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2013

Alcohol drinking and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Fedirko V., Jenab M., Rinaldi S., Biessy C., Allen N.E., Dossus L., Onland-Moret N.C., Schutze M., Tjonneland A., Hansen L., Overvad K., Clavel-Chapelon F., Chabbert-Buffet N., Kaaks R., Lukanova A., Bergmann M.M., Boeing H., Trichopoulou A., Oustoglou E., Barbitsioti A., Saieva C., Tagliabue G., Galasso R., Tumino R., Sacerdote C., Peeters P.H., Bueno-de-Mesquita H.B., Weiderpass E., Gram I.T., Sanchez S., Duell E.J., Molina-Montes E., Arriola L., Chirlaque M.D., Ardanaz E., Manjer J., Lundin E., Idahl A., Khaw K.T., Romaguera-Bosch D., Wark P.A., Norat T., Romieu I.

Ann Epidemiol; 2013; 23(2): 93-98

Abstract as provided by PubMed

PURPOSE: Alcohol intake may adversely affect the concentrations of endogenous sex hormones, and thus increase the risk of endometrial cancer. However, epidemiologic studies have provided conflicting results. Therefore, we investigated the association between alcohol intake and endometrial cancer risk a large, multicenter, prospective study. METHODS: From 1992 through 2010, 301,051 women in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were followed for incident endometrial cancer (n = 1382). Baseline alcohol consumption was assessed by country-specific, validated dietary questionnaires. Information on past alcohol consumption was collected by lifestyle questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox proportional hazard models. RESULTS: The multivariable HRs (and 95% CIs) compared with light drinkers (0.1-6 g/d) were 1.03 (0.88-1.20) for 0 g of alcohol per day at baseline, 1.01 (0.86-1.17) for 6.1-12 g/d, 1.03 (0.87-1.22) for 12.1-24 g/d, 1.07 (0.87-1.38) for 24.1-36 g/d, and 0.85 (0.61-1.18) for more than 36 g/d (p(trend) = 0.77). No association was observed among former drinkers (OR, 1.28; 95% CI, 0.98-1.68 compared with light drinkers). Null associations were also found between alcohol consumption at age 20 years, lifetime pattern of alcohol drinking, and baseline alcohol intake from specific alcoholic beverages and endometrial cancer risk. CONCLUSIONS: Our findings suggest no association between alcohol intake and endometrial cancer risk

Glycemic index, glycemic load, dietary carbohydrate, and dietary fiber intake and risk of liver and biliary tract cancers in Western Europeans

Fedirko V., Lukanova A., Bamia C., Trichopolou A., Trepo E., Nothlings U., Schlesinger S., Aleksandrova K., Boffetta P., Tjonneland A., Johnsen N.F., Overvad K., Fagherazzi G., Racine A., Boutron-Ruault M.C., Grote V., Kaaks R., Boeing H., Naska A., Adarakis G., Valanou E., Palli D., Sieri S., Tumino R., Vineis P., Panico S., Bueno-de-Mesquita H.B., Siersema P.D., Peeters P.H., Weiderpass E., Skeie G., Engeset D., Quiros J.R., Zamora-Ros R., Sanchez M.J., Amiano P., Huerta J.M., Barricarte A., Johansen D., Lindkvist B., Sund M., Werner M., Crowe F., Khaw K.T., Ferrari P., Romieu I., Chuang S.C., Riboli E., Jenab M.

Ann. Oncol; 2013; 24(2): 543-553

Abstract as provided by PubMed

BACKGROUND: The type and quantity of dietary carbohydrate as quantified by glycemic index (GI) and glycemic load (GL), and dietary fiber may influence the risk of liver and biliary tract cancers, but convincing evidence is lacking. PATIENTS AND METHODS: The association between dietary GI/GL and carbohydrate intake with hepatocellular carcinoma (HCC; N = 191), intrahepatic bile duct (IBD; N = 66), and biliary tract (N = 236) cancer risk was investigated in 477 206 participants of the European Prospective Investigation into Cancer and Nutrition cohort. Dietary intake was assessed by country-specific, validated dietary questionnaires. Hazard ratios and 95% confidence intervals were estimated from proportional hazard models. HBV/HCV status was measured in a nested case-control subset. RESULTS: Higher dietary GI, GL, or increased intake of total carbohydrate was not associated with liver or biliary tract cancer risk. For HCC, divergent risk estimates were observed for total sugar = 1.43 (1.17-1.74) per 50 g/day, total starch = 0.70 (0.55-0.90) per 50 g/day, and total dietary fiber = 0.70 (0.52-0.93) per 10 g/day. The findings for dietary fiber were confirmed among HBV/HCV-free participants [0.48 (0.23-1.01)]. Similar associations were observed for IBD [dietary fiber = 0.59 (0.37-0.99) per 10 g/day], but not biliary tract cancer. CONCLUSIONS: Findings suggest that higher consumption of dietary fiber and lower consumption of total sugars are associated with lower HCC risk. In addition, high dietary fiber intake could be associated with lower IBD cancer risk

Consumption of fish and meats and risk of hepatocellular carcinoma: the European Prospective Investigation into Cancer and Nutrition (EPIC)

Fedirko V., Trichopolou A., Bamia C., Duarte-Salles T., Trepo E., Aleksandrova K., Nothlings U., Lukanova A., Lagiou P., Boffetta P., Trichopoulos D., Katzke V.A., Overvad K., Tjonneland A., Hansen L., Boutron-Ruault M.C., Fagherazzi G., Bastide N., Panico S., Grioni S., Vineis P., Palli D., Tumino R., Bueno-de-Mesquita H.B., Peeters P.H., Skeie G., Engeset D., Parr C.L., Jakszyn P., Sanchez M.J., Barricarte A., Amiano P., Chirlaque M., Quiros J.R., Sund M., Werner M., Sonestedt E., Ericson U., Key T.J., Khaw K.T., Ferrari P., Romieu I., Riboli E., Jenab M.

Ann. Oncol; 2013; 24(8): 2166-2173

Abstract as provided by PubMed

BACKGROUND: While higher intake of fish and lower consumption of red/processed meats have been suggested to play a protective role in the etiology of several cancers, prospective evidence for hepatocellular carcinoma (HCC) is limited, particularly in Western European populations. METHODS: The associations of fish and meats with HCC risk were analyzed in the EPIC cohort. Between 1992 and 2010, 191 incident HCC were identified among 477 206 participants. Baseline diet was assessed using validated dietary questionnaires. A single 24-h diet recall from a cohort subsample was used for calibration. Multivariable proportional hazard regression was utilized to estimate hazard ratios (HR) and 95% confidence intervals (CI). In a nested case-control subset (HCC = 122), HBV/HCV status and liver function biomarkers were measured. RESULTS: HCC risk was inversely associated with intake of total fish (per 20 g/day increase, HR = 0.83, 95% CI 0.74-0.95 and HR = 0.80, 95% CI 0.69-0.97 before and after calibration, respectively). This inverse association was also suggested after adjusting for HBV/HCV status and liver function score (per 20-g/day increase, RR = 0.86, 95% CI 0.66-1.11 and RR = 0.74, 95% CI 0.50-1.09, respectively) in a nested case-control subset. Intakes of total meats or subgroups of red/processed meats, and poultry were not associated with HCC risk. CONCLUSIONS: In this large European cohort, total fish intake is associated with lower HCC risk

Dietary fiber intake and risk of hormonal receptor-defined breast cancer in the European Prospective Investigation into Cancer and Nutrition study

Ferrari P., Rinaldi S., Jenab M., Lukanova A., Olsen A., Tjonneland A., Overvad K., Clavel-Chapelon F., Fagherazzi G., Touillaud M., Kaaks R., von Rusten A., Boeing H., Trichopoulou A., Lagiou P., Benetou V., Grioni S., Panico S., Masala G., Tumino R., Polidoro S., Bakker M.F., Van Gils C.H., Ros M.M., Bueno-de-Mesquita H.B., Krum-Hansen S., Engeset D., Skeie G., Pilar A., Sanchez M.J., Buckland G., Ardanaz E., Chirlaque D., Rodriguez L., Travis R., Key T., Khaw K.T., Wareham N.J., Sund M., Lenner P., Slimani N., Norat T., Aune D., Riboli E., Romieu I.

Am J Clin. Nutr; 2013; 97(2): 344-353

Abstract as provided by PubMed

BACKGROUND: Limited scientific evidence has characterized the association between dietary fiber intake and risk of breast cancer (BC) by menopausal status and hormone receptor expression in tumors. OBJECTIVE: We investigated the relation between total dietary fiber and its main food sources (vegetables, fruit, cereals, and legumes) and BC risk by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN: A total of 11,576 invasive BC cases in 334,849 EPIC women mostly aged 35-70 y at baseline were identified over a median follow-up of 11.5 y. Dietary fiber was estimated from country-specific dietary questionnaires. Multivariable Cox proportional hazards regression models were used to quantify the association between dietary variables and BC risk with energy adjustment by using the residual method. Subgroup analyses were performed by menopausal status and estrogen receptor (ER) and progesterone receptor (PR) expression in tumors. RESULTS: BC risk was inversely associated with intakes of total dietary fiber [hazard ratio comparing fifth quintile to first quintile (HR(Q5-Q1)): 0.95; 95% CI: 0.89, 1.01; P-trend = 0.03] and fiber from vegetables (0.90; 0.84, 0.96; P-trend < 0.01) but not with fiber from fruit, cereals, or legumes. Overall, associations were homogeneous by menopausal status and ER and PR expression in tumors. For vegetable fiber, stronger associations were observed for estrogen receptor-negative and progesterone receptor-negative (HR(Q5-Q1):0.74; 95% CI: 0.59, 0.93; P-trend = 0.01) than for estrogen receptor-positive and progesterone receptor-positive tumors (0.92: 0.81, 1.03; P-trend = 0.05), with P-heterogeneity = 0.09. CONCLUSION: Diets rich in dietary fiber and, particularly, fiber from vegetables may be associated with a small reduction in risk of BC, independently of menopausal status

Challenges in estimating the validity of dietary acrylamide measurements

Ferrari P., Freisling H., Duell E.J., Kaaks R., Lujan-Barroso L., Clavel-Chapelon F., Boutron-Ruault M.C., Nailler L., Polidoro S., Mattiello A., Palli D., Tumino R., Grioni S., Knuppel S., Tjonneland A., Olsen A., Overvad K., Orfanos P., Katsoulis M., Trichopoulou A., Quiros J.R., Ardanaz E., Huerta J.M., Etxezarreta P.A., Sanchez M.J., Crowe F., Khaw K.T., Wareham N.J., Ocke M., Bueno-de-Mesquita B., Peeters P.H., Ericson U., Wirfalt E., Hallmans G., Johansson I., Engeset D., Nicolas G., Gallo V., Norat T., Riboli E., Slimani N.

Eur. J Nutr; 2013; 52(5): 1503-1512

Abstract as provided by PubMed

BACKGROUND: Acrylamide is a chemical compound present in tobacco smoke and food, classified as a probable human carcinogen and a known human neurotoxin. Acrylamide is formed in foods, typically carbohydrate-rich and protein-poor plant foods, during high-temperature cooking or other thermal processing. The objectives of this study were to compare dietary estimates of acrylamide from questionnaires (DQ) and 24-h recalls (R) with levels of acrylamide adduct (AA) in haemoglobin. METHODS: In the European Prospective Investigation into Cancer and Nutrition (EPIC) study, acrylamide exposure was assessed in 510 participants from 9 European countries, randomly selected and stratified by age, sex, with equal numbers of never and current smokers. After adjusting for country, alcohol intake, smoking status, number of cigarettes and energy intake, correlation coefficients between various acrylamide measurements were computed, both at the individual and at the aggregate (centre) level. RESULTS: Individual level correlation coefficient between DQ and R measurements (r DQ,R) was 0.17, while r DQ,AA and r R,AA were 0.08 and 0.06, respectively. In never smokers, r DQ,R, r DQ,AA and r R,AA were 0.19, 0.09 and 0.02, respectively. The correlation coefficients between means of DQ, R and AA measurements at the centre level were larger (r > 0.4). CONCLUSIONS: These findings suggest that estimates of total acrylamide intake based on self-reported diet correlate weakly with biomarker AA Hb levels. Possible explanations are the lack of AA levels to capture dietary acrylamide due to individual differences in the absorption and metabolism of acrylamide, and/or measurement errors in acrylamide from self-reported dietary assessments, thus limiting the possibility to validate acrylamide DQ measurements

Dietary acrylamide intake of adults in the European Prospective Investigation into Cancer and Nutrition differs greatly according to geographical region

Freisling H., Moskal A., Ferrari P., Nicolas G., Knaze V., Clavel-Chapelon F., Boutron-Ruault M.C., Nailler L., Teucher B., Grote V.A., Boeing H., Clemens M., Tjonneland A., Olsen A., Overvad K., Quiros J.R., Duell E.J., Sanchez M.J., Amiano P., Chirlaque M.D., Barricarte A., Khaw K.T., Wareham N.J., Crowe F.L., Gallo V., Oikonomou E., Naska A., Trichopoulou A., Palli D., Agnoli C., Tumino R., Polidoro S., Mattiello A., Bueno-de-Mesquita H.B., Ocke M.C., Peeters P.H., Wirfalt E., Ericson U., Bergdahl I.A., Johansson I., Hjartaker A., Engeset D., Skeie G., Riboli E., Slimani N.

Eur. J Nutr; 2013; 52(4): 1369-1380

Abstract as provided by PubMed

PURPOSE: Methodological differences in assessing dietary acrylamide (AA) often hamper comparisons of intake across populations. Our aim was to describe the mean dietary AA intake in 27 centers of 10 European countries according to selected lifestyle characteristics and its contributing food sources in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS: In this cross-sectional analysis, 36 994 men and women, aged 35-74 years completed a single, standardized 24-hour dietary recall using EPIC-Soft. Food consumption data were matched to a harmonized AA database. Intake was computed by gender and center, and across categories of habitual alcohol consumption, smoking status, physical activity, education, and body mass index (BMI). Adjustment was made for participants' age, height, weight, and energy intake using linear regression models. RESULTS: Adjusted mean AA intake across centers ranged from 13 to 47 mug/day in men and from 12 to 39 mug/day in women; intakes were higher in northern European centers. In most centers, intake in women was significantly higher among alcohol drinkers compared with abstainers. There were no associations between AA intake and physical activity, BMI, or education. At least 50 % of AA intake across centers came from two food groups "bread, crisp bread, rusks" and "coffee." The third main contributing food group was "potatoes". CONCLUSIONS: Dietary AA intake differs greatly among European adults residing in different geographical regions. This observed heterogeneity in AA intake deserves consideration in the design and interpretation of population-based studies of dietary AA intake and health outcomes

Prediagnostic body fat and risk of death from amyotrophic lateral sclerosis: the EPIC cohort

Gallo V., Wark P.A., Jenab M., Pearce N., Brayne C., Vermeulen R., Andersen P.M., Hallmans G., Kyrozis A., Vanacore N., Vahdaninia M., Grote V., Kaaks R., Mattiello A., Bueno-de-Mesquita H.B., Peeters P.H., Travis R.C., Petersson J., Hansson O., Arriola L., Jimenez-Martin J.M., Tjonneland A., Halkjaer J., Agnoli C., Sacerdote C., Bonet C., Trichopoulou A., Gavrila D., Overvad K., Weiderpass E., Palli D., Quiros J.R., Tumino R., Khaw K.T., Wareham N., Barricante-Gurrea A., Fedirko V., Ferrari P., Clavel-Chapelon F., Boutron-Ruault M.C., Boeing H., Vigl M., Middleton L., Riboli E., Vineis P.

Neurology; 2013; 80(9): 829-838

Abstract as provided by PubMed

OBJECTIVES: The aim of this study was to investigate for the first time the association between body fat and risk of amyotrophic lateral sclerosis (ALS) with an appropriate prospective study design. METHODS: The EPIC (European Prospective Investigation into Cancer and Nutrition) study included 518,108 individuals recruited from the general population across 10 Western European countries. At recruitment, information on lifestyle was collected and anthropometric characteristics were measured. Cox hazard models were fitted to investigate the associations between anthropometric measures and ALS mortality. RESULTS: Two hundred twenty-two ALS deaths (79 men and 143 women) occurred during the follow-up period (mean follow-up = 13 years). There was a statistically significant interaction between categories of body mass index and sex regarding ALS risk (p = 0.009): in men, a significant linear decrease of risk per unit of body mass index was observed (hazard ratio = 0.93, 95% confidence interval 0.86-0.99 per kg/m(2)); among women, the risk was more than 3-fold increased for underweight compared with normal-weight women. Among women, a significant risk reduction increasing the waist/hip ratio was also evident: women in the top quartile had less than half the risk of ALS compared with those in the bottom quartile (hazard ratio = 0.48, 95% confidence interval 0.25-0.93) with a borderline significant p value for trend across quartiles (p = 0.056). CONCLUSION: Increased prediagnostic body fat is associated with a decreased risk of ALS mortality

Fish consumption and subsequent change in body weight in European women and men

Jakobsen M.U., Dethlefsen C., Due K.M., May A.M., Romaguera D., Vergnaud A.C., Norat T., Sorensen T.I., Halkjaer J., Tjonneland A., Boutron-Ruault M.C., Clavel-Chapelon F., Fagherazzi G., Teucher B., Kuhn T., Bergmann M.M., Boeing H., Naska A., Orfanos P., Trichopoulou A., Palli D., Santucci de Magistris M., Sieri S., Bueno-de-Mesquita H.B., van derA D.L., Engeset D., Hjartaker A., Rodriguez L., Agudo A., Molina-Montes E., Huerta J.M., Barricarte A., Amiano P., Manjer J., Wirfalt E., Hallmans G., Johansson I., Khaw K.T., Wareham N.J., Key T.J., Chajes V., Slimani N., Riboli E., Peeters P.H., Overvad K.

Br J Nutr; 2013; 109(2): 353-362

Abstract as provided by PubMed

Fish consumption is the major dietary source of EPA and DHA, which according to rodent experiments may reduce body fat mass and prevent obesity. Only a few human studies have investigated the association between fish consumption and body-weight gain. We investigated the association between fish consumption and subsequent change in body weight. Women and men (n 344,757) participating in the European Prospective Investigation into Cancer and Nutrition were followed for a median of 5.0 years. Linear and logistic regression were used to investigate the associations between fish consumption and subsequent change in body weight. Among women, the annual weight change was 5.70 (95 % CI 4.35, 7.06), 2.23 (95 % CI 0.16, 4.31) and 11.12 (95 % CI 8.17, 14.08) g/10 g higher total, lean and fatty fish consumption per d, respectively. The OR of becoming overweight in 5 years among women who were normal weight at enrolment was 1.02 (95 % CI 1.01, 1.02), 1.01 (95 % CI 1.00, 1.02) and 1.02 (95 % CI 1.01, 1.04) g/10 g higher total, lean and fatty consumption per d, respectively. Among men, fish consumption was not statistically significantly associated with weight change. Adjustment for potential over- or underestimation of fish consumption did not systematically change the observed associations, but the 95 % CI became wider. The results in subgroups from analyses stratified by age or BMI at enrolment were not systematically different. In conclusion, the present study suggests that fish consumption has no appreciable association with body-weight gain

Meat and heme iron intake and esophageal adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition study

Jakszyn P., Lujan-Barroso L., Agudo A., Bueno-de-Mesquita H.B., Molina E., Sanchez M.J., Fonseca-Nunes A., Siersema P.D., Matiello A., Tumino R., Saieva C., Pala V., Vineis P., Boutron-Ruault M.C., Racine A., Bastide N., Travis R.C., Khaw K.T., Riboli E., Murphy N., Vergnaud A.C., Trichopoulou A., Valanou E., Oikonomidou E., Weiderpass E., Skeie G., Johansen D., Lindkvist B., Johansson M., Duarte-Salles T., Freisling H., Barricarte A., Huerta J.M., Amiano P., Tjonneland A., Overvad K., Kuehn T., Grote V., Boeing H., Peeters P.H., Gonzalez C.A.

Int. J Cancer; 2013; 133(11): 2744-2750

Abstract as provided by PubMed

Although recent studies suggest that high intakes of meat and heme iron are risk factors for several types of cancer, studies in relation to esophageal adenocarcinoma (EAC) are scarce. Previous results in the European Prospective Investigation into Cancer and Nutrition (EPIC) based on a relatively small number of cases suggested a positive association between processed meat and EAC. In this study, we investigate the association between intake of different types of meats and heme iron intake and EAC risk in a larger number of cases from EPIC. The study included 481,419 individuals and 137 incident cases of EAC that occurred during an average of 11 years of follow-up. Dietary intake of meat (unprocessed/processed red and white meat) was assessed by validated center-specific questionnaires. Heme iron was calculated as a type-specific percentage of the total iron content in meat. After adjusting for relevant confounders, we observed a statistically significant positive association of EAC risk with heme iron and processed meat intake, with HR: 1.67, 95% CI: 1.05-2.68 and HR: 2.27, 95% CI:1.33-3.89, respectively, for comparison of the highest vs. lowest tertile of intake. Our results suggest a potential association between higher intakes of processed meat and heme iron and risk of EAC

Evaluation of human papillomavirus antibodies and risk of subsequent head and neck cancer

Kreimer A.R., Johansson M., Waterboer T., Kaaks R., Chang-Claude J., Drogen D., Tjonneland A., Overvad K., Quiros J.R., Gonzalez C.A., Sanchez M.J., Larranaga N., Navarro C., Barricarte A., Travis R.C., Khaw K.T., Wareham N., Trichopoulou A., Lagiou P., Trichopoulos D., Peeters P.H., Panico S., Masala G., Grioni S., Tumino R., Vineis P., Bueno-de-Mesquita H.B., Laurell G., Hallmans G., Manjer J., Ekstrom J., Skeie G., Lund E., Weiderpass E., Ferrari P., Byrnes G., Romieu I., Riboli E., Hildesheim A., Boeing H., Pawlita M., Brennan P.

J Clin Oncol; 2013; 31(21): 2708-2715

Abstract as provided by PubMed

PURPOSE: Human papillomavirus type 16 (HPV16) infection is causing an increasing number of oropharyngeal cancers in the United States and Europe. The aim of our study was to investigate whether HPV antibodies are associated with head and neck cancer risk when measured in prediagnostic sera. METHODS: We identified 638 participants with incident head and neck cancers (patients; 180 oral cancers, 135 oropharynx cancers, and 247 hypopharynx/larynx cancers) and 300 patients with esophageal cancers as well as 1,599 comparable controls from within the European Prospective Investigation Into Cancer and Nutrition cohort. Prediagnostic plasma samples from patients (collected, on average, 6 years before diagnosis) and control participants were analyzed for antibodies against multiple proteins of HPV16 as well as HPV6, HPV11, HPV18, HPV31, HPV33, HPV45, and HPV52. Odds ratios (ORs) of cancer and 95% CIs were calculated, adjusting for potential confounders. All-cause mortality was evaluated among patients using Cox proportional hazards regression. RESULTS: HPV16 E6 seropositivity was present in prediagnostic samples for 34.8% of patients with oropharyngeal cancer and 0.6% of controls (OR, 274; 95% CI, 110 to 681) but was not associated with other cancer sites. The increased risk of oropharyngeal cancer among HPV16 E6 seropositive participants was independent of time between blood collection and diagnosis and was observed more than 10 years before diagnosis. The all-cause mortality ratio among patients with oropharyngeal cancer was 0.30 (95% CI, 0.13 to 0.67), for patients who were HPV16 E6 seropositive compared with seronegative. CONCLUSION: HPV16 E6 seropositivity was present more than 10 years before diagnosis of oropharyngeal cancers

Plasma 25-hydroxyvitamin D and the risk of breast cancer in the European prospective investigation into cancer and nutrition: a nested case-control study

Kuhn T., Kaaks R., Becker S., Eomois P.P., Clavel-Chapelon F., Kvaskoff M., Dossus L., Tjonneland A., Olsen A., Overvad K., Chang-Claude J., Lukanova A., Buijsse B., Boeing H., Trichopoulou A., Lagiou P., Bamia C., Masala G., Krogh V., Sacerdote C., Tumino R., Mattiello A., Buckland G., Sanchez M.J., Menendez V., Chirlaque M.D., Barricarte A., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Van Gils C.H., Bakker M.F., Weiderpass E., Skeie G., Brustad M., Andersson A., Sund M., Wareham N., Khaw K.T., Travis R.C., Schmidt J.A., Rinaldi S., Romieu I., Gallo V., Murphy N., Riboli E., Linseisen J.

Int. J Cancer; 2013; 133(7): 1689-1700

Abstract as provided by PubMed

Experimental evidence suggests that vitamin D might play a role in the development of breast cancer. Although the results of case-control studies indicate that circulating 25-hydroxyvitamin D [25(OH)D] is inversely associated with the risk of breast cancer, the results of prospective studies are inconsistent. A case-control study embedded in the European Prospective Investigation into Cancer and Nutrition (EPIC) was carried out comprising 1,391 incident breast cancer cases and 1,391 controls. Multivariable conditional logistic regression models did not reveal a significant overall association between season-standardized 25(OH)D levels and the risk of breast cancer (ORQ4-Q1 [95% CI]: 1.07 [0.85-1.36], ptrend = 0.67). Moreover, 25(OH)D levels were not related to the risks of estrogen receptor positive tumors (ORQ4-Q1 [95% CI]: 0.97 [0.67-1.38], ptrend = 0.90) and estrogen receptor negative tumors (ORQ4-Q1 [95% CI]: 0.97 [0.66-1.42], ptrend = 0.98). In hormone replacement therapy (HRT) users, 25(OH)D was significantly inversely associated with incident breast cancer (ORlog2 [95% CI]: 0.62 [0.42-0.90], p = 0.01), whereas no significant association was found in HRT nonusers (ORlog2 [95% CI]: 1.14 [0.80-1.62], p = 0.48). Further, a nonsignificant inverse association was found in women with body mass indices (BMI) < 25 kg/m(2) (ORlog2 [95% CI]: 0.83 [0.67-1.03], p = 0.09), as opposed to a borderline significant positive association in women with BMI >/= 25 kg/m(2) (ORlog2 [95% CI]: 1.30 [1.0-1.69], p = 0.05). Overall, prediagnostic levels of circulating 25(OH)D were not related to the risk of breast cancer in the EPIC study. This result is in line with findings in the majority of prospective studies and does not support a role of vitamin D in the development of breast cancer

Polymorphisms in genes related to one-carbon metabolism are not related to pancreatic cancer in PanScan and PanC4

Leenders M., Bhattacharjee S., Vineis P., Stevens V., Bueno-de-Mesquita H.B., Shu X.O., Amundadottir L., Gross M., Tobias G.S., Wactawski-Wende J., Arslan A.A., Duell E.J., Fuchs C.S., Gallinger S., Hartge P., Hoover R.N., Holly E.A., Jacobs E.J., Klein A.P., Kooperberg C., Lacroix A., Li D., Mandelson M.T., Olson S.H., Petersen G., Risch H.A., Yu K., Wolpin B.M., Zheng W., Agalliu I., Albanes D., Boutron-Ruault M.C., Bracci P.M., Buring J.E., Canzian F., Chang K., Chanock S.J., Cotterchio M., Gaziano J.M., Giovanucci E.L., Goggins M., Hallmans G., Hankinson S.E., Hoffman-Bolton J.A., Hunter D.J., Hutchinson A., Jacobs K.B., Jenab M., Khaw K.T., Kraft P., Krogh V., Kurtz R.C., McWilliams R.R., Mendelsohn J.B., Patel A.V., Rabe K.G., Riboli E., Tjonneland A., Trichopoulos D., Virtamo J., Visvanathan K., Elena J.W., Yu H., Zeleniuch-Jacquotte A., Stolzenberg-Solomon R.Z.

Cancer Causes Control; 2013; 24(3): 595-602

Abstract as provided by PubMed

PURPOSE: The evidence of a relation between folate intake and one-carbon metabolism (OCM) with pancreatic cancer (PanCa) is inconsistent. In this study, the association between genes and single-nucleotide polymorphisms (SNPs) related to OCM and PanCa was assessed. METHODS: Using biochemical knowledge of the OCM pathway, we identified thirty-seven genes and 834 SNPs to examine in association with PanCa. Our study included 1,408 cases and 1,463 controls nested within twelve cohorts (PanScan). The ten SNPs and five genes with lowest p values (<0.02) were followed up in 2,323 cases and 2,340 controls from eight case-control studies (PanC4) that participated in PanScan2. The correlation of SNPs with metabolite levels was assessed for 649 controls from the European Prospective Investigation into Cancer and Nutrition. RESULTS: When both stages were combined, we observed suggestive associations with PanCa for rs10887710 (MAT1A) (OR 1.13, 95 %CI 1.04-1.23), rs1552462 (SYT9) (OR 1.27, 95 %CI 1.02-1.59), and rs7074891 (CUBN) (OR 1.91, 95 %CI 1.12-3.26). After correcting for multiple comparisons, no significant associations were observed in either the first or second stage. The three suggested SNPs showed no correlations with one-carbon biomarkers. CONCLUSIONS: This is the largest genetic study to date to examine the relation between germline variations in OCM-related genes polymorphisms and the risk of PanCa. Suggestive evidence for an association between polymorphisms and PanCa was observed among the cohort-nested studies, but this did not replicate in the case-control studies. Our results do not strongly support the hypothesis that genes related to OCM play a role in pancreatic carcinogenesis

Fruit and vegetable consumption and mortality: European prospective investigation into cancer and nutrition

Leenders M., Sluijs I., Ros M.M., Boshuizen H.C., Siersema P.D., Ferrari P., Weikert C., Tjonneland A., Olsen A., Boutron-Ruault M.C., Clavel-Chapelon F., Nailler L., Teucher B., Li K., Boeing H., Bergmann M.M., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Pala V., Panico S., Tumino R., Sacerdote C., Peeters P.H., Van Gils C.H., Lund E., Engeset D., Redondo M.L., Agudo A., Sanchez M.J., Navarro C., Ardanaz E., Sonestedt E., Ericson U., Nilsson L.M., Khaw K.T., Wareham N.J., Key T.J., Crowe F.L., Romieu I., Gunter M.J., Gallo V., Overvad K., Riboli E., Bueno-de-Mesquita H.B.

Am. J Epidemiol; 2013; 178(4): 590-602

Abstract as provided by PubMed

In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death

Plasma 25-hydroxyvitamin D concentration and lymphoma risk: results of the European Prospective Investigation into Cancer and Nutrition

Luczynska A., Kaaks R., Rohrmann S., Becker S., Linseisen J., Buijsse B., Overvad K., Trichopoulou A., Valanou E., Barmpitsioti A., Masala G., Agnoli C., Tumino R., Panico S., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Peeters P.H., Vermeulen R., Weiderpass E., Brustad M., Skeie G., Gonzalez C.A., Jakszyn P., Quiros J.R., Sanchez M.J., Huerta J.M., Ardanaz E., Melin B., Johansson A.S., Almquist M., Malm J., Khaw K.T., Wareham N., Travis R.C., Fedirko V., Romieu I., Jenab M., Gallo V., Riboli E., Vineis P., Nieters A.

Am. J Clin Nutr; 2013; 98(3): 827-838

Abstract as provided by PubMed

BACKGROUND: The relation between vitamin D status and lymphoma risk is inconclusive. OBJECTIVE: We examined the association between prediagnostic plasma 25-hydroxyvitamin D [25(OH)D] and lymphoid cancer risk. DESIGN: We conducted a study nested within the European Prospective Investigation into Cancer and Nutrition cohort of 1127 lymphoma cases and 1127 matched controls with a mean follow-up time of 7.1 y. Conditional logistic regression was used to estimate multivariable-adjusted incidence rate ratios of lymphoma risk in relation to plasma 25(OH)D. Season-standardized and season-specific 25(OH)D quartiles were used. We also analyzed 25(OH)D as a continuous variable and used predefined cutoffs. RESULTS: No statistically significant association between plasma 25(OH)D and overall lymphoid cancer risk was observed. A positive association for B-cell non-Hodgkin lymphoma was noted only in those with a diagnosis made during the first 2 y of follow-up (P-heterogeneity = 0.03), which suggests the possibility of reverse causality. Further analysis restricted to participants with >/=2 y of follow-up time showed a significant association between 25(OH)D and chronic lymphocytic leukemia (CLL) (n = 161): adjusted incidence rate ratios were 0.40 (95% CI: 0.18, 0.90; P-trend = 0.05) and 0.31 (95% CI: 0.13, 0.76; P-trend = 0.03) for the top compared with the bottom season-standardized and season-specific quartiles, respectively. Data on dietary vitamin D intake provided further support for the observed association (incidence rate ratio: 0.33; 95% CI = 0.12, 0.89; P-trend = 0.006). CONCLUSIONS: Our findings do not support a protective role of high 25(OH)D concentration in lymphoid cancers overall. However, they suggest that higher concentrations of 25(OH)D are associated with a reduced risk of CLL

Plasma antibodies to oral bacteria and risk of pancreatic cancer in a large European prospective cohort study

Michaud D.S., Izard J., Wilhelm-Benartzi C.S., You D.H., Grote V.A., Tjonneland A., Dahm C.C., Overvad K., Jenab M., Fedirko V., Boutron-Ruault M.C., Clavel-Chapelon F., Racine A., Kaaks R., Boeing H., Foerster J., Trichopoulou A., Lagiou P., Trichopoulos D., Sacerdote C., Sieri S., Palli D., Tumino R., Panico S., Siersema P.D., Peeters P.H., Lund E., Barricarte A., Huerta J.M., Molina-Montes E., Dorronsoro M., Quiros J.R., Duell E.J., Ye W., Sund M., Lindkvist B., Johansen D., Khaw K.T., Wareham N., Travis R.C., Vineis P., Bueno-de-Mesquita H.B., Riboli E.

Gut; 2013; 62(12): 1764-1770

Abstract as provided by PubMed

OBJECTIVE: Examine the relationship between antibodies to 25 oral bacteria and pancreatic cancer risk in a prospective cohort study. DESIGN: We measured antibodies to oral bacteria in prediagnosis blood samples from 405 pancreatic cancer cases and 416 matched controls, nested within the European Prospective Investigation into Cancer and Nutrition study. Analyses were conducted using conditional logistic regression and additionally adjusted for smoking status and body mass index. RESULTS: Individuals with high levels of antibodies against Porphyromonas gingivalis ATTC 53978, a pathogenic periodontal bacteria, had a twofold higher risk of pancreatic cancer than individuals with lower levels of these antibodies (OR 2.14; 95% CI 1.05 to 4.36; >200 ng/ml vs </=200 ng/ml). To explore the association with commensal (non-pathogenic) oral bacteria, we performed a cluster analysis and identified two groups of individuals, based on their antibody profiles. A cluster with overall higher levels of antibodies had a 45% lower risk of pancreatic cancer than a cluster with overall lower levels of antibodies (OR 0.55; 95% CI 0.36 to 0.83). CONCLUSIONS: Periodontal disease might increase the risk for pancreatic cancer. Moreover, increased levels of antibodies against specific commensal oral bacteria, which can inhibit growth of pathogenic bacteria, might reduce the risk of pancreatic cancer. Studies are needed to determine whether oral bacteria have direct effects on pancreatic cancer pathogenesis or serve as markers of the immune response

Consumption of dairy products and colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Murphy N., Norat T., Ferrari P., Jenab M., Bueno-de-Mesquita B., Skeie G., Olsen A., Tjonneland A., Dahm C.C., Overvad K., Boutron-Ruault M.C., Clavel-Chapelon F., Nailler L., Kaaks R., Teucher B., Boeing H., Bergmann M.M., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Pala V., Tumino R., Vineis P., Panico S., Peeters P.H., Dik V.K., Weiderpass E., Lund E., Garcia J.R., Zamora-Ros R., Perez M.J., Dorronsoro M., Navarro C., Ardanaz E., Manjer J., Almquist M., Johansson I., Palmqvist R., Khaw K.T., Wareham N., Key T.J., Crowe F.L., Fedirko V., Gunter M.J., Riboli E.

PLoS. One; 2013; 8(9): e72715

Abstract as provided by PubMed

BACKGROUND: Prospective studies have consistently reported lower colorectal cancer risks associated with higher intakes of total dairy products, total milk and dietary calcium. However, less is known about whether the inverse associations vary for individual dairy products with differing fat contents. MATERIALS AND METHODS: In the European Prospective Investigation into Cancer and Nutrition (EPIC), we investigated the associations between intakes of total milk and milk subtypes (whole-fat, semi-skimmed and skimmed), yoghurt, cheese, and dietary calcium with colorectal cancer risk amongst 477,122 men and women. Dietary questionnaires were administered at baseline. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusted for relevant confounding variables. RESULTS: During the mean 11 years of follow-up, 4,513 incident cases of colorectal cancer occurred. After multivariable adjustments, total milk consumption was inversely associated with colorectal cancer risk (HR per 200 g/day 0.93, 95% CI: 0.89-0.98). Similar inverse associations were observed for whole-fat (HR per 200 g/day 0.90, 95% CI: 0.82-0.99) and skimmed milk (HR per 200 g/day 0.90, 95% CI: 0.79-1.02) in the multivariable models. Inverse associations were observed for cheese and yoghurt in the categorical models; although in the linear models, these associations were non-significant. Dietary calcium was inversely associated with colorectal cancer risk (HR per 200 mg/day 0.95, 95% CI: 0.91-0.99); this association was limited to dairy sources of calcium only (HR per 200 mg/day 0.95, 95% CI: 0.91-0.99), with no association observed for non-dairy calcium sources (HR per 200 mg/day 1.00, 95% CI: 0.81-1.24). CONCLUSIONS: Our results strengthen the evidence for a possible protective role of dairy products on colorectal cancer risk. The inverse associations we observed did not differ by the fat content of the dairy products considered

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

Obon-Santacana M., Slimani N., Lujan-Barroso L., Travier N., Hallmans G., Freisling H., Ferrari P., Boutron-Ruault M.C., Racine A., Clavel F., Saieva C., Pala V., Tumino R., Mattiello A., Vineis P., Arguelles M., Ardanaz E., Amiano P., Navarro C., Sanchez M.J., Molina Montes E., Key T., Khaw K.T., Wareham N., Peeters P.H., Trichopoulou A., Bamia C., Trichopoulos D., Boeing H., Kaaks R., Katzke V., Ye W., Sund M., Ericson U., Wirfalt E., Overvad K., Tjonneland A., Olsen A., Skeie G., Asli L.A., Weiderpass E., Riboli E., Bueno-de-Mesquita H.B., Duell E.J.

Ann. Oncol; 2013; 24(10): 2645-2651

Abstract as provided by PubMed

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

N-acetyltransferase 2 Phenotype, Occupation, and Bladder Cancer Risk: Results from the EPIC Cohort

Pesch B., Gawrych K., Rabstein S., Weiss T., Casjens S., Rihs H.P., Ding H., Angerer J., Illig T., Klopp N., Bueno-de-Mesquita B., Ros M.M., Kaaks R., Chang-Claude J., Roswall N., Tjonneland A., Overvad K., Clavel-Chapelon F., Boutron-Ruault M.C., Dossus L., Boeing H., Weikert S., Trichopoulos D., Palli D., Sieri S., Tumino R., Panico S., Quiros J.R., Gonzalez C., Sanchez M.J., Dorronsoro M., Navarro C., Barricarte A., Ljungberg B., Johansson M., Ulmert D., Ehrnstrom R., Khaw K.T., Wareham N., Key T.J., Ferrari P., Romieu I., Riboli E., Bruning T., Vineis P.

Cancer Epidemiol. Biomarkers Prev; 2013; 22(11): 2055-2065

Abstract as provided by PubMed

BACKGROUND: An association between N-acetyltransferase 2 (NAT2) slow acetylation and bladder cancer has been consistently observed in epidemiologic studies. However, evidence has been mainly derived from case-control studies and was sparse from cohort studies. We evaluated the association between NAT2 slow acetylation and bladder cancer in a case-control study nested in the European Prospective Investigation into Cancer and Nutrition. METHODS: Exposure to aromatic amines and polycyclic aromatic hydrocarbons (PAH) could be assessed for 754 cases and 833 controls for whom occupational information was documented. A semiquantitative job-exposure matrix was applied to at-risk occupations to estimate the exposure as low, medium, or high based on tertiles of the distribution of the exposure score in controls. Using a comprehensive genotyping, NAT2 acetylation status could be categorized from 6-single-nucleotide polymorphism genotypes as slow or fast in 607 cases and 695 controls with DNA from archived blood samples. RESULTS: Occupational exposure to aromatic amines and PAH was associated with an increased bladder cancer risk [upper tertile of the distribution of the exposure score: OR = 1.37; 95% confidence interval (CI), 1.02-1.84, and OR = 1.50; 95% CI, 1.09-2.05, respectively]. NAT2 slow acetylation did not modify these risk estimates and was not itself associated with bladder cancer risk (OR = 1.02; 95% CI, 0.81-1.29). CONCLUSIONS: These findings confirm established or suspected occupational risk factors but not the anticipated role of NAT2 slow acetylation in bladder cancer. No interaction was detected between NAT2 and any exposure of interest, including smoking. IMPACT: Genetic testing for NAT2 would be inappropriate in occupational settings. Cancer Epidemiol Biomarkers Prev; 22(11); 2055-65. (c)2013 AACR

Height, age at menarche and risk of hormone receptor-positive and -negative breast cancer: a cohort study

Ritte R., Lukanova A., Tjonneland A., Olsen A., Overvad K., Mesrine S., Fagherazzi G., Dossus L., Teucher B., Steindorf K., Boeing H., Aleksandrova K., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Grioni S., Mattiello A., Tumino R., Sacerdote C., Quiros J.R., Buckland G., Molina-Montes E., Chirlaque M.D., Ardanaz E., Amiano P., Bueno-de-Mesquita B., van Duijnhoven F., Van Gils C.H., Peeters P.H., Wareham N., Khaw K.T., Key T.J., Travis R.C., Krum-Hansen S., Gram I.T., Lund E., Sund M., Andersson A., Romieu I., Rinaldi S., McCormack V., Riboli E., Kaaks R.

Int J Cancer; 2013; 132(11): 2619-2629

Abstract as provided by PubMed

Associations of breast cancer overall with indicators of exposures during puberty are reasonably well characterized; however, uncertainty remains regarding the associations of height, leg length, sitting height and menarcheal age with hormone receptor-defined malignancies. Within the European Prospective Investigation into Cancer and Nutrition cohort, Cox proportional hazards models were used to describe the relationships of adult height, leg length and sitting height and age at menarche with risk of estrogen and progesterone receptor negative (ER-PR-) (n = 990) and ER+PR+ (n = 3,524) breast tumors. Height as a single risk factor was compared to a model combining leg length and sitting height. The possible interactions of height, leg length and sitting height with menarche were also analyzed. Risk of both ER-PR- and ER+PR+ malignancies was positively associated with standing height, leg length and sitting height and inversely associated with increasing age at menarche. For ER+PR+ disease, sitting height (hazard ratios: 1.14[95% confidence interval: 1.08-1.20]) had a stronger risk association than leg length (1.05[1.00-1.11]). In comparison, for ER-PR- disease, no distinct differences were observed between leg length and sitting height. Women who were tall and had an early menarche (</=13 years) showed an almost twofold increase in risk of ER+PR+ tumors but no such increase in risk was observed for ER-PR- disease. Indicators of exposures during rapid growth periods were associated with risks of both HR-defined breast cancers. Exposures during childhood promoting faster development may establish risk associations for both HR-positive and -negative malignancies. The stronger associations of the components of height with ER+PR+ tumors among older women suggest possible hormonal links that could be specific for postmenopausal women

Meat and fish consumption and risk of pancreatic cancer: results from the European Prospective Investigation into Cancer and Nutrition

Rohrmann S., Linseisen J., Nothlings U., Overvad K., Egeberg R., Tjonneland A., Boutron-Ruault M.C., Clavel-Chapelon F., Cottet V., Pala V., Tumino R., Palli D., Panico S., Vineis P., Boeing H., Pischon T., Grote V., Teucher B., Khaw K.T., Wareham N.J., Crowe F.L., Goufa I., Orfanos P., Trichopoulou A., Jeurnink S.M., Siersema P.D., Peeters P.H., Brustad M., Engeset D., Skeie G., Duell E.J., Amiano P., Barricarte A., Molina-Montes E., Rodriguez L., Tormo M.J., Sund M., Ye W., Lindkvist B., Johansen D., Ferrari P., Jenab M., Slimani N., Ward H., Riboli E., Norat T., Bueno-de-Mesquita H.B.

Int J Cancer; 2013; 132(3): 617-624

Abstract as provided by PubMed

Pancreatic cancer is the fourth most common cause of cancer death worldwide with large geographical variation, which implies the contribution of diet and lifestyle in its etiology. We examined the association of meat and fish consumption with risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). A total of 477,202 EPIC participants from 10 European countries recruited between 1992 and 2000 were included in our analysis. Until 2008, 865 nonendocrine pancreatic cancer cases have been observed. Calibrated relative risks (RRs) and 95% confidence intervals (CIs) were computed using multivariable-adjusted Cox hazard regression models. The consumption of red meat (RR per 50 g increase per day = 1.03, 95% CI = 0.93-1.14) and processed meat (RR per 50 g increase per day = 0.93, 95% CI = 0.71-1.23) were not associated with an increased pancreatic cancer risk. Poultry consumption tended to be associated with an increased pancreatic cancer risk (RR per 50 g increase per day = 1.72, 95% CI = 1.04-2.84); however, there was no association with fish consumption (RR per 50 g increase per day = 1.22, 95% CI = 0.92-1.62). Our results do not support the conclusion of the World Cancer Research Fund that red or processed meat consumption may possibly increase the risk of pancreatic cancer. The positive association of poultry consumption with pancreatic cancer might be a chance finding as it contradicts most previous findings

Smoking and the risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition

Rohrmann S., Linseisen J., Allen N., Bueno-de-Mesquita H.B., Johnsen N.F., Tjonneland A., Overvad K., Kaaks R., Teucher B., Boeing H., Pischon T., Lagiou P., Trichopoulou A., Trichopoulos D., Palli D., Krogh V., Tumino R., Ricceri F., Arguelles Suarez M.V., Agudo A., Sanchez M.J., Chirlaque M.D., Barricarte A., Larranaga N., Boshuizen H., van Kranen H.J., Stattin P., Johansson M., Bjartell A., Ulmert D., Khaw K.T., Wareham N.J., Ferrari P., Romieux I., Gunter M.J., Riboli E., Key T.J.

Br J Cancer; 2013; 108(3): 708-714

Abstract as provided by PubMed

BACKGROUND: Smoking is not associated with prostate cancer incidence in most studies, but associations between smoking and fatal prostate cancer have been reported. METHODS: During 1992 and 2000, lifestyle information was assessed via questionnaires and personal interview in a cohort of 145,112 European men. Until 2009, 4623 incident cases of prostate cancer were identified, including 1517 cases of low-grade, 396 cases of high grade, 1516 cases of localised, 808 cases of advanced disease, and 432 fatal cases. Multivariable Cox proportional hazards regression models were used to examine the association of smoking status, smoking intensity, and smoking duration with the risk of incident and fatal prostate cancer. RESULTS: Compared with never smokers, current smokers had a reduced risk of prostate cancer (RR=0.90, 95% CI: 0.83-0.97), which was statistically significant for localised and low-grade disease, but not for advanced or high-grade disease. In contrast, heavy smokers (25+ cigarettes per day) and men who had smoked for a long time (40+ years) had a higher risk of prostate cancer death (RR=1.81, 95% CI: 1.11-2.93; RR=1.38, 95% CI: 1.01-1.87, respectively). CONCLUSION: The observation of an increased prostate cancer mortality among heavy smokers confirms the results of previous prospective studies

Meat consumption and mortality--results from the European Prospective Investigation into Cancer and Nutrition

Rohrmann S., Overvad K., Bueno-de-Mesquita H.B., Jakobsen M.U., Egeberg R., Tjonneland A., Nailler L., Boutron-Ruault M.C., Clavel-Chapelon F., Krogh V., Palli D., Panico S., Tumino R., Ricceri F., Bergmann M.M., Boeing H., Li K., Kaaks R., Khaw K.T., Wareham N.J., Crowe F.L., Key T.J., Naska A., Trichopoulou A., Trichopoulos D., Leenders M., Peeters P.H., Engeset D., Parr C.L., Skeie G., Jakszyn P., Sanchez M.J., Huerta J.M., Redondo M.L., Barricarte A., Amiano P., Drake I., Sonestedt E., Hallmans G., Johansson I., Fedirko V., Romieux I., Ferrari P., Norat T., Vergnaud A.C., Riboli E., Linseisen J.

BMC. Med; 2013; 63

Abstract as provided by PubMed

BACKGROUND: Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: Included in the analysis were 448,568 men and women without prevalent cancer, stroke, or myocardial infarction, and with complete information on diet, smoking, physical activity and body mass index, who were between 35 and 69 years old at baseline. Cox proportional hazards regression was used to examine the association of meat consumption with all-cause and cause-specific mortality. RESULTS: As of June 2009, 26,344 deaths were observed. After multivariate adjustment, a high consumption of red meat was related to higher all-cause mortality (hazard ratio (HR) = 1.14, 95% confidence interval (CI) 1.01 to 1.28, 160+ versus 10 to 19.9 g/day), and the association was stronger for processed meat (HR = 1.44, 95% CI 1.24 to 1.66, 160+ versus 10 to 19.9 g/day). After correction for measurement error, higher all-cause mortality remained significant only for processed meat (HR = 1.18, 95% CI 1.11 to 1.25, per 50 g/d). We estimated that 3.3% (95% CI 1.5% to 5.0%) of deaths could be prevented if all participants had a processed meat consumption of less than 20 g/day. Significant associations with processed meat intake were observed for cardiovascular diseases, cancer, and 'other causes of death'. The consumption of poultry was not related to all-cause mortality. CONCLUSIONS: The results of our analysis support a moderate positive association between processed meat consumption and mortality, in particular due to cardiovascular diseases, but also to cancer

Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct

Romaguera D., Norat T., Wark P. A., Vergnaud A. C., Schulze M. B., van Woudenbergh G. J., Drogan D., Amiano P., Molina-Montes E., Sanchez M. J., Balkau B., Barricarte A., Beulens J. W., Clavel-Chapelon F., Crispim S. P., Fagherazzi G., Franks P. W., Grote V. A., Huybrechts I., Kaaks R., Key T. J., Khaw K. T., Nilsson P., Overvad K., Palli D., Panico S., Quiros J. R., Rolandsson O., Sacerdote C., Sieri S., Slimani N., Spijkerman A. M., Tjonneland A., Tormo M. J., Tumino R., van den Berg S. W., Wermeling P. R., Zamara-Ros R., Feskens E. J., Langenberg C., Sharp S. J., Forouhi N. G., Riboli E., Wareham N. J.

Diabetologia; 2013; 56(7): 1520-30

PMID:23620057

Abstract as provided by PubMed

AIMS/HYPOTHESIS: Consumption of sugar-sweetened beverages has been shown, largely in American populations, to increase type 2 diabetes incidence. We aimed to evaluate the association of consumption of sweet beverages (juices and nectars, sugar-sweetened soft drinks and artificially sweetened soft drinks) with type 2 diabetes incidence in European adults. METHODS: We established a case-cohort study including 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants selected from eight European cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. After exclusions, the final sample size included 11,684 incident cases and a subcohort of 15,374 participants. Cox proportional hazards regression models (modified for the case-cohort design) and random-effects meta-analyses were used to estimate the association between sweet beverage consumption (obtained from validated dietary questionnaires) and type 2 diabetes incidence. RESULTS: In adjusted models, one 336 g (12 oz) daily increment in sugar-sweetened and artificially sweetened soft drink consumption was associated with HRs for type 2 diabetes of 1.22 (95% CI 1.09, 1.38) and 1.52 (95% CI 1.26, 1.83), respectively. After further adjustment for energy intake and BMI, the association of sugar-sweetened soft drinks with type 2 diabetes persisted (HR 1.18, 95% CI 1.06, 1.32), but the association of artificially sweetened soft drinks became statistically not significant (HR 1.11, 95% CI 0.95, 1.31). Juice and nectar consumption was not associated with type 2 diabetes incidence. CONCLUSIONS/INTERPRETATION: This study corroborates the association between increased incidence of type 2 diabetes and high consumption of sugar-sweetened soft drinks in European adults.

Occupation and risk of lymphoid and myeloid leukaemia in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Saberi Hosnijeh F., Christopher Y., Peeters P., Romieu I., Xun W., Riboli E., Raaschou-Nielsen O., Tjonneland A., Becker N., Nieters A., Trichopoulou A., Bamia C., Orfanos P., Oddone E., Lujan-Barroso L., Dorronsoro M., Navarro C., Barricarte A., Molina-Montes E., Wareham N., Vineis P., Vermeulen R.

Occup. Environ. Med; 2013; 70(7): 464-470

Abstract as provided by PubMed

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

Anthropometric characteristics and risk of lymphoid and myeloid leukemia in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Saberi Hosnijeh F., Romieu I., Gallo V., Riboli E., Tjonneland A., Halkjaer 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 J.M., Ardanaz E., Sanchez M.J., Johansen D., Borgquist S., Peeters P., Bueno-de-Mesquita H.B., Ros M.M., Travis R.C., Key T.J., Vineis P., Vermeulen R.

Cancer Causes Control; 2013; 24(3): 427-438

Abstract as provided by PubMed

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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