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2013

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

PMID:22716915 https://www

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

PMID:23728954

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

PMID:23775966

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

PMID:23526380

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

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

PMID:23599238 http://aje.

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

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

PMID:23334854

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

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

PMID:23885049

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

PMID:22990306

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

PMID:24023767

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

PMID:23857962

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

PMID:24092628

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

PMID:23090881

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 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

PMID:23497300

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

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

PMID:22610753

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

PMID:23169298

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

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

PMID:23576671

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

PMID:23288400

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

Abdominal obesity, weight gain during adulthood and risk of liver and biliary tract cancer in a European cohort

Schlesinger S., Aleksandrova K., Pischon T., Fedirko V., Jenab M., Trepo E., Boffetta P., Dahm C.C., Overvad K., Tjonneland A., Halkjaer J., Fagherazzi G., Boutron-Ruault M.C., Carbonnel F., Kaaks R., Lukanova A., Boeing H., Trichopoulou A., Bamia C., Lagiou P., Palli D., Grioni S., Panico S., Tumino R., Vineis P., Bueno-de-Mesquita H.B., van den Berg S., Peeters P.H., Braaten T., Weiderpass E., Quiros J.R., Travier N., Sanchez M.J., Navarro C., Barricarte A., Dorronsoro M., Lindkvist B., Regner S., Werner M., Sund M., Khaw K.T., Wareham N., Travis R.C., Norat T., Wark P.A., Riboli E., Nothlings U.

Int J Cancer; 2013; 132(3): 645-657

PMID:22618881

Abstract as provided by PubMed

General obesity has been positively associated with risk of liver and probably with biliary tract cancer, but little is known about abdominal obesity or weight gain during adulthood. We used multivariable Cox proportional hazard models to investigate associations between weight, body mass index, waist and hip circumference, waist-to-hip and waist-to-height ratio (WHtR), weight change during adulthood and risk of hepatocellular carcinoma (HCC), intrahepatic (IBDC) and extrahepatic bile duct system cancer [EBDSC including gallbladder cancer (GBC)] among 359,525 men and women in the European Prospective Investigation into Cancer and Nutrition study. Hepatitis B and C virus status was measured in a nested case-control subset. During a mean follow-up of 8.6 years, 177 cases of HCC, 58 cases of IBDC and 210 cases of EBDSC, including 76 cases of GBC, occurred. All anthropometric measures were positively associated with risk of HCC and GBC. WHtR showed the strongest association with HCC [relative risk (RR) comparing extreme tertiles 3.51, 95% confidence interval (95% CI): 2.09-5.87; p(trend) < 0.0001] and with GBC (RR: 1.56, 95% CI: 1.12-2.16 for an increment of one unit in WHtR). Weight gain during adulthood was also positively associated with HCC when comparing extreme tertiles (RR: 2.48, 95% CI: 1.49-4.13; <0.001). No statistically significant association was observed between obesity and risk of IBDC and EBDSC. Our results provide evidence of an association between obesity, particularly abdominal obesity, and risk of HCC and GBC. Our findings support public health recommendations to reduce the prevalence of obesity and weight gain in adulthood for HCC and GBC prevention in Western populations

Dietary glycemic index, glycemic load, and digestible carbohydrate intake are not associated with risk of type 2 diabetes in eight European countries

Sluijs I., Beulens J.W., van der Schouw Y.T., van der A.D.L., Buckland G., Kuijsten A., Schulze M.B., Amiano P., Ardanaz E., Balkau B., Boeing H., Gavrila D., Grote V.A., Key T.J., Li K., Nilsson P., Overvad K., Palli D., Panico S., Quiros J.R., Rolandsson O., Roswall N., Sacerdote C., Sanchez M.J., Sieri S., Slimani N., Spijkerman A.M., Tjonneland A., Tumino R., Sharp S.J., Langenberg C., Feskens E.J., Forouhi N.G., Riboli E., Wareham N.J.

J Nutr; 2013; 143(1): 93-99

PMID:23190759

Abstract as provided by PubMed

The association of glycemic index (GI) and glycemic load (GL) with the risk of type 2 diabetes remains unclear. We investigated associations of dietary GI, GL, and digestible carbohydrate with incident type 2 diabetes. We performed a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition Study, including a random subcohort (n = 16,835) and incident type 2 diabetes cases (n = 12,403). The median follow-up time was 12 y. Baseline dietary intakes were assessed using country-specific dietary questionnaires. Country-specific HR were calculated and pooled using random effects meta-analysis. Dietary GI, GL, and digestible carbohydrate in the subcohort were (mean +/- SD) 56 +/- 4, 127 +/- 23, and 226 +/- 36 g/d, respectively. After adjustment for confounders, GI and GL were not associated with incident diabetes [HR highest vs. lowest quartile (HR(Q4)) for GI: 1.05 (95% CI = 0.96, 1.16); HR(Q4) for GL: 1.07 (95% CI = 0.95, 1.20)]. Digestible carbohydrate intake was not associated with incident diabetes [HR(Q4): 0.98 (95% CI = 0.86, 1.10)]. In additional analyses, we found that discrepancies in the GI value assignment to foods possibly explain differences in GI associations with diabetes within the same study population. In conclusion, an expansion of the GI tables and systematic GI value assignment to foods may be needed to improve the validity of GI values derived in such studies, after which GI associations may need reevaluation. Our study shows that digestible carbohydrate intake is not associated with diabetes risk and suggests that diabetes risk with high-GI and -GL diets may be more modest than initial studies suggested

Physical activity and risk of breast cancer overall and by hormone receptor status: the European prospective investigation into cancer and nutrition

Steindorf K., Ritte R., Eomois P.P., Lukanova A., Tjonneland A., Johnsen N.F., Overvad K., Ostergaard J.N., Clavel-Chapelon F., Fournier A., Dossus L., Teucher B., Rohrmann S., Boeing H., Wientzek A., Trichopoulou A., Karapetyan T., Trichopoulos D., Masala G., Berrino F., Mattiello A., Tumino R., Ricceri F., Quiros J.R., Travier N., Sanchez M.J., Navarro C., Ardanaz E., Amiano P., Bueno-de-Mesquita H.B., van Duijnhoven F., Monninkhof E., May A.M., Khaw K.T., Wareham N., Key T.J., Travis R.C., Borch K.B., Sund M., Andersson A., Fedirko V., Rinaldi S., Romieu I., Wahrendorf J., Riboli E., Kaaks R.

Int J Cancer; 2013; 132(7): 1667-1678

PMID:22903273

Abstract as provided by PubMed

Physical activity is associated with reduced risks of invasive breast cancer. However, whether this holds true for breast cancer subtypes defined by the estrogen receptor (ER) and the progesterone receptor (PR) status is controversial. The study included 257,805 women from the multinational EPIC-cohort study with detailed information on occupational, recreational and household physical activity and important cofactors assessed at baseline. During 11.6 years of median follow-up, 8,034 incident invasive breast cancer cases were identified. Data on ER, PR and combined ER/PR expression were available for 6,007 (67.6%), 4,814 (54.2%) and 4,798 (53.9%) cases, respectively. Adjusted hazard ratios (HR) were estimated by proportional hazards models. Breast cancer risk was inversely associated with moderate and high levels of total physical activity (HR = 0.92, 95% confidence interval (CI): 0.86-0.99, HR = 0.87, 95%-CI: 0.79-0.97, respectively; p-trend = 0.002), compared to the lowest quartile. Among women diagnosed with breast cancer after age 50, the largest risk reduction was found with highest activity (HR = 0.86, 95%-CI: 0.77-0.97), whereas for cancers diagnosed before age 50 strongest associations were found for moderate total physical activity (HR = 0.78, 95%-CI: 0.64-0.94). Analyses by hormone receptor status suggested differential associations for total physical activity (p-heterogeneity = 0.04), with a somewhat stronger inverse relationship for ER+/PR+ breast tumors, primarily driven by PR+ tumors (p-heterogeneity < 0.01). Household physical activity was inversely associated with ER-/PR- tumors. The results of this largest prospective study on the protective effects of physical activity indicate that moderate and high physical activity are associated with modest decreased breast cancer risk. Heterogeneities by receptor status indicate hormone-related mechanisms

Genetic variation in the lactase gene, dairy product intake and risk for prostate cancer in the European prospective investigation into cancer and nutrition

Travis R.C., Appleby P.N., Siddiq A., Allen N.E., Kaaks R., Canzian F., Feller S., Tjonneland A., Fons Johnsen N., Overvad K., Ramon Quiros J., Gonzalez C.A., Sanchez M.J., Larranaga N., Chirlaque M.D., Barricarte A., Khaw K.T., Wareham N., Trichopoulou A., Valanou E., Oustoglou E., Palli D., Sieri S., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., Stattin P., Ferrari P., Johansson M., Norat T., Riboli E., Key T.J.

Int J Cancer; 2013; 132(8): 1901-1910

PMID:22965418

Abstract as provided by PubMed

High dairy protein intake has been found to be associated with increased prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). To further examine this possible relationship, we investigated the hypothesis that a genetic polymorphism in the lactase (LCT) gene might be associated with elevated dairy product intake and increased prostate cancer risk in a case-control study nested in EPIC. The C/T-13910 lactase variant (rs4988235) was genotyped in 630 men with prostate cancer and 873 matched control participants. Dairy product consumption was assessed by diet questionnaire. Odds ratios (ORs) for prostate cancer in relation to lactase genotype were estimated by conditional logistic regression. Lactase genotype frequency varied significantly between countries, with frequencies of the T (lactase persistence) allele ranging from 7% in Greece to 79% in Denmark. Intake of milk and total dairy products varied significantly by lactase genotype after adjustment for recruitment center; adjusted mean intakes of milk were 44.4, 69.8 and 82.3 g/day among men with CC, CT and TT genotypes, respectively. The lactase variant was not significantly associated with prostate cancer risk, both in our data (adjusted OR for TT vs. CC homozygotes: 1.10, 95% CI: 0.76-1.59) and in a meta-analysis of all the published data (combined OR for T allele carriers vs. CC homozygotes: 1.12, 0.96-1.32). These findings show that while variation in the lactase gene is associated with milk intake in men, the lactase polymorphism does not have a large effect on prostate cancer risk

The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study

van den Berg S.W., van der A D.L., Spijkerman A.M., van Woudenbergh G.J., Tijhuis M.J., Amiano P., Ardanaz E., Beulens J.W., Boeing H., Clavel-Chapelon F., Crowe F.L., de Lauzon-Guillain B., Fagherazzi G., Franks P.W., Freisling H., Gonzalez C., Grioni S., Halkjaer J., Huerta J.M., Huybrechts I., Kaaks R., Khaw K.T., Masala G., Nilsson P.M., Overvad K., Panico S., Quiros J.R., Rolandsson O., Sacerdote C., Sanchez M.J., Schulze M.B., Slimani N., Struijk E.A., Tjonneland A., Tumino R., Sharp S.J., Langenberg C., Forouhi N.G., Feskens E.J., Riboli E., Wareham N.J.

PLoS. One; 2013; 8(5): e59947

PMID:23696784

Abstract as provided by PubMed

BACKGROUND: Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake. METHODOLOGY/PRINCIPAL FINDINGS: A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93-1.13), which was consistent across countries (I(2) = 2.9%). CONCLUSIONS/SIGNIFICANCE: In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases

Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study1,4

Vergnaud A.C., Romaguera D., Peeters P.H., Van Gils C.H., Chan D.S., Romieu I., Freisling H., Ferrari P., Clavel-Chapelon F., Fagherazzi G., Dartois L., Li K., Tikk K., Bergmann M.M., Boeing H., Tjonneland A., Olsen A., Overvad K., Dahm C.C., Redondo M.L., Agudo A., Sanchez M.J., Amiano P., Chirlaque M.D., Ardanaz E., Khaw K.T., Wareham N.J., Crowe F., Trichopoulou A., Orfanos P., Trichopoulos D., Masala G., Sieri S., Tumino R., Vineis P., Panico S., Bueno-de-Mesquita H.B., Ros M.M., May A., Wirfalt E., Sonestedt E., Johansson I., Hallmans G., Lund E., Weiderpass E., Parr C.L., Riboli E., Norat T.

Am J Clin Nutr; 2013; 97(5): 1107-1120

PMID:23553166

Abstract as provided by PubMed

BACKGROUND: In 2007, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued recommendations on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence. OBJECTIVE: We investigated whether concordance with WCRF/AICR recommendations is related to risk of death. DESIGN: The current study included 378,864 participants from 9 European countries enrolled in the European Prospective Investigation into Cancer and Nutrition study. At recruitment (1992-1998), dietary, anthropometric, and lifestyle information was collected. A WCRF/AICR score, which incorporated 6 of the WCRF/AICR recommendations for men [regarding body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, and alcoholic drinks (score range: 0-6)] and 7 WCRF/AICR recommendations for women [plus breastfeeding (score range: 0-7)], was constructed. Higher scores indicated greater concordance with WCRF/AICR recommendations. Associations between the WCRF/AICR score and risks of total and cause-specific death were estimated by using Cox regression analysis. RESULTS: After a median follow-up time of 12.8 y, 23,828 deaths were identified. Participants within the highest category of the WCRF/AICR score (5-6 points in men; 6-7 points in women) had a 34% lower hazard of death (95% CI: 0.59, 0.75) compared with participants within the lowest category of the WCRF/AICR score (0-2 points in men; 0-3 points in women). Significant inverse associations were observed in all countries. The WCRF/AICR score was also significantly associated with a lower hazard of dying from cancer, circulatory disease, and respiratory disease. CONCLUSION: Results of this study suggest that following WCRF/AICR recommendations could significantly increase longevity

Dietary flavonoid intake and esophageal cancer risk in the European prospective investigation into cancer and nutrition cohort

Vermeulen E., Zamora-Ros R., Duell E.J., Lujan-Barroso L., Boeing H., Aleksandrova K., Bueno-de-Mesquita H.B., Scalbert A., Romieu I., Fedirko V., Touillaud M., Fagherazzi G., Perquier F., Molina-Montes E., Chirlaque M.D., Vicente Arguelles M., Amiano P., Barricarte A., Pala V., Mattiello A., Saieva C., Tumino R., Ricceri F., Trichopoulou A., Vasilopoulou E., Ziara G., Crowe F.L., Khaw K.T., Wareham N.J., Lukanova A., Grote V.A., Tjonneland A., Halkjaer J., Bredsdorff L., Overvad K., Siersema P.D., Peeters P.H., May A.M., Weiderpass E., Skeie G., Hjartaker A., Landberg R., Johansson I., Sonestedt E., Ericson U., Riboli E., Gonzalez C.A.

Am. J Epidemiol; 2013; 178(4): 570-581

PMID:23652166

Abstract as provided by PubMed

We prospectively investigated dietary flavonoid intake and esophageal cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,312 adult subjects from 10 European countries. At baseline, country-specific validated dietary questionnaires were used. During a mean follow-up of 11 years (1992-2010), there were 341 incident esophageal cancer cases, of which 142 were esophageal adenocarcinoma (EAC), 176 were esophageal squamous cell carcinoma (ESCC), and 23 were other types of esophageal cancer. In crude models, a doubling in total dietary flavonoid intake was inversely associated with esophageal cancer risk (hazard ratio (HR) (log(2)) = 0.87, 95% confidence interval (CI): 0.78, 0.98) but not in multivariable models (HR (log(2)) = 0.97, 95% CI: 0.86, 1.10). After covariate adjustment, no statistically significant association was found between any flavonoid subclass and esophageal cancer, EAC, or ESCC. However, among current smokers, flavonols were statistically significantly associated with a reduced esophageal cancer risk (HR (log(2)) = 0.72, 95% CI: 0.56, 0.94), whereas total flavonoids, flavanols, and flavan-3-ol monomers tended to be inversely associated with esophageal cancer risk. No associations were found in either never or former smokers. These findings suggest that dietary flavonoid intake was not associated with overall esophageal cancer, EAC, or ESCC risk, although total flavonoids and some flavonoid subclasses, particularly flavonols, may reduce the esophageal cancer risk among current smokers

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