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1. Lifetime and baseline alcohol intake and risk of colon and rectal cancers in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author

Ferrari, P. Jenab, M. Norat, T. Moskal, A. Slimani, N. Olsen, A. Tjønneland, A. Overvad, K. Jensen, M.K. Boutron-Ruault, M.-C. Clavel-Chapelon, F. Morois, S. Rohrmann, S. Linseisen, J. Boeing, H. Bergmann, M. Kontopoulou, D. Trichopoulou, A. Kassapa, C. Masala, G. Krogh, V. Vineis, P. Panico, S. Tumino, R. Van Gils, C.H. Peeters, P. Bueno-de-Mesquita, H.B. Ocké, M.C. Skeie, G. Lund, E. Agudo, A. Ardanaz, E. López, D.C. Sanchez, M.-J. Quirós, J.R. Amiano, P. Berglund, G. Manjer, J. Palmqvist, R. Van Guelpen, B. Allen, N. Key, T. Bingham, S. Mazuir, M. Boffetta, P. Kaaks, R. Riboli, E.

Abstract

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

Published
2007

2. Consumption and portion sizes of tree nuts, peanuts and seeds in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries

Author

Jenab, M. Sabaté, J. Slimani, N. Ferrari, P. Mazuir, M. Casagrande, C. Deharveng, G. Tjønneland, A. Olsen, A. Overvad, K. Boutron-Ruault, M.C. Clavel-Chapelon, F. Boeing, H. Weikert, C. Linseisen, J. Rohrmann, S. Trichopoulou, A. Naska, A. Palli, D. Sacerdote, C. Tumino, R. Mattiello, A. Pala, V. Bueno-De-Mesquita, H.B. Ocké, M.C. Peeters, P.H. Engeset, D. Skeie, G. Jakszyn, P. Ardanaz, E. Quirós, J.R. Chirlaque, M.D. Martinez, C. Amiano, P. Berglund, G. Palmqvist, R. Van Guelpen, B. Bingham, S. Key, T. Riboli, E.

Subjects
food and beverages
Abstract

Tree nuts, peanuts and seeds are nutrient dense foods whose intake has been shown to be associated with reduced risk of some chronic diseases. They are regularly consumed in European diets either as whole, in spreads or from hidden sources (e.g. commercial products). However, little is known about their intake profiles or differences in consumption between European countries or geographic regions. The objective of this study was to analyse the population mean intake and average portion sizes in subjects reporting intake of nuts and seeds consumed as whole, derived from hidden sources or from spreads. Data was obtained from standardised 24-hour dietary recalls collected from 36 994 subjects in 10 different countries that are part of the European Prospective Investigation into Cancer and Nutrition (EPIC). Overall, for nuts and seeds consumed as whole, the percentage of subjects reporting intake on the day of the recall was: tree nuts = 4· 4%, peanuts = 2·3% and seeds = 1·3%. The data show a clear northern (Sweden: mean intake = 0·15 g/d, average portion size = 15·1 g/d) to southern (Spain: mean intake = 2·99 g/d, average portion size = 34·7 g/d) European gradient of whole tree nut intake. The three most popular tree nuts were walnuts, almonds and hazelnuts, respectively. In general, tree nuts were more widely consumed than peanuts or seeds. In subjects reporting intake, men consumed a significantly higher average portion size of tree nuts (28·5 v. 23·1 g/d, P,0·01) and peanuts (46·1 v. 35·1 g/d, P,0·01) per day than women. These data may be useful in devising research initiatives and health policy strategies based on the intake of this food group. © The Authors 2006.

Published
2006

3. Physical activity and risk of colon and rectal cancers: The European Prospective Investigation into Cancer and Nutrition

Author

Friedenreich, C. Norat, T. Steindorf, K. Boutron-Ruault, M.-C. Pischon, T. Mazuir, M. Clavel-Chapelon, F. Linseisen, J. Boeing, H. Bergman, M. Johnsen, N.F. Tjønneland, A. Overvad, K. Mendez, M. Quirós, J.R. Martinez, C. Dorronsoro, M. Navarro, C. Barricarte Gurrea, A. Bingham, S. Khaw, K.-T. Allen, N. Key, T. Trichopoulou, A. Trichopoulos, D. Orfanou, N. Krogh, V. Palli, D. Tumino, R. Panico, S. Vineis, P. Bueno-De-Mesquita, H.B. Peeters, P.H.M. Monninkhof, E. Berglund, G. Manjer, J. Ferrari, P. Slimani, N. Kaaks, R. Riboli, E.

Abstract

We investigated several aspects of the role of physical activity in colon and rectal cancer etiology that remain unclear in the European Prospective Investigation into Nutrition and Cancer. This cohort of 413,044 men and women had 1,094 cases of colon and 599 cases of rectal cancer diagnosed during an average of 6.4 years of follow-up. We analyzed baseline data on occupational, household, and recreational activity to examine associations by type of activity, tumor subsite, body mass index (BMI), and energy intake. The multivariate hazard ratio for colon cancer was 0.78 [95% confidence interval (95% CI), 0.59-1.03] among the most active participants when compared with the inactive, with evidence of a dose-response effect (Ptrend = 0.04). For right-sided colon tumors, the risk was 0.65 (95% CI, 0.43-1.00) in the highest quartile of activity with evidence of a linear trend (Ptrend = 0.004). Active participants with a BMI under 25 had a risk of 0.63 (95% CI, 0.39-1.01) for colon cancer compared with the inactive. Finally, an interaction between BMI and activity (Pinteraction = 0.03) was observed for right-sided colon cancers; among moderately active and active participants with a BMI under 25, a risk of 0.38 (95% CI, 0.21-0.68) was found as compared with inactive participants with BMI >30. No comparable decreased risks were observed for rectal cancer for any type of physical activity for any subgroup analyses or interactions considered. We found that physical activity reduced colon cancer risk, specifically for right-sided tumors and for lean participants, but not rectal cancer. Copyright © 2006 American Association for Cancer Research.

Published
2006

4. Meat, fish, and colorectal cancer risk: The European prospective investigation into cancer and nutrition

Author

Norat, T Bingham, S Ferrari, P Slimani, N Jenab, M and Mazuir, M Overvad, K Olsen, A Tjonneland, A Clavel, F and Boutron-Ruault, MC Kesse, E Boeing, H Bergmann, MM and Nieters, A Linseisen, J Trichopoulou, A Trichopoulos, D and Tountas, Y Berrino, F Palli, D Panico, S Tumino, R and Vineis, P Bueno-De-Mesquita, HB Peeters, PHM Engeset, D and Lund, E Skeie, G Ardanaz, E Gonzalez, C Navarro, C and Quiros, JR Sanchez, MJ Berglund, G Mattisson, I and Hallmans, G Palmqvist, R Day, NE Khaw, KT Key, TJ and San Joaquin, M Hemon, B Saracci, R Kaaks, R Riboli, E

Abstract

Background. Current evidence suggests that high red meat intake is associated with increased colorectal cancer risk. High fish intake may be associated with a decreased risk, but the existing evidence is less convincing. Methods: We prospectively followed 478040 men and women from 10 European countries who were free of cancer at enrollment between 1992 and 1998. Information on diet and lifestyle was collected at baseline. After a mean follow-up of 4.8 years, 1329 incident colorectal cancers were documented. We examined the relationship between intakes of red and processed meat, poultry, and fish and colorectal cancer risk using a proportional hazards model adjusted for age, sex, energy (nonfat and fat sources), height, weight, work-related physical activity, smoking status, dietary fiber and folate, and alcohol consumption, stratified by center. A calibration substudy based on 36994 subjects was used to correct hazard ratios (HRs) and 95% confidence intervals (CIs) for diet measurement errors. All statistical tests were two-sided. Results: Colorectal cancer risk was positively associated with intake of red and processed meat (highest [> 160 g/day] versus lowest [< 20 g/day] intake, HR = 1.35, 95% CI = 0.96 to 1.88; P-trend = .03) and inversely associated with intake of fish (> 80 g/day versus < 10 g/day, HR = 0.69, 95% CI = 0.54 to 0.88; P-trend < .001), but was not related to poultry intake. Correcting for measurement error strengthened the associations between colorectal cancer and red and processed meat intake (per 100-g increase HR = 1.25, 95% CI = 1.09 to 1.41, P-trend = .001 and HR = 1.55, 95% CI = 1.19 to 2.02, P-trend = .001 before and after calibration, respectively) and for fish (per 100 g increase HR = 0.70, 95% CI = 0.57 to 0.87, P-trend < .001 and HR = 0.46, 95% CI = 0.27 to 0.77, P-trend = .003; before and after correction, respectively). In this study population, the absolute risk of development of colorectal cancer within 10 years for a study subject aged 50 years was 1.71% for the highest category of red and processed meat intake and 1.28% for the lowest category of intake and was 1.86% for subjects in the lowest category of fish intake and 1.28% for subjects in the highest category of fish intake. Conclusions: Our data confirm that colorectal cancer risk is positively associated with high consumption of red and processed meat and support an inverse association with fish intake.

Published
2005

6. Meat, fish and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition.

Author

Norat, T., Bingham, S, Ferrari, P., Slimani, N., Jenab, M., Mazuir, M., Overvad, K., Olsen, A., Tjonneland, A., Clavel, F., Boutron-Ruault, M.C., Kesse, E., Boeing, H.H., Bergmann, M.M., Nieters, A., Linseisen, J., Trichopoulou, A., Trichopoulos, D., Tountas, Y., Berrino, F., Palli, D., Panico, S., Tumino, R., Vineis, P., Bueno de Mesquita, H.B., Peeters, P.H.M., Engeset, D., Lund, E., Skeie, G., Ardanaz, E., Gonzalez, C., Navarro, C., Quiros, J.R., Sanchez, M.J., Berglund, G., Mattisson, I., Hallmans, G., Palmqvist, R., Day, N.E., Khaw, K.T., Key, T.J., San Joaquin, M., Hemon, B., Saracci, R., Kaaks, R., Riboli, E., Norat, T., Bingham, S, Ferrari, P., Slimani, N., Jenab, M., Mazuir, M., Overvad, K., Olsen, A., Tjonneland, A., Clavel, F., Boutron-Ruault, M.C., Kesse, E., Boeing, H.H., Bergmann, M.M., Nieters, A., Linseisen, J., Trichopoulou, A., Trichopoulos, D., Tountas, Y., Berrino, F., Palli, D., Panico, S., Tumino, R., Vineis, P., Bueno de Mesquita, H.B., Peeters, P.H.M., Engeset, D., Lund, E., Skeie, G., Ardanaz, E., Gonzalez, C., Navarro, C., Quiros, J.R., Sanchez, M.J., Berglund, G., Mattisson, I., Hallmans, G., Palmqvist, R., Day, N.E., Khaw, K.T., Key, T.J., San Joaquin, M., Hemon, B., Saracci, R., Kaaks, R., and Riboli, E.

Published
2005

7. Meat, fish and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition.

Author

JC onderzoeksprogramma Kanker, Epidemiology & Health Economics, Norat, T., Bingham, S, Ferrari, P., Slimani, N., Jenab, M., Mazuir, M., Overvad, K., Olsen, A., Tjonneland, A., Clavel, F., Boutron-Ruault, M.C., Kesse, E., Boeing, H.H., Bergmann, M.M., Nieters, A., Linseisen, J., Trichopoulou, A., Trichopoulos, D., Tountas, Y., Berrino, F., Palli, D., Panico, S., Tumino, R., Vineis, P., Bueno de Mesquita, H.B., Peeters, P.H.M., Engeset, D., Lund, E., Skeie, G., Ardanaz, E., Gonzalez, C., Navarro, C., Quiros, J.R., Sanchez, M.J., Berglund, G., Mattisson, I., Hallmans, G., Palmqvist, R., Day, N.E., Khaw, K.T., Key, T.J., San Joaquin, M., Hemon, B., Saracci, R., Kaaks, R., Riboli, E., JC onderzoeksprogramma Kanker, Epidemiology & Health Economics, Norat, T., Bingham, S, Ferrari, P., Slimani, N., Jenab, M., Mazuir, M., Overvad, K., Olsen, A., Tjonneland, A., Clavel, F., Boutron-Ruault, M.C., Kesse, E., Boeing, H.H., Bergmann, M.M., Nieters, A., Linseisen, J., Trichopoulou, A., Trichopoulos, D., Tountas, Y., Berrino, F., Palli, D., Panico, S., Tumino, R., Vineis, P., Bueno de Mesquita, H.B., Peeters, P.H.M., Engeset, D., Lund, E., Skeie, G., Ardanaz, E., Gonzalez, C., Navarro, C., Quiros, J.R., Sanchez, M.J., Berglund, G., Mattisson, I., Hallmans, G., Palmqvist, R., Day, N.E., Khaw, K.T., Key, T.J., San Joaquin, M., Hemon, B., Saracci, R., Kaaks, R., and Riboli, E.

Published
2005

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

Author

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

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

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

Published
2007

10. Meat, fish, and colorectal cancer risk: the European Prospective Investigation into cancer and nutrition

Author

Salvatore Panico, Emmanuelle Kesse, Pietro Ferrari, Bertrand Hémon, Anne Tjønneland, Eiliv Lund, Guri Skeie, Timothy J. Key, Kim Overvad, Göran Berglund, H. Bas Bueno-de-Mesquita, Carmen Navarro, Mazda Jenab, Teresa Norat, Iréne Mattisson, Nicholas E. Day, Carlos González, Dagrun Engeset, María José Sánchez, Marie-Christine Boutron-Ruault, Rudolf Kaaks, Françoise Clavel, Mathieu Mazuir, Elio Riboli, Petra H.M. Peeters, Yannis Tountas, Göran Hallmans, Manuela M. Bergmann, Anja Olsen, Sheila Bingham, Nadia Slimani, Antonia Trichopoulou, Richard Palmqvist, Dimitrios Trichopoulos, Heiner Boeing, Rosario Tumino, Jakob Linseisen, Franco Berrino, Paolo Vineis, Rodolfo Saracci, J. Ramón Quirós, Eva Ardanaz, Kay-Tee Khaw, Domenico Palli, Alexandra Nieters, Unit of Nutrition, Environment, and Cancer, Catalan Institute of Oncology, Nutrition Unit, MRC Dunn Human, Department of Clinical Epidemiology, Aarhus University Hospital, Department of Cardiology and Department of Clinical Epidemiology, Institute of Cancer Epidemiology, Danish Cancer Society, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke (DifE), Leibniz Association, Division of Clinical Epidemiology, Deutches Krebsforschungszentrum, Department of Hygiene and Epidemiology, University of Athens Medical School [Athens], Epidemiology Unit, Istituto Tumori, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Center, Department of Clinical and Experimental Medicine, Università degli studi di Napoli Federico II, Ragusa Cancer Registry, Azienda Ospedaliera Civile MP, University of Torino and CPO-Piemonte, Università degli studi di Torino (UNITO), Center for Nutrition and Health, National Institute of Public Health and Environment, Julius Center for Health Sciences and Primary Care, VU University Medical Center [Amsterdam], Institute of Community Medicine, University of Tromsø (UiT), Public Health Institute of Navarra, Department of Epidemiology, Epidemiology Department, Health Council of Murcia, Public Health and Health Planning Directorate, Andalusian School of Public Health [Granada], Malmö Diet and Cancer Study, Lund University [Lund], Department of Nutritional Research, Umeå University, Department of Medical Biosciences, Pathology, Strangeways Research Laboratory, Clinical Gerontology Unit, University of Cambridge [UK] (CAM), Cancer Research UK Epidemiology Unit, University of Oxford [Oxford], The work described in this article was carried out with financial support of the 'Europe Against Cancer Program' of the European Commission (SANCO), the Danish Cancer Society, German Cancer Aid, Ligue Nationale contre le Cancer, the 3M Company, INSERM, the German Cancer Research Center, the GermanFederal Ministry of Education and Research, the Dutch Ministry of Public Health, Welfare and Sports, the National Cancer Registry and the Regional Cancer Registries Amsterdam, East and Maastricht of The Netherlands, the Norwegian Cancer Society, the Norwegian Research Council, the Health Research Fund (FIS) of the Spanish Ministry of Health, the Greek Ministry of Health, the Greek Ministry of Education, the Italian Association for Research on Cancer, Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, and ISCIII, Red de Centros RCESP, C03/09, the Swedish Cancer Society, the Swedish Scientific Council, the Regional Government of Skane, Sweden, Cancer Research UK, the Medical Research Council, U.K., the Stroke Association, U.K., the British Heart Foundation, the Department of Health, U.K., the Food Standards Agency, U.K., and the Wellcome Trust, U.K., University of Naples Federico II = Università degli studi di Napoli Federico II, Università degli studi di Torino = University of Turin (UNITO), University of Oxford, Clavel-Chapelon, F., Norat, T, Bingham, S, Ferrari, P, Slimani, N, Jenab, M, Mazuir, M, Overvad, K, Olsen, A, Tjonneland, A, Clavel, F, BOUTRON RUAULT, Mc, Kesse, E, Boeing, H, Bergmann, Mm, Nieters, A, Linseisen, J, Trichopoulou, A, Trichopoulos, D, Tountas, Y, Berrino, F, Palli, D, Panico, Salvatore, Tumino, R, Vineis, P, BUENO DE MESQUITA, Hb, Peeters, Ph, Engeset, D, Lund, E, Skeie, G, Ardanaz, E, Gonzalez, C, Navarro, C, Quiros, Jr, Sanchez, Mj, Berglund, G, Mattisson, I, Hallmans, G, Palmqvist, R, Day, Ne, Khaw, Kt, Key, Tj, SAN JOAQUIN, M, Hemon, B, Saracci, R, Kaaks, R, and Riboli, E.

Subjects
Dietary Fiber, Male, Cancer Research, 030309 nutrition & dietetics, Colorectal cancer, MESH: Food Habits, Gastroenterology, Poultry, MESH: Proportional Hazards Models, 0302 clinical medicine, Risk Factors, MESH: Poultry, Surveys and Questionnaires, Odds Ratio, MESH: Animals, Prospective Studies, Prospective cohort study, 2. Zero hunger, MESH: Aged, MESH: Meat, 0303 health sciences, MESH: Middle Aged, MESH: Risk, Fishes, Absolute risk reduction, MESH: Life Style, Confounding Factors, Epidemiologic, Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Oncology, Research Design, 030220 oncology & carcinogenesis, Income, Red meat, Educational Status, Population study, Female, Colorectal Neoplasms, Adult, medicine.medical_specialty, Meat, [SDV.CAN]Life Sciences [q-bio]/Cancer, Risk Assessment, Article, MESH: Multivariate Analysis, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Animals, Humans, ddc:610, European Union, Risk factor, Life Style, Aged, Proportional Hazards Models, MESH: Humans, business.industry, MESH: Questionnaires, Cancer, MESH: Adult, Feeding Behavior, medicine.disease, MESH: Male, MESH: Odds Ratio, MESH: Prospective Studies, Surgery, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, MESH: Fishes, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Multivariate Analysis, MESH: Dietary Fiber, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Europe, business, MESH: Female, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, MESH: Colorectal Neoplasms
Abstract

Background: Current evidence suggests that high red meat intake is associated with increased colorectal cancer risk. High fish intake may be associated with a decreased risk, but the existing evidence is less convincing. Methods: We prospectively followed 478 040 men and women from 10 European countries who were free of cancer at enrollment between 1992 and 1998. Information on diet and lifestyle was collected at baseline. After a mean follow-up of 4.8 years, 1329 incident colorectal cancers were documented. We examined the relationship between intakes of red and processed meat, poultry, and fish and colorectal cancer risk using a proportional hazards model adjusted for age, sex, energy (nonfat and fat sources), height, weight, work-related physical activity, smoking status, dietary fiber and folate, and alcohol consumption, stratified by center. A calibration substudy based on 36 994 subjects was used to correct hazard ratios (HRs) and 95% confidence intervals (CIs) for diet measurement errors. All statistical tests were two-sided. Results: Colorectal cancer risk was positively associated with intake of red and processed meat (highest [>160 g/day] versus lowest [80 g/day versus

Published
2016

11. Physical activity and risk of colon and rectal cancers: the European prospective investigation into cancer and nutrition

Author

Kay-Tee Khaw, Jakob Linseisen, H. Bas Bueno-de-Mesquita, Paolo Vineis, Nina Føns Johnsen, Teresa Norat, J. Ramón Quirós, Christine M. Friedenreich, Dimitrios Trichopoulos, Manuela M. Bergman, Heiner Boeing, Petra H.M. Peeters, Karen Steindorf, Evelyn M. Monninkhof, Anne Tjønneland, Naomi E. Allen, Rosario Tumino, Natassa Orfanou, Françoise Clavel-Chapelon, Jonas Manjer, Göran Berglund, Kim Overvad, Domenico Palli, Elio Riboli, Carmen Martinez, Marie-Christine Boutron-Ruault, Salvatore Panico, Miren Dorronsoro, Michelle A. Mendez, Carmen Navarro, Tobias Pischon, Nadia Slimani, Mathieu Mazuir, Pietro Ferrari, Timothy J. Key, Aurelio Barricarte Gurrea, Sheila Bingham, Antonia Trichopoulou, Rudolf Kaaks, Vittorio Krogh, Friedenreich, C, Norat, T, Steindorf, K, BOUTRON RUAULT, Mc, Pischon, T, Mazuir, M, CLAVEL CHAPELON, F, Linseisen, J, Boeing, H, Bergman, M, Johnsen, Nf, Tjonneland, A, Overvad, K, Mendez, M, Quiros, Jr, Martinez, C, Dorronsoro, M, Navarro, C, Gurrea, Ab, Bingham, S, Khaw, Kt, Allen, N, Key, T, Trichopoulou, A, Trichopoulos, D, Orfanou, N, Krogh, V, Palli, D, Tumino, R, Panico, Salvatore, Vineis, P, BUENO DE MESQUITA, Hb, Peeters, Ph, Monninkhof, E, Berglund, G, Manjer, J, Ferrari, P, Slimani, N, Kaaks, R, and Riboli, E.

Subjects
Male, medicine.medical_specialty, Nutritional Sciences, Epidemiology, Colorectal cancer, etiology, physical activity, Motor Activity, Gastroenterology, Body Mass Index, endometrial cancer, biologic mechanisms, Risk Factors, Internal medicine, Humans, Medicine, Prospective Studies, Risk factor, Rectal Neoplasms, business.industry, Endometrial cancer, Hazard ratio, Cancer, Middle Aged, medicine.disease, European Prospective Investigation into Cancer and Nutrition, Europe, Oncology, Colonic Neoplasms, Cohort, Female, Energy Intake, business, Body mass index
Abstract

We investigated several aspects of the role of physical activity in colon and rectal cancer etiology that remain unclear in the European Prospective Investigation into Nutrition and Cancer. This cohort of 413,044 men and women had 1,094 cases of colon and 599 cases of rectal cancer diagnosed during an average of 6.4 years of follow-up. We analyzed baseline data on occupational, household, and recreational activity to examine associations by type of activity, tumor subsite, body mass index (BMI), and energy intake. The multivariate hazard ratio for colon cancer was 0.78 [95% confidence interval (95% CI), 0.59-1.03] among the most active participants when compared with the inactive, with evidence of a dose-response effect (Ptrend = 0.04). For right-sided colon tumors, the risk was 0.65 (95% CI, 0.43-1.00) in the highest quartile of activity with evidence of a linear trend (Ptrend = 0.004). Active participants with a BMI under 25 had a risk of 0.63 (95% CI, 0.39-1.01) for colon cancer compared with the inactive. Finally, an interaction between BMI and activity (Pinteraction = 0.03) was observed for right-sided colon cancers; among moderately active and active participants with a BMI under 25, a risk of 0.38 (95% CI, 0.21-0.68) was found as compared with inactive participants with BMI >30. No comparable decreased risks were observed for rectal cancer for any type of physical activity for any subgroup analyses or interactions considered. We found that physical activity reduced colon cancer risk, specifically for right-sided tumors and for lean participants, but not rectal cancer. (Cancer Epidemiol Biomarkers Prev 2006;15(12):2398–407)

Published
2006

12. Oral cavity cancer in developed and in developing countries: population-based incidence.

Author

de Camargo Cancela M, Voti L, Guerra-Yi M, Chapuis F, Mazuir M, and Curado MP

Subjects
Adult, Age Distribution, Aged, Female, Humans, Incidence, Male, Middle Aged, Mouth Neoplasms pathology, Mouth Neoplasms therapy, Registries, Risk Factors, Sex Distribution, Socioeconomic Factors, Young Adult, Developed Countries statistics & numerical data, Developing Countries statistics & numerical data, Mouth Neoplasms epidemiology
Abstract

Background: The incidence of oral cavity cancer (OCC) is not well documented because it is rarely described in accord with the anatomic definition but is usually grouped with oropharyngeal subsites. We studied the incidence of OCC in developed and in developing countries., Methods: The age-standardized and age-specific incidence rates of OCC were calculated for the period 1998-2002, using the topographic definition used by the Union Internationale Contre le Cancer (UICC), based on data from CI5-IX., Results: The highest rates are observed in Pakistan, Brazil, India, and France and were consistent with country-specific risk factors and their prevalence., Conclusions: In developing countries, people are exposed to a wider range of risk factors, starting at younger ages, and primary prevention measures and policies are needed. Awareness of professionals must be improved to identify people at risk and target them for prevention and to minimize the consequences of OCC.

Published
2010
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13. Lifetime and baseline alcohol intake and risk of colon and rectal cancers in the European prospective investigation into cancer and nutrition (EPIC).

Author

Ferrari P, Jenab M, Norat T, Moskal A, Slimani N, Olsen A, Tjønneland A, Overvad K, Jensen MK, Boutron-Ruault MC, Clavel-Chapelon F, Morois S, Rohrmann S, Linseisen J, Boeing H, Bergmann M, Kontopoulou D, Trichopoulou A, Kassapa C, Masala G, Krogh V, Vineis P, Panico S, Tumino R, Gils CHV, Peeters P, Bueno-de-Mesquita HB, Ocké MC, Skeie G, Lund E, Agudo A, Ardanaz E, López DC, Sanchez MJ, Quirós JR, Amiano P, Berglund G, Manjer J, Palmqvist R, Guelpen BV, Allen N, Key T, Bingham S, Mazuir M, Boffetta P, Kaaks R, and Riboli E

Subjects
Europe, Female, Humans, Male, Middle Aged, Risk Factors, Sex Characteristics, Time Factors, Alcohol Drinking adverse effects, Colonic Neoplasms epidemiology, Nutrition Assessment, Rectal Neoplasms epidemiology
Abstract

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

Published
2007
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14. Physical activity and risk of colon and rectal cancers: the European prospective investigation into cancer and nutrition.

Author

Friedenreich C, Norat T, Steindorf K, Boutron-Ruault MC, Pischon T, Mazuir M, Clavel-Chapelon F, Linseisen J, Boeing H, Bergman M, Johnsen NF, Tjønneland A, Overvad K, Mendez M, Quirós JR, Martinez C, Dorronsoro M, Navarro C, Gurrea AB, Bingham S, Khaw KT, Allen N, Key T, Trichopoulou A, Trichopoulos D, Orfanou N, Krogh V, Palli D, Tumino R, Panico S, Vineis P, Bueno-de-Mesquita HB, Peeters PH, Monninkhof E, Berglund G, Manjer J, Ferrari P, Slimani N, Kaaks R, and Riboli E

Subjects
Body Mass Index, Colonic Neoplasms epidemiology, Energy Intake, Europe epidemiology, Female, Humans, Male, Middle Aged, Prospective Studies, Rectal Neoplasms epidemiology, Risk Factors, Colonic Neoplasms etiology, Motor Activity, Nutritional Sciences, Rectal Neoplasms etiology
Abstract

We investigated several aspects of the role of physical activity in colon and rectal cancer etiology that remain unclear in the European Prospective Investigation into Nutrition and Cancer. This cohort of 413,044 men and women had 1,094 cases of colon and 599 cases of rectal cancer diagnosed during an average of 6.4 years of follow-up. We analyzed baseline data on occupational, household, and recreational activity to examine associations by type of activity, tumor subsite, body mass index (BMI), and energy intake. The multivariate hazard ratio for colon cancer was 0.78 [95% confidence interval (95% CI), 0.59-1.03] among the most active participants when compared with the inactive, with evidence of a dose-response effect (P(trend) = 0.04). For right-sided colon tumors, the risk was 0.65 (95% CI, 0.43-1.00) in the highest quartile of activity with evidence of a linear trend (P(trend) = 0.004). Active participants with a BMI under 25 had a risk of 0.63 (95% CI, 0.39-1.01) for colon cancer compared with the inactive. Finally, an interaction between BMI and activity (P(interaction) = 0.03) was observed for right-sided colon cancers; among moderately active and active participants with a BMI under 25, a risk of 0.38 (95% CI, 0.21-0.68) was found as compared with inactive participants with BMI >30. No comparable decreased risks were observed for rectal cancer for any type of physical activity for any subgroup analyses or interactions considered. We found that physical activity reduced colon cancer risk, specifically for right-sided tumors and for lean participants, but not rectal cancer.

Published
2006
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15. Variations in lycopene blood levels and tomato consumption across European countries based on the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

Author

Jenab M, Ferrari P, Mazuir M, Tjonneland A, Clavel-Chapelon F, Linseisen J, Trichopoulou A, Tumino R, Bueno-de-Mesquita HB, Lund E, Gonzalez CA, Johansson G, Key TJ, and Riboli E

Subjects
Europe, Feeding Behavior, Humans, Lycopene, Anticarcinogenic Agents blood, Carotenoids blood, Solanum lycopersicum, Neoplasms prevention & control, Nutritional Physiological Phenomena
Published
2005
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16. Meat, fish, and colorectal cancer risk: the European Prospective Investigation into cancer and nutrition.

Author

Norat T, Bingham S, Ferrari P, Slimani N, Jenab M, Mazuir M, Overvad K, Olsen A, Tjønneland A, Clavel F, Boutron-Ruault MC, Kesse E, Boeing H, Bergmann MM, Nieters A, Linseisen J, Trichopoulou A, Trichopoulos D, Tountas Y, Berrino F, Palli D, Panico S, Tumino R, Vineis P, Bueno-de-Mesquita HB, Peeters PH, Engeset D, Lund E, Skeie G, Ardanaz E, González C, Navarro C, Quirós JR, Sanchez MJ, Berglund G, Mattisson I, Hallmans G, Palmqvist R, Day NE, Khaw KT, Key TJ, San Joaquin M, Hémon B, Saracci R, Kaaks R, and Riboli E

Subjects
Adult, Aged, Animals, Europe epidemiology, Female, Humans, Life Style, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Poultry, Proportional Hazards Models, Prospective Studies, Risk Assessment, Risk Factors, Surveys and Questionnaires, Colorectal Neoplasms epidemiology, Colorectal Neoplasms etiology, Dietary Fiber administration & dosage, Feeding Behavior, Fishes, Meat
Abstract

Background: Current evidence suggests that high red meat intake is associated with increased colorectal cancer risk. High fish intake may be associated with a decreased risk, but the existing evidence is less convincing., Methods: We prospectively followed 478 040 men and women from 10 European countries who were free of cancer at enrollment between 1992 and 1998. Information on diet and lifestyle was collected at baseline. After a mean follow-up of 4.8 years, 1329 incident colorectal cancers were documented. We examined the relationship between intakes of red and processed meat, poultry, and fish and colorectal cancer risk using a proportional hazards model adjusted for age, sex, energy (nonfat and fat sources), height, weight, work-related physical activity, smoking status, dietary fiber and folate, and alcohol consumption, stratified by center. A calibration substudy based on 36 994 subjects was used to correct hazard ratios (HRs) and 95% confidence intervals (CIs) for diet measurement errors. All statistical tests were two-sided., Results: Colorectal cancer risk was positively associated with intake of red and processed meat (highest [>160 g/day] versus lowest [<20 g/day] intake, HR = 1.35, 95% CI = 0.96 to 1.88; Ptrend = .03) and inversely associated with intake of fish (>80 g/day versus <10 g/day, HR = 0.69, 95 % CI = 0.54 to 0.88; Ptrend<.001), but was not related to poultry intake. Correcting for measurement error strengthened the associations between colorectal cancer and red and processed meat intake (per 100-g increase HR = 1.25, 95% CI =1.09 to 1.41, Ptrend = .001 and HR = 1.55, 95% CI = 1.19 to 2.02, Ptrend = .001 before and after calibration, respectively) and for fish (per 100 g increase HR = 0.70, 95% CI = 0.57 to 0.87, Ptrend<.001 and HR = 0.46, 95% CI = 0.27 to 0.77, Ptrend = .003; before and after correction, respectively). In this study population, the absolute risk of development of colorectal cancer within 10 years for a study subject aged 50 years was 1.71% for the highest category of red and processed meat intake and 1.28% for the lowest category of intake and was 1.86% for subjects in the lowest category of fish intake and 1.28% for subjects in the highest category of fish intake., Conclusions: Our data confirm that colorectal cancer risk is positively associated with high consumption of red and processed meat and support an inverse association with fish intake.

Published
2005
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