Ardanaz E, Dorronsoro M, Quirós JR, Sonestedt E, Johansson M, Grankvist K, Key T, Khaw KT, Wareham N, Cross AJ, Norat T, Riboli E, Fanidi A, Muller D, and Bueno-de-Mesquita HB
- Subjects
- Adult, Aged, Anthropometry, Body Mass Index, Comorbidity, Confounding Factors, Epidemiologic, Diet adverse effects, Europe epidemiology, Female, Humans, Male, Middle Aged, Multicenter Studies as Topic, Proportional Hazards Models, Prospective Studies, Risk Assessment, Smoking adverse effects, Smoking epidemiology, Lung Neoplasms epidemiology, Obesity epidemiology, Waist Circumference physiology, Waist-Hip Ratio statistics & numerical data
- Abstract
The associations of body mass index (BMI) and other anthropometric measurements with lung cancer were examined in 348,108 participants in the European Investigation Into Cancer and Nutrition (EPIC) between 1992 and 2010. The study population included 2,400 case patients with incident lung cancer, and the average length of follow-up was 11 years. Hazard ratios were calculated using Cox proportional hazard models in which we modeled smoking variables with cubic splines. Overall, there was a significant inverse association between BMI (weight (kg)/height (m)(2)) and the risk of lung cancer after adjustment for smoking and other confounders (for BMI of 30.0-34.9 versus 18.5-25.0, hazard ratio = 0.72, 95% confidence interval: 0.62, 0.84). The strength of the association declined with increasing follow-up time. Conversely, after adjustment for BMI, waist circumference and waist-to-height ratio were significantly positively associated with lung cancer risk (for the highest category of waist circumference vs. the lowest, hazard ratio = 1.25, 95% confidence interval: 1.05, 1.50). Given the decline of the inverse association between BMI and lung cancer over time, the association is likely at least partly due to weight loss resulting from preclinical lung cancer that was present at baseline. Residual confounding by smoking could also have influenced our findings., (© The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2016
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22. Pre-diagnostic meat and fibre intakes in relation to colorectal cancer survival in the European Prospective Investigation into Cancer and Nutrition.
- Author
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Ward HA, Norat T, Overvad K, Dahm CC, Bueno-de-Mesquita HB, Jenab M, Fedirko V, van Duijnhoven FJ, Skeie G, Romaguera-Bosch D, Tjønneland A, Olsen A, Carbonnel F, Affret A, Boutron-Ruault MC, Katzke V, Kühn T, Aleksandrova K, Boeing H, Trichopoulou A, Lagiou P, Bamia C, Palli D, Sieri S, Tumino R, Naccarati A, Mattiello A, Peeters PH, Weiderpass E, Åsli LA, Jakszyn P, Ramón Quirós J, Sánchez MJ, Dorronsoro M, Huerta JM, Barricarte A, Jirström K, Ericson U, Johansson I, Gylling B, Bradbury KE, Khaw KT, Wareham NJ, Stepien M, Freisling H, Murphy N, Cross AJ, and Riboli E
- Subjects
- Adult, Aged, Animals, Europe epidemiology, Female, Humans, Life Style, Male, Middle Aged, Nutrition Policy, Poultry, Proportional Hazards Models, Prospective Studies, Red Meat adverse effects, Sex Factors, White People, Colorectal Neoplasms mortality, Diet, Dietary Fiber therapeutic use, Feeding Behavior, Meat adverse effects
- Abstract
Improvements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors. Pre-diagnostic red meat, processed meat or fibre intakes (defined as quartiles and continuous grams per day) were not associated with CRC-specific or all-cause mortality among CRC survivors; however, a marginal trend across quartiles of processed meat in relation to CRC mortality was detected (P 0·053). Pre-diagnostic poultry intake was inversely associated with all-cause mortality among women (hazard ratio (HR)/20 g/d 0·92; 95 % CI 0·84, 1·00), but not among men (HR 1·00; 95 % CI 0·91, 1·09) (P for heterogeneity=0·10). Pre-diagnostic intake of red meat or fibre is not associated with CRC survival in the EPIC cohort. There is suggestive evidence of an association between poultry intake and all-cause mortality among female CRC survivors and between processed meat intake and CRC-specific mortality; however, further research using post-diagnostic dietary data is required to confirm this relationship.
- Published
- 2016
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23. The association of coffee intake with liver cancer risk is mediated by biomarkers of inflammation and hepatocellular injury: data from the European Prospective Investigation into Cancer and Nutrition.
- Author
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Aleksandrova K, Bamia C, Drogan D, Lagiou P, Trichopoulou A, Jenab M, Fedirko V, Romieu I, Bueno-de-Mesquita HB, Pischon T, Tsilidis K, Overvad K, Tjønneland A, Bouton-Ruault MC, Dossus L, Racine A, Kaaks R, Kühn T, Tsironis C, Papatesta EM, Saitakis G, Palli D, Panico S, Grioni S, Tumino R, Vineis P, Peeters PH, Weiderpass E, Lukic M, Braaten T, Quirós JR, Luján-Barroso L, Sánchez MJ, Chilarque MD, Ardanas E, Dorronsoro M, Nilsson LM, Sund M, Wallström P, Ohlsson B, Bradbury KE, Khaw KT, Wareham N, Stepien M, Duarte-Salles T, Assi N, Murphy N, Gunter MJ, Riboli E, Boeing H, and Trichopoulos D
- Subjects
- Adult, Aged, Biomarkers blood, Carcinoma, Hepatocellular blood, Carcinoma, Hepatocellular epidemiology, Carcinoma, Hepatocellular immunology, Case-Control Studies, Cohort Studies, Europe epidemiology, Female, Hepatitis blood, Hepatitis epidemiology, Hepatitis immunology, Humans, Incidence, Liver Neoplasms blood, Liver Neoplasms epidemiology, Liver Neoplasms immunology, Male, Middle Aged, Prospective Studies, Risk Factors, Statistics as Topic, Carcinoma, Hepatocellular prevention & control, Coffee adverse effects, Diet adverse effects, Hepatitis prevention & control, Liver immunology, Liver Neoplasms prevention & control
- Abstract
Background: Higher coffee intake has been purportedly related to a lower risk of liver cancer. However, it remains unclear whether this association may be accounted for by specific biological mechanisms., Objective: We aimed to evaluate the potential mediating roles of inflammatory, metabolic, liver injury, and iron metabolism biomarkers on the association between coffee intake and the primary form of liver cancer-hepatocellular carcinoma (HCC)., Design: We conducted a prospective nested case-control study within the European Prospective Investigation into Cancer and Nutrition among 125 incident HCC cases matched to 250 controls using an incidence-density sampling procedure. The association of coffee intake with HCC risk was evaluated by using multivariable-adjusted conditional logistic regression that accounted for smoking, alcohol consumption, hepatitis infection, and other established liver cancer risk factors. The mediating effects of 21 biomarkers were evaluated on the basis of percentage changes and associated 95% CIs in the estimated regression coefficients of models with and without adjustment for biomarkers individually and in combination., Results: The multivariable-adjusted RR of having ≥4 cups (600 mL) coffee/d compared with <2 cups (300 mL)/d was 0.25 (95% CI: 0.11, 0.62; P-trend = 0.006). A statistically significant attenuation of the association between coffee intake and HCC risk and thereby suspected mediation was confirmed for the inflammatory biomarker IL-6 and for the biomarkers of hepatocellular injury glutamate dehydrogenase, alanine aminotransferase, aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), and total bilirubin, which-in combination-attenuated the regression coefficients by 72% (95% CI: 7%, 239%). Of the investigated biomarkers, IL-6, AST, and GGT produced the highest change in the regression coefficients: 40%, 56%, and 60%, respectively., Conclusion: These data suggest that the inverse association of coffee intake with HCC risk was partly accounted for by biomarkers of inflammation and hepatocellular injury.
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- 2015
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24. General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition.
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Steffen A, Huerta JM, Weiderpass E, Bueno-de-Mesquita HB, May AM, Siersema PD, Kaaks R, Neamat-Allah J, Pala V, Panico S, Saieva C, Tumino R, Naccarati A, Dorronsoro M, Sánchez-Cantalejo E, Ardanaz E, Quirós JR, Ohlsson B, Johansson M, Wallner B, Overvad K, Halkjaer J, Tjønneland A, Fagherazzi G, Racine A, Clavel-Chapelon F, Key TJ, Khaw KT, Wareham N, Lagiou P, Bamia C, Trichopoulou A, Ferrari P, Freisling H, Lu Y, Riboli E, Cross AJ, Gonzalez CA, and Boeing H
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- Adult, Aged, Body Mass Index, Body Weights and Measures, Europe epidemiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Population Surveillance, Prospective Studies, Risk, Risk Factors, Adenocarcinoma epidemiology, Adenocarcinoma etiology, Esophageal Neoplasms epidemiology, Esophageal Neoplasms etiology, Obesity complications, Obesity, Abdominal complications, Stomach Neoplasms epidemiology, Stomach Neoplasms etiology
- Abstract
General obesity, as reflected by BMI, is an established risk factor for esophageal adenocarcinoma (EAC), a suspected risk factor for gastric cardia adenocarcinoma (GCC) and appears unrelated to gastric non-cardia adenocarcinoma (GNCC). How abdominal obesity, as commonly measured by waist circumference (WC), relates to these cancers remains largely unexplored. Using measured anthropometric data from 391,456 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) study and 11 years of follow-up, we comprehensively assessed the association of anthropometric measures with risk of EAC, GCC and GNCC using multivariable proportional hazards regression. One hundred twenty-four incident EAC, 193 GCC and 224 GNCC were accrued. After mutual adjustment, BMI was unrelated to EAC, while WC showed a strong positive association (highest vs. lowest quintile HR = 1.19; 95% CI, 0.63-2.22 and HR = 3.76; 1.72-8.22, respectively). Hip circumference (HC) was inversely related to EAC after controlling for WC, while WC remained positively associated (HR = 0.35; 0.18-0.68, and HR=4.10; 1.94-8.63, respectively). BMI was not associated with GCC or GNCC. WC was related to higher risks of GCC after adjustment for BMI and more strongly after adjustment for HC (highest vs. lowest quintile HR = 1.91; 1.09-3.37, and HR = 2.23; 1.28-3.90, respectively). Our study demonstrates that abdominal, rather than general, obesity is an indisputable risk factor for EAC and also provides evidence for a protective effect of gluteofemoral (subcutaneous) adipose tissue in EAC. Our study further shows that general obesity is not a risk factor for GCC and GNCC, while the role of abdominal obesity in GCC needs further investigation., (© 2015 UICC.)
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- 2015
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25. Coffee, tea and decaffeinated coffee in relation to hepatocellular carcinoma in a European population: multicentre, prospective cohort study.
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Bamia C, Lagiou P, Jenab M, Trichopoulou A, Fedirko V, Aleksandrova K, Pischon T, Overvad K, Olsen A, Tjønneland A, Boutron-Ruault MC, Fagherazzi G, Racine A, Kuhn T, Boeing H, Floegel A, Benetou V, Palli D, Grioni S, Panico S, Tumino R, Vineis P, Bueno-de-Mesquita HB, Dik VK, Bhoo-Pathy N, Uiterwaal CS, Weiderpass E, Lund E, Quirós JR, Zamora-Ros R, Molina-Montes E, Chirlaque MD, Ardanaz E, Dorronsoro M, Lindkvist B, Wallström P, Nilsson LM, Sund M, Khaw KT, Wareham N, Bradbury KE, Travis RC, Ferrari P, Duarte-Salles T, Stepien M, Gunter M, Murphy N, Riboli E, and Trichopoulos D
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- Beverages adverse effects, Case-Control Studies, Europe, Female, Humans, Incidence, Male, Middle Aged, Prospective Studies, Risk, Risk Assessment, Risk Factors, Caffeine adverse effects, Carcinoma, Hepatocellular epidemiology, Carcinoma, Hepatocellular etiology, Coffee adverse effects, Liver Neoplasms epidemiology, Liver Neoplasms etiology, Tea adverse effects
- Abstract
Inverse associations of coffee and/or tea in relation to hepatocellular carcinoma (HCC) risk have been consistently identified in studies conducted mostly in Asia where consumption patterns of such beverages differ from Europe. In the European Prospective Investigation into Cancer and nutrition (EPIC), we identified 201 HCC cases among 486,799 men/women, after a median follow-up of 11 years. We calculated adjusted hazard ratios (HRs) for HCC incidence in relation to quintiles/categories of coffee/tea intakes. We found that increased coffee and tea intakes were consistently associated with lower HCC risk. The inverse associations were substantial, monotonic and statistically significant. Coffee consumers in the highest compared to the lowest quintile had lower HCC risk by 72% [HR: 0.28; 95% confidence intervals (CIs): 0.16-0.50, p-trend < 0.001]. The corresponding association of tea with HCC risk was 0.41 (95% CI: 0.22-0.78, p-trend = 0.003). There was no compelling evidence of heterogeneity of these associations across strata of important HCC risk factors, including hepatitis B or hepatitis C status (available in a nested case-control study). The inverse, monotonic associations of coffee intake with HCC were apparent for caffeinated (p-trend = 0.009), but not decaffeinated (p-trend = 0.45) coffee for which, however, data were available for a fraction of subjects. Results from this multicentre, European cohort study strengthen the existing evidence regarding the inverse association between coffee/tea and HCC risk. Given the apparent lack of heterogeneity of these associations by HCC risk factors and that coffee/tea are universal exposures, our results could have important implications for high HCC risk subjects., (© 2014 UICC.)
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- 2015
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26. Selenium status is associated with colorectal cancer risk in the European prospective investigation of cancer and nutrition cohort.
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Hughes DJ, Fedirko V, Jenab M, Schomburg L, Méplan C, Freisling H, Bueno-de-Mesquita HB, Hybsier S, Becker NP, Czuban M, Tjønneland A, Outzen M, Boutron-Ruault MC, Racine A, Bastide N, Kühn T, Kaaks R, Trichopoulos D, Trichopoulou A, Lagiou P, Panico S, Peeters PH, Weiderpass E, Skeie G, Dagrun E, Chirlaque MD, Sánchez MJ, Ardanaz E, Ljuslinder I, Wennberg M, Bradbury KE, Vineis P, Naccarati A, Palli D, Boeing H, Overvad K, Dorronsoro M, Jakszyn P, Cross AJ, Quirós JR, Stepien M, Kong SY, Duarte-Salles T, Riboli E, and Hesketh JE
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- Adult, Aged, Case-Control Studies, Colorectal Neoplasms blood, Colorectal Neoplasms epidemiology, Europe epidemiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Nutritional Status, Prognosis, Prospective Studies, ROC Curve, Risk Factors, Spectrometry, X-Ray Emission, Biomarkers, Tumor blood, Colorectal Neoplasms etiology, Selenium blood, Selenoprotein P blood
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Suboptimal intakes of the micronutrient selenium (Se) are found in many parts of Europe. Low Se status may contribute to colorectal cancer (CRC) development. We assessed Se status by measuring serum levels of Se and Selenoprotein P (SePP) and examined the association with CRC risk in a nested case-control design (966 CRC cases; 966 matched controls) within the European Prospective Investigation into Cancer and Nutrition. Se was measured by total reflection X-ray fluorescence and SePP by immunoluminometric sandwich assay. Multivariable incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression. Respective mean Se and SePP levels were 84.0 μg/L and 4.3 mg/L in cases and 85.6 μg/L and 4.4 mg/L in controls. Higher Se concentrations were associated with a non-significant lower CRC risk (IRR = 0.92, 95% CI: 0.82-1.03 per 25 μg/L increase). However, sub-group analyses by sex showed a statistically significant association for women (p(trend) = 0.032; per 25 μg/L Se increase, IRR = 0.83, 95% CI: 0.70-0.97) but not for men. Higher SePP concentrations were inversely associated with CRC risk (p(trend) = 0.009; per 0.806 mg/L increase, IRR = 0.89, 95% CI: 0.82-0.98) with the association more apparent in women (p(trend) = 0.004; IRR = 0.82, 95% CI: 0.72-0.94 per 0.806 mg/L increase) than men (p(trend) = 0.485; IRR = 0.98, 95% CI: 0.86-1.12 per 0.806 mg/L increase). The findings indicate that Se status is suboptimal in many Europeans and suggest an inverse association between CRC risk and higher serum Se status, which is more evident in women., (© 2014 UICC.)
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- 2015
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27. A prospective study of the immune system activation biomarker neopterin and colorectal cancer risk.
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Aleksandrova K, Chuang SC, Boeing H, Zuo H, Tell GS, Pischon T, Jenab M, Bueno-de-Mesquita B, Vollset SE, Midttun Ø, Ueland PM, Fedirko V, Johansson M, Weiderpass E, Severi G, Racine A, Boutron-Ruault MC, Kaaks R, Kühn T, Tjønneland A, Overvad K, Quirós JR, Jakszyn P, Sánchez MJ, Dorronsoro M, Chirlaque MD, Ardanaz E, Khaw KT, Wareham NJ, Travis RC, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Sieri S, Tumino R, Panico S, May AM, Palmqvist R, Ljuslinder I, Kong SY, Freisling H, Gunter MJ, Lu Y, Cross AJ, Riboli E, and Vineis P
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- Adult, Aged, Case-Control Studies, Chromatography, Liquid, Colonic Neoplasms blood, Colonic Neoplasms immunology, Europe, Female, Humans, Male, Middle Aged, Neopterin analogs & derivatives, Odds Ratio, Prospective Studies, Rectal Neoplasms blood, Rectal Neoplasms immunology, Sensitivity and Specificity, T-Lymphocytes, Helper-Inducer, Tandem Mass Spectrometry, Biomarkers, Tumor blood, Colorectal Neoplasms blood, Colorectal Neoplasms immunology, Immunity, Cellular, Neopterin blood
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Background: Neopterin may be relevant for colorectal cancer (CRC) development, as a biomarker of cellular immune activity exerting pleiotropic effects on cellular ageing, oxidative stress, and inflammation. So far, the association between prediagnostic neopterin and colon and rectal cancer risk has not been evaluated in human populations., Methods: A nested case-control study was conducted within the European Prospective Investigation into Cancer and Nutrition cohort using data on plasma concentrations of total neopterin (T-N, sum of neopterin and 7,8-dihydroneopterin) in 830 incident CRC case patients (561 colon and 269 rectal) matched within risk sets to 830 control participants. A subsequent replication study used data from the Hordaland Health Study, where 173 CRC case patients have been diagnosed among 6594 healthy participants over 12 years of follow-up., Results: After multivariable adjustment for a priori chosen CRC risk factors, a "U-shaped" association of T-N with CRC was revealed. Compared with the second quintile of the T-N distribution, the relative risks for the first, third, fourth, and fifth quintiles were 2.37 (95% CI = 1.66 to 3.39), 1.24 (95% CI = 0.87 to 1.77), 1.55 (95% CI = 1.08 to 2.22), and 2.31 (95% CI = 1.63 to 3.27), respectively. Replication of these associations within the Hordaland Health Study yielded similar results. No differences have been observed when the associations were explored by colon and rectal cancer site (two-sided P difference = .87) and after excluding case patients diagnosed within the first four follow-up years., Conclusions: These novel findings provide evidence of the role of both suppressed and activated cell-mediated immunity as reflected by prediagnostic T-N concentrations in the development of CRC., (© The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)
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- 2015
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28. Plasma elaidic acid level as biomarker of industrial trans fatty acids and risk of weight change: report from the EPIC study.
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Chajès V, Biessy C, Ferrari P, Romieu I, Freisling H, Huybrechts I, Scalbert A, Bueno de Mesquita B, Romaguera D, Gunter MJ, Vineis P, Hansen CP, Jakobsen MU, Clavel-Chapelon F, Fagherazzi G, Boutron-Ruault MC, Katzke V, Neamat-Allah J, Boeing H, Bachlechner U, Trichopoulou A, Naska A, Orfanos P, Pala V, Masala G, Mattiello A, Skeie G, Weiderpass E, Agudo A, Huerta JM, Ardanaz E, Sánchez MJ, Dorronsoro M, Quirós JR, Johansson I, Winkvist A, Sonested E, Key T, Khaw KT, Wareham NJ, Peeters PH, and Slimani N
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- Biomarkers, Europe, Female, Follow-Up Studies, Humans, Male, Obesity epidemiology, Obesity etiology, Oleic Acids, Prospective Studies, Risk, Surveys and Questionnaires, Body Weight, Oleic Acid blood, Public Health Surveillance, Trans Fatty Acids metabolism
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Background: Few epidemiological studies have examined the association between dietary trans fatty acids and weight gain, and the evidence remains inconsistent. The main objective of the study was to investigate the prospective association between biomarker of industrial trans fatty acids and change in weight within the large study European Prospective Investigation into Cancer and Nutrition (EPIC) cohort., Methods: Baseline plasma fatty acid concentrations were determined in a representative EPIC sample from the 23 participating EPIC centers. A total of 1,945 individuals were followed for a median of 4.9 years to monitor weight change. The association between elaidic acid level and percent change of weight was investigated using a multinomial logistic regression model, adjusted by length of follow-up, age, energy, alcohol, smoking status, physical activity, and region., Results: In women, doubling elaidic acid was associated with a decreased risk of weight loss (odds ratio (OR) = 0.69, 95% confidence interval (CI) = 0.55-0.88, p = 0.002) and a trend was observed with an increased risk of weight gain during the 5-year follow-up (OR = 1.23, 95% CI = 0.97-1.56, p = 0.082) (p-trend<.0001). In men, a trend was observed for doubling elaidic acid level and risk of weight loss (OR = 0.82, 95% CI = 0.66-1.01, p = 0.062) while no significant association was found with risk of weight gain during the 5-year follow-up (OR = 1.08, 95% CI = 0.88-1.33, p = 0.454). No association was found for saturated and cis-monounsaturated fatty acids., Conclusions: These data suggest that a high intake of industrial trans fatty acids may decrease the risk of weight loss, particularly in women. Prevention of obesity should consider limiting the consumption of highly processed foods, the main source of industrially-produced trans fatty acids.
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- 2015
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29. Prediagnostic telomere length and risk of B-cell lymphoma-Results from the EPIC cohort study.
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Hosnijeh FS, Matullo G, Russo A, Guarrera S, Modica F, Nieters A, Overvad K, Guldberg P, Tjønneland A, Canzian F, Boeing H, Aleksandrova K, Trichopoulou A, Lagiou P, Trichopoulos D, Tagliabue G, Tumino R, Panico S, Palli D, Olsen KS, Weiderpass E, Dorronsoro M, Ardanaz E, Chirlaque MD, Sánchez MJ, Quirós JR, Venceslá A, Melin B, Johansson AS, Nilsson P, Borgquist S, Peeters PH, Onland-Moret NC, Bueno-de-Mesquita HB, Travis RC, Khaw KT, Wareham N, Brennan P, Ferrari P, Gunter MJ, Vineis P, and Vermeulen R
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- Adult, Aged, Aged, 80 and over, Case-Control Studies, DNA analysis, Europe, Female, Follow-Up Studies, Hodgkin Disease epidemiology, Hodgkin Disease genetics, Humans, Incidence, Leukocytes cytology, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Prospective Studies, Risk Factors, Lymphoma, B-Cell epidemiology, Lymphoma, B-Cell genetics, Telomere ultrastructure
- Abstract
Recent epidemiological investigations have reported on the association between telomere length (TL) and a number of malignancies, including B-cell lymphoma (BCL). The reported results for BCLs are however inconsistent. We carried out a nested case-control study to determine whether TL is associated with future risk of BCL. Using quantitative polymerase chain reaction, the relative TL (i.e. the ratio of telomere repeat copy number to single gene copy number) was measured in mononuclear cell DNA of prediagnostic peripheral blood samples of 464 lymphoma cases and 464 matched controls (median time between blood collection and diagnosis, 4.6 years). Conditional logistic regression was used to analyze the association between TL and the risk of developing lymphoma and histologic subtypes. TL was significantly longer in cases compared to controls (p = 0.01). Multivariable models showed a significantly increased risk of BCL [odds ratio (OR) = 1.66, 1.80 and 3.20 for quartiles 2-4, respectively, p-trend = 0.001], diffuse large B-cell lymphoma (DLBCL) (OR = 1.20, 2.48 and 2.36 for quartiles 2-4, respectively, p-trend = 0.03) and follicular lymphoma (FL) (OR = 1.39, 1.90 and 2.69 for quartiles 2-4, respectively, p-trend = 0.02) with increasing TL. This study suggests an association between longer leucocyte TL and increased risk of BCL which was most pronounced for DLBCL and FL., (© 2014 UICC.)
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- 2014
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30. Circulating biomarkers of one-carbon metabolism in relation to renal cell carcinoma incidence and survival.
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Johansson M, Fanidi A, Muller DC, Bassett JK, Midttun Ø, Vollset SE, Travis RC, Palli D, Mattiello A, Sieri S, Trichopoulou A, Lagiou P, Trichopoulos D, Ljungberg B, Hallmans G, Weiderpass E, Skeie G, González CA, Dorronsoro M, Peeters PH, Bueno-de-Mesquita HB, Ros MM, Boutron Ruault MC, Fagherazzi G, Clavel F, Sánchez MJ, Gurrea AB, Navarro C, Quiros JR, Overvad K, Tjønneland A, Aleksandrova K, Vineis P, Gunter MJ, Kaaks R, Giles G, Relton C, Riboli E, Boeing H, Ueland PM, Severi G, and Brennan P
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- Adult, Aged, Biomarkers blood, Carcinoma, Renal Cell mortality, Case-Control Studies, Europe epidemiology, Female, Folic Acid blood, Humans, Kaplan-Meier Estimate, Kidney Neoplasms mortality, Logistic Models, Male, Middle Aged, Odds Ratio, Proportional Hazards Models, Riboflavin blood, Risk Assessment, Vitamin B 12 blood, Vitamin B 6 blood, Carbon metabolism, Carcinoma, Renal Cell blood, Carcinoma, Renal Cell epidemiology, Kidney Neoplasms blood, Kidney Neoplasms epidemiology, Vitamins blood
- Abstract
Background: The etiology of renal cell carcinoma (RCC) is only partially understood, but a metabolic component appears likely. We investigated biomarkers of one-carbon metabolism and RCC onset and survival., Methods: The European Prospective Investigation into Cancer and Nutrition (EPIC) recruited 385747 participants with blood samples between 1992 and 2000, and this analysis included 556 RCC case-control pairs. A subsequent replication study included 144 case-control pairs nested within the Melbourne Collaborative Cohort Study (MCCS). Plasma concentrations of vitamin B2, vitamin B6, folate, vitamin B12, methionine and homocysteine were measured in prediagnostic samples and evaluated with respect to RCC risk using conditional and unconditional logistic regression models, and to all-cause mortality in RCC cases using Cox regression models. All statistical tests were two-sided., Results: EPIC participants with higher plasma concentrations of vitamin B6 had lower risk of RCC, the odds ratio comparing the 4(th) and 1(st) quartiles (OR4vs1) being 0.40 95% confidence interval [CI] = 0.28 to 0.57, P trend < .001. We found similar results after adjusting for potential confounders (adjusted P trend < .001). In survival analysis, the hazard ratio for all-cause mortality in RCC cases when comparing the 4(th) and 1(st) quartiles (HR4vs1) of vitamin B6 was 0.57 (95% CI = 0.37 to 0.87, P trend < .001). Subsequent replication of these associations within the MCCS yielded very similar results for both RCC risk (OR4vs1 = 0.47, 95% CI = 0.23 to 0.99, P trend = .07) and all-cause mortality (HR4vs1 = 0.56, 95% CI = 0.27 to 1.17, P trend = .02). No association was evident for the other measured biomarkers., Conclusion: Study participants with higher circulating concentrations of vitamin B6 had lower risk of RCC and improved survival following diagnosis in two independent cohorts., (© The Author 2014. Published by Oxford University Press.)
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- 2014
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31. Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study.
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Aleksandrova K, Pischon T, Jenab M, Bueno-de-Mesquita HB, Fedirko V, Norat T, Romaguera D, Knüppel S, Boutron-Ruault MC, Dossus L, Dartois L, Kaaks R, Li K, Tjønneland A, Overvad K, Quirós JR, Buckland G, Sánchez MJ, Dorronsoro M, Chirlaque MD, Barricarte A, Khaw KT, Wareham NJ, Bradbury KE, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Krogh V, Tumino R, Naccarati A, Panico S, Siersema PD, Peeters PH, Ljuslinder I, Johansson I, Ericson U, Ohlsson B, Weiderpass E, Skeie G, Borch KB, Rinaldi S, Romieu I, Kong J, Gunter MJ, Ward HA, Riboli E, and Boeing H
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- Adult, Aged, Alcohol Drinking, Cohort Studies, Diet, Europe epidemiology, Female, Humans, Incidence, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Risk Factors, White People, Colorectal Neoplasms psychology, Health Behavior, Life Style
- Abstract
Background: Excess body weight, physical activity, smoking, alcohol consumption and certain dietary factors are individually related to colorectal cancer (CRC) risk; however, little is known about their joint effects. The aim of this study was to develop a healthy lifestyle index (HLI) composed of five potentially modifiable lifestyle factors--healthy weight, physical activity, non-smoking, limited alcohol consumption and a healthy diet, and to explore the association of this index with CRC incidence using data collected within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort., Methods: In the EPIC cohort, a total of 347,237 men and women, 25- to 70-years old, provided dietary and lifestyle information at study baseline (1992 to 2000). Over a median follow-up time of 12 years, 3,759 incident CRC cases were identified. The association between a HLI and CRC risk was evaluated using Cox proportional hazards regression models and population attributable risks (PARs) have been calculated., Results: After accounting for study centre, age, sex and education, compared with 0 or 1 healthy lifestyle factors, the hazard ratio (HR) for CRC was 0.87 (95% confidence interval (CI): 0.44 to 0.77) for two factors, 0.79 (95% CI: 0.70 to 0.89) for three factors, 0.66 (95% CI: 0.58 to 0.75) for four factors and 0.63 (95% CI: 0.54 to 0.74) for five factors; P-trend<0.0001. The associations were present for both colon and rectal cancers, HRs, 0.61 (95% CI: 0.50 to 0.74; P for trend<0.0001) for colon cancer and 0.68 (95% CI: 0.53 to 0.88; P-trend<0.0001) for rectal cancer, respectively (P-difference by cancer sub-site=0.10). Overall, 16% of the new CRC cases (22% in men and 11% in women) were attributable to not adhering to a combination of all five healthy lifestyle behaviours included in the index., Conclusions: Combined lifestyle factors are associated with a lower incidence of CRC in European populations characterized by western lifestyles. Prevention strategies considering complex targeting of multiple lifestyle factors may provide practical means for improved CRC prevention.
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- 2014
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32. t(14;18) Translocation: A predictive blood biomarker for follicular lymphoma.
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Roulland S, Kelly RS, Morgado E, Sungalee S, Solal-Celigny P, Colombat P, Jouve N, Palli D, Pala V, Tumino R, Panico S, Sacerdote C, Quirós JR, Gonzáles CA, Sánchez MJ, Dorronsoro M, Navarro C, Barricarte A, Tjønneland A, Olsen A, Overvad K, Canzian F, Kaaks R, Boeing H, Drogan D, Nieters A, Clavel-Chapelon F, Trichopoulou A, Trichopoulos D, Lagiou P, Bueno-de-Mesquita HB, Peeters PH, Vermeulen R, Hallmans G, Melin B, Borgquist S, Carlson J, Lund E, Weiderpass E, Khaw KT, Wareham N, Key TJ, Travis RC, Ferrari P, Romieu I, Riboli E, Salles G, Vineis P, and Nadel B
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- Adult, Aged, Case-Control Studies, Cohort Studies, Europe epidemiology, Female, Humans, Lymphoma, Follicular epidemiology, Male, Middle Aged, Molecular Epidemiology, Polymerase Chain Reaction methods, Prevalence, Biomarkers, Tumor blood, Biomarkers, Tumor genetics, Chromosomes, Human, Pair 14, Chromosomes, Human, Pair 18, Lymphoma, Follicular blood, Lymphoma, Follicular genetics, Translocation, Genetic
- Abstract
Purpose: The (14;18) translocation constitutes both a genetic hallmark and critical early event in the natural history of follicular lymphoma (FL). However, t(14;18) is also detectable in the blood of otherwise healthy persons, and its relationship with progression to disease remains unclear. Here we sought to determine whether t(14;18)-positive cells in healthy individuals represent tumor precursors and whether their detection could be used as an early predictor for FL., Participants and Methods: Among 520,000 healthy participants enrolled onto the EPIC (European Prospective Investigation Into Cancer and Nutrition) cohort, we identified 100 who developed FL 2 to 161 months after enrollment. Prediagnostic blood from these and 218 controls were screened for t(14;18) using sensitive polymerase chain reaction-based assays. Results were subsequently validated in an independent cohort (65 case participants; 128 controls). Clonal relationships between t(14;18) cells and FL were also assessed by molecular backtracking of paired prediagnostic blood and tumor samples., Results: Clonal analysis of t(14;18) junctions in paired prediagnostic blood versus tumor samples demonstrated that progression to FL occurred from t(14;18)-positive committed precursors. Furthermore, healthy participants at enrollment who developed FL up to 15 years later showed a markedly higher t(14;18) prevalence and frequency than controls (P < .001). Altogether, we estimated a 23-fold higher risk of subsequent FL in blood samples associated with a frequency > 10(-4) (odds ratio, 23.17; 95% CI, 9.98 to 67.31; P < .001). Remarkably, risk estimates remained high and significant up to 15 years before diagnosis., Conclusion: High t(14;18) frequency in blood from healthy individuals defines the first predictive biomarker for FL, effective years before diagnosis.
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- 2014
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33. Long-term exposure to air pollution and cardiovascular mortality: an analysis of 22 European cohorts.
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Beelen R, Stafoggia M, Raaschou-Nielsen O, Andersen ZJ, Xun WW, Katsouyanni K, Dimakopoulou K, Brunekreef B, Weinmayr G, Hoffmann B, Wolf K, Samoli E, Houthuijs D, Nieuwenhuijsen M, Oudin A, Forsberg B, Olsson D, Salomaa V, Lanki T, Yli-Tuomi T, Oftedal B, Aamodt G, Nafstad P, De Faire U, Pedersen NL, Östenson CG, Fratiglioni L, Penell J, Korek M, Pyko A, Eriksen KT, Tjønneland A, Becker T, Eeftens M, Bots M, Meliefste K, Wang M, Bueno-de-Mesquita B, Sugiri D, Krämer U, Heinrich J, de Hoogh K, Key T, Peters A, Cyrys J, Concin H, Nagel G, Ineichen A, Schaffner E, Probst-Hensch N, Dratva J, Ducret-Stich R, Vilier A, Clavel-Chapelon F, Stempfelet M, Grioni S, Krogh V, Tsai MY, Marcon A, Ricceri F, Sacerdote C, Galassi C, Migliore E, Ranzi A, Cesaroni G, Badaloni C, Forastiere F, Tamayo I, Amiano P, Dorronsoro M, Katsoulis M, Trichopoulou A, Vineis P, and Hoek G
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- Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Air Pollutants chemistry, Cardiovascular Diseases etiology, Cardiovascular Diseases physiopathology, Cohort Studies, Databases, Factual, Environmental Exposure adverse effects, Europe, Female, Humans, Incidence, Male, Middle Aged, Nitric Oxide adverse effects, Particulate Matter, Proportional Hazards Models, Sex Distribution, Time Factors, Young Adult, Air Pollutants adverse effects, Air Pollution adverse effects, Cardiovascular Diseases mortality, Cause of Death
- Abstract
Background: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death., Methods: Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO2 and NOx); particles with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 10 μm to 2.5 μm (PMcoarse); PM2.5 absorbance estimated by land-use regression models; and traffic indicators. We applied cohort-specific Cox proportional hazards models using a standardized protocol. Random-effects meta-analysis was used to obtain pooled effect estimates., Results: The total study population consisted of 367,383 participants, with 9994 deaths from CVD (including 4,992 from ischemic heart disease, 2264 from myocardial infarction, and 2484 from cerebrovascular disease). All hazard ratios were approximately 1.0, except for particle mass and cerebrovascular disease mortality; for PM2.5, the hazard ratio was 1.21 (95% confidence interval = 0.87-1.69) per 5 μg/m and for PM10, 1.22 (0.91-1.63) per 10 μg/m., Conclusion: In a joint analysis of data from 22 European cohorts, most hazard ratios for the association of air pollutants with mortality from overall CVD and with specific CVDs were approximately 1.0, with the exception of particulate mass and cerebrovascular disease mortality for which there was suggestive evidence for an association.
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- 2014
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34. Effects of long-term exposure to air pollution on natural-cause mortality: an analysis of 22 European cohorts within the multicentre ESCAPE project.
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Beelen R, Raaschou-Nielsen O, Stafoggia M, Andersen ZJ, Weinmayr G, Hoffmann B, Wolf K, Samoli E, Fischer P, Nieuwenhuijsen M, Vineis P, Xun WW, Katsouyanni K, Dimakopoulou K, Oudin A, Forsberg B, Modig L, Havulinna AS, Lanki T, Turunen A, Oftedal B, Nystad W, Nafstad P, De Faire U, Pedersen NL, Östenson CG, Fratiglioni L, Penell J, Korek M, Pershagen G, Eriksen KT, Overvad K, Ellermann T, Eeftens M, Peeters PH, Meliefste K, Wang M, Bueno-de-Mesquita B, Sugiri D, Krämer U, Heinrich J, de Hoogh K, Key T, Peters A, Hampel R, Concin H, Nagel G, Ineichen A, Schaffner E, Probst-Hensch N, Künzli N, Schindler C, Schikowski T, Adam M, Phuleria H, Vilier A, Clavel-Chapelon F, Declercq C, Grioni S, Krogh V, Tsai MY, Ricceri F, Sacerdote C, Galassi C, Migliore E, Ranzi A, Cesaroni G, Badaloni C, Forastiere F, Tamayo I, Amiano P, Dorronsoro M, Katsoulis M, Trichopoulou A, Brunekreef B, and Hoek G
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- Adolescent, Adult, Aged, Air Pollutants analysis, Air Pollution analysis, Cause of Death, Child, Child, Preschool, Cohort Studies, Environmental Exposure analysis, Europe epidemiology, Female, Humans, Infant, Male, Middle Aged, Multicenter Studies as Topic, Particulate Matter analysis, Young Adult, Air Pollutants toxicity, Air Pollution adverse effects, Environmental Exposure adverse effects, Particulate Matter toxicity
- Abstract
Background: Few studies on long-term exposure to air pollution and mortality have been reported from Europe. Within the multicentre European Study of Cohorts for Air Pollution Effects (ESCAPE), we aimed to investigate the association between natural-cause mortality and long-term exposure to several air pollutants., Methods: We used data from 22 European cohort studies, which created a total study population of 367,251 participants. All cohorts were general population samples, although some were restricted to one sex only. With a strictly standardised protocol, we assessed residential exposure to air pollutants as annual average concentrations of particulate matter (PM) with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and between 10 μm and 2.5 μm (PMcoarse), PM2.5 absorbance, and annual average concentrations of nitrogen oxides (NO2 and NOx), with land use regression models. We also investigated two traffic intensity variables-traffic intensity on the nearest road (vehicles per day) and total traffic load on all major roads within a 100 m buffer. We did cohort-specific statistical analyses using confounder models with increasing adjustment for confounder variables, and Cox proportional hazards models with a common protocol. We obtained pooled effect estimates through a random-effects meta-analysis., Findings: The total study population consisted of 367,251 participants who contributed 5,118,039 person-years at risk (average follow-up 13.9 years), of whom 29,076 died from a natural cause during follow-up. A significantly increased hazard ratio (HR) for PM2.5 of 1.07 (95% CI 1.02-1.13) per 5 μg/m(3) was recorded. No heterogeneity was noted between individual cohort effect estimates (I(2) p value=0.95). HRs for PM2.5 remained significantly raised even when we included only participants exposed to pollutant concentrations lower than the European annual mean limit value of 25 μg/m(3) (HR 1.06, 95% CI 1.00-1.12) or below 20 μg/m(3) (1.07, 1.01-1.13)., Interpretation: Long-term exposure to fine particulate air pollution was associated with natural-cause mortality, even within concentration ranges well below the present European annual mean limit value., Funding: European Community's Seventh Framework Program (FP7/2007-2011)., (Copyright © 2014 Elsevier Ltd. All rights reserved.)
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- 2014
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35. Adiposity, mediating biomarkers and risk of colon cancer in the European prospective investigation into cancer and nutrition study.
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Aleksandrova K, Drogan D, Boeing H, Jenab M, Bas Bueno-de-Mesquita H, Jansen E, van Duijnhoven FJ, Rinaldi S, Fedirko V, Romieu I, Kaaks R, Riboli E, Gunter MJ, Romaguera D, Westhpal S, Overvad K, Tjønneland A, Halkjaer J, Boutron-Ruault MC, Clavel-Chapelon F, Lukanova A, Trichopoulou A, Trichopoulos D, Vidalis P, Panico S, Agnoli C, Palli D, Tumino R, Vineis P, Buckland G, Sánchez-Cruz JJ, Dorronsoro M, Díaz MJ, Barricarte A, Ramon Quiros J, Peeters PH, May AM, Hallmans G, Palmqvist R, Crowe FL, Khaw KT, Wareham N, and Pischon T
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- Aged, Case-Control Studies, Colonic Neoplasms blood, Europe, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Adiposity, Biomarkers, Tumor blood, Colonic Neoplasms epidemiology, Nutritional Status
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Adiposity is a risk factor for colon cancer, but underlying mechanisms are not well understood. We evaluated the extent to which 11 biomarkers with inflammatory and metabolic actions mediate the association of adiposity measures, waist circumference (WC) and body mass index (BMI), with colon cancer in men and women. We analyzed data from a prospective nested case-control study among 662 incident colon cancer cases matched within risk sets to 662 controls. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression. The percent effect change and corresponding CIs were estimated after adjusting for biomarkers shown to be associated with colon cancer risk. After multivariable adjustment, WC was associated with colon cancer risk in men (top vs. bottom tertile RR 1.68, 95% CI 1.06-2.65; ptrend = 0.02) and in women (RR 1.67, 95% CI 1.09-2.56; ptrend = 0.03). BMI was associated with risk only in men. The association of WC with colon cancer was accounted mostly for by three biomarkers, high-density lipoprotein cholesterol, non-high-molecular-weight adiponectin and soluble leptin receptor, which in combination explained 46% (95% CI 37-57%) of the association in men and 50% (95% CI 40-65%) of the association in women. Similar results were observed for the associations with BMI in men. These data suggest that alterations in levels of these metabolic biomarkers may represent a primary mechanism of action in the relation of adiposity with colon cancer. Further studies are warranted to determine whether altering their concentrations may reduce colon cancer risk., (© 2013 UICC.)
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- 2014
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36. Dietary intakes and risk of lymphoid and myeloid leukemia in the European Prospective Investigation into Cancer and Nutrition (EPIC).
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Saberi Hosnijeh F, Peeters P, Romieu I, Kelly R, Riboli E, Olsen A, Tjønneland A, Fagherazzi G, Clavel-Chapelon F, Dossus L, Nieters A, Teucher B, Trichopoulou A, Naska A, Valanou E, Mattiello A, Sieri S, Parr CL, Engeset D, Skeie G, Dorronsoro M, Barricarte A, Sánchez MJ, Ericson U, Sonestedt E, Bueno-de-Mesquita HB, Ros MM, Travis RC, Key TJ, Vineis P, and Vermeulen R
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- Adult, Aged, Dairy Products, Energy Intake, Europe epidemiology, Female, Follow-Up Studies, Fruit, Humans, Male, Meat Products, Middle Aged, Nutrition Assessment, Nutritional Status, Nuts, Proportional Hazards Models, Prospective Studies, Risk Assessment, Risk Factors, Surveys and Questionnaires, Vegetables, White People, Feeding Behavior, Leukemia, Lymphoid epidemiology, Leukemia, Myeloid epidemiology
- Abstract
The etiology of leukemias cannot entirely be explained by known risk factors, including ionizing radiation, benzene exposure, and infection with human T cell leukemia virus. A number of studies suggested that diet influences the risk of adult leukemias. However, results have been largely inconsistent. We examined the potential association between dietary factors and risk of leukemias among participants of the European Prospective Investigation into Cancer and Nutrition study. Among the 477,325 participants with mean follow-up of 11.34 yr (SD = 2.47), 773 leukemias (373 and 342 cases of lymphoid and myeloid leukemia, respectively) were identified. Diet over the previous 12 mo was assessed at baseline using a validated country-specific dietary questionnaire. Cox proportional hazards regression was used to explore the association between dietary factors that have previously been associated with leukemia risk, including red and processed meat, poultry, offal, fish, dairy products, vegetables, fruits, and seeds/nuts, and risk of both lymphoid and myeloid leukemias. No significant associations were observed between dietary measures and total, lymphoid, and myeloid leukemias. Additional subtype analyses showed no dietary association with risk of major subtypes of leukemias. In summary, this study did not support a possible link between selected dietary factors and risk of leukemias.
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- 2014
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37. Polymorphisms of Helicobacter pylori signaling pathway genes and gastric cancer risk in the European Prospective Investigation into Cancer-Eurgast cohort.
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Companioni O, Bonet C, Muñoz X, Weiderpass E, Panico S, Tumino R, Palli D, Agnoli C, Vineis P, Boutron-Ruault MC, Racine A, Clavel-Chapelon F, Travis RC, Khaw KT, Riboli E, Murphy N, Vergnaud AC, Trichopoulou A, Benetou V, Trichopoulos D, Lund E, Johansen D, Lindkvist B, Johansson M, Sund M, Ardanaz E, Sánchez-Cantalejo E, Huerta JM, Dorronsoro M, Ramón Quirós J, Tjonneland A, Mortensen LM, Overvad K, Chang-Claude J, Rizzato C, Boeing H, Bueno-de-Mesquita HB, Siersema P, Peeters PH, Numans ME, Carneiro F, Licaj I, Freisling H, Sala N, and González CA
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- Adenocarcinoma pathology, Cardia pathology, Cohort Studies, Europe, Female, Genetic Predisposition to Disease genetics, Genotype, Helicobacter Infections genetics, Helicobacter pylori genetics, Humans, Lipopolysaccharide Receptors genetics, Male, Middle Aged, Nod2 Signaling Adaptor Protein genetics, Prospective Studies, Risk Factors, Signal Transduction, Stomach Neoplasms pathology, Adenocarcinoma genetics, Adenocarcinoma microbiology, Helicobacter Infections complications, Polymorphism, Single Nucleotide, Stomach Neoplasms genetics, Stomach Neoplasms microbiology
- Abstract
Helicobacter pylori is a recognized causal factor of noncardia gastric cancer (GC). Lipopolysaccharide and peptidoglycan of this bacterium are recognized by CD14, TLR4 and NOD2 human proteins, while NFKB1 activates the transcription of pro-inflammatory cytokines to elicit an immune response. Single nucleotide polymorphisms (SNPs) in these genes have been associated with GC in different populations. We genotyped 30 SNPs of these genes, in 365 gastric adenocarcinomas and 1,284 matched controls from the European Prospective Investigation into Cancer cohort. The association with GC and its histological and anatomical subtypes was analyzed by logistic regression and corrected for multiple comparisons. Using a log-additive model, we found a significant association between SNPs in CD14, NOD2 and TLR4 with GC risk. However, after applying the multiple comparisons tests only the NOD2 region remained significant (p = 0.009). Analysis according to anatomical subtypes revealed NOD2 and NFKB1 SNPs associated with noncardia GC and CD14 SNPs associated with cardia GC, while analysis according to histological subtypes showed that CD14 was associated with intestinal but not diffuse GC. The multiple comparisons tests confirmed the association of NOD2 with noncardia GC (p = 0.0003) and CD14 with cardia GC (p = 0.01). Haplotype analysis was in agreement with single SNP results for NOD2 and CD14 genes. From these results, we conclude that genetic variation in NOD2 associates with noncardia GC while variation in CD14 is associated with cardia GC., (Copyright © 2013 UICC.)
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- 2014
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38. Lifestyle, dietary factors, and antibody levels to oral bacteria in cancer-free participants of a European cohort study.
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Michaud DS, Izard J, Rubin Z, Johansson I, Weiderpass E, Tjønneland A, Olsen A, Overvad K, Boutron-Ruault MC, Clavel-Chapelon F, Dossus L, Kaaks R, Katzke VA, Boeing H, Foerster J, Trichopoulou A, Naska A, Ziara G, Vineis P, Grioni S, Palli D, Tumino R, Mattiello A, Peeters PH, Siersema PD, Barricarte A, Huerta JM, Molina-Montes E, Dorronsoro M, Quirós JR, Duell EJ, Ohlsson B, Jeppsson B, Johansson A, Lif P, Khaw KT, Wareham N, Travis RC, Key TJ, Freisling H, Duarte-Salles T, Stepien M, Riboli E, and Bueno-de-Mesquita HB
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- Aged, Antibodies, Bacterial immunology, Bacteria classification, Bacteria immunology, Blotting, Western, Body Mass Index, Cohort Studies, Diabetes Mellitus immunology, Diabetes Mellitus metabolism, Educational Status, Europe, Female, Host-Pathogen Interactions immunology, Humans, Immunoglobulin G immunology, Immunoglobulin G metabolism, Linear Models, Male, Microbiota, Middle Aged, Mouth microbiology, Neoplasms immunology, Neoplasms metabolism, White People, Antibodies, Bacterial metabolism, Bacteria growth & development, Diet, Life Style, Smoking
- Abstract
Background: Increasing evidence suggests that oral microbiota play a pivotal role in chronic diseases, in addition to the well-established role in periodontal disease. Moreover, recent studies suggest that oral bacteria may also be involved in carcinogenesis; periodontal disease has been linked to several cancers. In this study, we examined whether lifestyle factors have an impact on antibody levels to oral bacteria., Methods: Data on demographic characteristics, lifestyle factors, and medical conditions were obtained at the time of blood sample collection. For the current analysis, we measured antibody levels to 25 oral bacteria in 395 cancer-free individuals using an immunoblot array. Combined total immunoglobin G (IgG) levels were obtained by summing concentrations for all oral bacteria measured., Results: IgG antibody levels were substantially lower among current and former smokers (1,697 and 1,677 ng/mL, respectively) than never smokers (1,960 ng/mL; p trend = 0.01), but did not vary by other factors, including body mass index, diabetes, physical activity, or by dietary factors, after adjusting for age, sex, education, country, and smoking status. The highest levels of total IgG were found among individuals with low education (2,419 ng/mL)., Conclusions: Our findings on smoking are consistent with previous studies and support the notion that smokers have a compromised humoral immune response. Moreover, other major factors known to be associated with inflammatory markers, including obesity, were not associated with antibody levels to a large number of oral bacteria.
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- 2013
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39. Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE).
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Raaschou-Nielsen O, Andersen ZJ, Beelen R, Samoli E, Stafoggia M, Weinmayr G, Hoffmann B, Fischer P, Nieuwenhuijsen MJ, Brunekreef B, Xun WW, Katsouyanni K, Dimakopoulou K, Sommar J, Forsberg B, Modig L, Oudin A, Oftedal B, Schwarze PE, Nafstad P, De Faire U, Pedersen NL, Ostenson CG, Fratiglioni L, Penell J, Korek M, Pershagen G, Eriksen KT, Sørensen M, Tjønneland A, Ellermann T, Eeftens M, Peeters PH, Meliefste K, Wang M, Bueno-de-Mesquita B, Key TJ, de Hoogh K, Concin H, Nagel G, Vilier A, Grioni S, Krogh V, Tsai MY, Ricceri F, Sacerdote C, Galassi C, Migliore E, Ranzi A, Cesaroni G, Badaloni C, Forastiere F, Tamayo I, Amiano P, Dorronsoro M, Trichopoulou A, Bamia C, Vineis P, and Hoek G
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- Adenocarcinoma etiology, Adult, Aged, Carcinoma, Squamous Cell etiology, Environmental Exposure, Europe epidemiology, Female, Follow-Up Studies, Humans, Incidence, Lung Neoplasms etiology, Male, Middle Aged, Prognosis, Prospective Studies, Adenocarcinoma epidemiology, Air Pollution adverse effects, Carcinoma, Squamous Cell epidemiology, Lung Neoplasms epidemiology, Particulate Matter adverse effects
- Abstract
Background: Ambient air pollution is suspected to cause lung cancer. We aimed to assess the association between long-term exposure to ambient air pollution and lung cancer incidence in European populations., Methods: This prospective analysis of data obtained by the European Study of Cohorts for Air Pollution Effects used data from 17 cohort studies based in nine European countries. Baseline addresses were geocoded and we assessed air pollution by land-use regression models for particulate matter (PM) with diameter of less than 10 μm (PM10), less than 2·5 μm (PM2·5), and between 2·5 and 10 μm (PMcoarse), soot (PM2·5absorbance), nitrogen oxides, and two traffic indicators. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effects models for meta-analyses., Findings: The 312 944 cohort members contributed 4 013 131 person-years at risk. During follow-up (mean 12·8 years), 2095 incident lung cancer cases were diagnosed. The meta-analyses showed a statistically significant association between risk for lung cancer and PM10 (hazard ratio [HR] 1·22 [95% CI 1·03-1·45] per 10 μg/m(3)). For PM2·5 the HR was 1·18 (0·96-1·46) per 5 μg/m(3). The same increments of PM10 and PM2·5 were associated with HRs for adenocarcinomas of the lung of 1·51 (1·10-2·08) and 1·55 (1·05-2·29), respectively. An increase in road traffic of 4000 vehicle-km per day within 100 m of the residence was associated with an HR for lung cancer of 1·09 (0·99-1·21). The results showed no association between lung cancer and nitrogen oxides concentration (HR 1·01 [0·95-1·07] per 20 μg/m(3)) or traffic intensity on the nearest street (HR 1·00 [0·97-1·04] per 5000 vehicles per day)., Interpretation: Particulate matter air pollution contributes to lung cancer incidence in Europe., Funding: European Community's Seventh Framework Programme., (Copyright © 2013 Elsevier Ltd. All rights reserved.)
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- 2013
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40. Development and validation of a risk score predicting substantial weight gain over 5 years in middle-aged European men and women.
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Steffen A, Sørensen TI, Knüppel S, Travier N, Sánchez MJ, Huerta JM, Quirós JR, Ardanaz E, Dorronsoro M, Teucher B, Li K, Bueno-de-Mesquita HB, van der A D, Mattiello A, Palli D, Tumino R, Krogh V, Vineis P, Trichopoulou A, Orfanos P, Trichopoulos D, Hedblad B, Wallström P, Overvad K, Halkjær J, Tjønneland A, Fagherazzi G, Dartois L, Crowe F, Khaw KT, Wareham N, Middleton L, May AM, Peeters PH, and Boeing H
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- Adult, Aged, Europe, Female, Humans, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Risk Factors, Weight Gain physiology
- Abstract
Background: Identifying individuals at high risk of excess weight gain may help targeting prevention efforts at those at risk of various metabolic diseases associated with weight gain. Our aim was to develop a risk score to identify these individuals and validate it in an external population., Methods: We used lifestyle and nutritional data from 53°758 individuals followed for a median of 5.4 years from six centers of the European Prospective Investigation into Cancer and Nutrition (EPIC) to develop a risk score to predict substantial weight gain (SWG) for the next 5 years (derivation sample). Assuming linear weight gain, SWG was defined as gaining ≥ 10% of baseline weight during follow-up. Proportional hazards models were used to identify significant predictors of SWG separately by EPIC center. Regression coefficients of predictors were pooled using random-effects meta-analysis. Pooled coefficients were used to assign weights to each predictor. The risk score was calculated as a linear combination of the predictors. External validity of the score was evaluated in nine other centers of the EPIC study (validation sample)., Results: Our final model included age, sex, baseline weight, level of education, baseline smoking, sports activity, alcohol use, and intake of six food groups. The model's discriminatory ability measured by the area under a receiver operating characteristic curve was 0.64 (95% CI = 0.63-0.65) in the derivation sample and 0.57 (95% CI = 0.56-0.58) in the validation sample, with variation between centers. Positive and negative predictive values for the optimal cut-off value of ≥ 200 points were 9% and 96%, respectively., Conclusion: The present risk score confidently excluded a large proportion of individuals from being at any appreciable risk to develop SWG within the next 5 years. Future studies, however, may attempt to further refine the positive prediction of the score.
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- 2013
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41. Occupation and risk of lymphoid and myeloid leukaemia in the European Prospective Investigation into Cancer and Nutrition (EPIC).
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Saberi Hosnijeh F, Christopher Y, Peeters P, Romieu I, Xun W, Riboli E, Raaschou-Nielsen O, Tjønneland A, Becker N, Nieters A, Trichopoulou A, Bamia C, Orfanos P, Oddone E, Luján-Barroso L, Dorronsoro M, Navarro C, Barricarte A, Molina-Montes E, Wareham N, Vineis P, and Vermeulen R
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- Acute Disease, Adult, Aged, Chronic Disease, Europe epidemiology, Female, Humans, Incidence, Leukemia, Lymphoid epidemiology, Leukemia, Myeloid epidemiology, Male, Middle Aged, Multivariate Analysis, Prospective Studies, Risk Factors, Leukemia, Lymphoid etiology, Leukemia, Myeloid etiology, Occupational Diseases etiology, Occupational Exposure adverse effects, Occupations classification
- Abstract
Objectives: Established risk factors for leukaemia do not explain the majority of leukaemia cases. Previous studies have suggested the importance of occupation and related exposures in leukaemogenesis. We evaluated possible associations between job title and selected hazardous agents and leukaemia in the European Prospective Investigation into Cancer and Nutrition., Methods: The mean follow-up time for 241 465 subjects was 11.20 years (SD 2.42 years). During the follow-up period, 477 incident cases of myeloid and lymphoid leukaemia occurred. Data on 52 occupations considered a priori to be at high risk of developing cancer were collected through standardised questionnaires. Occupational exposures were estimated by linking the reported occupations to a job exposure matrix. Cox proportional hazard models were used to explore the association between occupation and related exposures and risk of leukaemia., Results: The risk of lymphoid leukaemia significantly increased for working in chemical laboratories (HR 8.35, 95% CI 1.58 to 44.24), while the risk of myeloid leukaemia increased for working in the shoe or other leather goods industry (HR 2.54, 95% CI 1.28 to 5.06). Exposure-specific analyses showed a non-significant increased risk of myeloid leukaemias for exposure to benzene (HR 1.15, 95% CI 0.75 to 1.40; HR=1.60, 95% CI 0.95 to 2.69 for the low and high exposure categories, respectively). This association was present both for acute and chronic myeloid leukaemia at high exposure levels. However, numbers were too small to reach statistical significance., Conclusions: Our findings suggest a possible role of occupational exposures in the development of both lymphoid and myeloid leukaemia. Exposure to benzene seemed to be associated with both acute and chronic myeloid leukaemia.
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- 2013
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42. Mediterranean diet and colorectal cancer risk: results from a European cohort.
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Bamia C, Lagiou P, Buckland G, Grioni S, Agnoli C, Taylor AJ, Dahm CC, Overvad K, Olsen A, Tjønneland A, Cottet V, Boutron-Ruault MC, Morois S, Grote V, Teucher B, Boeing H, Buijsse B, Trichopoulos D, Adarakis G, Tumino R, Naccarati A, Panico S, Palli D, Bueno-de-Mesquita HB, van Duijnhoven FJ, Peeters PH, Engeset D, Skeie G, Lund E, Sánchez MJ, Barricarte A, Huerta JM, Quirós JR, Dorronsoro M, Ljuslinder I, Palmqvist R, Drake I, Key TJ, Khaw KT, Wareham N, Romieu I, Fedirko V, Jenab M, Romaguera D, Norat T, and Trichopoulou A
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- Adult, Aged, Colorectal Neoplasms prevention & control, Confidence Intervals, Europe epidemiology, Female, Follow-Up Studies, Humans, Incidence, Middle Aged, Proportional Hazards Models, Prospective Studies, Risk Factors, Sex Distribution, Socioeconomic Factors, Surveys and Questionnaires, Colorectal Neoplasms epidemiology, Diet, Mediterranean, White People statistics & numerical data
- Abstract
The authors investigated the association of adherence to Mediterranean diet with colorectal cancer (CRC) risk in the European Prospective Investigation into Cancer and nutrition study. Adherence to Mediterranean diet was expressed through two 10-unit scales, the Modified Mediterranean diet score (MMDS) and the Centre-Specific MMDS (CSMMDS). Both scales share the same dietary components but differ in the cut-off values that were used for these components in the construction of the scales. Adjusted hazard ratios (HR) for the associations of these scales with CRC incidence were estimated. After 5,296,617 person-years of follow-up, 4,355 incident CRC cases were identified. A decreased risk of CRC, of 8 and 11 % was estimated when comparing the highest (scores 6-9) with the lowest (scores 0-3) adherence to CSMMDS and MMDS respectively. For MMDS the HR was 0.89 (95 % confidence interval (CI): 0.80, 0.99). A 2-unit increment in either Mediterranean scale was associated with a borderline statistically significant 3 to 4 % reduction in CRC risk (HR for MMDS: 0.96; 95 % CI: 0.92, 1.00). These associations were somewhat more evident, among women, were mainly manifested for colon cancer risk and their magnitude was not altered when alcohol was excluded from MMDS. These findings suggest that following a Mediterranean diet may have a modest beneficial effect on CRC risk.
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- 2013
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43. Anthropometric characteristics and risk of lymphoid and myeloid leukemia in the European Prospective Investigation into Cancer and Nutrition (EPIC).
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Saberi Hosnijeh F, Romieu I, Gallo V, Riboli E, Tjønneland A, Halkjær J, Fagherazzi G, Clavel-Chapelon F, Dossus L, Lukanova A, Kaaks R, Trichopoulou A, Lagiou P, Katsoulis M, Panico S, Tagliabue G, Bonet C, Dorronsoro M, Huerta JM, Ardanaz E, Sánchez MJ, Johansen D, Borgquist S, Peeters P, Bueno-de-Mesquita HB, Ros MM, Travis RC, Key TJ, Vineis P, and Vermeulen R
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- Cohort Studies, Europe epidemiology, Female, Humans, Leukemia, Lymphoid complications, Leukemia, Myeloid complications, Male, Middle Aged, Obesity complications, Prospective Studies, Risk Factors, Leukemia, Lymphoid epidemiology, Leukemia, Myeloid epidemiology, Obesity epidemiology
- Abstract
Purpose: Overweight and obesity have been suggested as a risk factor for leukemia. Impaired immune function associated with obesity, increased insulin-like growth factor-I activity and stimulating effects of leptin suggest a possible biological link between anthropometric measures and leukemia. However, evidence from epidemiological studies has been inconsistent. We examined the potential association between prospective measurements of body size and risk of leukemia among participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)., Methods: During follow-up (mean = 11.52 years, standard deviation = 2.63), 671 leukemia (lymphoid leukemia = 50.1 %, myeloid leukemia = 43.2 %) cases were identified. Anthropometric measures including weight, height, body mass index (BMI), waist circumference (WC), hip circumference, and waist-to-hip ratio (WHR) were measured. Cox proportional hazard models were used to explore the association between anthropometric measures and risk of leukemia., Results: No associations were observed between anthropometric measures and total leukemia, and lymphoid leukemia. Risk of myeloid leukemia significantly increased for higher categories of BMI and WC among women. Analyses by subtype of myeloid leukemia showed an increased risk of acute myeloid leukemia (AML) for higher categories of WHR among women. This association seemed to be reversed for chronic myeloid leukemia. No association between anthropometric measures and myeloid leukemia were observed among men except an increased risk of AML with height., Conclusion: The study showed no associations between anthropometric measures and total leukemia, and lymphoid leukemia among men and women. A possible association between BMI as general obesity and WC as abdominal obesity and increased risk of myeloid leukemia among women were observed.
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- 2013
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44. Abdominal obesity, weight gain during adulthood and risk of liver and biliary tract cancer in a European cohort.
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Schlesinger S, Aleksandrova K, Pischon T, Fedirko V, Jenab M, Trepo E, Boffetta P, Dahm CC, Overvad K, Tjønneland A, Halkjær J, Fagherazzi G, Boutron-Ruault MC, Carbonnel F, Kaaks R, Lukanova A, Boeing H, Trichopoulou A, Bamia C, Lagiou P, Palli D, Grioni S, Panico S, Tumino R, Vineis P, Bueno-de-Mesquita HB, van den Berg S, Peeters PH, Braaten T, Weiderpass E, Quirós JR, Travier N, Sánchez MJ, Navarro C, Barricarte A, Dorronsoro M, Lindkvist B, Regner S, Werner M, Sund M, Khaw KT, Wareham N, Travis RC, Norat T, Wark PA, Riboli E, and Nöthlings U
- Subjects
- Biliary Tract Neoplasms etiology, Body Composition, Body Mass Index, Body Weight, Carcinoma, Hepatocellular etiology, Case-Control Studies, Europe epidemiology, Female, Hepatitis B epidemiology, Hepatitis C epidemiology, Humans, Liver Neoplasms etiology, Male, Middle Aged, Nutritional Status, Proportional Hazards Models, Prospective Studies, Waist-Hip Ratio, Biliary Tract Neoplasms epidemiology, Carcinoma, Hepatocellular epidemiology, Liver Neoplasms epidemiology, Obesity, Abdominal epidemiology, Weight Gain
- Abstract
General obesity has been positively associated with risk of liver and probably with biliary tract cancer, but little is known about abdominal obesity or weight gain during adulthood. We used multivariable Cox proportional hazard models to investigate associations between weight, body mass index, waist and hip circumference, waist-to-hip and waist-to-height ratio (WHtR), weight change during adulthood and risk of hepatocellular carcinoma (HCC), intrahepatic (IBDC) and extrahepatic bile duct system cancer [EBDSC including gallbladder cancer (GBC)] among 359,525 men and women in the European Prospective Investigation into Cancer and Nutrition study. Hepatitis B and C virus status was measured in a nested case-control subset. During a mean follow-up of 8.6 years, 177 cases of HCC, 58 cases of IBDC and 210 cases of EBDSC, including 76 cases of GBC, occurred. All anthropometric measures were positively associated with risk of HCC and GBC. WHtR showed the strongest association with HCC [relative risk (RR) comparing extreme tertiles 3.51, 95% confidence interval (95% CI): 2.09-5.87; p(trend) < 0.0001] and with GBC (RR: 1.56, 95% CI: 1.12-2.16 for an increment of one unit in WHtR). Weight gain during adulthood was also positively associated with HCC when comparing extreme tertiles (RR: 2.48, 95% CI: 1.49-4.13; <0.001). No statistically significant association was observed between obesity and risk of IBDC and EBDSC. Our results provide evidence of an association between obesity, particularly abdominal obesity, and risk of HCC and GBC. Our findings support public health recommendations to reduce the prevalence of obesity and weight gain in adulthood for HCC and GBC prevention in Western populations., (Copyright © 2012 UICC.)
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- 2013
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45. Physical activity and risk of cerebrovascular disease in the European Prospective Investigation into Cancer and Nutrition-Spain study.
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Huerta JM, Chirlaque MD, Tormo MJ, Gavrila D, Arriola L, Moreno-Iribas C, Amiano P, Ardanaz E, Barricarte A, Dorronsoro M, Egüés N, Larrañaga N, Molina-Montes E, Quirós JR, Sánchez MJ, González CA, and Navarro C
- Subjects
- Adult, Aged, Cerebrovascular Disorders physiopathology, Cerebrovascular Disorders prevention & control, Cohort Studies, Europe epidemiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasms physiopathology, Neoplasms prevention & control, Prospective Studies, Risk Factors, Spain epidemiology, Surveys and Questionnaires, Cerebrovascular Disorders epidemiology, Motor Activity physiology, Neoplasms epidemiology, Nutrition Surveys methods
- Abstract
Background and Purpose: Large-scale prospective epidemiological data testing the association between physical activity (PA) and cerebrovascular diseases (CVDs) are scarce, particularly in Europe. The objective was to assess the risk of CVD according to PA levels in adults., Methods: We included a total of 13 576 men and 19 416 women aged 29 to 69 years and participating in the European Prospective Investigation into Cancer and Nutrition cohort in Spain, recruited between 1992 and 1996 and followed-up until 2006 to ascertain incident CVD events. The validated European Prospective Investigation into Cancer and Nutrition PA questionnaire was used to assess metabolic equivalent × hours per week dedicated to different types of PA. Hazard ratios of CVD by PA levels were estimated using multivariate Cox regression. Extensive baseline data collected on diet, lifestyle habits, medical history, and anthropometry were available to adjust for., Results: A total of 210 transient ischemic attacks and 442 stroke cases (80% ischemic, 10% hemorrhagic, 7% subarachnoid hemorrhage, and 3% mixed or unspecified) were registered after 12.3 years of mean follow-up. Recreational activity was inversely associated with risk of CVD in women but not in men. Women walking for ≥3.5 hours per week were at lower risk of stroke than those who did not engage in regular walking. No significant associations were found for other leisure time activities or vigorous PA with CVD in either sex., Conclusions: Recreational PA of moderate intensity was inversely associated with stroke incidence in women, whereas PA showed no effect on CVD risk in men. Increasing time dedicated to activities such as walking would be expected to help to reduce the stroke burden in women.
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- 2013
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46. Fruit and vegetable intake and the risk of gastric adenocarcinoma: a reanalysis of the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST) study after a longer follow-up.
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Gonzalez CA, Lujan-Barroso L, Bueno-de-Mesquita HB, Jenab M, Duell EJ, Agudo A, Tjønneland A, Boutron-Ruault MC, Clavel-Chapelon F, Touillaud M, Teucher B, Kaaks R, Boeing H, Steffen A, Trichopoulou A, Roukos D, Karapetyan T, Palli D, Tagliabue G, Mattiello A, Tumino R, Ricceri F, Siersema PD, Numans ME, Peeters PP, Parr CL, Skeie G, Lund E, Quirós JR, Sánchez-Cantalejo E, Navarro C, Barricarte A, Dorronsoro M, Ehrnström R, Regner S, Khaw KT, Wareham N, Key TJ, Crowe FL, Blaker H, Romieu I, and Riboli E
- Subjects
- Adult, Aged, Calibration, Diet, Europe epidemiology, Female, Follow-Up Studies, Humans, Life Style, Male, Middle Aged, Risk Factors, Adenocarcinoma epidemiology, Fruit, Stomach Neoplasms epidemiology, Vegetables
- Abstract
In a previous European prospective investigation into cancer and nutrition (EPIC) analysis, we found an inverse association between total intake of vegetables, onion and garlic, and risk of intestinal gastric cancer (GC) and between citrus fruit and risk of cardia GC. The aim of this study is to reanalyze the effect of fruit and vegetables (F&V), based on a longer follow-up and twice the number of GC cases. Subjects are 477,312 men and women mostly aged 35 to 70 years participating in the EPIC cohort, including 683 gastric adenocarcinomas with 11 years of follow-up. Information on diet and lifestyle was collected at baseline. A calibration study in a subsample was used to correct for dietary measurement errors. When comparing the highest vs. lowest quintile of intake, we found an inverse association between total intake of V&F and GC risk [hazard ratio (HR) 0.77; 95% confidence interval (CI) 0.57-1.04; p for trend 0.02], between fresh fruit and risk of the diffuse type (HR 0.59; 95% CI 0.36-0.97; p for trend 0.03) and an inverse association between citrus fruit and risk of cardia cancer (HR 0.61; 95% CI 0.38-1.00, p for trend 0.01). Although calibration revealed somewhat stronger inverse associations, none of the risks reached statistical significance. There was no association between total or specific vegetables intake and GC risk. The inverse association between fresh fruit and citrus fruits and risk of GC seems to be restricted to smokers and the Northern European countries. Fresh fruit and citrus fruit consumption may protect against diffuse and cardia GC, respectively., (Copyright © 2012 UICC.)
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- 2012
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47. Determinants of non- response to a second assessment of lifestyle factors and body weight in the EPIC-PANACEA study.
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May AM, Adema LE, Romaguera D, Vergnaud AC, Agudo A, Ekelund U, Steffen A, Orfanos P, Slimani N, Rinaldi S, Mouw T, Rohrmann S, Hermann S, Boeing H, Bergmann MM, Jakobsen MU, Overvad K, Wareham NJ, Gonzalez C, Tjonneland A, Halkjaer J, Key TJ, Spencer EA, Hellstrom V, Manjer J, Hedblad B, Lund E, Braaten T, Clavel-Chapelon F, Boutron-Ruault MC, Rodríguez L, Sánchez MJ, Dorronsoro M, Barricarte A, Huerta JM, Naska A, Trichopoulou A, Palli D, Pala V, Norat T, Mattiello A, Tumino R, van der A D, Bueno-de-Mesquita HB, Riboli E, and Peeters PH
- Subjects
- Adult, Aged, Anthropometry, Body Mass Index, Cross-Sectional Studies, Eating, Energy Intake, Europe epidemiology, Female, Humans, Male, Middle Aged, Prospective Studies, Restaurants, Risk Factors, Sex Factors, Weight Gain physiology, Workplace statistics & numerical data, Body Weight physiology, Obesity epidemiology
- Abstract
Background: This paper discusses whether baseline demographic, socio-economic, health variables, length of follow-up and method of contacting the participants predict non-response to the invitation for a second assessment of lifestyle factors and body weight in the European multi-center EPIC-PANACEA study., Methods: Over 500.000 participants from several centers in ten European countries recruited between 1992 and 2000 were contacted 2-11 years later to update data on lifestyle and body weight. Length of follow-up as well as the method of approaching differed between the collaborating study centers. Non-responders were compared with responders using multivariate logistic regression analyses., Results: Overall response for the second assessment was high (81.6%). Compared to postal surveys, centers where the participants completed the questionnaire by phone attained a higher response. Response was also high in centers with a short follow-up period. Non-response was higher in participants who were male (odds ratio 1.09 (confidence interval 1.07; 1.11), aged under 40 years (1.96 (1.90; 2.02), living alone (1.40 (1.37; 1.43), less educated (1.35 (1.12; 1.19), of poorer health (1.33 (1.27; 1.39), reporting an unhealthy lifestyle and who had either a low (<18.5 kg/m2, 1.16 (1.09; 1.23)) or a high BMI (>25, 1.08 (1.06; 1.10); especially ≥30 kg/m2, 1.26 (1.23; 1.29))., Conclusions: Cohort studies may enhance cohort maintenance by paying particular attention to the subgroups that are most unlikely to respond and by an active recruitment strategy using telephone interviews.
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- 2012
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48. Is concordance with World Cancer Research Fund/American Institute for Cancer Research guidelines for cancer prevention related to subsequent risk of cancer? Results from the EPIC study.
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Romaguera D, Vergnaud AC, Peeters PH, van Gils CH, Chan DS, Ferrari P, Romieu I, Jenab M, Slimani N, Clavel-Chapelon F, Fagherazzi G, Perquier F, Kaaks R, Teucher B, Boeing H, von Rüsten A, Tjønneland A, Olsen A, Dahm CC, Overvad K, Quirós JR, Gonzalez CA, Sánchez MJ, Navarro C, Barricarte A, Dorronsoro M, Khaw KT, Wareham NJ, Crowe FL, Key TJ, Trichopoulou A, Lagiou P, Bamia C, Masala G, Vineis P, Tumino R, Sieri S, Panico S, May AM, Bueno-de-Mesquita HB, Büchner FL, Wirfält E, Manjer J, Johansson I, Hallmans G, Skeie G, Benjaminsen Borch K, Parr CL, Riboli E, and Norat T
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- Adult, Aged, Cohort Studies, Diet adverse effects, Europe epidemiology, Female, Guidelines as Topic, Humans, Incidence, International Agencies, Life Style, Male, Middle Aged, Motor Activity, Neoplasms epidemiology, Organizations, Nonprofit, Overweight prevention & control, Prospective Studies, Risk, Health Promotion, Neoplasms prevention & control, Nutrition Policy, Patient Compliance
- Abstract
Background: In 2007 the World Cancer Research Fund (WCRF) and the American Institute of Cancer Research (AICR) issued 8 recommendations (plus 2 special recommendations) on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence., Objective: We aimed to investigate whether concordance with the WCRF/AICR recommendations was related to cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study., Design: The present study included 386,355 EPIC participants from 9 European countries. At recruitment, dietary, anthropometric, and lifestyle information was collected. A score was constructed based on the WCRF/AICR recommendations on weight management, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, alcoholic drinks, and breastfeeding for women; the score range was 0-6 for men and 0-7 for women. Higher scores indicated greater concordance with WCRF/AICR recommendations. The association between the score and cancer risk was estimated by using multivariable Cox regression models., Results: Concordance with the score was significantly associated with decreased risk of cancer. A 1-point increment in the score was associated with a risk reduction of 5% (95% CI: 3%, 7%) for total cancer, 12% (95% CI: 9%, 16%) for colorectal cancer, and 16% (95% CI: 9%, 22%) for stomach cancer. Significant associations were also observed for cancers of the breast, endometrium, lung, kidney, upper aerodigestive tract, liver, and esophagus but not for prostate, ovarian, pancreatic, and bladder cancers., Conclusion: Adherence to the WCRF/AICR recommendations for cancer prevention may lower the risk of developing most types of cancer.
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- 2012
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49. Total and high-molecular weight adiponectin and risk of colorectal cancer: the European Prospective Investigation into Cancer and Nutrition Study.
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Aleksandrova K, Boeing H, Jenab M, Bueno-de-Mesquita HB, Jansen E, van Duijnhoven FJ, Fedirko V, Rinaldi S, Romieu I, Riboli E, Romaguera D, Westphal S, Overvad K, Tjønneland A, Boutron-Ruault MC, Clavel-Chapelon F, Kaaks R, Lukanova A, Trichopoulou A, Lagiou P, Trichopoulos D, Agnoli C, Mattiello A, Saieva C, Vineis P, Tumino R, Peeters PH, Argüelles M, Bonet C, Sánchez MJ, Dorronsoro M, Huerta JM, Barricarte A, Palmqvist R, Hallmans G, Khaw KT, Wareham N, Allen NE, Crowe FL, and Pischon T
- Subjects
- Body Mass Index, Case-Control Studies, Colorectal Neoplasms pathology, Europe, Female, Humans, Male, Middle Aged, Molecular Weight, Obesity complications, Obesity pathology, Prospective Studies, Risk Factors, Adiponectin blood, Colorectal Neoplasms blood, Obesity blood
- Abstract
Adiponectin-an adipose tissue-derived protein-may provide a molecular link between obesity and colorectal cancer (CRC), but evidence from large prospective studies is limited. In particular, no epidemiological study explored high-molecular weight (HMW) and non-HMW adiponectin fractions in relation to CRC risk, despite them being hypothesized to have differential biological activities, i.e. regulating insulin sensitivity (HMW adiponectin) versus inflammatory response (non-HMW adiponectin). In a prospective, nested case-control study, we investigated whether prediagnostic serum concentrations of total, HMW and non-HMW adiponectin are associated with risk of CRC, independent of obesity and other known CRC risk factors. A total of 1206 incident cases (755 colon and 451 rectal) were matched to 1206 controls using incidence-density sampling. In conditional logistic regression, adjusted for dietary and lifestyle factors, total adiponectin and non-HMW adiponectin concentrations were inversely associated with risk of CRC [relative risk (RR) comparing highest versus lowest quintile = 0.71, 95% confidence interval (CI) = 0.53-0.95, P(trend) = 0.03 for total adiponectin and RR = 0.45, 95% CI = 0.34-0.61, P(trend) < 0.0001 for non-HMW adiponectin]. HMW adiponectin concentrations were not associated with CRC risk (RR = 0.91, 95% CI = 0.68-1.22, P(trend) = 0.55). Non-HMW adiponectin was associated with CRC risk even after adjustment for body mass index and waist circumference (RR = 0.39, 95% CI = 0.26-0.60, P(trend) < 0.0001), whereas the association with total adiponectin was no longer significant (RR = 0.81, 95% CI = 0.60-1.09, P(trend) = 0.23). When stratified by cancer site, non-HMW adiponectin was inversely associated with both colon and rectal cancer. These findings suggest an important role of the relative proportion of non-HMW adiponectin in CRC pathogenesis. Future studies are warranted to confirm these results and to elucidate the underlying mechanisms.
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- 2012
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50. Intragenic ATM methylation in peripheral blood DNA as a biomarker of breast cancer risk.
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Brennan K, Garcia-Closas M, Orr N, Fletcher O, Jones M, Ashworth A, Swerdlow A, Thorne H, Riboli E, Vineis P, Dorronsoro M, Clavel-Chapelon F, Panico S, Onland-Moret NC, Trichopoulos D, Kaaks R, Khaw KT, Brown R, and Flanagan JM
- Subjects
- Adult, Aged, Aged, 80 and over, Ataxia Telangiectasia Mutated Proteins, Australia epidemiology, Breast Neoplasms blood, Breast Neoplasms epidemiology, Case-Control Studies, DNA, Neoplasm genetics, Europe epidemiology, Female, Humans, Leukocytes physiology, Middle Aged, New Zealand epidemiology, United Kingdom epidemiology, Young Adult, Breast Neoplasms genetics, Cell Cycle Proteins genetics, DNA Methylation, DNA, Neoplasm blood, DNA-Binding Proteins genetics, Protein Serine-Threonine Kinases genetics, Tumor Suppressor Proteins genetics
- Abstract
Few studies have evaluated the association between DNA methylation in white blood cells (WBC) and the risk of breast cancer. The evaluation of WBC DNA methylation as a biomarker of cancer risk is of particular importance as peripheral blood is often available in prospective cohorts and easier to obtain than tumor or normal tissues. Here, we used prediagnostic blood samples from three studies to analyze WBC DNA methylation of two ATM intragenic loci (ATMmvp2a and ATMmvp2b) and genome-wide DNA methylation in long interspersed nuclear element-1 (LINE1) repetitive elements. Samples were from a case-control study derived from a cohort of high-risk breast cancer families (KConFab) and nested case-control studies in two prospective cohorts: Breakthrough Generations Study (BGS) and European Prospective Investigation into Cancer and Nutrition (EPIC). Bisulfite pyrosequencing was used to quantify methylation from 640 incident cases of invasive breast cancer and 741 controls. Quintile analyses for ATMmvp2a showed an increased risk of breast cancer limited to women in the highest quintile [OR, 1.89; 95% confidence interval (CI), 1.36-2.64; P = 1.64 × 10(-4)]. We found no significant differences in estimates across studies or in analyses stratified by family history or menopausal status. However, a more consistent association was observed in younger than in older women and individually significant in KConFab and BGS, but not EPIC. We observed no differences in LINE1 or ATMmvp2b methylation between cases and controls. Together, our findings indicate that WBC DNA methylation levels at ATM could be a marker of breast cancer risk and further support the pursuit of epigenome-wide association studies of peripheral blood DNA methylation., (©2012 AACR)
- Published
- 2012
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