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2009

A prospective analysis of the association between dietary fiber intake and prostate cancer risk in EPIC

Suzuki R., Allen N.E., Key T.J., Appleby P.N., Tjonneland A., Johnsen N.F., Jensen M.K., Overvad K., Boeing H., Pischon T., Kaaks R., Rohrmann S., Trichopoulou A., Misirli G., Trichopoulos D., Bueno-de-Mesquita H.B., van Duijnhoven F., Sacerdote C., Pala V., Palli D., Tumino R., Ardanaz E., Quiros J.R., Larranaga N., Sanchez M.J., Tormo M.J., Jakszyn P., Johansson I., Stattin P., Berglund G., Manjer J., Bingham S., Khaw K.T., Egevad L., Ferrari P., Jenab M., Riboli E.

Int J Cancer; 2009; 124(1): 245-249

PMID:18814263

Abstract as provided by PubMed

Few studies have examined the association between dietary fiber intake and prostate cancer risk. We evaluated the association between dietary fiber intake and the risk of prostate cancer among 142,590 men in the European Prospective Investigation into Cancer and Nutrition (EPIC). Consumption of dietary fiber (total, cereal, fruit and vegetable fiber) was estimated by validated dietary questionnaires and calibrated using 24-hr dietary recalls. Incidence rate ratios were estimated using Cox regression and adjusted for potential confounding factors. During an average of 8.7 years follow-up, prostate cancer was diagnosed in 2,747 men. Overall, there was no association between dietary fiber intake (total, cereal, fruit or vegetable fiber) and prostate cancer risk, although calibrated intakes of total fiber and fruit fiber were associated with nonstatistically significant reductions in risk. There was no association between fiber derived from cereals or vegetables and risk and no evidence for heterogeneity in any of the risk estimates by stage or grade of disease. Our results suggest that dietary fiber intake is not associated with prostate cancer risk. (c) 2008 Wiley-Liss, Inc

Lifestyle factors and serum androgens among 636 middle aged men from seven countries in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Suzuki R., Allen N.E., Appleby P.N., Key T.J., Dossus L., Tjonneland A., Fons Johnsen N., Overvad K., Sacerdote C., Palli D., Krogh V., Tumino R., Rohrmann S., Linseisen J., Boeing H., Trichopoulou A., Makrygiannis G., Misirli G., Bueno-de-Mesquita H.B., May A.M., Diaz M.J., Sanchez M.J., Barricarte Gurrea A., Rodriguez Suarez L., Buckland G., Larranaga N., Bingham S., Khaw K.T., Rinaldi S., Slimani N., Jenab M., Riboli E., Kaaks R.

Cancer Causes Control; 2009; 20(6): 811-821

PMID:19306067

Abstract as provided by PubMed

OBJECTIVE: To evaluate the association between lifestyle and dietary factors and serum concentrations of androgens in middle-aged healthy men. METHODS: We conducted a cross-sectional analysis of the association of lifestyle factors with circulating concentrations of androstenedione (A-dione), 3-alpha-androstanediol glucuronide (A-diol-g), testosterone (T), SHBG (sex hormone-binding globulin), and free testosterone (FT) among 636 men in the European Prospective Investigation into Cancer and Nutrition. RESULTS: Compared with the youngest age group (40-49 years), the oldest (70-79 years) had a higher mean concentration of SHBG (by 44%) and lower mean concentrations of A-diol-g (by 29%) FT (19%). Men in the highest BMI group (> or =29.83 kg/m(2)) had a higher mean A-diol-g concentration (by 38%) and lower mean concentration of T (by 20%) SHBG (29%) compared with the lowest (<24.16 kg/m(2)). Current smokers had higher mean concentrations of T (by 13%), SHBG (14%), and A-dione (15%) compared with never smokers. Physical activity and dietary factors were not associated with androgen concentrations, although men in the highest fifth of alcohol intake had higher mean concentrations of A-dione (by 9%), FT (11%) compared with the lowest. CONCLUSION: Our results suggest that age, body weight, smoking, and alcohol intake are associated with circulating androgen concentrations in men

Smoking and body fatness measurements: a cross-sectional analysis in the EPIC-PANACEA study

Travier N., Agudo A., May A.M., Gonzalez C., Luan J., Besson H., Wareham N.J., Slimani N., Rinaldi S., Clavel-Chapelon F., Boutron-Ruault M.C., Palli D., Agnoli C., Mattiello A., Tumino R., Vineis P., Rodriguez L., Sanchez M.J., Dorronsoro M., Barricarte A., Tormo M.J., Norat T., Mouw T., Key T.J., Spencer E.A., Bueno-de-Mesquita H.B., Vrieling A., Orfanos P., Naska A., Trichopoulou A., Rohrmann S., Kaaks R., Bergmann M., Boeing H., Hallmans G., Johansson I., Manjer J., Lindkvist B., Jakobsen M.U., Overvad K., Tjonneland A., Halkjaer J., Lund E., Braaten T., Odysseos A., Riboli E., Peeters P.H.

Prev Med; 2009; 49(5): 365-373

PMID:19716380

Abstract as provided by PubMed

OBJECTIVE: The present study investigates the cross-sectional relationship between tobacco smoking and body fatness. METHODS: This cross-sectional study consisted of 469,543 men and women who participated in the European Prospective Investigation into Cancer and Nutrition (EPIC) study between 1992 and 2000 providing anthropometric measurements and information on smoking. Adjusted multilevel mixed-effects linear regression models were used to assess the association between smoking and body fat mass. RESULTS: The analyses showed that BMI and WC were positively associated with smoking intensity in current smokers but negatively associated with time since quitting in former smokers. When compared to never smokers, average current smokers (17 and 13 cig/day for men and women, respectively) showed a lower BMI. When average former smokers (men and women who had stopped smoking for 16 and 15 years, respectively) were compared to never smokers, higher BMI and WC were observed in men, whereas no significant associations were observed in women. CONCLUSIONS: This cross-sectional study suggests that smoking may be associated with body fatness and fat distribution. Although our findings cannot establish cause and effect, they suggest that providing information and support to those who want to stop may help in preventing weight gain and therefore weaken a barrier against stopping smoking

Serum vitamin D and risk of prostate cancer in a case-control analysis nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)

Travis R.C., Crowe F.L., Allen N.E., Appleby P.N., Roddam A.W., Tjonneland A., Olsen A., Linseisen J., Kaaks R., Boeing H., Kroger J., Trichopoulou A., Dilis V., Trichopoulos D., Vineis P., Palli D., Tumino R., Sieri S., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Chirlaque M.D., Barricarte A., Larranaga N., Gonzalez C.A., Arguelles M.V., Sanchez M.J., Stattin P., Hallmans G., Khaw K.T., Bingham S., Rinaldi S., Slimani N., Jenab M., Riboli E., Key T.J.

Am J Epidemiol; 2009; 169(10): 1223-1232

PMID:19359375

Abstract as provided by PubMed

Results from the majority of studies show little association between circulating concentrations of vitamin D and prostate cancer risk, a finding that has not been demonstrated in a wider European population, however. The authors examined whether vitamin D concentrations were associated with prostate cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (1994-2000). Serum concentrations of 25-hydroxyvitamin D were measured in 652 prostate cancer cases matched to 752 controls from 7 European countries after a median follow-up time of 4.1 years. Conditional logistic regression models were used to calculate odds ratios for prostate cancer risk in relation to serum 25-hydroxyvitamin D after standardizing for month of blood collection and adjusting for covariates. No significant association was found between 25-hydroxyvitamin D and risk of prostate cancer (highest vs. lowest quintile: odds ratio = 1.28, 95% confidence interval: 0.88, 1.88; P for trend = 0.188). Subgroup analyses showed no significant heterogeneity by cancer stage or grade, age at diagnosis, body mass index, time from blood collection to diagnosis, or calcium intake. In summary, the results of this large nested case-control study provide no evidence in support of a protective effect of circulating concentrations of vitamin D on the risk of prostate cancer

Methodological challenges in the application of the glycemic index in epidemiological studies using data from the European Prospective Investigation into Cancer and Nutrition

van Bakel M.M., Slimani N., Feskens E.J., Du H., Beulens J.W., van der Schouw Y.T., Brighenti F., Halkjaer J., Cust A.E., Ferrari P., Brand-Miller J., Bueno-de-Mesquita H.B., Peeters P., Ardanaz E., Dorronsoro M., Crowe F.L., Bingham S., Rohrmann S., Boeing H., Johansson I., Manjer J., Tjonneland A., Overvad K., Lund E., Skeie G., Mattiello A., Salvini S., Clavel-Chapelon F., Kaaks R.

J Nutr; 2009; 139(3): 568-575 + supplement

PMID:19158224

Abstract as provided by PubMed

Associations between the glycemic index (GI) or glycemic load (GL) and diseases are heterogeneous in epidemiological studies. Differences in assigning GI values to food items may contribute to this inconsistency. Our objective was to address methodological issues related to the use of current GI and GL values in epidemiological studies. We performed ecological comparison and correlation studies by calculating dietary GI and GL from country-specific dietary questionnaires (DQ) from 422,837 participants from 9 countries participating in the European Prospective Investigation into Cancer and Nutrition study and single standardized 24-h dietary recalls (24-HDR) obtained from a representative sample (n = 33,404) using mainly Foster Powell's international table as a reference source. Further, 2 inter-rater and 1 inter-method comparison were conducted, comparing DQ GI values assigned by independent groups with values linked by us. The ecological correlation between DQ and 24-HDR was good for GL (overall r = 0.76; P < 0.005) and moderate for GI (r = 0.57; P < 0.05). Mean GI/GL differences between DQ and 24-HDR were significant for most centers. GL but not GI from DQ was highly correlated with total carbohydrate (r = 0.98 and 0.15, respectively; P < 0.0001) and this was higher for starch (r = 0.72; P < 0.0001) than for sugars (r = 0.36; P < 0.0001). The inter-rater and inter-method variations were considerable for GI (weighted kappa coefficients of 0.49 and 0.65 for inter-rater and 0.25 for inter-method variation, respectively) but only mild for GL (weighted kappa coefficients > 0.80). A more consistent methodology to attribute GI values to foods and validated DQ is needed to derive meaningful GI/GL estimates for nutritional epidemiology

Dietary glycaemic index and glycaemic load in the European Prospective Investigation into Cancer and Nutrition

van Bakel M.M., Kaaks R., Feskens E.J.M., Rohrmann S., Welch A.A., Pala V., Avloniti K., van der Schouw Y.T., van der A D.L., Du H., Halkjaer J., Tormo M.J., Cust A.E., Brighenti F., Beulens J.W., Ferrari P., Biessy C., Lentjes M., Spencer E.A., Panico S., Masala G., Bueno-de-Mesquita H.B., Peeters P.H.M., Trichopoulou A., Psaltopoulou T., Clavel-Chapelon F., Touvier M., Skeie G., Rinaldi S., Sonestedt E., Johansson I., Schulze M., Ardanaz E., Buckland G., Tjonneland A., Overvad K., Bingham S., Riboli E., Slimani N.

Eur J Clin Nutr; 2009; S188-S205

PMID:19888274

Abstract as provided by PubMed

Objectives: To describe dietary glycaemic index (GI) and glycaemic load (GL) values in the population participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study according to food groups, nutrients and lifestyle characteristics. Methods: Single 24-h dietary recalls (24-HDRs) from 33 566 subjects were used to calculate dietary GI and GL, and an ad hoc database was created as the main reference source. Mean GI and GL intakes were adjusted for age, total energy intake, height and weight, and were weighted by season and day of recall. Results: GI was the lowest in Spain and Germany, and highest in the Netherlands, United Kingdom and Denmark for both genders. In men, GL was the lowest in Spain and Germany and highest in Italy, whereas in women, it was the lowest in Spain and Greece and highest in the UK health-conscious cohort. Bread was the largest contributor to GL in all centres (15-45%), but it also showed the largest inter-individual variation. GL, but not GI, tended to be lower in the highest body mass index category in both genders. GI was positively correlated with starch and intakes of bread and potatoes, whereas it was correlated negatively with intakes of sugar, fruit and dairy products. GL was positively correlated with all carbohydrate components and intakes of cereals, whereas it was negatively correlated with fat and alcohol and with intakes of wine, with large variations across countries. Conclusions: GI means varied modestly across countries and genders, whereas GL means varied more, but it may possibly act as a surrogate of carbohydrate intake. European Journal of Clinical Nutrition (2009) 63, S188-S205; doi: 10.1038/ejcn.2009.81

Fruit, vegetables, and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition - Reply

van Duijnhoven F.J.B., Bueno-de-Mesquita H.B., Jenab M., Riboli E.

Am J Clin Nutr; 2009; 90(4): 1112-1114

PMID:19675109

Fruit, vegetables, and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition

van Duijnhoven F.J., Bueno-de-Mesquita H.B., Ferrari P., Jenab M., Boshuizen H.C., Ros M.M., Casagrande C., Tjonneland A., Olsen A., Overvad K., Thorlacius-Ussing O., Clavel-Chapelon F., Boutron-Ruault M.C., Morois S., Kaaks R., Linseisen J., Boeing H., Nothlings U., Trichopoulou A., Trichopoulos D., Misirli G., Palli D., Sieri S., Panico S., Tumino R., Vineis P., Peeters P.H., Van Gils C.H., Ocke M.C., Lund E., Engeset D., Skeie G., Suarez L.R., Gonzalez C.A., Sanchez M.J., Dorronsoro M., Navarro C., Barricarte A., Berglund G., Manjer J., Hallmans G., Palmqvist R., Bingham S.A., Khaw K.T., Key T.J., Allen N.E., Boffetta P., Slimani N., Rinaldi S., Gallo V., Norat T., Riboli E.

Am J Clin Nutr; 2009; 89(5): 1441-1452

PMID:19339391

Abstract as provided by PubMed

BACKGROUND: A high consumption of fruit and vegetables is possibly associated with a decreased risk of colorectal cancer (CRC). However, the findings to date are inconsistent. OBJECTIVE: We examined the relation between self-reported usual consumption of fruit and vegetables and the incidence of CRC. DESIGN: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 452,755 subjects (131,985 men and 320,770 women) completed a dietary questionnaire in 1992-2000 and were followed up for cancer incidence and mortality until 2006. A multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HRs) and 95% CIs. RESULTS: After an average follow-up of 8.8 y, 2,819 incident CRC cases were reported. Consumption of fruit and vegetables was inversely associated with CRC in a comparison of the highest with the lowest EPIC-wide quintile of consumption (HR: 0.86; 95% CI: 0.75, 1.00; P for trend = 0.04), particularly with colon cancer risk (HR: 0.76; 95% CI: 0.63, 0.91; P for trend < 0.01). Only after exclusion of the first 2 y of follow-up were these findings corroborated by calibrated continuous analyses for a 100-g increase in consumption: HRs of 0.95 (95% CI: 0.91, 1.00; P = 0.04) and 0.94 (95% CI: 0.89, 0.99; P = 0.02), respectively. The association between fruit and vegetable consumption and CRC risk was inverse in never and former smokers, but positive in current smokers. This modifying effect was found for fruit and vegetables combined and for vegetables alone (P for interaction < 0.01 for both). CONCLUSIONS: These findings suggest that a high consumption of fruit and vegetables is associated with a reduced risk of CRC, especially of colon cancer. This effect may depend on smoking status

Fruit and vegetable consumption and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition

Vrieling A., Verhage B.A., van Duijnhoven F.J., Jenab M., Overvad K., Tjonneland A., Olsen A., Clavel-Chapelon F., Boutron-Ruault M.C., Kaaks R., Rohrmann S., Boeing H., Nothlings U., Trichopoulou A., John T., Dimosthenes Z., Palli D., Sieri S., Mattiello A., Tumino R., Vineis P., Van Gils C.H., Peeters P.H., Engeset D., Lund E., Rodriguez Suarez L., Jakszyn P., Larranaga N., Sanchez M.J., Chirlaque M.D., Ardanaz E., Manjer J., Lindkvist B., Hallmans G., Ye W., Bingham S., Khaw K.T., Roddam A., Key T., Boffetta P., Duell E.J., Michaud D.S., Riboli E., Bueno-de-Mesquita H.B.

Int J Cancer; 2009; 124(8): 1926-1934

PMID:19107929

Abstract as provided by PubMed

Many case-control studies have suggested that higher consumption of fruit and vegetables is associated with a lower risk of pancreatic cancer, whereas cohort studies do not support such an association. We examined the associations of the consumption of fruits and vegetables and their main subgroups with pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is comprised of over 520,000 subjects recruited from 10 European countries. The present study included 555 exocrine pancreatic cancer cases after an average follow-up of 8.9 years. Estimates of risk were obtained by Cox proportional hazard models, stratified by age at recruitment, gender, and study center, and adjusted for total energy intake, weight, height, history of diabetes mellitus, and smoking status. Total consumption of fruit and vegetables, combined or separately, as well as subgroups of vegetables and fruits were unrelated to risk of pancreatic cancer. Hazard ratios (95% CI) for the highest versus the lowest quartile were 0.92 (0.68-1.25) for total fruit and vegetables combined, 0.99 (0.73-1.33) for total vegetables, and 1.02 (0.77-1.36) for total fruits. Stratification by gender or smoking status, restriction to microscopically verified cases, and exclusion of the first 2 years of follow-up did not materially change the results. These results from a large European prospective cohort suggest that higher consumption of fruit and vegetables is not associated with decreased risk of pancreatic cancer

Lifetime and baseline alcohol intake and risk of cancer of the upper aero-digestive tract in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Weikert C., Dietrich T., Boeing H., Bergmann M.M., Boutron-Ruault M.C., Clavel-Chapelon F., Allen N., Key T., Lund E., Olsen A., Tjonneland A., Overvad K., Rohrmann S., Linseisen J., Pischon T., Trichopoulou A., Weinehall L., Johansson I., Sanchez M.J., Agudo A., Barricarte A., Amiano P., Chirlaque M.D., Quiros J.R., Wirfalt E., Peeters P.H., Bueno-de-Mesquita H.B., Vrieling A., Pala V., Palli D., Vineis P., Tumino R., Panico S., Bingham S., Khaw K.T., Norat T., Jenab M., Ferrari P., Slimani N., Riboli E.

Int J Cancer; 2009; 125(2): 406-412

PMID:19378340

Abstract as provided by PubMed

Recent alcohol consumption is an established risk factor for squamous cell carcinoma (SCC) of the upper aero-digestive tract. In contrast, the role of lifetime exposure to alcohol with regard to risk of SCC is not well established. Historical data on alcohol use are available in 271,253 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). During 2,330,381 person years, 392 incident SCC cases (279 men and 113 women) were identified. Cox regression was applied to model sex-specific associations between lifetime alcohol intake and SCC risk adjusting for potential confounders including smoking. Compared to men who drank 0.1-6.0 g/day alcohol at lifetime, the relative risks (RR) for developing SCC were significantly increased for men who drank 30.1-60.0 g/day (RR 1.65, 95% confidence interval:1.00-2.71), 60.1-96.0 g/day (RR 2.20, 95%CI 1.23-3.95), and >96.0 g/day, (RR 4.63, 95% CI 2.52-8.48), and for former drinkers (RR 4.14, 95%CI 2.38-7.19). These risk estimates did not considerably change when baseline alcohol intake was analyzed. Compared to women who drank 0.1-6.0 g/day alcohol intake at lifetime, the RR were significantly increased for women who drank >30 g/d (RR 6.05, 95%CI 2.98-12.3). Applying similar categories, the relative risk for baseline alcohol intake was 3.26 (95%CI 1.82-5.87). We observed a stronger association between alcohol intake at lifetime and risk of SCC in women compared to men (p for interaction = 0.045). The strong dose-response relation for lifetime alcohol use underscores that alcohol is an important risk factor of SCC of the upper aero-digestive tract throughout life. (c) 2009 UICC

Variation in intakes of calcium, phosphorus, magnesium, iron and potassium in 10 countries in the European Prospective Investigation into Cancer and Nutrition study

Welch A.A., Fransen H., Jenab M., Boutron-Ruault M.C., Tumino R., Agnoli C., Ericson U., Johansson I., Ferrari P., Engeset D., Lund E., Lentjes M., Key T., Touvier M., Niravong M., Larranaga N., Rodriguez L., Ocke M.C., Peeters P.H.M., Tjonneland A., Bjerregaard L., Vasilopoulou E., Dilis V., Linseisen J., Nothlings U., Riboli E., Slimani N., Bingham S.

Eur J Clin Nutr; 2009; S101-S121

PMID:19888269

Abstract as provided by PubMed

Background/objectives: Adequate mineral intake is important for the maintenance of bone health, cellular function and general metabolism, and possibly in the aetiology of cancer and other chronic diseases. This study aimed at investigating variation in intakes of selected minerals across 10 European countries participating in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. Methods: Nutrient intakes for 36 034 subjects, aged between 35 and 74 years, in 27 centres were obtained using standardized 24-h dietary recall software (EPIC-SOFT). Mean intakes of calcium, phosphorus, magnesium, iron and potassium were calculated by centre and weighted by season and day of the week and were also stratified by age group. The contribution of food groups to total nutrient intake was calculated. Results: There was clear geographical variability in intakes, with differences ranging from 35% for magnesium to 90% for iron in men and 36% for potassium to 75% for calcium in women, and a twofold difference in sources of haem iron (meat and fish). There was a geographical gradient in iron intake, with higher intakes in Southern than in Northern Europe and also around a twofold north-south gradient in the contribution of fruits and vegetables to potassium intake. Compared with reference intakes, the majority of age groups and centres had intakes above the recommended levels. Dairy foods and products contributed the most to calcium and phosphorus intake in almost all centres. Cereals and cereal products contributed the most to magnesium and iron intakes, except in Greece and Germany. Conclusions: Intakes of minerals vary substantially throughout Europe, with some geographical variability in their food sources. European Journal of Clinical Nutrition (2009) 63, S101-S121; doi: 10.1038/ejcn.2009.77

2008

Endogenous sex hormones and endometrial cancer risk in women in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Allen N.E., Key T.J., Dossus L., Rinaldi S., Cust A., Lukanova A., Peeters P.H., Onland-Moret N.C., Lahmann P.H., Berrino F., Panico S., Larranaga N., Pera G., Tormo M.J., Sanchez M.J., Ramon Quiros J., Ardanaz E., Tjonneland A., Olsen A., Chang-Claude J., Linseisen J., Schulz M., Boeing H., Lundin E., Palli D., Overvad K., Clavel-Chapelon F., Boutron-Ruault M.C., Bingham S., Khaw K.T., Bas Bueno-de-Mesquita H., Trichopoulou A., Trichopoulos D., Naska A., Tumino R., Riboli E., Kaaks R.

Endocr Relat Cancer; 2008; 15(2): 485-497

PMID:18509001

Abstract as provided by PubMed

Epidemiological data show that reproductive and hormonal factors are involved in the etiology of endometrial cancer, but there is little data on the association with endogenous sex hormone levels. We analyzed the association between prediagnostic serum concentrations of sex steroids and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition using a nested case-control design of 247 incident endometrial cancer cases and 481 controls, matched on center, menopausal status, age, variables relating to blood collection, and, for premenopausal women, phase of menstrual cycle. Using conditional regression analysis, endometrial cancer risk among postmenopausal women was positively associated with increasing levels of total testosterone, free testosterone, estrone, total estradiol, and free estradiol. The odds ratios (ORs) for the highest versus lowest tertile were 2.66 (95% confidence interval (CI) 1.50-4.72; P=0.002 for a continuous linear trend) for estrone, 2.07 (95% CI 1.20-3.60; P=0.001) for estradiol, and 1.66 (95% CI 0.98-2.82; P=0.001) for free estradiol. For total and free testosterone, ORs for the highest versus lowest tertile were 1.44 (95% CI 0.88-2.36; P=0.05) and 2.05 (95% CI 1.23-3.42; P=0.005) respectively. Androstenedione and dehydroepiandrosterone sulfate were not associated with risk. Sex hormone-binding globulin was significantly inversely associated with risk (OR for the highest versus lowest tertile was 0.57, 95% CI 0.34-0.95; P=0.004). In premenopausal women, serum sex hormone concentrations were not clearly associated with endometrial cancer risk, but numbers were too small to draw firm conclusions. In conclusion, relatively high blood concentrations of estrogens and free testosterone are associated with an increased endometrial cancer risk in postmenopausal women

Animal foods, protein, calcium and prostate cancer risk: the European Prospective Investigation into Cancer and Nutrition

Allen N.E., Key T.J., Appleby P.N., Travis R.C., Roddam A.W., Tjonneland A., Johnsen N.F., Overvad K., Linseisen J., Rohrmann S., Boeing H., Pischon T., Bueno-de-Mesquita H.B., Kiemeney L., Tagliabue G., Palli D., Vineis P., Tumino R., Trichopoulou A., Kassapa C., Trichopoulos D., Ardanaz E., Larranaga N., Tormo M.J., Gonzalez C.A., Quiros J.R., Sanchez M.J., Bingham S., Khaw K.T., Manjer J., Berglund G., Stattin P., Hallmans G., Slimani N., Ferrari P., Rinaldi S., Riboli E.

Br J Cancer; 2008; 98(9): 1574-1581

PMID:18382426

Abstract as provided by PubMed

We examined consumption of animal foods, protein and calcium in relation to risk of prostate cancer among 142 251 men in the European Prospective Investigation into Cancer and Nutrition. Associations were examined using Cox regression, stratified by recruitment centre and adjusted for height, weight, education, marital status and energy intake. After an average of 8.7 years of follow-up, there were 2727 incident cases of prostate cancer, of which 1131 were known to be localised and 541 advanced-stage disease. A high intake of dairy protein was associated with an increased risk, with a hazard ratio for the top versus the bottom fifth of intake of 1.22 (95% confidence interval (CI): 1.07-1.41, P(trend)=0.02). After calibration to allow for measurement error, we estimated that a 35-g day(-1) increase in consumption of dairy protein was associated with an increase in the risk of prostate cancer of 32% (95% CI: 1-72%, P(trend)=0.04). Calcium from dairy products was also positively associated with risk, but not calcium from other foods. The results support the hypothesis that a high intake of protein or calcium from dairy products may increase the risk for prostate cancer

Plasma selenium concentration and prostate cancer risk: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)

Allen N.E., Appleby P.N., Roddam A.W., Tjonneland A., Johnsen N.F., Overvad K., Boeing H., Weikert S., Kaaks R., Linseisen J., Trichopoulou A., Misirli G., Trichopoulos D., Sacerdote C., Grioni S., Palli D., Tumino R., Bueno-de-Mesquita H.B., Kiemeney L.A., Barricarte A., Larranaga N., Sanchez M.J., Agudo A., Tormo M.J., Rodriguez L., Stattin P., Hallmans G., Bingham S., Khaw K.T., Slimani N., Rinaldi S., Boffetta P., Riboli E., Key T.J.

Am J Clin Nutr; 2008; 88(6): 1567-1575

PMID:19064517

Abstract as provided by PubMed

BACKGROUND: Some evidence indicates that a low selenium intake may be associated with an increased risk of prostate cancer. OBJECTIVE: The aim of this study was to investigate the association of plasma selenium concentration with subsequent prostate cancer risk and to examine this association by stage and grade of disease and other factors. DESIGN: A nested case-control study was performed among men in the European Prospective Investigation into Cancer and Nutrition (EPIC). The association between plasma selenium concentration and prostate cancer risk was assessed in 959 men with incident prostate cancer and 1059 matched controls. RESULTS: Overall, plasma selenium concentration was not associated with prostate cancer risk; the multivariate relative risk for men in the highest fifth of selenium concentration compared with the lowest fifth was 0.96 (95% CI: 0.70, 1.31; P for trend = 0.25). There were no significant differences in the association of plasma selenium with risk when analyzed by stage or grade of disease. Similarly, the association of selenium with risk did not differ by smoking status or by plasma alpha- or gamma-tocopherol concentration. CONCLUSION: Plasma selenium concentration was not associated with prostate cancer risk in this large cohort of European men

Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort

Benetou V., Trichopoulou A., Orfanos P., Naska A., Lagiou P., Boffetta P., Trichopoulos D.

Br J Cancer; 2008; 99(1): 191-195

PMID:18594542

Abstract as provided by PubMed

Adherence to traditional Mediterranean diet (MD) has been reported to be inversely associated with total, as well as cardiovascular, mortality. We have examined the relation between degree of such adherence and incidence of cancer overall in a general population sample of 25 623 participants (10 582 men, 15 041 women) of the Greek segment of the European Prospective Investigation into Cancer and nutrition (EPIC). All subjects completed a validated, interviewer-administered, semi-quantitative food-frequency questionnaire at enrolment. Degree of adherence to the traditional MD was assessed through a 10-point scale (0 minimal; 9 maximal) that incorporated key dietary characteristics. During a median follow-up of 7.9 years and 188 042 total person-years, 851 medically confirmed incident cancer cases (421 men, 430 women) were recorded. Using proportional hazards regression with adjustment for potential confounders, we found that a higher degree of MD adherence was associated with lower overall cancer incidence. A two-point increase in the score corresponded to a 12% reduction in cancer incidence (adjusted hazard ratio, 0.88 (95% confidence interval 0.80, 0.95)). The association was exposure-dependent and stronger among women. This inverse association with MD adherence was considerably stronger than that predicted on the basis of the associations of the individual components of this diet and points to the value of analysing dietary patterns in cancer studies

Vegetables and fruits in relation to cancer risk: Evidence from the Greek EPIC cohort study

Benetou V., Orfanos P., Lagiou P., Trichopoulos D., Boffetta P., Trichopoulou A.

Cancer Epidemiol Biomarkers Prev; 2008; 17(2): 387-392

PMID:18268122

Abstract as provided by PubMed

INTRODUCTION: Vegetables and fruits have long been considered as conducive to cancer prevention, but this view has recently been challenged. We investigated the relation of vegetable and fruit intake with total cancer occurrence in the population-based cohort of the Greek component of the European Prospective Investigation into Cancer and nutrition (EPIC), which is characterized by high consumption of these foods. MATERIALS AND METHODS: For a median of 7.9 years, 25,623 participants (10,582 men, 15,031 women) were actively followed-up, contributing 188,042 person-years. Cancer at any site was diagnosed in 851 participants (421 men, 430 women). Dietary intakes were ascertained at enrollment through an extensive, validated, interviewer-administered food frequency questionnaire. Data were analyzed through Cox regression, controlling for potential confounders. RESULTS: An inverse association of cancer incidence with vegetables and fruits (mutually adjusted) was noted, reaching statistical significance for vegetables among women. When vegetables and fruits were combined, the inverse association with cancer occurrence was statistically significant for the entire cohort [hazard ratio per increasing quintile, 0.94; 95% confidence interval (95% CI), 0.88-0.99], as well as among women (hazard ratio per increasing quintile, 0.90; 95% CI, 0.83-0.98), but not among men (hazard ratio per increasing quintile, 0.95; 95% CI, 0.87-1.04). CONCLUSIONS: In a general population-based Greek cohort, we have found evidence that consumption of vegetables and fruits is inversely associated with incidence of cancer overall, although the associations seem to be weaker than expected on the basis of case-control studies previously undertaken in Greece. (Cancer Epidemiol Biomarkers Prev 2008;17(2):387-92)

Anthropometric characteristics and non-Hodgkin\'s lymphoma and multiple myeloma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Britton J.A., Khan A.E., Rohrmann S., Becker N., Linseisen J., Nieters A., Kaaks R., Tjonneland A., Halkjaer J., Severinsen M.T., Overvad K., Pischon T., Boeing H., Trichopoulou A., Kalapothaki V., Trichopoulos D., Mattiello A., Tagliabue G., Sacerdote C., Peeters P.H., Bueno-de-Mesquita H.B., Ardanaz E., Navarro C., Jakszyn P., Altzibar J.M., Hallmans G., Malmer B., Berglund G., Manjer J., Allen N., Key T., Bingham S., Besson H., Ferrari P., Jenab M., Boffetta P., Vineis P., Riboli E.

Haematologica; 2008; 93(11): 1666-1677

PMID:18835833

Abstract as provided by PubMed

BACKGROUND: The incidences of non-Hodgkin's lymphoma and multiple myeloma are increasing steadily. It has been hypothesized that this may be due, in part, to the parallel rising prevalence of obesity. It is biologically plausible that anthropometric characteristics can infuence the risk of non-Hodgkin's lymphoma and multiple myeloma. DESIGN AND METHODS: In the context of the European Prospective Investigation into Cancer and Nutrition (EPIC), anthropometric characteristics were assessed in 371,983 cancer-free individuals at baseline. During the 8.5 years of follow-up, 1,219 histologically confirmed incident cases of non-Hodgkin's lymphoma and multiple myeloma occurred in 609 men and 610 women. Gender-specific proportional hazards models were used to estimate relative risks and 95% confidence intervals (95% CI) of development of non-Hodgkin's lymphoma and multiple myeloma in relation to the anthropometric characteristics. RESULTS: Height was associated with overall non-Hodgkin's lymphoma and multiple myeloma in women (RR 1.50, 95% CI 1.14-1.98) for highest versus lowest quartile; p-trend < 0.01) but not in men. Neither obesity (weight and body mass index) nor abdominal fat (waist-to-hip ratio, waist or hip circumference) measures were positively associated with overall non-Hodgkin's lymphoma and multiple myeloma. Relative risks for highest versus lowest body mass index quartile were 1.09 (95% CI 0.85-1.38) and 0.92 (95% CI 0.71-1.19) for men and women, respectively. Women in the upper body mass index quartile were at greater risk of diffuse large B-cell lymphoma (RR 2.18, 95% CI 1.05-4.53) and taller women had an elevated risk of follicular lymphoma (RR 1.25, 95% CI 0.59-2.62). Among men, height and body mass index were non-significantly, positively related to follicular lymphoma. Multiple myeloma risk alone was elevated for taller women (RR 2.34, 95% CI 1.29-4.21) and heavier men (RR 1.77, 95% CI 1.02-3.05). CONCLUSIONS: The EPIC analyses support an association between height and overall non-Hodgkin's lymphoma and multiple myeloma among women and suggest heterogeneous subtype associations. This is one of the first prospective studies focusing on central adiposity and non-Hodgkin's lymphoma subtypes

Dietary fat intake and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition

Crowe F.L., Key T.J., Appleby P.N., Travis R.C., Overvad K., Jakobsen M.U., Johnsen N.F., Tjonneland A., Linseisen J., Rohrmann S., Boeing H., Pischon T., Trichopoulou A., Lagiou P., Trichopoulos D., Sacerdote C., Palli D., Tumino R., Krogh V., Bueno-de-Mesquita H.B., Kiemeney L.A., Chirlaque M.D., Ardanaz E., Sanchez M.J., Larranaga N., Gonzalez C.A., Quiros J.R., Manjer J., Wirfalt E., Stattin P., Hallmans G., Khaw K.T., Bingham S., Ferrari P., Slimani N., Jenab M., Riboli E.

Am J Clin Nutr; 2008; 87(5): 1405-1413

PMID:18469265

Abstract as provided by PubMed

BACKGROUND: Findings from early observational studies have suggested that the intake of dietary fat might be a contributing factor in the etiology of prostate cancer. However, the results from more recent prospective studies do not support this hypothesis, and the possible association between different food sources of fat and prostate cancer risk also remains unclear. OBJECTIVE: The objectives were to assess whether intakes of dietary fat, subtypes of fat, and fat from animal products were associated with prostate cancer risk. DESIGN: This was a multicenter prospective study of 142,520 men in the European Prospective Investigation into Cancer and Nutrition (EPIC). Dietary fat intake was estimated with the use of country-specific validated food questionnaires. The association between dietary fat and risk of prostate cancer was assessed by using Cox regression, stratified by recruitment center and adjusted for height, weight, smoking, education, marital status, and energy intake. RESULTS: After a median follow-up time of 8.7 y, prostate cancer was diagnosed in 2727 men. There was no significant association between dietary fat (total, saturated, monounsaturated, and polyunsaturated fat and the ratio of polyunsaturated to saturated fat) and risk of prostate cancer. The hazard ratio for prostate cancer for the highest versus the lowest quintile of total fat intake was 0.96 (95% CI: 0.84, 1.09; P for trend = 0.155). There were no significant associations between prostate cancer risk and fat from red meat, dairy products, and fish. CONCLUSION: The results from this large multicenter study suggest that there is no association between dietary fat and prostate cancer risk

Cytokine gene polymorphisms and the risk of adenocarcinoma of the stomach in the European prospective investigation into cancer and nutrition (EPIC-EURGAST)

Crusius J.B., Canzian F., Capella G., Pena A.S., Pera G., Sala N., Agudo A., Rico F., Del Giudice G., Palli D., Plebani M., Boeing H., Bueno-de-Mesquita H.B., Carneiro F., Pala V., Save V.E., Vineis P., Tumino R., Panico S., Berglund G., Manjer J., Stenling R., Hallmans G., Martinez C., Dorronsoro M., Barricarte A., Navarro C., Quiros J.R., Allen N., Key T.J., Binghan S., Caldas C., Linseisen J., Kaaks R., Overvad K., Tjonneland A., Buchner F.C., Peeters P.H., Numans M.E., Clavel-Chapelon F., Trichopoulou A., Lund E., Jenab M., Rinaldi S., Ferrari P., Riboli E., Gonzalez C.A.

Ann Oncol; 2008; 19(11): 1894-1902

PMID:18628242

Abstract as provided by PubMed

BACKGROUND: The relative contribution to gastric cancer (GC) risk of variants in genes that determine the inflammatory response remains mostly unknown and results from genotyping studies are inconsistent. PATIENTS AND METHODS: A nested case-control study within the prospective European Prospective Investigation into Cancer and Nutrition cohort was carried out, including 248 gastric adenocarcinomas and 770 matched controls. Twenty common polymorphisms at cytokine genes [interleukin (IL)1A, IL1B, IL1RN, IL4, IL4R, IL6, IL8, IL10, IL12A, IL12B, lymphotoxin alpha and tumor necrosis factor (TNF)] were analyzed. Antibodies against Helicobacter pylori (Hp) and CagA were measured. RESULTS: IL1RN 2R/2R genotype [odds ratio (OR) 2.43; 95% confidence interval (CI) 1.19-4.96] and allele IL1RN Ex5-35C were associated with an increased risk of Hp(+) non-cardia GC. IL8 -251AA genotype was associated with a decreased risk of Hp(+) non-cardia GC (OR 0.51; 95% CI 0.32-0.81), mainly of the intestinal type. These associations were not modified by CagA status. Carriers of IL1B -580C and TNF -487A alleles did not associate with an increased risk. A moderately increased risk of Hp(+) non-cardia GC for IL4R -29429T variant was observed (OR 1.74; 95% CI 1.15-2.63). CONCLUSION: This prospective study confirms the association of IL1RN polymorphisms with the risk of non-cardia GC and indicates that IL8 -251T>A may modify the risk for GC

Polymorphisms of genes coding for ghrelin and its receptor in relation to anthropometry, circulating levels of IGF-I and IGFBP-3, and breast cancer risk: a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)

Dossus L., McKay J.D., Canzian F., Wilkening S., Rinaldi S., Biessy C., Olsen A., Tjonneland A., Jakobsen M.U., Overvad K., Clavel-Chapelon F., Boutron-Ruault M.C., Fournier A., Linseisen J., Lukanova A., Boeing H., Fisher E., Trichopoulou A., Georgila C., Trichopoulos D., Palli D., Krogh V., Tumino R., Vineis P., Quiros J.R., Sala N., Martinez-Garcia C., Dorronsoro M., Chirlaque M.D., Barricarte A., van Duijnhoven F.J., Bueno-de-Mesquita H.B., Van Gils C.H., Peeters P.H., Hallmans G., Lenner P., Bingham S., Khaw K.T., Key T.J., Travis R.C., Ferrari P., Jenab M., Riboli E., Kaaks R.

Carcinogenesis; 2008; 29(7): 1360-1366

PMID:18375957

Abstract as provided by PubMed

Ghrelin, an endogenous ligand for the growth hormone secretagogue receptor, has two major functions: the stimulation of the growth hormone production and the stimulation of food intake. Accumulating evidence also suggests a role of ghrelin in cancer development. We conducted a case-control study on 1359 breast cancer cases and 2389 matched controls, nested within the European Prospective Investigation into Cancer and Nutrition, to examine the association of common genetic variants in the genes coding for ghrelin (GHRL) and its receptor (GHSR) with anthropometric measures, circulating insulin growth factor I (IGF-I) and insulin-like growth factor-binding protein 3 and breast cancer risk. Pair-wise tagging was used to select the 15 polymorphisms that represent the majority of common genetic variants across the GHRL and GHSR genes. A significant increase in breast cancer risk was observed in carriers of the GHRL rs171407-G allele (odds ratio: 1.2; 95% confidence interval: 1.0-1.4; P = 0.02). The GHRL single-nucleotide polymorphism rs375577 was associated with a 5% increase in IGF-I levels (P = 0.01). A number of GHRL and GHSR polymorphisms were associated with body mass index (BMI) and height (P between <0.01 and 0.04). The false-positive report probability (FPRP) approach suggests that these results are noteworthy (FPRP < 0.20). The results presented here add to a growing body of evidence that GHRL variations are associated with BMI. Furthermore, we have observed evidence for association of GHRL polymorphisms with circulating IGF-I levels and with breast cancer risk. These associations, however, might also be due to chance findings and further large studies are needed to confirm our results

The evaluation of the diet/disease relation in the EPIC study: considerations for the calibration and the disease models

Ferrari P., Day N.E., Boshuizen H.C., Roddam A., Hoffmann K., Thiebaut A., Pera G., Overvad K., Lund E., Trichopoulou A., Tumino R., Gullberg B., Norat T., Slimani N., Kaaks R., Riboli E.

Int J Epidemiol; 2008; 37(2): 368-378

PMID:18180242

Abstract as provided by PubMed

BACKGROUND: International multicentre studies on diet and cancer are relatively new in epidemiological research. They offer a series of challenging methodological issues for the evaluation of the association between dietary exposure and disease outcomes, which can both be quite heterogeneous across different geographical regions. This requires considerable work to standardize dietary measurements at the food and the nutrient levels. METHODS: Within the European Prospective Investigation into Cancer and Nutrition (EPIC), a calibration study was set up to express individual dietary intakes according to the same reference scale. A linear regression calibration model was used to correct the association between diet and disease for measurement errors in dietary exposures. In the present work, we describe an approach for analysing the EPIC data, using as an example the evaluation of the association between fish intake and colorectal cancer incidence. RESULTS: Sex- and country-specific attenuation factors ranged from 0.083 to 0.784, with values overall higher for men compared with women. Hazard ratio estimates of colorectal cancer for a 10 g/day increase in fish intake were 0.97 [95% confidence interval (CI): 0.95-0.99] and 0.93 (0.88-0.98), before and after calibration, respectively. CONCLUSIONS: In a multicentre study, the diet/disease association can be evaluated by exploiting the whole variability of intake over the entire study. Calibration may reduce between-centre heterogeneity in the diet-disease relationship caused by differential impact of measurement errors across cohorts

A Bayesian multilevel model for estimating the diet/disease relationship in a multicenter study with exposures measured with error: The EPIC study

Ferrari P., Carroll R.J., Gustafson P., Riboli E.

Stat Med; 2008; 27(29): 6037-6054

PMID:18951369

Abstract as provided by PubMed

In a multicenter study, the overall relationship between diet and cancer risk can be broken down into: (a) within-center relationships, which reflect the relationships at the individual level in each of the centers, and (b) a between-center relationship, which captures the association between exposure and disease risk at the aggregate level. In this work, we propose the use of a Bayesian multilevel model that takes into account the within- and between-center levels of evidence, using information at the individual and aggregate level. Correction for measurement error is performed in order to correct for systematic between-center measurement error in dietary exposure, and for attenuation biases in relative risk estimates within centers. The estimation of the parameters is carried out in a Bayesian framework using Gibbs sampling. The model entails a measurement, an exposure, and a disease component. Within the European Prospective Investigation into Cancer and Nutrition (EPIC) the association between lipid intake, assessed through dietary questionnaire and 24-hour dietary recall, and breast cancer incidence was evaluated. This analysis involved 21 534 women and 334 incident breast cancer cases from the EPIC calibration study. In this study, total energy intake was positively associated with breast cancer incidence at the aggregate level, whereas no effect was observed for fat. At the individual level, height was positively related to breast cancer incidence, whereas a weaker association was observed for fat. The use of multilevel models, which constitute a very powerful approach to estimating individual vs aggregate levels of evidence should be considered in multicenter studies. Copyright (c) 2008 John Wiley & Sons, Ltd

CDH1 gene polymorphisms, smoking, Helicobacter pylori infection and the risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST)

Jenab M., McKay J.D., Ferrari P., Biessy C., Laing S., Capella Munar G.M., Sala N., Pena S., Crusius J.B., Overvad K., Jensen M.K., Olsen A., Tjonneland A., Clavel-Chapelon F., Boutron-Ruault M.C., Kaaks R., Linseisen J., Boeing H., Bergmann M.M., Trichopoulou A., Georgila C., Psaltopoulou T., Mattiello A., Vineis P., Pala V., Palli D., Tumino R., Numans M.E., Peeters P.H., Bueno-de-Mesquita H.B., Lund E., Ardanaz E., Sanchez M.J., Dorronsoro M., Navarro Sanchez C., Quiros J.R., Hallmans G., Stenling R., Manjer J., Regner S., Key T., Bingham S., Khaw K.T., Slimani N., Rinaldi S., Boffetta P., Carneiro F., Riboli E., Gonzalez C.

Eur J Cancer; 2008; 44(6): 774-780

PMID:18342503

Abstract as provided by PubMed

Despite declining incidence rates, gastric cancer (GC) is a major cause of death worldwide. E-Cadherin is an adhesion molecule that is thought to be involved in GC. Germline mutations in the E-Cadherin gene (CDH1) have been identified in hereditary diffuse GC. Also, a promoter polymorphism at position -160 C/A has been suggested to lead to transcriptional down regulation and has been shown to affect GC risk in some studies. However, very little information exists on the GC risk association of other CDH1 polymorphisms and it is unclear whether any associations may be different by GC anatomical sites or histological types. Thus, a case-control study (cases=245/controls=950) nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort was conducted to assess the GC risk association of eight CDH1 gene polymorphisms. None of the CDH1 polymorphisms or haplotypes analysed were associated with GC risk and no differences of effect were observed by Helicobacter pylori infection status. However, three CDH1 polymorphisms in the same haplotype block, including the CDH1-160C/A, interacted with smoking to increase GC risk in smokers but not in never smokers. These findings should be confirmed in larger independent studies

Circulating concentrations of folate and vitamin B12 in relation to prostate cancer risk: results from the European prospective investigation into cancer and nutrition study

Johansson M., Appleby P.N., Allen N.E., Travis R.C., Roddam A.W., Egevad L., Jenab M., Rinaldi S., Kiemeney L.A., Bueno-de-Mesquita H.B., Vollset S.E., Ueland P.M., Sanchez M.J., Quiros J.R., Gonzalez C.A., Larranaga N., Chirlaque M.D., Ardanaz E., Sieri S., Palli D., Vineis P., Tumino R., Linseisen J., Kaaks R., Boeing H., Pischon T., Psaltopoulou T., Trichopoulou A., Trichopoulos D., Khaw K.T., Bingham S., Hallmans G., Riboli E., Stattin P., Key T.J.

Cancer Epidemiol Biomarkers Prev; 2008; 17(2): 279-285

PMID:18268110

Abstract as provided by PubMed

BACKGROUND: Determinants of one-carbon metabolism, such as folate and vitamin B(12), have been implicated in cancer development. Previous studies have not provided conclusive evidence for the importance of circulating concentrations of folate and vitamin B(12) in prostate cancer etiology. The aim of the present study was to investigate the relationship between prostate cancer risk and circulating concentrations of folate and vitamin B(12) in a large prospective cohort. METHODS: We analyzed circulating concentrations of folate and vitamin B(12) in 869 cases and 1,174 controls, individually matched on center, age, and date of recruitment, nested within the European Prospective Investigation into Cancer and Nutrition cohort. Relative risks (RR) for prostate cancer were estimated using conditional logistic regression models. RESULTS: Overall, no significant associations were observed for circulating concentrations of folate (P(trend) = 0.62) or vitamin B(12) (P(trend) = 0.21) with prostate cancer risk. RRs for a doubling in folate and vitamin B(12) concentrations were 1.03 [95% confidence interval (95% CI), 0.92-1.16] and 1.12 (95% CI, 0.94-1.35), respectively. In the subgroup of cases diagnosed with advanced stage prostate cancer, elevated concentrations of vitamin B(12) were associated with increased risk (RR for a doubling in concentration, 1.69; 95% CI, 1.05-2.72, P(trend) = 0.03). No other subgroup analyses resulted in a statistically significant association. CONCLUSION: This study does not provide strong support for an association between prostate cancer risk and circulating concentrations of folate or vitamin B(12). Elevated concentrations of vitamin B(12) may be associated with an increased risk for advanced stage prostate cancer, but this association requires examination in other large prospective studies. (Cancer Epidemiol Biomarkers Prev 2007;17(2):279-85)

Diabetes and the risk of non-Hodgkin\'s lymphoma and multiple myeloma in the European Prospective Investigation into Cancer and Nutrition

Khan A.E., Gallo V., Linseisen J., Kaaks R., Rohrmann S., Raaschou-Nielsen O., Tjonneland A., Johnsen H.E., Overvad K., Bergmann M.M., Boeing H., Benetou V., Psaltopoulou T., Trichopoulou A., Masala G., Mattiello A., Grioni S., Tumino R., Vermeulen R.C., Peeters P.H., Bueno-de-Mesquita H.B., Ros M.M., Lund E., Ardanaz E., Chirlaque M.D., Jakszyn P., Larranaga N., Losada A., Becker N., Nieters A., Martinez-Garcia C., Agren A., Hallmans G., Berglund G., Manjer J., Allen N.E., Key T.J., Bingham S., Khaw K.T., Slimani N., Ferrari P., Boffetta P., Norat T., Vineis P., Riboli E.

Haematologica; 2008; 93(6): 842-850

PMID:18443270

Abstract as provided by PubMed

BACKGROUND: Non-Hodgkin's lymphomas are a heterogeneous group of neoplasms arising from the lymphopoietic system including a wide range of subtypes of either B-cell or T-cell lymphomas. The few established risk factors for the development of these neoplasms include viral infections and immunological abnormalities, but their etiology remains largely unknown. Evidence suggests that certain medical conditions may be linked, through immunosuppression, to the risk of non-Hodgkin's lymphoma. Multiple myeloma is a neoplasm of plasma cells that accounts for approximately 15% of lymphopoietic cancers. Increases in the incidence of non-Hodgkin's lymphoma and multiple myeloma in the past implicate environmental factors as potential causal agents. DESIGN AND METHODS: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 1,213 histologically confirmed incident cases of non-Hodgkin's lymphoma and multiple myeloma (594 men; 619 women) were identified during a follow-up of 8.5 years. Cox proportional hazard models were used to explore the association between self-reported diabetes, diagnosed after 30 years of age, and the risk of non-Hodgkin's lymphoma overall and multiple myeloma and various lymphoma subtypes. RESULTS: We found no association between a personal history of diabetes and the risk of non-Hodgkin's lymphoma overall in men (HR: 1.28, 95% CI: 0.89-1.84), in women (HR: 0.71, 95% CI: 0.41- 1.24), or in men and women combined (HR: 1.09, 95% CI: 0.80-1.47). Among the B-non-Hodgkin's lymphoma subtypes, we observed a statistically significant increased risk of B-cell chronic lymphocytic leukemia (HR: 2.0, 95% CI: 1.04-3.86) in men, but not in women (HR: 1.07, 95% CI: 0.33-3.43). CONCLUSIONS: This prospective study did not provide evidence for a role of self-reported diabetes in the etiology of non-Hodgkin's lymphoma overall or multiple myeloma. We found an increased risk of B-cell chronic lymphocytic leukemia among men with diabetes, but not among women. We hypothesize that diabetes may not play a causal role in the etiology of B-cell chronic lymphocytic leukemia, though the underlying pathogenic mechanisms of both disorders may include shared genetic, host and/or environmental susceptibility factors

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