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2011

Cigarette smoking and colorectal cancer risk in the European prospective investigation into cancer and nutrition study

Leufkens A.M., van Duijnhoven F.J., Siersema P.D., Boshuizen H.C., Vrieling A., Agudo A., Gram I.T., Weiderpass E., Dahm C., Overvad K., Tjonneland A., Olsen A., Boutron-Ruault M.C., Clavel-Chapelon F., Morois S., Palli D., Grioni S., Tumino R., Sacerdote C., Mattiello A., Herman S., Kaaks R., Steffen A., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Peeters P.H., Van Gils C.H., van Kranen H., Lund E., Dumeaux V., Engeset D., Rodriguez L., Sanchez M.J., Chirlaque M.D., Barricarte A., Manjer J., Almquist M., Van Guelpen B., Hallmans G., Khaw K.T., Wareham N., Tsilidis K.K., Straif K., Leon-Roux M., Vineis P., Norat T., Riboli E., Bueno-de-Mesquita H.B.

Clin Gastroenterol Hepatol; 2011; 9(2): 137-144

Abstract as provided by PubMed

BACKGROUND & AIMS: There has been consistent evidence for a relationship between smoking and colorectal cancer (CRC), although it is not clear whether the colon or rectum is more sensitive to the effects of smoking. We investigated the relationships between cigarette smoking and risk of CRC and tumor location. METHODS: We analyzed data from 465,879 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study; 2741 developed CRC during the follow-up period (mean, 8.7 years). Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: The risk of colon carcinoma was increased among ever smokers (HR, 1.18; 95% CI, 1.06-1.32) and former cigarette smokers (HR, 1.21; 95% CI, 1.08-1.36), compared with never smokers; the increased risk for current smokers was of borderline significance (HR, 1.13; 95% CI, 0.98-1.31). When stratified for tumor location, the risk of proximal colon cancer was increased for former (HR, 1.25; 95% CI, 1.04-1.50) and current smokers (HR, 1.31; 95% CI, 1.06-1.64), but the risks for cancers in the distal colon or rectum were not. Subsite analyses showed a nonsignificant difference between the proximal and distal colon (P = .45) for former smokers and a significant difference for current smokers (P = .02). For smokers who had stopped smoking for at least 20 years, the risk of developing colon cancer was similar to that of never smokers. CONCLUSIONS: Ever smokers have an increased risk of colon cancer, which appeared to be more pronounced in the proximal than the distal colon location

Consumption of meat and fish and risk of lung cancer: results from the European Prospective Investigation into Cancer and Nutrition

Linseisen J., Rohrmann S., Bueno-de-Mesquita B., Buchner F.L., Boshuizen H.C., Agudo A., Gram I.T., Dahm C.C., Overvad K., Egeberg R., Tjonneland A., Boeing H., Steffen A., Kaaks R., Lukanova A., Berrino F., Palli D., Panico S., Tumino R., Ardanaz E., Dorronsoro M., Huerta J.M., Rodriguez L., Sanchez M.J., Rasmuson T., Hallmans G., Manjer J., Wirfalt E., Engeset D., Skeie G., Katsoulis M., Oikonomou E., Trichopoulou A., Peeters P.H., Khaw K.T., Wareham N., Allen N., Key T., Brennan P., Romieu I., Slimani N., Vergnaud A.C., Xun W.W., Vineis P., Riboli E.

Cancer Causes Control; 2011; 22(6): 909-918

Abstract as provided by PubMed

Evidence from case-control studies, but less so from cohort studies, suggests a positive association between meat intake and risk of lung cancer. Therefore, this association was evaluated in the frame of the European Prospective Investigation into Cancer and Nutrition, EPIC. Data from 478,021 participants, recruited from 10 European countries, who completed a dietary questionnaire in 1992-2000 were evaluated; 1,822 incident primary lung cancer cases were included in the present evaluation. Relative risk estimates were calculated for categories of meat intake using multi-variably adjusted Cox proportional hazard models. In addition, the continuous intake variables were calibrated by means of 24-h diet recall data to account for part of the measurement error. There were no consistent associations between meat consumption and the risk of lung cancer. Neither red meat (RR = 1.06, 95% CI 0.89-1.27 per 50 g intake/day; calibrated model) nor processed meat (RR = 1.13, 95% CI 0.95-1.34 per 50 g/day; calibrated model) was significantly related to an increased risk of lung cancer. Also, consumption of white meat and fish was not associated with the risk of lung cancer. These findings do not support the hypothesis that a high intake of red and processed meat is a risk factor for lung cancer

The contribution of risk factors to the higher incidence of invasive and in situ breast cancers in women with higher levels of education in the European prospective investigation into cancer and nutrition

Menvielle G., Kunst A.E., Van Gils C.H., Peeters P.H., Boshuizen H., Overvad K., Olsen A., Tjonneland A., Hermann S., Kaaks R., Bergmann M.M., Illner A.K., Lagiou P., Trichopoulos D., Trichopoulou A., Palli D., Berrino F., Mattiello A., Tumino R., Sacerdote C., May A., Monninkhof E., Braaten T., Lund E., Quiros J.R., Duell E.J., Sanchez M.J., Navarro C., Ardanaz E., Borgquist S., Manjer J., Khaw K.T., Allen N.E., Reeves G.K., Chajes V., Rinaldi S., Slimani N., Gallo V., Vineis P., Riboli E., Bueno-de-Mesquita H.B.

Am J Epidemiol; 2011; 173(1): 26-37

Abstract as provided by PubMed

The authors investigated the role of known risk factors in educational differences in breast cancer incidence. Analyses were based on the European Prospective Investigation Into Cancer and Nutrition and included 242,095 women, 433 cases of in situ breast cancer, and 4,469 cases of invasive breast cancer. Reproductive history (age at first full-term pregnancy and parity), exposure to endogenous and exogenous hormones, height, and health behaviors were accounted for in the analyses. Relative indices of inequality (RII) for education were estimated using Cox regression models. A higher risk of invasive breast cancer was found among women with higher levels of education (RII = 1.22, 95% confidence interval (CI): 1.09, 1.37). This association was not observed among nulliparous women (RII = 1.13, 95% CI: 0.84, 1.52). Inequalities in breast cancer incidence decreased substantially after adjusting for reproductive history (RII = 1.11, 95% CI: 0.98, 1.25), with most of the association being explained by age at first full-term pregnancy. Each other risk factor explained a small additional part of the inequalities in breast cancer incidence. Height accounted for most of the remaining differences in incidence. After adjusting for all known risk factors, the authors found no association between education level and risk of invasive breast cancer. Inequalities in incidence were more pronounced for in situ breast cancer, and those inequalities remained after adjustment for all known risk factors (RII = 1.61, 95% CI: 1.07, 2.41), especially among nulliparous women

Eating out, weight and weight gain. A cross-sectional and prospective analysis in the context of the EPIC-PANACEA study

Naska A., Orfanos P., Trichopoulou A., May A.M., Overvad K., Jakobsen M.U., Tjonneland A., Halkjaer J., Fagherazzi G., Clavel-Chapelon F., Boutron-Ruault M.C., Rohrmann S., Hermann S., Steffen A., Haubrock J., Oikonomou E., Dilis V., Katsoulis M., Sacerdote C., Sieri S., Masala G., Tumino R., Mattiello A., Bueno-de-Mesquita H.B., Skeie G., Engeset D., Barricarte A., Rodriguez L., Dorronsoro M., Sanchez M.J., Chirlaque M.D., Agudo A., Manjer J., Wirfalt E., Hellstrom V., Shungin D., Khaw K.T., Wareham N.J., Spencer E.A., Freisling H., Slimani N., Vergnaud A.C., Mouw T., Romaguera D., Odysseos A., Peeters P.H.

Int J Obes (Lond); 2011; 35(3): 416-426

Abstract as provided by PubMed

Objective:The aim of this study was to examine the association of body mass index (BMI) and weight gain with eating at restaurants and similar establishments or eating at work among 10 European countries of the European Prospective Investigation into Cancer and Nutrition (EPIC) study.Subjects:This study included a representative sample of 24 310 randomly selected EPIC participants.Methods:Single 24-h dietary recalls with information on the place of consumption were collected using standardized procedures between 1995 and 2000. Eating at restaurants was defined to include all eating and drinking occasions at restaurants, cafeterias, bars and fast food outlets. Eating at work included all eating and drinking occasions at the workplace. Associations between eating at restaurants or eating at work and BMI or annual weight changes were assessed using sex-specific linear mixed-effects models, controlling for potential confounders.Results:In southern Europe energy intake at restaurants was higher than intake at work, whereas in northern Europe eating at work appeared to contribute more to the mean daily intake than eating at restaurants. Cross-sectionally, eating at restaurants was found to be positively associated with BMI only among men (beta=+0.24, P=0.003). Essentially no association was found between BMI and eating at work among both genders. In a prospective analysis among men, eating at restaurants was found to be positively, albeit nonsignificantly, associated with weight gain (beta=+0.05, P=0.368). No association was detected between energy intake at restaurants and weight changes, controlling for total energy intake.Conclusion:Among men, eating at restaurants and similar establishments was associated with higher BMI and possibly weight gain

Occupation and risk of lymphoma: a multicentre prospective cohort study (EPIC)

Neasham D., Sifi A., Nielsen K.R., Overvad K., Raaschou-Nielsen O., Tjonneland A., Barricarte A., Gonzalez C.A., Navarro C., Rodriguez Suarez L., Travis R.C., Key T., Linseisen J., Kaaks R., Crosignani P., Berrino F., Rosso S., Mattiello A., Vermeulen R.C., Bueno-de-Mesquita H.B., Berglund G., Manjer J., Zackrisson S., Hallmans G., Malmer B., Bingham S., Khaw K.T., Bergmann M.M., Boeing H., Trichopoulou A., Masala G., Tumino R., Lund E., Slimani N., Ferrari P., Boffetta P., Vineis P., Riboli E.

Occup Environ Med; 2011; 68(1): 77-81

Abstract as provided by PubMed

OBJECTIVES: Evidence suggests that certain occupations and related exposures may increase the risk of malignant lymphoma. Farming, printing and paper industry, wood processing, meat handling and processing, welding, shoe and leather manufacturing and teaching profession are among the categories that have been implicated in previous studies. The relationship between occupation and malignant lymphoma has been investigated in a large European prospective study. METHODS: We investigated occupational risks for lymphomas in the European Prospective Investigation into Cancer and Nutrition (EPIC). The mean follow-up time for 348,555 subjects was 9 years (SD: 2 years). The analysis was based on 866 and 48 newly diagnosed cases of non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL). These were identified in the EPIC subcohorts with occupational data. Data on 52 occupations were collected through standardised questionnaires. Cox proportional hazard models were used to explore the association between occupation and risk of malignant lymphoma. RESULTS: The following occupations were positively associated with malignant NHL after adjustment for study centre, age, sex, socioeconomic status (SES), smoking and alcohol: butchers (HR=1.53, 95% CI 1.05 to 2.48, including multiple myeloma/plasmacytoma; HR=1.30, 95% CI 1.00 to 2.66, excluding multiple myeloma/plasmacytoma) and car repair workers (HR=1.50, 95% CI 1.01 to 2.00, including multiple myeloma/plasmacytoma; HR=1.51, 95% CI 1.01 to 2.31, excluding multiple myeloma/plasmacytoma). HL was associated with gasoline station occupation (HR=4.59, 95% CI 1.08 to 19.6). CONCLUSION: The findings in this current study of a higher risk of NHL among car repair workers and butchers and a higher risk of HL among gasoline station workers suggest a possible role from occupationally related exposures, such as solvents and zoonotic viruses, as risk factors for malignant lymphoma

Potential and requirements for a standardized pan-European food consumption survey using the EPIC-Soft software

Ocke M.C., Slimani N., Brants H., Buurma-Rethans E., Casagrande C., Nicolas G., Dofkova M., le Donne C., Freisling H., Geelen A., Huybrechts I., De Keyzer W., van der Laan J.D., Lafay L., Lillegaard I.T., Niekerk E.M., de Vries J.H., Wilson-van den Hooven EC, de Boer E.J.

Eur J Clin Nutr; 2011; S48-S57

Abstract as provided by PubMed

BACKGROUND/OBJECTIVES: To describe the strengths, limitations and requirements of using EPIC-Soft software (the software developed to conduct 24-h dietary recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) in pan-European food consumption surveys, and to discuss potentials and barriers for a harmonized pan-European food consumption survey. SUBJECTS/METHODS: The paper is based on the experiences in the 'European Food Consumption and Validation' Project, which included updating six existing and preparing one new country-specific EPIC-Soft version, applying EPIC-Soft in validation and feasibility studies, and estimating the intake of nutrients and flavoring substances. The experiences were discussed in the September 2009 workshop 'Pan-European Food Consumption Surveys--for Standardized and Comparable Transnational Data Collection'. RESULTS: EPIC-Soft is suitable for detailed and standardized food consumption data collection in pan-European food consumption surveys. A thorough preparation of all aspects of the food consumption survey is important for the quality and efficiency during data collection and processing. The preparation and data-handling phase of working with EPIC-Soft is labor intensive and requires trained, motivated and qualified personnel. CONCLUSIONS: Given the suitability of EPIC-Soft as standardized dietary assessment tool in European dietary monitoring, the proposed strategy toward a pan-European food consumption survey is to prepare well, to allow flexibility in national extensions and to start with a limited number of countries that are interested

Endogenous Sex Steroids and Risk of Cervical Carcinoma: Results from the EPIC Study

Rinaldi S., Plummer M., Biessy C., Castellsague X., Overvad K., Kruger Kjaer S., Tjonneland A., Clavel-Chapelon F., Chabbert-Buffet N., Mesrine S., Lukanova A., Kaaks R., Weikert C., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Agnoli C., Tumino R., Vineis P., Panico S., Bueno-de-Mesquita B., van Kranen H.J., Peeters P.H., Bakken K., Lund E., Gram I.T., Rodriguez L., Bosch F.X., Sanchez M.J., Dorronsoro M., Navarro C., Gurrea A.B., Kjellberg L., Dillner J., Manjer J., Butt S., Khaw K.T., Wareham N., Allen N.E., Travis R., Romieu I., Ferrari P., Riboli E., Franceschi S.

Cancer Epidemiol Biomarkers Prev; 2011; 20(12): 2532-2540

Abstract as provided by PubMed

BACKGROUND: Epidemiologic data and animal models suggest that, despite the predominant role of human papillomavirus infection, sex steroid hormones are also involved in the etiology of invasive cervical carcinoma (ICC). METHODS: Ninety-nine ICC cases, 121 cervical intraepithelial neoplasia grade 3 (CIN3) cases and 2 control women matched with each case for center, age, menopausal status and blood collection-related variables, were identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Circulating levels of testosterone (T) and estradiol (E(2)); dehydroepiandrosterone sulfate (DHEAS); progesterone (premenopausal women); and sex hormone-binding globulin (SHBG) were measured using immunoassays. Levels of free (f) T and E(2) were calculated from absolute concentrations of T, E(2), and SHBG. Odds ratios (ORs) and 95% confidence intervals (CI) were computed using regularized conditional logistic regression. RESULTS: Among premenopausal women, associations with ICC were observed for fT (OR for highest vs. lowest tertile = 5.16, 95% CI, 1.50-20.1). SHBG level was associated with a significant downward trend in ICC risk. T, E(2), fE(2), and DHEAS showed nonsignificant positive association with ICC. Progesterone was uninfluential. Among postmenopausal women, associations with ICC were found for T (OR = 3.14; 95% CI, 1.21-9.37), whereas E(2) and fT showed nonsignificant positive association. SHBG level was unrelated to ICC risk in postmenopausal women. No associations between any hormone and CIN3 were detected in either pre- or postmenopausal women. CONCLUSIONS: Our findings suggest for the first time that T and possibly E(2) may be involved in the etiology of ICC. Impact: The responsiveness of cervical tumors to hormone modulators is worth exploring. Cancer Epidemiol Biomarkers Prev; 20(12); 2532-40. (c)2011 AACR

Consumption of meat and dairy and lymphoma risk in the European Prospective Investigation into Cancer and Nutrition

Rohrmann S., Linseisen J., Jakobsen M.U., Overvad K., Raaschou-Nielsen O., Tjonneland A., Boutron-Ruault M.C., Kaaks R., Becker N., Bergmann M., Boeing H., Khaw K.T., Wareham N.J., Key T.J., Travis R., Benetou V., Naska A., Trichopoulou A., Pala V., Tumino R., Masala G., Mattiello A., Brustad M., Lund E., Skeie G., Bueno-de-Mesquita H.B., Peeters P.H., Vermeulen R.C., Jakszyn P., Dorronsoro M., Barricarte A., Tormo M.J., Molina E., Arguelles M., Melin B., Ericson U., Manjer J., Rinaldi S., Slimani N., Boffetta P., Vergnaud A.C., Khan A., Norat T., Vineis P.

Int J Cancer; 2011; 128(3): 623-634

Abstract as provided by PubMed

The consumption of meat and other foods of animal origin is a risk factor for several types of cancer, but the results for lymphomas are inconclusive. Therefore, we examined these associations among 411,097 participants of the European Prospective Investigation into Cancer and Nutrition. During a median follow-up of 8.5 years, 1,334 lymphomas (1,267 non-Hodgkin lymphoma (NHL) and 67 Hodgkin lymphomas) were identified. Consumption of red and processed meat, poultry, milk and dairy products was assessed by dietary questionnaires. Cox proportional hazard regression was used to evaluate the association of the consumption of these food groups with lymphoma risk. Overall, the consumption of foods of animal origin was not associated with an increased risk of NHLS or HL, but the associations with specific subgroups of NHL entities were noted. A high intake of processed meat was associated with an increased risk of B-cell chronic lymphocytic leukemia (BCLL) [relative risk (RR) per 50 g intake = 1.31, 95% confidence interval (CI) 1.06-1.63], but a decreased risk of follicular lymphomas (FL) (RR = 0.58; CI 0.38-0.89). A high intake of poultry was related to an increased risk of B-cell lymphomas (RR = 1.22; CI 1.05-1.42 per 10 g intake), FL (RR = 1.65; CI 1.18-2.32) and BCLL (RR = 1.54; CI 1.18-2.01) in the continuous models. In conclusion, no consistent associations between red and processed meat consumption and lymphoma risk were observed, but we found that the consumption of poultry was related to an increased risk of B-cell lymphomas. Chance is a plausible explanation of the observed associations, which need to be confirmed in further studies

Concentrations of IGF-I and IGFBP-3 and Brain Tumor Risk in the European Prospective Investigation into Cancer and Nutrition

Rohrmann S., Linseisen J., Becker S., Allen N., Schlehofer B., Overvad K., Olsen A., Tjonneland A., Melin B.S., Lund E., Vineis P., Grioni S., Tumino R., Palli D., Mattiello A., Bonet C., Chirlaque M.D., Sanchez M.J., Rodriguez L., Dorronsoro M., Ardanaz E., Lagiou P., Trichopoulou A., Trichopoulos D., Dossus L., Grote V.A., Boeing H., Aleksandrova K., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Peeters P.H., Khaw K.T., Wareham N.J., Key T.J., Rinaldi S., Romieux I., Gallo V., Michaud D.S., Riboli E., Kaaks R.

Cancer Epidemiol Biomarkers Prev; 2011; 20(10): 2174-2182

Abstract as provided by PubMed

BACKGROUND: Insulin-like growth factor-1 (IGF-I) is important in normal brain development but in the adult brain, IGF-I overexpression may be a risk factor for tumor development. METHODS: We examined the association between circulating concentrations of IGF-I and IGFBP-3 in relation to risk of gliomas (74 low-grade, 206 high-grade gliomas), meningiomas (n = 174) and acoustic neuromas (n = 49) by using a case-control design nested in the European Prospective Investigation into Cancer and Nutrition. IGF-I and IGFBP-3 were measured by ELISAs.Conditional logistic regression was used to compute ORs and corresponding 95% CIs. RESULTS: The risk of low-grade gliomas was elevated with increased IGF-I (OR = 3.60, 95% CI: 1.11-11.7; top vs. bottom quartile) and decreased with elevated IGFBP-3 concentrations (OR = 0.28, 95% CI: 0.09-0.84) after mutual adjustment of these two factors; these results became nonsignificant after exclusion of the first year of follow-up. No association was observed for high-grade gliomas or meningiomas. Both high IGF-I and IGFBP-3 concentrations were associated with risk of acoustic neuromas (IGF-I: OR = 6.63, 95% CI: 2.27-19.4, top vs. bottom tertile; IGFBP-3: OR = 7.07, 95% CI: 2.32-21.6), even after excluding the first year of follow-up. CONCLUSION: High concentrations of IGF-I might be positively associated with risk of low-grade gliomas and acoustic neuromas, although we cannot exclude reverse causation, in particular for low-grade gliomas. Impact: Factors of the IGF axis might be involved in the etiology of some types of brain tumors. Cancer Epidemiol Biomarkers Prev; 20(10); 2174-82. (c)2011 AACR

Fluid intake and the risk of urothelial cell carcinomas in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Ros M.M., Bas Bueno-de-Mesquita HB, Buchner F.L., Aben K.K., Kampman E., Egevad L., Overvad K., Tjonneland A., Roswall N., Clavel-Chapelon F., Kaaks R., Chang-Claude J., Boeing H., Weikert S., Trichopoulou A., Orfanos P., Stasinopulou G., Saieva C., Krogh V., Vineis P., Tumino R., Mattiello A., Peeters P.H., van Duijnhoven F.J., Lund E., Gram I.T., Chirlaque M.D., Barricarte A., Rodriguez L., Molina E., Gonzalez C., Dorronsoro M., Manjer J., Ehrnstrom R., Ljungberg B., Allen N.E., Roddam A.W., Khaw K.T., Wareham N., Boffetta P., Slimani N., Michaud D.S., Kiemeney L.A., Riboli E.

Int J Cancer; 2011; 128(11): 2695-2708

Abstract as provided by PubMed

Results from previous studies investigating the association between fluid intake and urothelial cell carcinomas (UCC) are inconsistent. We evaluated this association among 233,236 subjects in the European Prospective Investigation into Cancer and Nutrition (EPIC), who had adequate baseline information on water and total fluid intake. During a mean follow-up of 9.3 years, 513 first primary UCC occurred. At recruitment, habitual fluid intake was assessed by a food frequency questionnaire. Multivariable hazard ratios were estimated using Cox regression stratified by age, sex and center and adjusted for energy intake, smoking status, duration of smoking and lifetime intensity of smoking. When using the lowest tertile of intake as reference, total fluid intake was not associated with risk of all UCC (HR 1.12; 95%CI 0.86-1.45, p-trend = 0.42) or with risk of prognostically high-risk UCC (HR 1.28; 95%CI 0.85-1.93, p-trend = 0.27) or prognostically low-risk UCC (HR 0.93; 95%CI 0.65-1.33, p-trend = 0.74). No associations were observed between risk of UCC and intake of water, coffee, tea and herbal tea and milk and other dairy beverages. For prognostically low-risk UCC suggestions of an inverse association with alcoholic beverages and of a positive association with soft drinks were seen. Increased risks were found for all UCC and prognostically low-risk UCC with higher intake of fruit and vegetable juices. In conclusion, total usual fluid intake is not associated with UCC risk in EPIC. The relationships observed for some fluids may be due to chance, but further investigation of the role of all types of fluid is warranted

Primary brain tumours and specific serum immunoglobulin E: a case-control study nested in the European Prospective Investigation into Cancer and Nutrition cohort

Schlehofer B., Siegmund B., Linseisen J., Schuz J., Rohrmann S., Becker S., Michaud D., Melin B., Bas Bueno-de-Mesquita H., Peeters P.H., Vineis P., Tjonneland A., Olsen A., Overvad K., Romieu I., Boeing H., Aleksandrova K., Trichopoulou A., Bamia C., Lagiou P., Sacerdote C., Palli D., Panico S., Sieri S., Tumino R., Sanchez M.J., Rodriguez L., Dorronsoro M., Duell E.J., Chirlaque M.D., Barricarte A., Borgquist S., Manjer J., Gallo V., Allen N.E., Key T.J., Riboli E., Kaaks R., Wahrendorf J.

Allergy; 2011; 66(11): 1434-1441

Abstract as provided by PubMed

To cite this article: Schlehofer B, Siegmund B, Linseisen J, Schuz J, Rohrmann S, Becker S, Michaud D, Melin B, Bas Bueno-de-Mesquita H, Peeters PHM, Vineis P, Tjonneland A, Olsen A, Overvad K, Romieu I, Boeing H, Aleksandrova K, Trichopoulou A, Bamia C, Lagiou P, Sacerdote C, Palli D, Panico S, Sieri S, Tumino R, Sanchez M-J, Rodriguez L, Dorronsoro M, Duell EJ, Chirlaque M-D, Barricarte A, Borgquist S, Manjer J, Gallo V, Allen NE, Key TJ, Riboli E, Kaaks R, Wahrendorf J. Primary brain tumours and specific serum immunoglobulin E: a case-control study nested in the European Prospective Investigation into Cancer and Nutrition cohort. Allergy 2011; 66: 1434-1441. ABSTRACT: Background: Case-control studies suggest that patients with allergic diseases have a lower risk of developing glioma but not meningioma or schwannoma. However, those data can be differentially biased. Prospective studies with objective measurements of immunologic biomarkers, like immunoglobulin E (IgE), in blood obtained before cancer diagnosis could help to clarify whether an aetiological association exists. Methods: The present case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) measured specific serum IgE as a biomarker for the most common inhalant allergens in 275 glioma, 175 meningioma and 49 schwannoma cases and 963 matched controls using the ImmunoCAP specific IgE test. Subjects with an IgE level >/=0.35 kUA/l (kilo antibody units per litre) were classified as sensitized by allergens. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by adjusted conditional logistic regression models for each tumour subtype. The effect of dose-response relationship was assessed in five increasing IgE level categories to estimate P-values for trend. Results: The risk of glioma was inversely related to allergic sensitization (OR = 0.73; 95% CI 0.51-1.06), especially pronounced in women (OR = 0.53; 95% CI 0.30-0.95). In dose-response analyses, for high-grade glioma, the lowest OR was observed in sera with the highest IgE levels (P for trend = 0.04). No association was seen for meningioma and schwannoma. Conclusion: The results, based on serum samples prospectively collected in a cohort study, provide some support for the hypothesis that individuals with allergic sensitization are at reduced risk of glioma and confirm results from previous case-control studies

Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study

Schutze M., Boeing H., Pischon T., Rehm J., Kehoe T., Gmel G., Olsen A., Tjonneland A.M., Dahm C.C., Overvad K., Clavel-Chapelon F., Boutron-Ruault M.C., Trichopoulou A., Benetou V., Zylis D., Kaaks R., Rohrmann S., Palli D., Berrino F., Tumino R., Vineis P., Rodriguez L., Agudo A., Sanchez M.J., Dorronsoro M., Chirlaque M.D., Barricarte A., Peeters P.H., Van Gils C.H., Khaw K.T., Wareham N., Allen N.E., Key T.J., Boffetta P., Slimani N., Jenab M., Romaguera D., Wark P.A., Riboli E., Bergmann M.M.

BMJ; 2011; d1584

Abstract as provided by PubMed

OBJECTIVE: To compute the burden of cancer attributable to current and former alcohol consumption in eight European countries based on direct relative risk estimates from a cohort study. DESIGN: Combination of prospective cohort study with representative population based data on alcohol exposure. Setting Eight countries (France, Italy, Spain, United Kingdom, the Netherlands, Greece, Germany, Denmark) participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. PARTICIPANTS: 109 118 men and 254 870 women, mainly aged 37-70. MAIN OUTCOME MEASURES: Hazard rate ratios expressing the relative risk of cancer incidence for former and current alcohol consumption among EPIC participants. Hazard rate ratios combined with representative information on alcohol consumption to calculate alcohol attributable fractions of causally related cancers by country and sex. Partial alcohol attributable fractions for consumption higher than the recommended upper limit (two drinks a day for men with about 24 g alcohol, one for women with about 12 g alcohol) and the estimated total annual number of cases of alcohol attributable cancer. RESULTS: If we assume causality, among men and women, 10% (95% confidence interval 7 to 13%) and 3% (1 to 5%) of the incidence of total cancer was attributable to former and current alcohol consumption in the selected European countries. For selected cancers the figures were 44% (31 to 56%) and 25% (5 to 46%) for upper aerodigestive tract, 33% (11 to 54%) and 18% (-3 to 38%) for liver, 17% (10 to 25%) and 4% (-1 to 10%) for colorectal cancer for men and women, respectively, and 5.0% (2 to 8%) for female breast cancer. A substantial part of the alcohol attributable fraction in 2008 was associated with alcohol consumption higher than the recommended upper limit: 33 037 of 178 578 alcohol related cancer cases in men and 17 470 of 397 043 alcohol related cases in women. CONCLUSIONS: In western Europe, an important proportion of cases of cancer can be attributable to alcohol consumption, especially consumption higher than the recommended upper limits. These data support current political efforts to reduce or to abstain from alcohol consumption to reduce the incidence of cancer

The standardized computerized 24-h dietary recall method EPIC-Soft adapted for pan-European dietary monitoring

Slimani N., Casagrande C., Nicolas G., Freisling H., Huybrechts I., Ocke M.C., Niekerk E.M., van Rossum C., Bellemans M., De Maeyer M., Lafay L., Krems C., Amiano P., Trolle E., Geelen A., de Vries J.H., de Boer E.J.

Eur J Clin Nutr; 2011; S5-S15

Abstract as provided by PubMed

Background/Objectives:The EPIC-Soft program (the software initially developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) was recommended as the best way to standardize 24-HDRs for future pan-European dietary monitoring. Within European Food Consumption Validation (EFCOVAL), EPIC-Soft was adapted and further developed on various aspects that were required to optimize its use. In this paper, we present the structure and main interview steps of the EPIC-Soft program, after implementation of a series of new specifications deemed to satisfy specific requirements of pan-European monitoring surveys and other international studies.Subjects/Methods:Updates to optimize the EPIC-Soft program were ascertained according to the following stepwise approach: (1) identification of requested specifications to be potentially implemented through an ad hoc 'EPIC-Soft specifications questionnaire' sent to past, current and possible future users of the software; (2) evaluation of the specifications in collaboration with two ad hoc task force groups and through a workshop; (3) development of a technical solution for each retained specification; (4) implementation of the specifications by software developers; (5) testing and amendment of bugs.Results:A number of new specifications and facilities were implemented to EPIC-Soft program. In addition, the software underwent a full reprogramming and migration to a modern Windows environment, including changes in its internal architecture and user interface. Although the overall concept and structure of the initial software were not changed substantially, these improvements ease the current and future use of EPIC-Soft and increase further its adaptation to other countries and study contexts.Conclusions:EPIC-Soft is enriched with further functions and facilities expected to fulfil specific needs of pan-European dietary monitoring and risk assessment purposes. The validity, feasibility and relevance of this software for different national and international study designs, and the logistical aspects related to its implementation are reported elsewhere

Genetic Polymorphisms in 15q25 and 19q13 Loci, Cotinine Levels, and Risk of Lung Cancer in EPIC

Timofeeva M.N., McKay J.D., Davey S.G., Johansson M., Byrnes G.B., Chabrier A., Relton C., Ueland P.M., Vollset S.E., Midttun O., Nygard O., Slimani N., Romieu I., Clavel-Chapelon F., Boutron-Ruault M.C., Fagherazzi G., Kaaks R., Teucher B., Boeing H., Weikert C., Bueno-de-Mesquita H.B., van Gils C., Peeters P.H., Agudo A., Barricarte A., Huerta J.M., Rodriguez L., Sanchez M.J., Larranaga N., Khaw K.T., Wareham N., Allen N.E., Travis R.C., Gallo V., Norat T., Krogh V., Masala G., Panico S., Sacerdote C., Tumino R., Trichopoulou A., Lagiou P., Trichopoulos D., Rasmuson T., Hallmans G., Riboli E., Vineis P., Brennan P.

Cancer Epidemiol Biomarkers Prev; 2011; 20(10): 2250-2261

Abstract as provided by PubMed

Backgrounds: Multiple polymorphisms affecting smoking behavior have been identified through genome-wide association studies. Circulating levels of the nicotine metabolite cotinine is a marker of recent smoking exposure. Hence, genetic variants influencing smoking behavior are expected to be associated with cotinine levels. METHODS: We conducted an analysis in a lung cancer case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. We investigated the effects of single-nucleotide polymorphisms (SNP) previously associated with smoking behavior on (i) circulating cotinine and (ii) lung cancer risk. A total of 894 cases and 1,805 controls were analyzed for cotinine and genotyped for 10 polymorphisms on 7p14, 8p11, 10q23, 15q25, and 19q13. RESULTS: Two variants in the nicotinic acetylcholine receptor subunit genes CHRNA5 and CHRNA3 on 15q25, rs16969968 and rs578776, were associated with cotinine (P = 0.001 and 0.03, respectively) in current smokers and with lung cancer risk (P < 0.001 and P = 0.001, respectively). Two 19q13 variants, rs7937 and rs4105144, were associated with increased cotinine (P = 0.003 and P < 0.001, respectively) but decreased lung cancer risk (P = 0.01 for both, after adjusting for cotinine). Variants in 7p14, 8p11, and 10q23 were not associated with cotinine or lung cancer risk. CONCLUSIONS: 15q25 and 19q13 SNPs were associated with circulating cotinine. The directions of association for 15q25 variants with cotinine were in accordance with that expected of lung cancer risk, whereas SNPs on 19q13 displayed contrasting associations of cotinine and lung cancer that require further investigation. Impact: This study is the largest to date investigating the effects of polymorphisms affecting smoking behavior on lung cancer risk using circulating cotinine measures as proxies for recent smoking behavior. Cancer Epidemiol Biomarkers Prev; 20(10); 2250-61. (c)2011 AACR

Hepatocellular carcinoma risk factors and disease burden in a European cohort: a nested case-control study

Trichopoulos D., Bamia C., Lagiou P., Fedirko V., Trepo E., Jenab M., Pischon T., Nothlings U., Overved K., Tjonneland A., Outzen M., Clavel-Chapelon F., Kaaks R., Lukanova A., Boeing H., Aleksandrova K., Benetou V., Zylis D., Palli D., Pala V., Panico S., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., van Kranen H.J., Peeters P.H., Lund E., Quiros J.R., Gonzalez C.A., Sanchez Perez M.J., Navarro C., Dorronsoro M., Barricarte A., Lindkvist B., Regner S., Werner M., Hallmans G., Khaw K.T., Wareham N., Key T., Romieu I., Chuang S.C., Murphy N., Boffetta P., Trichopoulou A., Riboli E.

J Natl Cancer Inst; 2011; 103(22): 1686-1695

Abstract as provided by PubMed

Background To date, no attempt has been made to systematically determine the apportionment of the hepatocellular carcinoma burden in Europe or North America among established risk factors. Methods Using data collected from 1992 to 2006, which included 4 409 809 person-years in the European Prospective Investigation into Cancer and nutrition (EPIC), we identified 125 case patients with hepatocellular carcinoma, of whom 115 were matched to 229 control subjects. We calculated odds ratios (ORs) for the association of documented risk factors for hepatocellular carcinoma with incidence of this disease and estimated their importance in this European cohort. Results Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection (OR = 9.10, 95% confidence interval [CI] = 2.10 to 39.50 and OR = 13.36, 95% CI = 4.11 to 43.45, respectively), obesity (OR = 2.13, 95% CI = 1.06 to 4.29), former or current smoking (OR = 1.98, 95% CI = 0.90 to 4.39 and OR = 4.55, 95% CI = 1.90 to 10.91, respectively), and heavy alcohol intake (OR = 1.77, 95% CI = 0.73 to 4.27) were associated with hepatocellular carcinoma. Smoking contributed to almost half of all hepatocellular carcinomas (47.6%), whereas 13.2% and 20.9% were attributable to chronic HBV and HCV infection, respectively. Obesity and heavy alcohol intake contributed 16.1% and 10.2%, respectively. Almost two-thirds (65.7%, 95% CI = 50.6% to 79.3%) of hepatocellular carcinomas can be accounted for by exposure to at least one of these documented risk factors. Conclusions Smoking contributed to more hepatocellular carcinomas in this Europe-wide cohort than chronic HBV and HCV infections. Heavy alcohol consumption and obesity also contributed to sizeable fractions of this disease burden. These contributions may be underestimates because EPIC volunteers are likely to be more health conscious than the general population

Menopausal hormone therapy and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition

Tsilidis K.K., Allen N.E., Key T.J., Sanjoaquin M.A., Bakken K., Berrino F., Fournier A., Lund E., Overvad K., Olsen A., Tjonneland A., Byrnes G., Chajes V., Rinaldi S., Boutron-Ruault M.C., Clavel-Chapelon F., Chang-Claude J., Kaaks R., Bergmann M., Boeing H., Koumantaki Y., Palli D., Pala V., Panico S., Tumino R., Vineis P., Bas Bueno-de-Mesquita H., van Duijnhoven F.J., Van Gils C.H., Peeters P.H., Rodriguez L., Gonzalez C.A., Sanchez M.J., Chirlaque M.D., Barricarte A., Dorronsoro M., Khaw K.T., Rodwell S.A., Norat T., Romaguera D., Riboli E.

Int J Cancer; 2011; 128(8): 1881-1889

Abstract as provided by PubMed

Menopausal hormone therapy (HT) may influence colorectal cancer risk. A total of 136,275 postmenopausal women from the European Prospective Investigation into Cancer and Nutrition were followed for an average of 9 years, during which time 1,186 colorectal cancers were diagnosed. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models stratified by center and age, and adjusted for body mass index, smoking, diabetes, physical activity and alcohol consumption. Compared to never use of HT at study enrolment, current use of estrogen-only (HR, 1.02; 95% CI, 0.79-1.31) or estrogen plus progestin (HR, 0.94; 95% CI, 0.77-1.14) was not significantly associated with the risk of colorectal cancer, and these associations did not vary by recency, duration, route of administration, regimen or specific constituent of HT. Our results show no significant association of estrogen-only or estrogen plus progestin therapy with colorectal cancer risk

Menopausal hormone therapy and risk of ovarian cancer in the European prospective investigation into cancer and nutrition

Tsilidis K.K., Allen N.E., Key T.J., Dossus L., Kaaks R., Bakken K., Lund E., Fournier A., Dahm C.C., Overvad K., Hansen L., Tjonneland A., Rinaldi S., Romieu I., Boutron-Ruault M.C., Clavel-Chapelon F., Lukanova A., Boeing H., Schutze M., Benetou V., Palli D., Berrino F., Galasso R., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Braem M.G., Onland-Moret N.C., Gram I.T., Rodriguez L., Duell E.J., Sanchez M.J., Huerta J.M., Ardanaz E., Amiano P., Khaw K.T., Wareham N., Riboli E.

Cancer Causes Control; 2011; 22(8): 1075-1084

Abstract as provided by PubMed

The association between menopausal hormone therapy (HT) and risk of ovarian cancer was assessed among 126,920 post-menopausal women recruited into the European Prospective Investigation into Cancer and Nutrition. After an average of 9-year follow-up, 424 incident ovarian cancers were diagnosed. Cox models adjusted for body mass index, smoking status, unilateral ovariectomy, simple hysterectomy, age at menarche, number of full-term pregnancies, and duration of oral contraceptives were used. Compared with baseline never use, current use of any HT was positively associated with risk (HR [hazard ratio], 1.29; 95% CI [confidence interval], 1.01-1.65), while former use was not (HR, 0.96; 95% CI, 0.70-1.30). Current estrogen-only HT was associated with a 63% higher risk (HR, 1.63; 95% CI, 1.08-2.47), while current estrogen plus progestin was associated with a smaller and non-significant higher risk (HR, 1.20; 95% CI, 0.89-1.62). Use of tibolone was associated with a twofold greater risk (HR, 2.19; 95% CI, 1.06-4.50), but was based on small numbers. In conclusion, women who currently use HT have a moderate increased risk of ovarian cancer, and which may be stronger for estrogen-only than estrogen plus progestin preparations

Oral contraceptive use and reproductive factors and risk of ovarian cancer in the European Prospective Investigation into Cancer and Nutrition

Tsilidis K.K., Allen N.E., Key T.J., Dossus L., Lukanova A., Bakken K., Lund E., Fournier A., Overvad K., Hansen L., Tjonneland A., Fedirko V., Rinaldi S., Romieu I., Clavel-Chapelon F., Engel P., Kaaks R., Schutze M., Steffen A., Bamia C., Trichopoulou A., Zylis D., Masala G., Pala V., Galasso R., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Braem M.G., Onland-Moret N.C., Gram I.T., Rodriguez L., Travier N., Sanchez M.J., Huerta J.M., Ardanaz E., Larranaga N., Jirstrom K., Manjer J., Idahl A., Ohlson N., Khaw K.T., Wareham N., Mouw T., Norat T., Riboli E.

Br J Cancer; 2011; 105(9): 1436-1442

Abstract as provided by PubMed

Background:It is well established that parity and use of oral contraceptives reduce the risk of ovarian cancer, but the associations with other reproductive variables are less clear.Methods:We examined the associations of oral contraceptive use and reproductive factors with ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 327 396 eligible women, 878 developed ovarian cancer over an average of 9 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models stratified by centre and age, and adjusted for smoking status, body mass index, unilateral ovariectomy, simple hysterectomy, menopausal hormone therapy, and mutually adjusted for age at menarche, age at menopause, number of full-term pregnancies and duration of oral contraceptive use.Results:Women who used oral contraceptives for 10 or more years had a significant 45% (HR, 0.55; 95% CI, 0.41-0.75) lower risk compared with users of 1 year or less (P-trend, <0.01). Compared with nulliparous women, parous women had a 29% (HR, 0.71; 95% CI, 0.59-0.87) lower risk, with an 8% reduction in risk for each additional pregnancy. A high age at menopause was associated with a higher risk of ovarian cancer (>52 vs </=45 years: HR, 1.46; 95% CI, 1.06-1.99; P-trend, 0.02). Age at menarche, age at first full-term pregnancy, incomplete pregnancies and breastfeeding were not associated with risk.Conclusion:This study shows a strong protective association of oral contraceptives and parity with ovarian cancer risk, a higher risk with a late age at menopause, and no association with other reproductive factors

Blood lipid and lipoprotein concentrations and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition

van Duijnhoven F.J., Bueno-de-Mesquita H.B., Calligaro M., Jenab M., Pischon T., Jansen E.H., Frohlich J., Ayyobi A., Overvad K., Toft-Petersen A.P., Tjonneland A., Hansen L., Boutron-Ruault M.C., Clavel-Chapelon F., Cottet V., Palli D., Tagliabue G., Panico S., Tumino R., Vineis P., Kaaks R., Teucher B., Boeing H., Drogan D., Trichopoulou A., Lagiou P., Dilis V., Peeters P.H., Siersema P.D., Rodriguez L., Gonzalez C.A., Molina-Montes E., Dorronsoro M., Tormo M.J., Barricarte A., Palmqvist R., Hallmans G., Khaw K.T., Tsilidis K.K., Crowe F.L., Chajes V., Fedirko V., Rinaldi S., Norat T., Riboli E.

Gut; 2011; 60(8): 1094-1102

Abstract as provided by PubMed

Objective To examine the association between serum concentrations of total cholesterol, high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol, triglycerides, apolipoprotein A-I (apoA), apolipoprotein B and the incidence of colorectal cancer (CRC). Design Nested case-control study. Setting The study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort of more than 520 000 participants from 10 western European countries. Participants 1238 cases of incident CRC, which developed after enrolment into the cohort, were matched with 1238 controls for age, sex, centre, follow-up time, time of blood collection and fasting status. Main outcome measures Serum concentrations were quantitatively determined by colorimetric and turbidimetric methods. Dietary and lifestyle data were obtained from questionnaires. Conditional logistic regression models were used to estimate incidence rate ratios (RRs) and 95% CIs which were adjusted for height, weight, smoking habits, physical activity, education, consumption of fruit, vegetables, meat, fish, alcohol, fibre and energy. Results After adjustments, the concentrations of HDL and apoA were inversely associated with the risk of colon cancer (RR for 1 SD increase of 16.6 mg/dl in HDL and 32.0 mg/dl in apoA of 0.78 (95% CI 0.68 to 0.89) and 0.82 (95% CI 0.72 to 0.94), respectively). No association was observed with the risk of rectal cancer. Additional adjustment for biomarkers of systemic inflammation, insulin resistance and oxidative stress or exclusion of the first 2 years of follow-up did not influence the association between HDL and risk of colon cancer. Conclusions These findings show that high concentrations of serum HDL are associated with a decreased risk of colon cancer. The mechanism behind this association needs further elucidation

Physical activity and lymphoid neoplasms in the European Prospective Investigation into Cancer and nutrition (EPIC)

van Veldhoven C.M., Khan A.E., Teucher B., Rohrmann S., Raaschou-Nielsen O., Tjonneland A., Overvad K., Vigl M., Boeing H., Benetou V., Trichopoulou A., Trichopoulos D., Masala G., Mattiello A., Krogh V., Tumino R., Vermeulen R., Monninkhof E., May A.M., Bueno-de-Mesquita B., Lund E., Ardanaz E., Huerta J.M., Jakszyn P., Dorronsoro M., Arguelles M., Sanchez M.J., Hallmans G., Manjer J., Borgquist S., Allen N.E., Travis R.C., Khaw K.T., Wareham N., Boffetta P., Vineis P., Riboli E.

Eur J Cancer; 2011; 47(5): 748-760

Abstract as provided by PubMed

BACKGROUND: Lymphoid neoplasms are a heterogeneous group of cancers that originate in the lymphatic cells of the immune system. Several risk factors have been identified or suggested, but they all account for only a small proportion of the lymphoid neoplasm incidence. It has been hypothesised that regular exercise may modulate the immune system and thereby reduce the risk of developing the disease. DESIGN AND METHODS: The European Investigation into Cancer and Nutrition (EPIC) cohort consists of 521,457 adults, recruited by 23 centres in 10 European countries. The analytical cohort included 343,756 participants, with 778 non-Hodgkin lymphoma (NHL) cases (376 men and 402 women) and 690 B-cell non-Hodgkin lymphoma (B-NHL) cases (326 men and 364 women). Multivariate Cox regression models were used to calculate hazard ratios (HR) for the association between total, recreational, occupational, and household physical activity and NHL and B-NHL risk, as well as the risk for several B-NHL subtypes. Models were stratified by study centre and age at recruitment and adjusted for various potential confounding factors. RESULTS: We found no evidence of any effect of total physical activity on NHL (adjusted p-trend=0.76 and 0.30 for men and women, respectively) and B-NHL risk (adjusted p-trend=0.99 and 0.21 for men and women, respectively) for either men or women. Also no robust results were found for B-NHL subtype analyses among men or women. CONCLUSIONS: This study provided no consistent evidence for an association between various physical activity measures and the risk of lymphoid neoplasms or any of the B-NHL subtypes

Single-nucleotide polymorphisms (5p15.33, 15q25.1, 6p22.1, 6q27 and 7p15.3) and lung cancer survival in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Xun W.W., Brennan P., Tjonneland A., Vogel U., Overvad K., Kaaks R., Canzian F., Boeing H., Trichopoulou A., Oustoglou E., Giotaki Z., Johansson M., Palli D., Agnoli C., Tumino R., Sacerdote C., Panico S., Bueno-de-Mesquita H.B., Peeters P.H., Lund E., Kumle M., Rodriguez L., Agudo A., Sanchez M.J., Arriola L., Chirlaque M.D., Barricarte A., Hallmans G., Rasmuson T., Khaw K.T., Wareham N., Key T., Riboli E., Vineis P.

Mutagenesis; 2011; 26(5): 657-666

Abstract as provided by PubMed

The single-nucleotide polymorphisms (SNPs) rs402710 (5p15.33), rs16969968 and rs8034191 (15q25.1) have been consistently identified by genome-wide association studies (GWAS) as significant predictors of lung cancer risk, while rs4324798 (6p22.1) was previously found to influence survival time in small-cell lung cancer (SCLC) patients. Using the same population of one of the original GWAS, we investigated whether the selected SNPs and 31 others (also identified in GWAS) influence survival time, assuming an additive model. The effect of each polymorphism on all cause survival was estimated in 1094 lung cancer patients, and lung cancer-specific survival in 763 patients, using Cox regression adjusted for a priori confounders and competing causes of death where appropriate. Overall, after 1558 person-years of post-diagnostic follow-up, 874 deaths occurred from all causes, including 690 from lung cancer. In the lung cancer-specific survival analysis (1102 person-years), only rs7452888 (6q27) and rs2710994 (7p15.3) modified survival, with adjusted hazard ratios of 1.19 (P = 0.009) and 1.32 (P = 0.011) respectively, taking competing risks into account. Some weak associations were identified in subgroup analysis for rs16969968 and rs8034191 (15q25.1) and rs4324798 (6p22.1) and survival in never-smokers, as well as for rs402710 in current smokers and SCLC patients. In conclusion, rs402710 (5p15.33), rs16969968 and rs8034191 (both 15q25.1) and rs4324798 (6p22.1) were found to be unrelated to survival times in this large cohort of lung cancer patients, regardless of whether the cause of death was from lung cancer or not. However, rs7452888 (6q27) was identified as a possible candidate SNP to influence lung cancer survival, while stratified analysis hinted at a possible role for rs8034191, rs16969968 (15q25.1) and rs4324798 (6p22.1) in influencing survival time in lung cancer patients who were never-smokers, based on a small sample

Estimation of the intake of anthocyanidins and their food sources in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Zamora-Ros R., Knaze V., Lujan-Barroso L., Slimani N., Romieu I., Touillaud M., Kaaks R., Teucher B., Mattiello A., Grioni S., Crowe F., Boeing H., Forster J., Quiros J.R., Molina E., Huerta J.M., Engeset D., Skeie G., Trichopoulou A., Dilis V., Tsiotas K., Peeters P.H., Khaw K.T., Wareham N., Bueno-de-Mesquita B., Ocke M.C., Olsen A., Tjonneland A., Tumino R., Johansson G., Johansson I., Ardanaz E., Sacerdote C., Sonestedt E., Ericson U., Clavel-Chapelon F., Boutron-Ruault M.C., Fagherazzi G., Salvini S., Amiano P., Riboli E., Gonzalez C.A.

Br J Nutr; 2011; 106(7): 1090-1099

Abstract as provided by PubMed

Anthocyanidins are bioactive flavonoids with potential health-promoting effects. These may vary among single anthocyanidins considering differences in their bioavailability and some of the mechanisms involved. The aim of the present study was to estimate the dietary intake of anthocyanidins, their food sources and the lifestyle factors (sex, age, BMI, smoking status, educational level and physisical activity) involved among twenty-seven centres in ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthocyanidin intake and their food sources for 36 037 subjects, aged between 35 and 74 years, in twenty-seven redefined centres were obtained using standardised 24 h dietary recall software (EPIC-SOFT). An ad hoc food composition database on anthocyanidins (cyanidin, delphinidin, malvidin, pelargonidin, peonidin, petunidin) was compiled using data from the US Department of Agriculture and Phenol-Explorer databases and was expanded by adding recipes, estimated values and cooking factors. For men, the total anthocyanidin mean intake ranged from 19.83 (se 1.53) mg/d (Bilthoven, The Netherlands) to 64.88 (se 1.86) mg/d (Turin, Italy), whereas for women the range was 18.73 (se 2.80) mg/d (Granada, Spain) to 44.08 (se 2.45) mg/d (Turin, Italy). A clear south to north gradient intake was observed. Cyanidins and malvidins were the main anthocynidin contributors depending on the region and sex. Anthocyanidin intake was higher in non-obese older females, non-smokers, and increased with educational level and physical activity. The major food sources were fruits, wine, non-alcoholic beverages and some vegetables. The present study shows differences in both total and individual anthocyanidin intakes and various lifestyle factors throughout Europe, with some geographical variability in their food sources

Estimated dietary intakes of flavonols, flavanones and flavones in the European Prospective Investigation into Cancer and Nutrition (EPIC) 24 hour dietary recall cohort

Zamora-Ros R., Knaze V., Lujan-Barroso L., Slimani N., Romieu I., Fedirko V., Santucci de Magistris M., Ericson U., Amiano P., Trichopoulou A., Dilis V., Naska A., Engeset D., Skeie G., Cassidy A., Overvad K., Peeters P.H., Maria Huerta J., Sanchez M.J., Quiros J.R., Sacerdote C., Grioni S., Tumino R., Johansson G., Johansson I., Drake I., Crowe F.L., Barricarte A., Kaaks R., Teucher B., Bas Bueno-de-Mesquita H., van Rossum C.T., Norat T., Romaguera D., Vergnaud A.C., Tjonneland A., Halkjaer J., Clavel-Chapelon F., Boutron-Ruault M.C., Touillaud M., Salvini S., Khaw K.T., Wareham N., Boeing H., Forster J., Riboli E., Gonzalez C.A.

Br J Nutr; 2011; 106(12): 1915-1925

Abstract as provided by PubMed

Flavonols, flavanones and flavones (FLAV) are sub-classes of flavonoids that exert cardioprotective and anti-carcinogenic properties in vitro and in vivo. We aimed to estimate the FLAV dietary intake, their food sources and associated lifestyle factors in ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. FLAV intake and their food sources for 36 037 subjects, aged between 35 and 74 years, in twenty-seven study centres were obtained using standardised 24 h dietary recall software (EPIC-SOFT). An ad hoc food composition database on FLAV was compiled using data from US Department of Agriculture and Phenol-Explorer databases and was expanded using recipes, estimations and flavonoid retention factors in order to increase its correspondence with the 24 h dietary recall. Our results showed that the highest FLAV-consuming centre was the UK health-conscious group, with 130.9 and 97.0 mg/d for men and women, respectively. The lowest FLAV intakes were 36.8 mg/d in men from Umea and 37.2 mg/d in women from Malmo (Sweden). The flavanone sub-class was the main contributor to the total FLAV intake ranging from 46.6 to 52.9 % depending on the region. Flavonols ranged from 38.5 to 47.3 % and flavones from 5.8 to 8.6 %. FLAV intake was higher in women, non-smokers, increased with level of education and physical activity. The major food sources were citrus fruits and citrus-based juices (especially for flavanones), tea, wine, other fruits and some vegetables. We concluded that the present study shows heterogeneity in intake of these three sub-classes of flavonoids across European regions and highlights differences by sex and other sociodemographic and lifestyle factors

2010

Circulating C-reactive protein concentrations and risks of colon and rectal cancer: a nested case-control study within the European prospective investigation into cancer and nutrition

Aleksandrova K., Jenab M., Boeing H., Jansen E., Bueno-de-Mesquita H.B., Rinaldi S., Riboli E., Overvad K., Dahm C.C., Olsen A., Tjonneland A., Boutron-Ruault M.C., Clavel-Chapelon F., Morois S., Palli D., Krogh V., Tumino R., Vineis P., Panico S., Kaaks R., Rohrmann S., Trichopoulou A., Lagiou P., Trichopoulos D., van Duijnhoven F.J., Leufkens A.M., Peeters P.H., Rodriguez L., Bonet C., Sanchez M.J., Dorronsoro M., Navarro C., Barricarte A., Palmqvist R., Hallmans G., Khaw K.T., Wareham N., Allen N.E., Spencer E., Romaguera D., Norat T., Pischon T.

Am J Epidemiol; 2010; 172(4): 407-418

Abstract as provided by PubMed

The authors investigated associations between serum C-reactive protein (CRP) concentrations and colon and rectal cancer risk in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (1992-2003) among 1,096 incident cases and 1,096 controls selected using risk-set sampling and matched on study center, age, sex, time of blood collection, fasting status, menopausal status, menstrual cycle phase, and hormone replacement therapy. In conditional logistic regression with adjustment for education, smoking, nutritional factors, body mass index, and waist circumference, CRP showed a significant nonlinear association with colon cancer risk but not rectal cancer risk. Multivariable-adjusted relative risks for CRP concentrations of >/=3.0 mg/L versus <1.0 mg/L were 1.36 (95% confidence interval (CI): 1.00, 1.85; P-trend = 0.01) for colon cancer and 1.02 (95% CI: 0.67, 1.57; P-trend = 0.65) for rectal cancer. Colon cancer risk was significantly increased in men (relative risk = 1.74, 95% CI: 1.11, 2.73; P-trend = 0.01) but not in women (relative risk = 1.06, 95% CI: 0.67, 1.68; P-trend = 0.13). Additional adjustment for C-peptide, glycated hemoglobin, and high density lipoprotein cholesterol did not attenuate these results. These data provide evidence that elevated CRP concentrations are related to a higher risk of colon cancer but not rectal cancer, predominantly among men and independently of obesity, insulin resistance, and dyslipidemia

Menopausal hormone therapy and risk of endometrial carcinoma among postmenopausal women in the European Prospective Investigation Into Cancer and Nutrition

Allen N.E., Tsilidis K.K., Key T.J., Dossus L., Kaaks R., Lund E., Bakken K., Gavrilyuk O., Overvad K., Tjonneland A., Olsen A., Fournier A., Fabre A., Clavel-Chapelon F., Chabbert-Buffet N., Sacerdote C., Krogh V., Bendinelli B., Tumino R., Panico S., Bergmann M., Schuetze M., van Duijnhoven F.J., Bueno-de-Mesquita H.B., Onland-Moret N.C., Van Gils C.H., Amiano P., Barricarte A., Chirlaque M.D., Molina-Montes M.E., Redondo M.L., Duell E.J., Khaw K.T., Wareham N., Rinaldi S., Fedirko V., Mouw T., Michaud D.S., Riboli E.

Am J Epidemiol; 2010; 172(12): 1394-1403

Abstract as provided by PubMed

Estrogen-only menopausal hormone therapy (HT) increases the risk of endometrial cancer, but less is known about the association with other types of HT. Using Cox proportional hazards regression, the authors examined the association of various types of HT with the risk of endometrial cancer among 115,474 postmenopausal women recruited into the European Prospective Investigation into Cancer and Nutrition between 1992 and 2000. After a mean follow-up period of 9 years, 601 incident cases of endometrial cancer were identified. In comparison with never users of HT, risk of endometrial cancer was increased among current users of estrogen-only HT (hazard ratio (HR) = 2.52, 95% confidence interval (CI): 1.77, 3.57), tibolone (HR = 2.96, 95% CI: 1.67, 5.26), and, to a lesser extent, estrogen-plus-progestin HT (HR = 1.41, 95% CI: 1.08, 1.83), although risks differed according to regimen and type of progestin constituent. The association of HT use with risk was stronger among women who were older, leaner, or had ever smoked cigarettes. The finding of a strong increased risk of endometrial cancer with estrogen-only HT and a weaker association with combined HT supports the hypothesis that progestins have an attenuating effect on endometrial cancer risk. The increased risk associated with tibolone use requires further investigation

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