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2011

Metabolic syndrome and risks of colon and rectal cancer: the European prospective investigation into cancer and nutrition study

Aleksandrova K., Boeing H., Jenab M., Bas Bueno-de-Mesquita H., Jansen E., van Duijnhoven F.J., Fedirko V., Rinaldi S., Romieu I., Riboli E., Romaguera D., Overvad K., Ostergaard J.N., Olsen A., Tjonneland A., Boutron-Ruault M.C., Clavel-Chapelon F., Morois S., Masala G., Agnoli C., Panico S., Tumino R., Vineis P., Kaaks R., Lukanova A., Trichopoulou A., Naska A., Bamia C., Peeters P.H., Rodriguez L., Buckland G., Sanchez M.J., Dorronsoro M., Huerta J.M., Barricarte A., Hallmans G., Palmqvist R., Khaw K.T., Wareham N., Allen N.E., Tsilidis K.K., Pischon T.

Cancer Prev Res (Phila); 2011; 4(11): 1873-1883

Abstract as provided by PubMed

Metabolic syndrome (MetS) is purportedly related to risk of developing colorectal cancer; however, the association of MetS, as defined according to recent international criteria, and colorectal cancer has not been yet evaluated. In particular, it remains unclear to what extent the MetS components individually account for such an association. We addressed these issues in a nested case-control study that included 1,093 incident cases matched (1:1) to controls by using incidence density sampling. Conditional logistic regression was used to estimate relative risks (RR) and 95% CIs. MetS was defined according to the criteria of the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATPIII), the International Diabetes Federation (IDF), and the 2009 harmonized definition. Among individual components, abdominal obesity (RR = 1.51; 95% CI: 1.16-1.96) was associated with colon cancer, whereas abnormal glucose metabolism was associated with both colon (RR = 2.05; 95% CI: 1.57-2.68) and rectal cancer (RR = 2.07; 95% CI: 1.45-2.96). MetS, as defined by each of the definitions, was similarly associated with colon cancer (e.g., RR = 1.91; 95% CI: 1.47-2.42 for MetS by NCEP/ATPIII), whereas MetS by NCEP/ATPIII, but not IDF or harmonized definition, was associated with rectal cancer (RR = 1.45; 95% CI: 1.02-2.06). Overall, these associations were stronger in women than in men. However, the association between MetS and colorectal cancer was accounted for by abdominal obesity and abnormal glucose metabolism such that MetS did not provide risk information beyond these components (likelihood ratio test P = 0.10 for MetS by NCEP/ATPIII). These data suggest that simple assessment of abnormal glucose metabolism and/or abdominal obesity to identify individuals at colorectal cancer risk may have higher clinical utility than applying more complex MetS definitions. Cancer Prev Res; 4(11); 1873-83. (c)2011 AACR

Menopausal hormone therapy and breast cancer risk: impact of different treatments. The European Prospective Investigation into Cancer and Nutrition

Bakken K., Fournier A., Lund E., Waaseth M., Dumeaux V., Clavel-Chapelon F., Fabre A., Hemon B., Rinaldi S., Chajes V., Slimani N., Allen N.E., Reeves G.K., Bingham S., Khaw K.T., Olsen A., Tjonneland A., Rodriguez L., Sanchez M.J., Etxezarreta P.A., Ardanaz E., Tormo M.J., Peeters P.H., Van Gils C.H., Steffen A., Schulz M., Chang-Claude J., Kaaks R., Tumino R., Gallo V., Norat T., Riboli E., Panico S., Masala G., Gonzalez C.A., Berrino F.

Int J Cancer; 2011; 128(1): 144-156

Abstract as provided by PubMed

Menopausal hormone therapy (MHT) is characterized by use of different constituents, regimens and routes of administration. We investigated the association between the use of different types of MHT and breast cancer risk in the EPIC cohort study. The analysis is based on data from 133,744 postmenopausal women. Approximately 133,744 postmenopausal women contributed to this analysis. Information on MHT was derived from country-specific self-administered questionnaires with a single baseline assessment. Incident breast cancers were identified through population cancer registries or by active follow-up (mean: 8.6 yr). Overall relative risks (RR) and 95% confidence interval (CI) were derived from country-specific Cox proportional hazard models estimates. A total of 4312 primary breast cancers were diagnosed during 1,153,747 person-years of follow-up. Compared with MHT never users, breast cancer risk was higher among current users of estrogen only (RR: 1.42, 95% CI 1.23-1.64) and higher still among current users of combined MHT (RR: 1.77, 95% CI 1.40-2.24; p = 0.02 for combined vs. estrogen-only). Continuous combined regimens conferred a 43% (95% CI: 19-72%) greater risk compared with sequential regimens. There was no significant difference between progesterone and testosterone derivatives in sequential regimens. There was no significant variation in risk linked to the estrogenic component of MHT, neither for oral vs. cutaneous administration nor for estradiol compounds vs. conjugated equine estrogens. Estrogen-only and combined MHT uses were associated with increased breast cancer risk. Continuous combined preparations were associated with the highest risk. Further studies are needed to disentangle the effects of the regimen and the progestin component

Aberrant DNA methylation of cancer-associated genes in gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST)

Balassiano K., Lima S., Jenab M., Overvad K., Tjonneland A., Boutron-Ruault M.C., Clavel-Chapelon F., Canzian F., Kaaks R., Boeing H., Meidtner K., Trichopoulou A., Laglou P., Vineis P., Panico S., Palli D., Grioni S., Tumino R., Lund E., Bueno-de-Mesquita H.B., Numans M.E., Peeters P.H., Ramon Quiros J., Sanchez M.A., Navarro C., Ardanaz E., Dorronsoro M., Hallmans G., Stenling R., Ehrnstrom R., Regner S., Allen N.E., Travis R.C., Khaw K.T., Offerhaus G.J., Sala N., Riboli E., Hainaut P., Scoazec J.Y., Sylla B.S., Gonzalez C.A., Herceg Z.

Cancer Lett; 2011; 311(1): 85-95

Abstract as provided by PubMed

Epigenetic events have emerged as key mechanisms in the regulation of critical biological processes and in the development of a wide variety of human malignancies, including gastric cancer (GC), however precise gene targets of aberrant DNA methylation in GC remain largely unknown. Here, we have combined pyrosequencing-based quantitative analysis of DNA methylation in 98 GC cases and 64 controls nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort and in cancer tissue and non-tumorigenic adjacent tissue of an independent series of GC samples. A panel of 10 cancer-associated genes (CHRNA3, DOK1, MGMT, RASSF1A, p14ARF, CDH1, MLH1, ALDH2, GNMT and MTHFR) and LINE-1 repetitive elements were included in the analysis and their association with clinicopathological characteristics (sex, age at diagnosis, anatomical sub-site, histological sub-type) was examined. Three out of the 10 genes analyzed exhibited a marked hypermethylation, whereas two genes (ALDH2 and MTHFR) showed significant hypomethylation, in gastric tumors. Among differentially methylated genes, we identified new genes (CHRNA3 and DOK1) as targets of aberrant hypermethylation in GC, suggesting that epigenetic deregulation of these genes and their corresponding cellular pathways may promote the development and progression of GC. We also found that global demethylation of tumor cell genomes occurs in GC, consistent with the notion that abnormal hypermethylation of specific genes occurs concomitantly with genome-wide hypomethylation. Age and gender had no significant influence on methylation states, but an association was observed between LINE-1 and MLH1 methylation levels with histological sub-type and anatomical sub-site. This study identifies aberrant methylation patters in specific genes in GC thus providing information that could be exploited as novel biomarkers in clinics and molecular epidemiology of GC

Smoking, Secondhand Smoke, and Cotinine Levels in a Subset of EPIC Cohort

Baltar V.T., Xun W.W., Chuang S.C., Relton C., Ueland P.M., Vollset S.E., Midttun O., Johansson M., Slimani N., Jenab M., Clavel-Chapelon F., Boutron-Ruault M.C., Fagherazzi G., Kaaks R., Rohrmann S., Boeing H., Weikert C., Bueno-de-Mesquita H.B., Boshuizen H.C., Van Gils C.H., Peeters P.H., Agudo A., Barricarte A., Navarro C., Rodriguez L., Castano J.M., Larranaga N., Perez M.J., Khaw K.T., Wareham N., Allen N.E., Crowe F., Gallo V., Norat T., Tagliabue G., Masala G., Panico S., Sacerdote C., Tumino R., Trichopoulou A., Lagiou P., Bamia C., Rasmuson T., Hallmans G., Roswall N., Tjonneland A., Riboli E., Brennan P., Vineis P.

Cancer Epidemiol Biomarkers Prev; 2011; 20(5): 869-875

Abstract as provided by PubMed

BACKGROUND: Several countries are discussing new legislation regarding the ban on smoking in public places, based on the growing evidence of the hazards of secondhand smoke (SHS) exposure. The objective of the present study is to quantitatively assess the relationship between smoking, SHS, and serum cotinine levels in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: From a study on lung cancer in the EPIC cohort, questionnaire information on smoking was collected at enrolment, and cotinine was measured in serum. Three statistical models were applied by using samples available in a cross-section design: (i) cotinine levels by categories combining smoking and SHS (n = 859); (ii) the effect of hours of passive smoking exposure in nonsmokers only (n = 107); (iii) the effect of the number of cigarettes consumed per day in current smokers only (n = 832). All models were adjusted for country, sex, age, and body mass index. RESULTS: Among nonsmokers, passive smokers presented significant differences in cotinine compared with nonexposed, with a marked (but not significant) difference among former-smokers. A one hour per day increment of SHS gave rise to a significant 2.58 nmol/L (0.45 ng/mL) increase in mean serum cotinine (P < 0.001). In current smokers, a one cigarette per day increment gave rise to a significant 22.44 nmol/L (3.95 ng/mL) increase in cotinine mean (P < 0.001). CONCLUSIONS: There is clear evidence that not only tobacco smoking but also involuntary exposure increases cotinine levels. Impact: This study strengthens the evidence for the benefits of a smoking ban in public places. Cancer Epidemiol Biomarkers Prev; 20(5); 869-75. (c)2011 AACR

Diet and hip fractures among elderly Europeans in the EPIC cohort

Benetou V., Orfanos P., Zylis D., Sieri S., Contiero P., Tumino R., Giurdanella M.C., Peeters P.H., Linseisen J., Nieters A., Boeing H., Weikert C., Pettersson U., Johansson I., Bueno-de-Mesquita H.B., Dorronsoro M., Boffetta P., Trichopoulou A.

Eur J Clin Nutr; 2011; 65(1): 132-139

Abstract as provided by PubMed

BACKGROUND/OBJECTIVES: Evidence on the role of diet during adulthood and beyond on fracture occurrence is limited. We investigated diet and hip fracture incidence in a population of elderly Europeans, participants in the European Prospective Investigation into Cancer and nutrition study. SUBJECTS/METHODS: 29, 122 volunteers (10,538 men, 18,584 women) aged 60 years and above (mean age: 64.3) from five countries were followed up for a median of 8 years and 275 incident hip fractures (222 women and 53 men) were recorded. Diet was assessed at baseline through validated dietary questionnaires. Data were analyzed through Cox proportional-hazards regression with adjustment for potential confounders. RESULTS: No food group or nutrient was significantly associated with hip fracture occurrence. There were suggestive inverse associations, however, with vegetable consumption (hazard ratio (HR) per increasing sex-specific quintile: 0.93, 95% confidence interval (CI): 0.85-1.01), fish consumption (HR per increasing sex-specific quintile: 0.93, 95% CI: 0.85-1.02) and polyunsaturated lipid intake (HR per increasing sex-specific quintile: 0.92, 95% CI: 0.82-1.02), whereas saturated lipid intake was positively associated with hip fracture risk (HR per increasing sex-specific quintile: 1.13, 95% CI: 0.99-1.29). Consumption of dairy products did not appear to influence the risk (HR per increasing sex-specific quintile: 1.02, 95% CI: 0.93-1.12). CONCLUSIONS: In a prospective study of the elderly, diet, including consumption of dairy products, alcohol and vitamin D, did not appear to play a major role in hip fracture incidence. There is however, weak and statistically non-significant evidence that vegetable and fish consumption and intake of polyunsaturated lipids may have a beneficial, whereas saturated lipid intake a detrimental effect

Anthropometry, physical activity and hip fractures in the elderly

Benetou V., Orfanos P., Benetos I.S., Pala V., Evangelista A., Frasca G., Giurdanella M.C., Peeters P.H., van der Schouw I, Rohrmann S., Linseisen J., Boeing H., Weikert C., Pettersson U., Van Guelpen B., Bueno de Mesquita H.B., Altzibar J., Boffetta P., Trichopoulou A.

Injury; 2011; 42(2): 188-193

Abstract as provided by PubMed

INTRODUCTION: Hip fractures constitute a major and growing public health problem amongst the elderly worldwide. We examined the association of anthropometry and physical activity with hip fracture incidence in a cohort of elderly Europeans, participants in the European Prospective Investigation into Cancer and nutrition (EPIC) study. MATERIALS AND METHODS: The study population consisted of 27 982 volunteers (10 553 men and 17 429 women) aged 60 years and above from five European countries. Information on anthropometry, physical activity, medical history and other characteristics was collected at baseline. During a median follow-up of 8 years, 261 incident hip fractures (203 women and 58 men) were recorded. Data were analysed through Cox proportional hazard regression with adjustment for potential confounders. RESULTS: A higher body mass index (BMI) was associated with lower hip fracture risk (hazard ratio (HR)per increasing sex-specific-quintile: 0.85, 95% confidence interval (95% CI): 0.77-0.94). Body height was associated with increased hip fracture risk (HR per 5 cm: 1.13, 95% CI: 1.01-1.25). Waist-to-hip ratio was not related to hip fracture risk. Increasing levels of leisure-time physical activity were related to lower risk (HR per increasing tertile: 0.84, 95% CI: 0.70-0.99, p for trend: 0.039). CONCLUSIONS: In a prospective cohort study of elderly Europeans, we found evidence that high body stature increased and high BMI decreased the incidence of hip fractures. After adjustment for BMI,waist to-hip ratio was not associated with hip fracture risk. Leisure-time physical activity appears to play a beneficial role in the prevention of hip fractures

The association of lifetime alcohol use with measures of abdominal and general adiposity in a large-scale European cohort

Bergmann M.M., Schutze M., Steffen A., Boeing H., Halkjaer J., Tjonneland A., Travier N., Agudo A., Slimani N., Rinaldi S., Norat T., Romaguera D., Rohrmann S., Kaaks R., Jakobsen M.U., Overvad K., Ekelund U., Spencer E.A., Rodriguez L., Sanchez M.J., Dorronsoro M., Barricarte A., Chirlaque M.D., Orfanos P., Naska A., Trichopoulou A., Palli D., Grioni S., Vineis P., Panico S., Tumino R., Riboli E., Wareham N.J., Bueno-de-Mesquita B., May A., Peeters P.H.

Eur J Clin Nutr; 2011; 65(10): 1079-1087

Abstract as provided by PubMed

Background/Objectives:The relation between lifetime use of alcohol and measures of abdominal and general adiposity is unknown.Subjects/Methods:Among 99 381 men and 158 796 women of the European Prospective Investigation into Cancer and Nutrition (EPIC) study, means of waist circumference (WC), waist-to-hip-ratio (WHR) and body mass index (BMI), and odds ratios (OR) for a larger WC than predicted for a given BMI (WClp=positive residuals of gender specific linear regression of BMI on WC) across categories of average lifetime use of alcohol (total, from wine and from beer) were calculated, all adjusted for socio-demographic, lifestyle and health factors.Results:WC, WHR and BMI in men using lifetime </=6 g/d alcohol were 95.1 cm, 0.942 and 27.3 kg/m(2), and 96.2 cm, 0.961 and 28.3 kg/m(2) when using >96 g/d. WC and WHR in women was 83.2 cm and 0.813 for </=6 g/d, and 84.6 cm and 0.830 for >60 g/d, whereas BMI deviated only slightly with the lowest BMI (26.7 kg/m(2)) observed for >6-24 g/d. Compared with </=6 g/d, OR for a WClp in both genders increased steadily across categories of alcohol use (up to 1.40 (95% confidence interval 1.32, 1.49) in men using >60 g/d and 1.63 (1.54, 1.73) in women using >24 g/d), though increase was higher for alcohol from beer than from wine (P for difference between beer and wine<0.001 (men) and=0.002 (women)).Conclusion:Lifetime alcohol use is positively related to abdominal and general adiposity in men, possibly following the male weight gain pattern; in women, it is positively related only to abdominal adiposity. In this context, beer may contribute additionally to abdominal adiposity

Variety in vegetable and fruit consumption and risk of bladder cancer in the European Prospective Investigation into Cancer and Nutrition

Buchner F.L., Bueno-de-Mesquita H.B., Ros M.M., Kampman E., Egevad L., Overvad K., Tjonneland A., Roswall N., Clavel-Chapelon F., Boutron-Ruault M.C., Touillaud M., Kaaks R., Chang-Claude J., Boeing H., Weikert S., Trichopoulou A., Naska A., Benetou V., Palli D., Sieri S., Vineis P., Tumino R., Panico S., van Duijnhoven F.J., Peeters P.H., Van Gils C.H., Lund E., Gram I.T., Sanchez M.J., Jakszyn P., Larranaga N., Ardanaz E., Navarro C., Rodriguez L., Manjer J., Ehrnstrom R., Hallmans G., Ljungberg B., Key T.J., Allen N.E., Khaw K.T., Wareham N., Slimani N., Jenab M., Boffetta P., Kiemeney L.A., Riboli E.

Int J Cancer; 2011; 128(12): 2971-2979

Abstract as provided by PubMed

Recent research does not show an association between fruit and vegetable consumption and bladder cancer risk. None of these studies investigated variety in fruit and vegetable consumption, which may capture different aspects of consumption. We investigated whether a varied consumption of vegetables and fruits is associated with bladder cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Detailed data on food consumption and complete follow-up for cancer incidence were available for 452,185 participants, who were recruited from ten European countries. After a mean follow-up of 8.7 years, 874 participants were diagnosed with bladder cancer. Diet diversity scores (DDSs) were used to quantify the variety in fruit and vegetable consumption. Multivariable Cox proportional hazard models were used to assess the effect of the DDSs on bladder cancer risk. There was no evidence of a statistically significant association between bladder cancer risk and any of the DDSs when these scores were considered as continuous covariates. However, the hazard ratio (HR) for the highest tertile of the DDS for combined fruit and vegetable consumption was marginally significant compared to the lowest (HR = 1.30, 95% confidence interval: 1.00-1.69, p-trend = 0.05). In EPIC, there is no clear association between a varied fruit and vegetable consumption and bladder cancer risk. This finding provides further evidence for the absence of any strong association between fruit and vegetable consumption as measured by a food frequency questionnaire and bladder cancer risk

Variation in genes coding for AMP-activated protein kinase (AMPK) and breast cancer risk in the European Prospective Investigation on Cancer (EPIC)

Campa D., Claus R., Dostal L., Stein A., Chang-Claude J., Meidtner K., Boeing H., Olsen A., Tjonneland A., Overvad K., Rodriguez L., Bonet C., Sanchez M.J., Amiano P., Huerta J.M., Barricarte A., Khaw K.T., Wareham N., Travis R.C., Allen N.E., Trichopoulou A., Bamia C., Benetou V., Palli D., Agnoli C., Panico S., Tumino R., Sacerdote C., van Kranen H., Bas Bueno-de-Mesquita H., Peeters P.H., Van Gils C.H., Lenner P., Sund M., Lund E., Gram I.T., Rinaldi S., Chajes V., Romieu I., Engel P., Boutron-Ruault M.C., Clavel-Chapelon F., Siddiq A., Riboli E., Canzian F., Kaaks R.

Breast Cancer Res Treat; 2011; 127(3): 761-767

Abstract as provided by PubMed

AMP-activated protein kinase (AMPK) is an energy sensing/signalling intracellular protein which is activated by an increase in the cellular AMP:ATP ratio after ATP depletion. Once activated, AMPK inhibits fatty acid synthesis and the Akt-mTOR pathway, and activates the p53-p21 axis. All these molecular mechanisms are thought to play a key role in breast carcinogenesis. We investigated the genetic variability of four genes encoding AMPK (PRKAA1, PRKAA2, PRKAB1 and PRKAB2). Using a tagging approach and selecting SNPs we covered all the common genetic variation of these genes. We tested association of tagging SNPs in our four candidate genes with breast cancer (BC) risk in a study of 1340 BC cases and 2536 controls nested into the European Prospective Investigation into Cancer and Nutrition (EPIC). Given the relevance of AMPK on fatty acid synthesis and the importance of body fatness as a BC risk factor, we tested association of SNPs and body-mass index as well. We observed no statistically significant association between the SNPs in the PRKAs genes and BC risk and BMI after correction for multiple testing

Genetic variability of the forkhead box O3 and prostate cancer risk in the European Prospective Investigation on Cancer

Campa D., Husing A., Dostal L., Stein A., Drogan D., Boeing H., Tjonneland A., Roswall N., Ostergaard J.N., Overvad K., Rodriguez L., Bonet C., Sanchez M.J., Larranaga N., Huerta J.M., Ardanaz E., Khaw K.T., Wareham N., Travis R.C., Allen N.E., Trichopoulou A., Zylis D., Karapetyan T., Palli D., Sieri S., Tumino R., Vineis P., Bueno-de-Mesquita H.B., Lenner P., Johansson M., Jenab M., Cox D., Siddiq A., Kaaks R., Canzian F.

Oncol Rep; 2011; 26(4): 979-986

Abstract as provided by PubMed

Forkhead box O3 (FOXO3) has a wide range of functions: it promotes tumor suppression, cell cycle arrest, repair of damaged DNA, detoxification of reactive oxygen species, apoptosis and plays a pivotal role in promoting longevity. FOXO3 is a key downstream target of the PI3K-Akt pathway in response to cellular stimulation by growth factors or insulin and has been proposed as a bridge between ageing and tumor suppression. Three SNPs in the FOXO3 gene (rs3800231, rs9400239 and rs479744) that have been shown to be strongly and consistently associated with longevity, were examined in relation to PC risk in a case control study of 1571 incident PC cases and 1840 controls nested within the European Prospective Investigation into Cancer and Nutrition (EPIC). There was no statistically significant association between the SNPs and PC risk regardless of the model of inheritance (dominant, codomi-nant and recessive). The associations were not modified by disease aggressiveness, circulating levels of steroid sex hormones, or IGFs or BMI. We conclude that polymorphisms in the FOXO3 gene that are associated with longevity are not major risk factors for PC risk, in this population of Caucasian men

Genetic Variability of the mTOR Pathway and Prostate Cancer Risk in the European Prospective Investigation on Cancer (EPIC)

Campa D., Husing A., Stein A., Dostal L., Boeing H., Pischon T., Tjonneland A., Roswall N., Overvad K., Ostergaard J.N., Rodriguez L., Sala N., Sanchez M.J., Larranaga N., Huerta J.M., Barricarte A., Khaw K.T., Wareham N., Travis R.C., Allen N.E., Lagiou P., Trichopoulou A., Trichopoulos D., Palli D., Sieri S., Tumino R., Sacerdote C., van Kranen H., Bueno-de-Mesquita H.B., Hallmans G., Johansson M., Romieu I., Jenab M., Cox D.G., Siddiq A., Riboli E., Canzian F., Kaaks R.

PLoS ONE; 2011; 6(2): e16914

Abstract as provided by PubMed

The mTOR (mammalian target of rapamycin) signal transduction pathway integrates various signals, regulating ribosome biogenesis and protein synthesis as a function of available energy and amino acids, and assuring an appropriate coupling of cellular proliferation with increases in cell size. In addition, recent evidence has pointed to an interplay between the mTOR and p53 pathways. We investigated the genetic variability of 67 key genes in the mTOR pathway and in genes of the p53 pathway which interact with mTOR. We tested the association of 1,084 tagging SNPs with prostate cancer risk in a study of 815 prostate cancer cases and 1,266 controls nested within the European Prospective Investigation into Cancer and Nutrition (EPIC). We chose the SNPs (n = 11) with the strongest association with risk (p<0.01) and sought to replicate their association in an additional series of 838 prostate cancer cases and 943 controls from EPIC. In the joint analysis of first and second phase two SNPs of the PRKCI gene showed an association with risk of prostate cancer (OR(allele) = 0.85, 95% CI 0.78-0.94, p = 1.3x10(-3) for rs546950 and OR(allele) = 0.84, 95% CI 0.76-0.93, p = 5.6x10(-4) for rs4955720). We confirmed this in a meta-analysis using as replication set the data from the second phase of our study jointly with the first phase of the Cancer Genetic Markers of Susceptibility (CGEMS) project. In conclusion, we found an association with prostate cancer risk for two SNPs belonging to PRKCI, a gene which is frequently overexpressed in various neoplasms, including prostate cancer

Plasma phospholipid fatty acid concentrations and risk of gastric adenocarcinomas in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST)

Chajes V., Jenab M., Romieu I., Ferrari P., Dahm C.C., Overvad K., Egeberg R., Tjonneland A., Clavel-Chapelon F., Boutron-Ruault M.C., Engel P., Teucher B., Kaaks R., Floegel A., Boeing H., Trichopoulou A., Dilis V., Karapetyan T., Mattiello A., Tumino R., Grioni S., Palli D., Vineis P., Bueno-de-Mesquita H.B., Numans M.E., Peeters P.H., Lund E., Navarro C., Quiros J.R., Sanchez-Cantalejo E., Gurrea A.B., Dorronsoro M., Regner S., Sonestedt E., Wirfalt E., Khaw K.T., Wareham N., Allen N.E., Crowe F.L., Rinaldi S., Slimani N., Carneiro F., Riboli E., Gonzalez C.A.

Am J Clin Nutr; 2011; 94(5): 1304-1313

Abstract as provided by PubMed

BACKGROUND: Epidemiologic data suggest that diet is a risk factor in the etiology of gastric cancer. However, the role of dietary fatty acids, a modifiable risk factor, remains relatively unexplored. OBJECTIVE: The objective of this study was to determine the association of plasma phospholipid fatty acid concentrations, as biomarkers of exogenous and endogenously derived fatty acids, with the risk of gastric adenocarcinoma in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition-Europe Gastric Cancer (EPIC-EURGAST). DESIGN: Fatty acids were measured by gas chromatography in prediagnostic plasma phospholipids from 238 cases matched to 626 controls by age, sex, study center, and date of blood donation. Conditional logistic regression models adjusted for Helicobacter pylori infection status, BMI, smoking, physical activity, education, and energy intake were used to estimate relative cancer risks. RESULTS: Positive risk associations for gastric cancer were observed in the highest compared with the lowest quartiles of plasma oleic acid (OR: 1.72; 95% CI: 1.01, 2.94), di-homo-gamma-linolenic acid (OR: 1.92; 95% CI: 1.10, 3.35), alpha-linolenic acid (OR: 3.20; 95% CI: 1.70, 6.06), and the ratio of MUFAs to saturated fatty acids, as an indicator of stearoyl-CoA desaturase-1 enzyme activity (OR: 1.40; 95% CI: 0.81, 2.43). An inverse risk association was observed with the ratio of linoleic to alpha-linolenic acid (OR: 0.37; 95% CI: 0.20, 0.66). CONCLUSION: These data suggest that a specific prediagnostic plasma phospholipid fatty acid profile, characterized mainly by high concentrations of oleic acid, alpha-linolenic acid, and di-homo-gamma-linolenic acid, which presumably reflect both a complex dietary pattern and altered fatty acid metabolism, may be related to increased gastric cancer risk

Ecological-Level Associations Between Highly Processed Food Intakes and Plasma Phospholipid Elaidic Acid Concentrations: Results From a Cross-Sectional Study Within the European Prospective Investigation Into Cancer and Nutrition (EPIC)

Chajes V., Biessy C., Byrnes G., Deharveng G., Saadatian-Elahi M., Jenab M., Peeters P.H., Ocke M., Bueno-de-Mesquita H.B., Johansson I., Hallmans G., Manjer J., Wirfalt E., Jakszyn P., Gonzalez C.A., Huerta J.M., Martinez C., Amiano P., Suarez L.R., Ardanaz E., Tjonneland A., Halkjaer J., Overvad K., Jakobsen M.U., Berrino F., Pala V., Palli D., Tumino R., Vineis P., de Magistris M.S., Spencer E.A., Crowe F.L., Bingham S., Khaw K.T., Linseisen J., Rohrmann S., Boeing H., Noethlings U., Olsen K.S., Skeie G., Lund E., Trichopoulou A., Zilis D., Oustoglou E., Clavel-Chapelon F., Riboli E., Slimani N.

Nutr Cancer; 2011; 63(8): 1235-1250

Abstract as provided by PubMed

Elaidic acid is the main unnatural trans fatty acid isomer occurring during partial hydrogenation of vegetable oils used as ingredients for the formulation of processed foods. The main objective is to assess associations between processed food intakes and plasma phospholipid elaidic acid concentrations within the European Prospective Investigation into Cancer and Nutrition study. A cross-sectional study was used to determine fatty acid profiles in 3,003 subjects from 16 centers. Single 24-h dietary recalls (24-HDR) were collected using a standardized computerized interview program. Food intakes were computed according to their degree of processing (moderately/nonprocessed foods, processed staple foods, highly processed foods). Adjusted ecological and individual correlations were calculated between processed food intakes and plasma elaidic acid levels. At the population level, mean intakes of highly processed foods were strongly correlated with mean levels of plasma elaidic acid in men (P = 0.0016) and in women (P = 0.0012). At the individual level, these associations remained but at a much lower level in men (r = 0.08, P = 0.006) and in women (r = 0.09, P = 0.0001). The use of an averaged 24-HDR measure of highly processed food intakes is adequate for predicting mean levels of plasma elaidic acid among European populations

Exposure to environmental tobacco smoke in childhood and incidence of cancer in adulthood in never smokers in the European prospective investigation into cancer and nutrition

Chuang S.C., Gallo V., Michaud D., Overvad K., Tjonneland A., Clavel-Chapelon F., Romieu I., Straif K., Palli D., Pala V., Tumino R., Sacerdote C., Panico S., Peeters P.H., Lund E., Gram I.T., Manjer J., Borgquist S., Riboli E., Vineis P.

Cancer Causes Control; 2011; 22(3): 487-494

Abstract as provided by PubMed

The association between childhood environmental tobacco smoke (ETS) exposure and adult cancer risk is controversial; we examined this relationship in never smokers within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Over an average of 10 years, 8,372 cases of cancer were diagnosed in 112,430 never smokers in EPIC. Childhood ETS was self-reported by participants at baseline, along with other lifestyle factors. Hazard ratios (HR) for ETS exposure in childhood and their 95% confidence intervals (CI) were estimated by Cox proportional hazards models stratified by age, sex, and study center and adjusted for education, alcohol drinking, body mass index, physical activity, non-alcoholic energy intake, fruit and vegetable intake, and adulthood ETS exposure. Models were further adjusted for reproductive factors for female cancers, for meat intake for digestive system cancers, and for diabetes status for pancreatic cancer. No association was observed between childhood ETS exposure and overall cancer risks (HR = 0.97, 95% CI = 0.92-1.02), and for selected sites. The only exception was pancreatic cancer, as previously reported by Vrieling et al., among those who had been exposed daily in childhood (overall HR = 2.09, 95% CI = 1.14-3.84). In conclusion, childhood ETS exposure might not be a major risk factor for common cancers in adulthood

A U-shaped relationship between plasma folate and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition

Chuang S.C., Stolzenberg-Solomon R., Ueland P.M., Vollset S.E., Midttun O., Olsen A., Tjonneland A., Overvad K., Boutron-Ruault M.C., Morois S., Clavel-Chapelon F., Teucher B., Kaaks R., Weikert C., Boeing H., Trichopoulou A., Benetou V., Naska A., Jenab M., Slimani N., Romieu I., Michaud D.S., Palli D., Sieri S., Panico S., Sacerdote C., Tumino R., Skeie G., Duell E.J., Rodriguez L., Molina-Montes E., Huerta J.M., Larranaga N., Gurrea A.B., Johansen D., Manjer J., Ye W., Sund M., Peeters P.H., Jeurnink S., Wareham N., Khaw K.T., Crowe F., Riboli E., Bueno-de-Mesquita B., Vineis P.

Eur J Cancer; 2011; 47(12): 1808-1816

Abstract as provided by PubMed

Folate intake has shown an inverse association with pancreatic cancer; nevertheless, results from plasma measurements were inconsistent. The aim of this study is to examine the association between plasma total homocysteine, methionine, folate, cobalamin, pyridoxal 5'-phosphate, riboflavin, flavin mononucleotide and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). We conducted a nested case-control study in the EPIC cohort, which has an average of 9.6years of follow-up (1992-2006), using 463 incident pancreatic cancer cases. Controls were matched to each case by center, sex, age (+/-1year), date (+/-1year) and time (+/-3h) at blood collection and fasting status. Conditional logistic regression was used to calculate the odds ratios (OR) and 95% confidence intervals (CI), adjusting for education, smoking status, plasma cotinine concentration, alcohol drinking, body mass index and diabetes status. We observed a U-shaped association between plasma folate and pancreatic cancer risk. The ORs for plasma folate 5, 5-10, 10-15 (reference), 15-20, and >20nmol/L were 1.58 (95% CI=0.72-3.46), 1.39 (0.93-2.08), 1.0 (reference), 0.79 (0.52-1.21), and 1.34 (0.89-2.02), respectively. Methionine was associated with an increased risk in men (per quintile increment: OR=1.17, 95% CI=1.00-1.38) but not in women (OR=0.91, 95% CI=0.78-1.07; p for heterogeneity <0.01). Our results suggest a U-shaped association between plasma folate and pancreatic cancer risk in both men and women. The positive association that we observed between methionine and pancreatic cancer may be sex dependent and may differ by time of follow-up. However, the mechanisms behind the observed associations warrant further investigation

Mediterranean dietary pattern and cancer risk in the EPIC cohort

Couto E., Boffetta P., Lagiou P., Ferrari P., Buckland G., Overvad K., Dahm C.C., Tjonneland A., Olsen A., Clavel-Chapelon F., Boutron-Ruault M.C., Cottet V., Trichopoulos D., Naska A., Benetou V., Kaaks R., Rohrmann S., Boeing H., von Ruesten A., Panico S., Pala V., Vineis P., Palli D., Tumino R., May A., Peeters P.H., Bueno-de-Mesquita H.B., Buchner F.L., Lund E., Skeie G., Engeset D., Gonzalez C.A., Navarro C., Rodriguez L., Sanchez M.J., Amiano P., Barricarte A., Hallmans G., Johansson I., Manjer J., Wirfart E., Allen N.E., Crowe F., Khaw K.T., Wareham N., Moskal A., Slimani N., Jenab M., Romaguera D., Mouw T., Norat T., Riboli E., Trichopoulou A.

Br J Cancer; 2011; 104(9): 1493-1499

Abstract as provided by PubMed

BACKGROUND: Although several studies have investigated the association of the Mediterranean diet with overall mortality or risk of specific cancers, data on overall cancer risk are sparse. METHODS: We examined the association between adherence to Mediterranean dietary pattern and overall cancer risk using data from the European Prospective Investigation Into Cancer and nutrition, a multi-centre prospective cohort study including 142,605 men and 335,873. Adherence to Mediterranean diet was examined using a score (range: 0-9) considering the combined intake of fruits and nuts, vegetables, legumes, cereals, lipids, fish, dairy products, meat products, and alcohol. Association with cancer incidence was assessed through Cox regression modelling, controlling for potential confounders. RESULTS: In all, 9669 incident cancers in men and 21,062 in women were identified. A lower overall cancer risk was found among individuals with greater adherence to Mediterranean diet (hazard ratio=0.96, 95% CI 0.95-0.98) for a two-point increment of the Mediterranean diet score. The apparent inverse association was stronger for smoking-related cancers than for cancers not known to be related to tobacco (P (heterogeneity)=0.008). In all, 4.7% of cancers among men and 2.4% in women would be avoided in this population if study subjects had a greater adherence to Mediterranean dietary pattern. CONCLUSION: Greater adherence to a Mediterranean dietary pattern could reduce overall cancer risk

Biomarker-based evaluation of two 24-h recalls for comparing usual fish, fruit and vegetable intakes across European centers in the EFCOVAL Study

Crispim S.P., Geelen A., Souverein O.W., Hulshof P.J., Ruprich J., Dofkova M., Huybrechts I., De Keyzer W., Lillegaard I.T., Andersen L.F., Lafay L., Rousseau A.S., Ocke M.C., Slimani N., Van 't Veer P., de Vries J.H.

Eur J Clin Nutr; 2011; S38-S47

Abstract as provided by PubMed

BACKGROUND/OBJECTIVES: A standardized methodology is important to enable consistent monitoring of dietary intake across European countries. For this reason, we evaluated the comparability of the assessment of usual food intake collected with two non-consecutive computerized 24-h dietary recalls (24-HDRs) and a food propensity questionnaire (FPQ) among five European centers. SUBJECTS/METHODS: Two 24-HDRs using EPIC-Soft (the software developed to conduct 24-HDRs in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) were performed to determine fish, fruit and vegetable (FV) consumed by 600 adults in Belgium (BE), the Czech Republic (CZ), France (FR), the Netherlands (NL) and Norway (NO) in a validation study. An FPQ was used to identify non-consumers. Information from the 24-HDRs and FPQ were used to estimate individual usual food intake by the Multiple Source Method (MSM). Blood samples were drawn to determine fatty acids in phospholipids and serum carotenoids as biomarkers of fish, and FV intake, respectively. RESULTS: The pooled correlation between usual fish intake and eicosapentaenoic acid plus docosahexaenoic acid in phospholipids was 0.19 in men and 0.31 in women (P for heterogeneity >0.50) and center-specific correlations ranged between 0.08 (CZ) and 0.28 (BE and NO) in men, and between 0.19 (BE) and 0.55 (FR) in women. For usual FV intake, the pooled correlation with serum carotenoids was 0.31 in men and 0.40 in women (P for heterogeneity >0.10); the center-specific correlations varied between 0.07 (NO) and 0.52 (FR) in men, and between 0.25 (NL) and 0.45 (NO) in women. CoNCLUSION: Two standardized 24-HDRs using EPIC-Soft and an FPQ appeared to be appropriate to rank individuals according to their fish and FV intake in a comparable way among five European centers

A cross-sectional analysis of the associations between adult height, BMI and serum concentrations of IGF-I and IGFBP-1 -2 and -3 in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Crowe F.L., Key T.J., Allen N.E., Appleby P.N., Overvad K., Gronbaek H., Tjonneland A., Halkjaer J., Dossus L., Boeing H., Kroger J., Trichopoulou A., Zylis D., Trichopoulos D., Boutron-Ruault M.C., de Lauzon-Guillain B., Clavel-Chapelon F., Palli D., Berrino F., Panico S., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., Van Gils C.H., Peeters P.H., Gram I.T., Rodriguez L., Jakszyn P., Molina-Montes E., Navarro C., Barricarte A., Larranaga N., Khaw K.T., Rodwell S., Rinaldi S., Slimani N., Norat T., Gallo V., Riboli E., Kaaks R.

Ann Hum Biol; 2011; 38(2): 194-202

Abstract as provided by PubMed

Background: Height and BMI are risk factors for several types of cancer and may be related to circulating concentrations of insulin-like growth factor-I (IGF-I), a peptide associated with increased cancer risk. Aim: To assess the associations between height, BMI and serum concentrations of IGF-I and IGF binding protein (IGFBP)-1, -2 and -3. Subjects and methods: This cross-sectional analysis included 1142 men and 3589 women aged 32-77 years from the multi-centre study, the European Prospective Investigation of Cancer and Nutrition (EPIC). Results: In men, there was a positive association between height and IGF-I; each 10 cm increment in height was associated with an increase in IGF-I concentrations of 4.3% (95% confidence interval (CI): 1.3-7.5%, p for trend = 0.005), but this association was not statistically significant for women (0.9%, 95% CI: - 0.7 to 2.6%, p for trend = 0.264). In both men and women, the association between IGF-I and BMI was non-linear and those with a BMI of 26-27 kg/m(2) had the highest IGF-I concentration. BMI was strongly inversely related to concentrations of IGFBP-1 and IGFBP-2 in men and in women (p for trend for all < 0.001). Conclusion: Height and BMI are associated with IGF-I and its binding proteins, which may be mechanisms through which body size contributes to increased risk of several cancers

Fruit and vegetable intake and mortality from ischaemic heart disease: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study

Crowe F.L., Roddam A.W., Key T.J., Appleby P.N., Overvad K., Jakobsen M.U., Tjonneland A., Hansen L., Boeing H., Weikert C., Linseisen J., Kaaks R., Trichopoulou A., Misirli G., Lagiou P., Sacerdote C., Pala V., Palli D., Tumino R., Panico S., Bueno-de-Mesquita H.B., Boer J., Van Gils C.H., Beulens J.W., Barricarte A., Rodriguez L., Larranaga N., Sanchez M.J., Tormo M.J., Buckland G., Lund E., Hedblad B., Melander O., Jansson J.H., Wennberg P., Wareham N.J., Slimani N., Romieu I., Jenab M., Danesh J., Gallo V., Norat T., Riboli E.

Eur Heart J; 2011; 32(10): 1235-1243

Abstract as provided by PubMed

Aims A higher intake of fruits and vegetables has been associated with a lower risk of ischaemic heart disease (IHD), but there is some uncertainty about the interpretation of this association. The objective was to assess the relation between fruit and vegetable intake and risk of mortality from IHD in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study. Methods and results After an average of 8.4 years of follow-up, there were 1636 deaths from IHD among 313 074 men and women without previous myocardial infarction or stroke from eight European countries. Participants consuming at least eight portions (80 g each) of fruits and vegetables a day had a 22% lower risk of fatal IHD [relative risk (RR) = 0.78, 95% confidence interval (CI): 0.65-0.95] compared with those consuming fewer than three portions a day. After calibration of fruit and vegetable intake to account for differences in dietary assessment between the participating centres, a one portion (80 g) increment in fruit and vegetable intake was associated with a 4% lower risk of fatal IHD (RR = 0.96, 95% CI: 0.92-1.00, P for trend = 0.033). Conclusion Results from this large observational study suggest that a higher intake of fruits and vegetables is associated with a reduced risk of IHD mortality. Whether this association is causal and, if so, the biological mechanism(s) by which fruits and vegetables operate to lower IHD risks remains unclear

The European Food Consumption Validation Project: conclusions and recommendations

de Boer E.J., Slimani N., Van t Veer P., Boeing H., Feinberg M., Leclercq C., Trolle E., Amiano P., Andersen L.F., Freisling H., Geelen A., Harttig U., Huybrechts I., Kaic-Rak A., Lafay L., Lillegaard I.T., Ruprich J., de Vries J.H., Ocke M.C.

Eur J Clin Nutr; 2011; S102-S107

Abstract as provided by PubMed

BACKGROUND/OBJECTIVES: To outline and discuss the main results and conclusions of the European Food Consumption Validation (EFCOVAL) Project. SUBJECTS/METHODS: The EFCOVAL Project was carried out within the EU Sixth Framework Program by researchers in 11 EU countries. The activities focused on (1) the further development of the EPIC-Soft software (the software developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) and the validation of the 2-day non-consecutive 24-HDR method using EPIC-Soft, (2) defining and investigating the applicability of the most appropriate dietary assessment method to younger age groups and expanding the applicability of the software for use in exposure assessment of some potentially hazardous chemicals and (3) to improve the methodology and statistical methods that estimate usual intake distributions from short-term dietary intake information and develop a methodology to quantify uncertainty in usual intake distributions. RESULTS: The preexisting EPIC-Soft application was reprogrammed into a Windows environment and more than 60 new specifications were implemented in the software. A validation study showed that two non-consecutive EPIC-Soft 24-HDRs are suitable to estimate the usual intake distributions of protein and potassium of European adult populations. The 2-day non-consecutive 24-HDRs in combination with a food propensity questionnaire also appeared to be appropriate to rank individuals according to their fish and fruit and vegetable intake in a comparable way in five European centers. Dietary intake of (young) children can be assessed by the combination of EPIC-Soft 24-HDRs and food recording booklets. The EPIC-Soft-standardized method of describing foods is useful to estimate dietary exposure to potentially hazardous chemicals such as specific flavoring substances. With the developed Multiple Source Method, repeated non-consecutive 24-HDR data in combination with food propensity data can be used to estimate the population distribution of the usual intake by estimating the individual usual intakes. CONCLUSIONS: The findings provide sufficient evidence to conclude that the repeated 24-HDR using EPIC-Soft for standardization in combination with a food propensity questionnaire and modeling of usual intake is a suitable method for pan-European surveillance of nutritional adequacy and food safety among healthy adults and maybe in children aged 7 years and older. To facilitate this methodology in other European countries, the next step is to provide and standardize an implementation plan that accounts for maintenance and updates, sampling designs, national surveillance programs, tailored capacity building and training, and linkage to food composition and occurrence databases

Rationale and methods of the European Food Consumption Validation (EFCOVAL) Project

de Boer E.J., Slimani N., Van't Veer P., Boeing H., Feinberg M., Leclercq C., Trolle E., Amiano P., Andersen L.F., Freisling H., Geelen A., Harttig U., Huybrechts I., Kaic-Rak A., Lafay L., Lillegaard I.T., Ruprich J., de Vries J.H., Ocke M.C.

Eur J Clin Nutr; 2011; S1-S4

Abstract as provided by PubMed

BACKGROUND/OBJECTIVES: The overall objective of the European Food Consumption Validation (EFCOVAL) Project was to further develop and validate a trans-European food consumption method to be used for the evaluation of the intake of foods, nutrients and potentially hazardous chemicals within the European population. SUBJECTS/METHODS: The EFCOVAL Project was carried out by 13 institutes from 11 European countries. The main activities were centered on the three main objectives of the project organized in different sub-projects. RESULTS: In EFCOVAL, EPIC-Soft (the software developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) was reprogrammed and adapted according to prioritized specifications, resulting in a software program working under the Windows operating system. In parallel of the EPIC-Soft development, the repeated 24-HDR method using EPIC-Soft and a food propensity questionnaire was evaluated against biomarkers in 24-h urine collections and in blood samples among adults from Belgium, the Czech Republic, (the South of) France, the Netherlands and Norway. As a result from an expert workshop on a proposed dietary assessment method for children (4-12 years), the suggested method was tested in a feasibility study in Denmark and Spain among children of 4-5, 7-8 and 12-13 years. To ensure that collected data had sufficient detail in food description for the assessment of additives and contaminants to foods the EPIC-Soft databases were adapted. Finally, the EFCOVAL Consortium developed a statistical tool (Multiple Source Method) for estimating the usual intake and distribution, which has been tested using real food consumption data and compared with three other statistical methods through a simulation study. In addition, a methodology was developed to quantify uncertainty due to portion-size estimation in usual intake distributions. CONCLUSION: The findings of EFCOVAL provide sufficient evidence to conclude that the repeated 24-HDR using EPIC-Soft for standardization in combination with a food propensity questionnaire and modeling of usual intake is a suitable method for pan-European surveillance of nutritional adequacy and food safety among healthy adults and maybe in children aged 7 years and older

Alcohol consumption and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Duell E.J., Travier N., Lujan-Barroso L., Clavel-Chapelon F., Boutron-Ruault M.C., Morois S., Palli D., Krogh V., Panico S., Tumino R., Sacerdote C., Quiros J.R., Sanchez-Cantalejo E., Navarro C., Gurrea A.B., Dorronsoro M., Khaw K.T., Allen N.E., Key T.J., Bueno-de-Mesquita H.B., Ros M.M., Numans M.E., Peeters P.H., Trichopoulou A., Naska A., Dilis V., Teucher B., Kaaks R., Boeing H., Schutze M., Regner S., Lindkvist B., Johansson I., Hallmans G., Overvad K., Egeberg R., Tjonneland A., Lund E., Weiderpass E., Braaten T., Romieu I., Ferrari P., Jenab M., Stenling R., Aune D., Norat T., Riboli E., Gonzalez C.A.

Am J Clin Nutr; 2011; 94(5): 1266-1275

Abstract as provided by PubMed

BACKGROUND: Gastric cancer (GC) is the second leading cause of cancer death worldwide. The association between alcohol consumption and GC has been investigated in numerous epidemiologic studies with inconsistent results. OBJECTIVE: We evaluated the association between alcohol consumption and GC risk. DESIGN: We conducted a prospective analysis in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which included 444 cases of first primary gastric adenocarcinoma. HRs and 95% CIs for GC were estimated by using multivariable Cox proportional hazards regression for consumption of pure ethanol in grams per day, with stratification by smoking status, anatomic subsite (cardia, noncardia), and histologic subtype (diffuse, intestinal). In a subset of participants, results were further adjusted for baseline Helicobacter pylori serostatus. RESULTS: Heavy (compared with very light) alcohol consumption (>/=60 compared with 0.1-4.9 g/d) at baseline was positively associated with GC risk (HR: 1.65; 95% CI: 1.06, 2.58), whereas lower consumption amounts (<60 g/d) were not. When we analyzed GC risk by type of alcoholic beverage, there was a positive association for beer (>/=30 g/d; HR: 1.75; 95% CI: 1.13, 2.73) but not for wine or liquor. Associations were primarily observed at the highest amounts of drinking in men and limited to noncardia subsite and intestinal histology; no statistically significant linear dose-response trends with GC risk were observed. CONCLUSION: Heavy (but not light or moderate) consumption of alcohol at baseline (mainly from beer) is associated with intestinal-type noncardia GC risk in men from the EPIC cohort

Physical activity and gain in abdominal adiposity and body weight: prospective cohort study in 288,498 men and women

Ekelund U., Besson H., Luan J., May A.M., Sharp S.J., Brage S., Travier N., Agudo A., Slimani N., Rinaldi S., Jenab M., Norat T., Mouw T., Rohrmann S., Kaaks R., Bergmann M.M., Boeing H., Clavel-Chapelon F., Boutron-Ruault M.C., Overvad K., Jakobsen M.U., Johnsen N.F., Halkjaer J., Gonzalez C.A., Rodriguez L., Sanchez M.J., Arriola L., Barricarte A., Navarro C., Key T.J., Spencer E.A., Orfanos P., Naska A., Trichopoulou A., Manjer J., Lund E., Palli D., Pala V., Vineis P., Mattiello A., Tumino R., Bueno-de-Mesquita H.B., van den Berg S.W., Odysseos A.D., Riboli E., Wareham N.J., Peeters P.H.

Am J Clin Nutr; 2011; 93(4): 826-835

Abstract as provided by PubMed

BACKGROUND: The protective effect of physical activity (PA) on abdominal adiposity is unclear. OBJECTIVE: We examined whether PA independently predicted gains in body weight and abdominal adiposity. DESIGN: In a prospective cohort study [the EPIC (European Prospective Investigation into Cancer and Nutrition)], we followed 84,511 men and 203,987 women for 5.1 y. PA was assessed by a validated questionnaire, and individuals were categorized into 4 groups (inactive, moderately inactive, moderately active, and active). Body weight and waist circumference were measured at baseline and self-reported at follow-up. We used multilevel mixed-effects linear regression models and stratified our analyses by sex with adjustments for age, smoking status, alcohol consumption, educational level, total energy intake, duration of follow-up, baseline body weight, change in body weight, and waist circumference (when applicable). RESULTS: PA significantly predicted a lower waist circumference (in cm) in men (beta = -0.045; 95% CI: -0.057, -0.034) and in women (beta = -0.035; 95% CI: -0.056, -0.015) independent of baseline body weight, baseline waist circumference, and other confounding factors. The magnitude of associations was materially unchanged after adjustment for change in body weight. PA was not significantly associated with annual weight gain (in kg) in men (beta = -0.008; 95% CI: -0.02, 0.003) and women (beta = -0.01; 95% CI: -0.02, 0.0006). The odds of becoming obese were reduced by 7% (P < 0.001) and 10% (P < 0.001) for a one-category difference in baseline PA in men and women, respectively. CONCLUSION: Our results suggest that a higher level of PA reduces abdominal adiposity independent of baseline and changes in body weight and is thus a useful strategy for preventing chronic diseases and premature deaths

Prediagnostic circulating parathyroid hormone concentration and colorectal cancer in the European prospective investigation into cancer and nutrition cohort

Fedirko V., Riboli E., Bueno-de-Mesquita H.B., Rinaldi S., Pischon T., Norat T., Jansen E.H., van Duijnhoven F.J., Tjonneland A., Olsen A., Overvad K., Boutron-Ruault M.C., Clavel-Chapelon F., Engel P., Kaaks R., Teucher B., Boeing H., Buijsse B., Trichopoulou A., Trichopoulos D., Lagiou P., Sieri S., Vineis P., Panico S., Palli D., Tumino R., Van Gils C.H., Peeters P.H., Chirlaque M.D., Gurrea A.B., Rodriguez L., Molina-Montes E., Dorronsoro M., Bonet C., Palmqvist R., Hallmans G., Key T.J., Tsilidis K.K., Khaw K.T., Romieu I., Straif K., Wark P.A., Romaguera D., Jenab M.

Cancer Epidemiol Biomarkers Prev; 2011; 20(5): 767-778

Abstract as provided by PubMed

BACKGROUND: Parathyroid hormone (PTH) has been proposed to play a promoting role in carcinogenesis. However, no epidemiologic studies have yet directly investigated its role in colorectal cancer (CRC). METHODS: A case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort was conducted with 1,214 incident, sporadic CRC cases matched to 1,214 controls. Circulating prediagnostic PTH and 25-hydroxy vitamin D [25(OH)D] concentrations were measured by enzyme-linked immunosorbent assays. Detailed dietary and lifestyle questionnaire data were collected at baseline. Multivariable conditional logistic regression was used to estimate the incidence rate ratio (RR) with 95% confidence intervals (95% CI) for the association between circulating PTH and CRC risk. RESULTS: In multivariate analyses [including adjustment for 25(OH)D concentration] with a priori defined cutoff points, high levels of serum PTH (>/=65 ng/L) compared with medium PTH levels of 30-65 ng/L were associated with increased CRC risk (RR = 1.41, 95% CI: 1.03-1.93). In analyses by sex, the CRC risk was 1.77 (95% CI: 1.14-2.75) and 1.15 (95% CI: 0.73-1.84) in men and women, respectively (P(heterogeneity) = 0.01). In subgroup analyses by anatomical subsite, the risk for colon cancer was RR = 1.56, 95% CI: 1.03-2.34, and for rectal cancer RR = 1.20, 95% CI: 0.72-2.01 (P(heterogeneity) = 0.21). Effect modification by various risk factors was examined. CONCLUSIONS: The results of this study suggest that high serum PTH levels may be associated with incident, sporadic CRC in Western European populations, and in particular among men. Impact: To our knowledge, this is the first study on PTH and CRC. The role of PTH in carcinogenesis needs to be further investigated. Cancer Epidemiol Biomarkers Prev; 20(5); 767-78. (c)2011 AACR

Infection with hepatitis B and C viruses and risk of lymphoid malignancies in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Franceschi S., Lise M., Trepo C., Berthillon P., Chuang S.C., Nieters A., Travis R.C., Vermeulen R., Overvad K., Tjonneland A., Olsen A., Bergmann M.M., Boeing H., Kaaks R., Becker N., Trichopoulou A., Lagiou P., Bamia C., Palli D., Sieri S., Panico S., Tumino R., Sacerdote C., Bueno-de-Mesquita B., Peeters P.H., Rodriguez L., Barroso L.L., Dorronsoro M., Sanchez M.J., Navarro C., Barricarte A., Regner S., Borgquist S., Melin B., Hallmans G., Khaw K.T., Wareham N., Rinaldi S., Hainaut P., Riboli E., Vineis P.

Cancer Epidemiol Biomarkers Prev; 2011; 20(1): 208-214

Abstract as provided by PubMed

BACKGROUND: Case-control studies suggested a moderate, but consistent, association of hepatitis C virus (HCV) infection with lymphoid tissue malignancies, especially non-Hodgkin lymphoma (NHL). More limited data suggested that hepatitis B virus (HBV) infection might also be associated with NHL. However, prospective studies on the topic are few. METHODS: A nested case-control study was conducted in eight countries participating in the EPIC prospective study. Seven hundred thirty-nine incident cases of NHL, 238 multiple myeloma (MM), and 46 Hodgkin lymphoma (HL) were matched with 2,028 controls. Seropositivity to anti-HCV, anti-HBc, and HBsAg was evaluated and conditional logistic regression was used to estimate odds ratios (OR) and corresponding 95% confidence intervals (CI) for NHL, MM, or HL, and their combination. RESULTS: Anti-HCV seropositivity among controls in different countries ranged from 0% to 5.3%; HBsAg from 0% to 2.7%; and anti-HBc from 1.9% to 45.9%. Similar nonsignificant associations were found with seropositivity to HBsAg for NHL (OR = 1.78; 95% CI: 0.78-4.04), MM (OR = 4.00; 95% CI: 1.00-16.0), and HL (OR = 2.00; 95% CI: 0.13-32.0). The association between HBsAg and the combination of NHL, MM, and HL (OR = 2.21; 95% CI: 1.12-4.33) was similar for cancer diagnosed less than 3 and 3 or more years after blood collection. No significant association was found between anti-HCV and NHL, MM, or HL risk, but the corresponding CIs were very broad. CONCLUSIONS: Chronic HBV infection may increase the risk of lymphoid malignancies among healthy European volunteers. IMPACT: Treatment directed at control of HBV infection should be evaluated in HBsAg-seropositive patients with lymphoid tissue malignancies

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