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Search Result (493 REFERENCES)

2008

Dietary fat and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition

Sieri S., Krogh V., Ferrari P., Berrino F., Pala V., Thiebaut A.C., Tjonneland A., Olsen A., Overvad K., Jakobsen M.U., Clavel-Chapelon F., Chajes V., Boutron-Ruault M.C., Kaaks R., Linseisen J., Boeing H., Nothlings U., Trichopoulou A., Naska A., Lagiou P., Panico S., Palli D., Vineis P., Tumino R., Lund E., Kumle M., Skeie G., Gonzalez C.A., Ardanaz E., Amiano P., Tormo M.J., Martinez-Garcia C., Quiros J.R., Berglund G., Gullberg B., Hallmans G., Lenner P., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Peeters P.H., Van Gils C.H., Key T.J., Crowe F.L., Bingham S., Khaw K.T., Rinaldi S., Slimani N., Jenab M., Norat T., Riboli E.

Am J Clin Nutr; 2008; 88(5): 1304-1312

Abstract as provided by PubMed

BACKGROUND: Epidemiologic studies have produced conflicting results with respect to an association of dietary fat with breast cancer. OBJECTIVE: We aimed to investigate the association between fat consumption and breast cancer. DESIGN: We prospectively investigated fat consumption in a large (n = 319,826), geographically and culturally heterogeneous cohort of European women enrolled in the European Prospective Investigation into Cancer and Nutrition who completed a dietary questionnaire. After a mean of 8.8 y of follow-up, 7119 women developed breast cancer. Cox proportional hazard models, stratified by age and center and adjusted for energy intake and confounders, were used to estimate hazard ratios (HRs) for breast cancer. RESULTS: An association between high saturated fat intake and greater breast cancer risk was found [HR = 1.13 (95% CI: 1.00, 1.27; P for trend = 0.038) for the highest quintile of saturated fat intake compared with the lowest quintile: 1.02 (1.00, 1.04) for a 20% increase in saturated fat consumption (continuous variable)]. No significant association of breast cancer with total, monounsaturated, or polyunsaturated fat was found, although trends were for a direct association of risk with monounsaturated fat and an inverse association with polyunsaturated fat. In menopausal women, the positive association with saturated fat was confined to nonusers of hormone therapy at baseline [1.21 (0.99, 1.48) for the highest quintile compared with the lowest quintile; P for trend = 0.044; and 1.03 (1.00, 1.07) for a 20% increase in saturated fat as a continuous variable]. CONCLUSIONS: Evidence indicates a weak positive association between saturated fat intake and breast cancer risk. This association was more pronounced for postmenopausal women who never used hormone therapy

Cross-sectional study on acrylamide hemoglobin adducts in subpopulations from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study

Vesper H.W., Slimani N., Hallmans G., Tjonneland A., Agudo A., Benetou V., Bingham S., Boeing H., Boutron-Ruault M.C., Bueno-de-Mesquita H.B., Chirlaque D., Clavel-Chapelon F., Crowe F., Drogan D., Ferrari P., Johansson I., Kaaks R., Linseisen J., Lund E., Manjer J., Mattiello A., Palli D., Peeters P.H., Rinaldi S., Skeie G., Trichopoulou A., Vineis P., Wirfalt E., Overvad K., Stromberg U.

J Agric Food Chem; 2008; 56(15): 6046-6053

Abstract as provided by PubMed

Acrylamide exposure was investigated in subgroups of the EPIC study population (510 subjects from 9 European countries, randomly selected and stratified by age, gender, and smoking status) using hemoglobin adducts of acrylamide (HbAA) and its primary metabolite glycidamide (HbGA). Blood samples were analyzed for HbAA and HbGA by HPLC/MS/MS. Statistical models for HbAA and HbGA were developed including body mass index (BMI), educational level, and physical activity. A large variability in acrylamide exposure and metabolism between individuals and country groups was observed with HbAA and HbGA values ranging between 15-623 and 8-377 pmol/g of Hb, respectively. Both adducts differed significantly by country, sex, and smoking status. HbGA values were significantly lower in high alcohol consumers than in moderate consumers. With increasing BMI, HbGA in nonsmokers and HbAA in smokers decreased significantly. In the assessment of potential health effects related to acrylamide exposure, country of origin, BMI, alcohol consumption, sex, and smoking status should be considered

Blood pressure and risk of renal cell carcinoma in the European prospective investigation into cancer and nutrition

Weikert S., Boeing H., Pischon T., Weikert C., Olsen A., Tjonneland A., Overvad K., Becker N., Linseisen J., Trichopoulou A., Mountokalakis T., Trichopoulos D., Sieri S., Palli D., Vineis P., Panico S., Peeters P.H., Bueno-de-Mesquita H.B., Verschuren W.M., Ljungberg B., Hallmans G., Berglund G., Gonzalez C.A., Dorronsoro M., Barricarte A., Tormo M.J., Allen N., Roddam A., Bingham S., Khaw K.T., Rinaldi S., Ferrari P., Norat T., Riboli E.

Am J Epidemiol; 2008; 167(4): 438-446

Abstract as provided by PubMed

Elevated blood pressure has been implicated as a risk factor for renal cell carcinoma (RCC), but prospective studies were confined to men and did not consider the effect of antihypertensive medication. The authors examined the relation among blood pressure, antihypertensive medication, and RCC in the European Prospective Investigation into Cancer and Nutrition (EPIC). Blood pressure was measured in 296,638 women and men, recruited in eight European countries during 1992-1998, 254,935 of whom provided information on antihypertensive medication. During a mean follow-up of 6.2 years, 250 cases of RCC were identified. Blood pressure was independently associated with risk of RCC. The relative risks for the highest versus the lowest category of systolic (>/=160 mmHg vs. <120 mmHg) and diastolic (>/=100 mmHg vs. <80 mmHg) blood pressures were 2.48 (95% confidence interval: 1.53, 4.02) and 2.34 (95% confidence interval: 1.54, 3.55). Risk estimates did not significantly differ according to sex or use of antihypertensive medication. Individuals taking antihypertensive drugs were not at a significantly increased risk unless blood pressure was poorly controlled. These results support the hypothesis that hypertension, rather than its medications, increases the risk of RCC in both sexes, while effective blood pressure control may lower the risk

2007

Serum insulin-like growth factor (IGF)-I and IGF-binding protein-3 concentrations and prostate cancer risk: results from the European Prospective Investigation into Cancer and Nutrition

Allen N.E., Key T.J., Appleby P.N., Travis R.C., Roddam A.W., Rinaldi S., Egevad L., Rohrmann S., Linseisen J., Pischon T., Boeing H., Johnsen N.F., Tjonneland A., Gronbaek H., Overvad K., Kiemeney L., Bueno-de-Mesquita H.B., Bingham S., Khaw K.T., Tumino R., Berrino F., Mattiello A., Sacerdote C., Palli D., Quiros J.R., Ardanaz E., Navarro C., Larranaga N., Gonzalez C., Sanchez M.J., Trichopoulou A., Travezea C., Trichopoulos D., Jenab M., Ferrari P., Riboli E., Kaaks R.

Cancer Epidemiol Biomarkers Prev; 2007; 16(6): 1121-1127

Abstract as provided by PubMed

BACKGROUND: Some studies suggest that elevated serum insulin-like growth factor (IGF)-I concentrations are associated with an increased risk of prostate cancer and, in particular, with an increased risk of advanced-stage prostate cancer. METHODS: We analyzed the association between prediagnostic serum concentrations of IGF-I and IGF-binding protein-3 (IGFBP-3) and prostate cancer risk in a case-control study nested in the European Prospective Investigation into Cancer and Nutrition. This study includes 630 incident prostate cancer cases and 630 matched control subjects. Odds ratios and their 95% confidence intervals (95% CI) were calculated for prostate cancer risk associated with increasing IGF-I and IGFBP-3 concentrations using conditional logistic regression. RESULTS: The risk of total prostate cancer in the highest versus the lowest third of serum peptide concentration was 1.35 (95% CI, 0.99-1.82; Ptrend = 0.08) for IGF-I, 1.39 (95% CI, 1.02-1.89; Ptrend = 0.12) for the IGF-I residuals after adjusting for IGFBP-3, 1.22 (95% CI, 0.92-1.64; Ptrend = 0.38) for IGFBP-3, and 1.01 (95% CI, 0.74-1.37; Ptrend = 0.75) for the IGFBP-3 residuals after adjusting for IGF-I. There was no significant difference in the association of peptide hormones and prostate cancer by stage of disease, although the association of serum IGF-I concentration with risk was slightly stronger for advanced-stage disease; the odds ratio for the highest versus the lowest third was 1.65 (95% CI, 0.88-3.08; Ptrend = 0.21) for IGF-I and 1.76 (95% CI, 0.92-3.40; Ptrend = 0.11) for IGF-I adjusted for IGFBP-3. CONCLUSIONS: In this large nested case-control study, serum IGF-I concentration is not strongly associated with prostate cancer risk, although the results are compatible with a small increase in risk, particularly for advanced-stage disease; no association for IGFBP-3 was observed

Risk of endometrial cancer in relationship to cigarette smoking: Results from the EPIC study

Al-Zoughool M., Dossus L., Kaaks R., Clavel-Chapelon F., Tjonneland A., Olsen A., Overvad K., Boutron-Ruault M.C., Gauthier E., Linseisen J., Chang-Claude J., Boeing H., Schulz M., Trichopoulou A., Chryssa T., Trichopoulos D., Berrino F., Palli D., Mattiello A., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., Boshuizen H.C., Peeters P.H., Gram I.T., Braaten T., Lund E., Chirlaque M.D., Ardanaz E., Agudo A., Larranaga N., Quiros J.R., Berglund G., Manjer J., Lundin E., Hallmans G., Khaw K.T., Bingham S., Allen N., Key T., Jenab M., Cust A.E., Rinaldi S., Riboli E.

Int J Cancer; 2007; 121(12): 2741-2747

Abstract as provided by PubMed

Current epidemiologic evidence indicates that cigarette smoking reduces the risk of endometrial cancer. We examined data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to analyze further aspects of the smoking-endometrial cancer relationship, such as possible modifying effects of menopausal status, HRT use, BMI and parity. In a total of 249,986 women with smoking exposure and menopausal status information, 619 incident endometrial cancer cases were identified during 1.56 million person-years of follow-up. Among postmenopausal women, the hazard ratio (HR) for current smokers versus never smokers was 0.70 (95% CI = 0.53-0.93), while it was 1.75 (95% CI = 1.13-2.70) among premenopausal women at recruitment. After adjustment for risk factors, the HR for postmenopausal women was slightly attenuated to 0.78 (95% CI = 0.59-1.03). No heterogeneity of effect was observed with HRT use or BMI. Among premenopausal women, current smokers of more than 15 cigarettes per day or who smoked for 30 years or more at the time of recruitment had a more than 2-fold increased risk of endometrial cancer compared to never smokers (HR = 2.54; 95% CI = 1.47-4.38 and HR = 2.23; 95% CI = 1.04-4.77, respectively). Past smoking was not associated with endometrial cancer risk, either among pre- or postmenopausal women. In this prospective study, we observed an increased risk of endometrial cancer with cigarette smoking in premenopausal women. The reduction of endometrial cancer risk observed among postmenopausal women does not have direct public health relevance since cigarette smoking is the main known risk factor for cancer. (c) 2007 Wiley-Liss, Inc

Dietary patterns and survival of older Europeans: The EPIC-Elderly Study (European Prospective Investigation into Cancer and Nutrition)

Bamia C., Trichopoulos D., Ferrari P., Overvad K., Bjerregaard L., Tjonneland A., Halkjaer J., Clavel-Chapelon F., Kesse E., Boutron-Ruault M.C., Boffetta P., Nagel G., Linseisen J., Boeing H., Hoffmann K., Kasapa C., Orfanou A., Travezea C., Slimani N., Norat T., Palli D., Pala V., Panico S., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., Waijers P.M., Peeters P.H., van der Schouw Y.T., Berenguer A., Martinez-Garcia C., Navarro C., Barricarte A., Dorronsoro M., Berglund G., Wirfalt E., Johansson I., Johansson G., Bingham S., Khaw K.T., Spencer E.A., Key T., Riboli E., Trichopoulou A.

Public Health Nutr; 2007; 10(6): 590-598
Pathology findings and validation of gastric and esophageal cancer cases in a European cohort (EPIC/EUR-GAST)

Carneiro F., Moutinho C., Pera G., Caldas C., Fenger C., Offerhaus J., Save V., Stenling R., Nesi G., Mahlke U., Blaker H., Torrado J., Roukos D.H., Sabourin J.C., Boeing H., Palli D., Bueno-de-Mesquita H.B., Overvad K., Bingham S., Clavel-Chapelon F., Lund E., Trichopoulou A., Manjer J., Riboli E., Gonzalez C.A.

Scand. J Gastroenterol; 2007; 42(5): 618-627

Abstract as provided by PubMed

OBJECTIVE: Cardia, non-cardia and intestinal and diffuse subtypes of gastric cancer may have different trends and etiological factors. However, the available information is not always collected in population cancer registries, and heterogeneous criteria have been applied for the histopathological classification of tumors. We describe the pathological features of incident gastric and esophageal cancers identified within the European Prospective Investigation into Cancer and Nutrition (EPIC). MATERIAL AND METHODS: In an investigation on gastric and esophageal cancer (EUR-GAST) in the EPIC project, a validation study of diagnoses reported by EPIC centers was conducted by a European panel of pathologists. Original pathology reports, stained slides of tumors and the respective paraffin blocks were requested from the centers. RESULTS: The whole series encompassed 467 cancer cases (gastric and esophageal cancers). Material was available for histopathological validation in 263 cases (56%); in the remaining cases, information was retrieved from the original reports (n=110; 24%) or codes provided by the EPIC centers (n=94; 20%). Among cases submitted to histopathological validation reported originally as unknown histotype or unknown site, a specific diagnosis was made in 95% and 74% of the cases, respectively. In cases for which only the original reports were available, the respective percentages were 46% and 67%. Gastric adenocarcinomas were classified according to site (cardia (29.4%), non-cardia (48.2%) and unknown (22.4%)) and histological type (intestinal (33.4%), diffuse (33.7%) and mixed, unclassified or unknown (32.9%)). Frequency of cardia was higher in Northern countries (35%) than in Mediterranean countries (18%). CONCLUSIONS: In addition to providing epidemiological data within the EPIC cohort on gastric and esophageal adenocarcinomas, the results reported here confirm the relevance of a validation study, notably for multicenter studies

Dietary Carbohydrates, Glycemic Index, Glycemic Load, and Endometrial Cancer Risk within the European Prospective Investigation into Cancer and Nutrition Cohort

Cust A.E., Slimani N., Kaaks R., van Bakel M., Biessy C., Ferrari P., Laville M., Tjonneland A., Olsen A., Overvad K., Lajous M., Clavel-Chapelon F., Boutron-Ruault M.C., Linseisen J., Rohrmann S., Nothlings U., Boeing H., Palli D., Sieri S., Panico S., Tumino R., Sacerdote C., Skeie G., Engeset D., Gram I.T., Quiros J.R., Jakszyn P., Sanchez M.J., Larranaga N., Navarro C., Ardanaz E., Wirfalt E., Berglund G., Lundin E., Hallmans G., Bueno-de-Mesquita H.B., Du H., Peeters P.H., Bingham S., Khaw K.T., Allen N.E., Key T.J., Jenab M., Riboli E.

Am J Epidemiol; 2007; 166(8): 912-923

Abstract as provided by PubMed

The associations of dietary total carbohydrates, overall glycemic index, total dietary glycemic load, total sugars, total starch, and total fiber with endometrial cancer risk were analyzed among 288,428 women in the European Prospective Investigation into Cancer and Nutrition cohort (1992-2004), including 710 incident cases diagnosed during a mean 6.4 years of follow-up. Cox proportional hazards models were used to estimate relative risks and 95% confidence intervals. There were no statistically significant associations with endometrial cancer risk for increasing quartile intakes of any of the exposure variables. However, in continuous models calibrated by using 24-hour recall values, the multivariable relative risks were 1.61 (95% confidence interval: 1.06, 2.45) per 100 g/day of total carbohydrates, 1.40 (95% confidence interval: 0.99, 1.99) per 50 units/day of total dietary glycemic load, and 1.36 (95% confidence interval: 1.05, 1.76) per 50 g/day of total sugars. These associations were stronger among women who had never used postmenopausal hormone therapy compared with ever users (total carbohydrates p(heterogeneity) = 0.04). Data suggest no association of overall glycemic index, total starch, and total fiber with risk, and a possible modest positive association of total carbohydrates, total dietary glycemic load, and total sugars with risk, particularly among never users of hormone replacement therapy

Metabolic syndrome, plasma lipid, lipoprotein and glucose levels, and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Cust A.E., Kaaks R., Friedenreich C., Bonnet F., Laville M., Tjonneland A., Olsen A., Overvad K., Jakobsen M.U., Chajes V., Clavel-Chapelon F., Boutron-Ruault M.C., Linseisen J., Lukanova A., Boeing H., Pischon T., Trichopoulou A., Christina B., Trichopoulos D., Palli D., Berrino F., Panico S., Tumino R., Sacerdote C., Gram I.T., Lund E., Quiros J.R., Travier N., Martinez-Garcia C., Larranaga N., Chirlaque M.D., Ardanaz E., Berglund G., Lundin E., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Peeters P.H., Bingham S., Khaw K.T., Allen N., Key T., Ferrari P., Rinaldi S., Slimani N., Riboli E.

Endocr Relat Cancer; 2007; 14(3): 755-767

Abstract as provided by PubMed

To clarify the role of metabolic factors in endometrial carcinogenesis, we conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), and examined the relation between prediagnostic plasma lipids, lipoproteins, and glucose, the metabolic syndrome (MetS; a cluster of metabolic factors) and endometrial cancer risk. Among pre- and postmenopausal women, 284 women developed endometrial cancer during follow-up. Using risk set sampling, 546 matched control subjects were selected. From conditional logistic regression models, high-density lipoprotein cholesterol (HDL-C) levels were inversely associated with risk body mass index (BMI)-adjusted relative risk (RR) for top versus bottom quartile 0.61 (95% confidence intervals (CI) 0.38-0.97), P(trend) = 0.02). Glucose levels were positively associated with risk (BMI-adjusted RR top versus bottom quartile 1.69 (95% CI 0.99-2.90), P(trend) = 0.03), which appeared stronger among postmenopausal women (BMI-adjusted RR top versus bottom tertile 2.61 (95% CI 1.46-4.66), P(trend) = 0.0006, P(heterogeneity) = 0.13) and never-users of exogenous hormones (P(heterogeneity) = 0.005 for oral contraceptive (OC) use and 0.05 for hormone replacement therapy-use). The associations of HDL-C and glucose with risk were no longer statistically significant after further adjustment for obesity-related hormones. Plasma total cholesterol, Low-density lipoprotein cholesterol (LDL-C), and triglycerides were not significantly related to overall risk. The presence of MetS was associated with risk (RR 2.12 (95% CI 1.51-2.97)), which increased with the number of MetS factors (P(trend) = 0.02). An increasing number of MetS factors other than waist circumference, however, was marginally significantly associated with risk only in women with waist circumference above the median (P(interaction) = 0.01). None of the associations differed significantly by fasting status. These findings suggest that metabolic abnormalities and obesity may act synergistically to increase endometrial cancer risk

Serum levels of C-peptide, IGFBP-1 and IGFBP-2 and endometrial cancer risk; results from the European prospective investigation into cancer and nutrition

Cust A.E., Allen N.E., Rinaldi S., Dossus L., Friedenreich C., Olsen A., Tjonneland A., Overvad K., Clavel-Chapelon F., Boutron-Ruault M.C., Linseisen J., Chang-Claude J., Boeing H., Schulz M., Benetou V., Trichopoulou A., Trichopoulos D., Palli D., Berrino F., Tumino R., Mattiello A., Vineis P., Quiros J.R., Agudo A., Sanchez M.J., Larranaga N., Navarro C., Ardanaz E., Bueno-de-Mesquita H.B., Peeters P.H., Van Gils C.H., Bingham S., Khaw K.T., Key T., Slimani N., Riboli E., Kaaks R.

Int J Cancer; 2007; 120(12): 2656-2664

Abstract as provided by PubMed

We conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition, to examine the associations between prediagnostic serum concentrations of C-peptide, insulin-like growth factor binding protein (IGFBP)-1 and IGFBP-2, and endometrial cancer risk. Among pre- and post-menopausal women, who were not currently using exogenous hormones, 286 women developed incident endometrial cancer during an average 5.1 years follow-up. Using risk set sampling, 555 matched control subjects were selected. In conditional logistic regression models adjusted for matching factors only, endometrial cancer risk increased with increasing serum levels of C-peptide (relative risks (RR) for the top vs. bottom quartile = 2.13 [95% confidence interval (CI) 1.33-3.41], p(trend) = 0.001, and decreasing serum levels of IGFBP-2 (RR for the top vs. bottom quartile = 0.56 [95% CI 0.35-0.90], p(trend) = 0.03, but was not significantly associated with IGFBP-1 levels (RR for the top vs. bottom quartile = 0.76 [95% CI 0.47-1.21], p(trend) = 0.25). In BMI-adjusted models, only the C-peptide association remained marginally statistically significant (RR for the top vs. bottom quartile = 1.56 [95% CI 0.94-2.57], p(trend) = 0.05 for C-peptide; 0.84 [95% CI 0.50-1.40], p(trend) = 0.74 for IGFBP-2; and 1.08 [95% CI 0.65-1.78], p(trend) = 0.86 for IGFBP-1 levels). These associations were stronger among nonfasting women (< or =< or =6 hr since last meal; 63% of subjects) but were not evident among fasting women, although the interactions were not statistically significant. The C-peptide-risk association was substantially attenuated after adjustment for free estradiol in postmenopausal women (RR for the top vs. bottom quartile = 1.28 [95% CI 0.67-2.45], p(trend) = 0.42. Our results provide modest support to the hypothesis that hyperinsulinaemia is a risk factor for endometrial cancer

Plasma adiponectin levels and endometrial cancer risk in pre- and postmenopausal women

Cust A.E., Kaaks R., Friedenreich C., Bonnet F., Laville M., Lukanova A., Rinaldi S., Dossus L., Slimani N., Lundin E., Tjonneland A., Olsen A., Overvad K., Clavel-Chapelon F., Mesrine S., Joulin V., Linseisen J., Rohrmann S., Pischon T., Boeing H., Trichopoulos D., Trichopoulou A., Benetou V., Palli D., Berrino F., Tumino R., Sacerdote C., Mattiello A., Quiros J.R., Mendez M.A., Sanchez M.J., Larranaga N., Tormo M.J., Ardanaz E., Bueno-de-Mesquita H.B., Peeters P.H., Van Gils C.H., Khaw K.T., Bingham S., Allen N., Key T., Jenab M., Riboli E.

J Clin Endocrinol Metab; 2007; 92(1): 255-263

Abstract as provided by PubMed

BACKGROUND: Adiponectin, an adipocytokine secreted by adipose tissue, is decreased in obesity, insulin resistance, type 2 diabetes, and polycystic ovary syndrome, all of which are well-established risk factors for endometrial cancer. METHODS: We conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition to examine the relation between prediagnostic plasma adiponectin levels and endometrial cancer risk. Among pre- and postmenopausal women who were not currently using exogenous hormones, 284 women developed incident endometrial cancer during an average of 5.1 yr of follow-up. Using risk set sampling, 548 control subjects were selected, matched on center, age, menopausal status, phase of menstrual cycle, time of blood draw, and fasting status. Conditional logistic regression models were used to estimate relative risks and 95% confidence intervals. RESULTS: Adiponectin levels were inversely associated with endometrial cancer risk [body mass index-adjusted relative risk for the top vs. bottom quartile = 0.56 (95% confidence interval 0.36-0.86), P(trend) = 0.006]. There was evidence of a stronger inverse association among obese women than among nonobese women (P(heterogeneity) = 0.03). The inverse association also appeared stronger for women who were postmenopausal or perimenopausal than premenopausal at baseline, but this was not statistically significantly heterogeneous (P(heterogeneity) = 0.51). The association remained statistically significant after separate adjustment for other obesity-related physiological risk factors such as C-peptide, IGF binding protein-1, IGF binding protein-2, SHBG, estrone, or free testosterone but only marginally statistically significant after simultaneous adjustment for these factors. CONCLUSIONS: High circulating adiponectin levels are associated with reduced endometrial cancer risk, largely independent of other obesity-related risk factors

EPIC-Heart: the cardiovascular component of a prospective study of nutritional, lifestyle and biological factors in 520,000 middle-aged participants from 10 European countries

Danesh J., Saracci R., Berglund G., Feskens E., Overvad K., Panico S., Thompson S., Fournier A., Clavel-Chapelon F., Canonico M., Kaaks R., Linseisen J., Boeing H., Pischon T., Weikert C., Olsen A., Tjonneland A., Johnsen S.P., Jensen M.K., Quiros J.R., Svatetz C.A., Perez M.J., Larranaga N., Sanchez C.N., Iribas C.M., Bingham S., Khaw K.T., Wareham N., Key T., Roddam A., Trichopoulou A., Benetou V., Trichopoulos D., Masala G., Sieri S., Tumino R., Sacerdote C., Mattiello A., Verschuren W.M., Bueno-de-Mesquita H.B., Grobbee D.E., van der Schouw Y.T., Melander O., Hallmans G., Wennberg P., Lund E., Kumle M., Skeie G., Ferrari P., Slimani N., Norat T., Riboli E.

Eur J Epidemiol; 2007; 22(2): 129-141

Abstract as provided by PubMed

EPIC-Heart is the cardiovascular component of the European Prospective Investigation into Cancer and Nutrition (EPIC), a multi-centre prospective cohort study investigating the relationship between nutrition and major chronic disease outcomes. Its objective is to advance understanding about the separate and combined influences of lifestyle (especially dietary), environmental, metabolic and genetic factors in the development of cardiovascular diseases by making best possible use of the unusually informative database and biological samples in EPIC. Between 1992 and 2000, 519,978 participants (366,521 women and 153,457 men, mostly aged 35-70 years) in 23 centres in 10 European countries commenced follow-up for cause- specific mortality, cancer incidence and major cardiovascular morbidity. Dietary information was collected with quantitative questionnaires or semi-quantitative food frequency questionnaires, including a 24-h dietary recall sub-study to help calibrate the dietary measurements. Information was collected on physical activity, tobacco smoking, alcohol consumption, occupational history, socio-economic status, and history of previous illnesses. Anthropometric measurements and blood pressure recordings were made in the majority of participants. Blood samples were taken from 385,747 individuals, from which plasma, serum, red cells, and buffy coat fractions were separated and aliquoted for long-term storage. By 2004, an estimated 10,000 incident fatal and non-fatal coronary and stroke events had been recorded. The first cycle of EPIC-Heart analyses will assess associations of coronary mortality with several prominent dietary hypotheses and with established cardiovascular risk factors. Subsequent analyses will extend this approach to non-fatal cardiovascular outcomes and to further dietary, biochemical and genetic factors

Lifetime and baseline alcohol intake and risk of colon and rectal cancers in the European prospective investigation into cancer and nutrition (EPIC)

Ferrari P., Jenab M., Norat T., Moskal A., Slimani N., Olsen A., Tjonneland A., Overvad K., Jensen M.K., Boutron-Ruault M.C., Clavel-Chapelon F., Morois S., Rohrmann S., Linseisen J., Boeing H., Bergmann M., Kontopoulou D., Trichopoulou A., Kassapa C., Masala G., Krogh V., Vineis P., Panico S., Tumino R., Gils C.H., Peeters P., Bueno-de-Mesquita H.B., Ocke M.C., Skeie G., Lund E., Agudo A., Ardanaz E., Lopez D.C., Sanchez M.J., Quiros J.R., Amiano P., Berglund G., Manjer J., Palmqvist R., Guelpen B.V., Allen N., Key T., Bingham S., Mazuir M., Boffetta P., Kaaks R., Riboli E.

Int J Cancer; 2007; 121(9): 2065-2072

Abstract as provided by PubMed

Alcohol consumption may be associated with risk of colorectal cancer (CRC), but the epidemiological evidence for an association with specific anatomical subsites, types of alcoholic beverages and current vs. lifetime alcohol intake is inconsistent. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), 478,732 study subjects free of cancer at enrolment between 1992 and 2000 were followed up for an average of 6.2 years, during which 1,833 CRC cases were observed. Detailed information on consumption of alcoholic beverages at baseline (all cases) and during lifetime (1,447 CRC cases, 69% of the cohort) was collected from questionnaires. Cox proportional hazard models were used to examine the alcohol-CRC association. After adjustment for potential confounding factors, lifetime alcohol intake was significantly positively associated to CRC risk (hazard ratio, HR = 1.08, 95%CI = 1.04-1.12 for 15 g/day increase), with higher cancer risks observed in the rectum (HR = 1.12, 95%CI = 1.06-1.18) than distal colon (HR = 1.08, 95%CI = 1.01-1.16), and proximal colon (HR = 1.02, 95%CI = 0.92-1.12). Similar results were observed for baseline alcohol intake. When assessed by alcoholic beverages at baseline, the CRC risk for beer (HR = 1.38, 95%CI = 1.08-1.77 for 20-39.9 vs. 0.1-2.9 g/day) was higher than wine (HR = 1.21, 95%CI = 1.02-1.44), although the two risk estimates were not significantly different from each other. Higher HRs for baseline alcohol were observed for low levels of folate intake (1.13, 95%CI = 1.06-1.20 for 15 g/day increase) compared to high folate intake (1.03, 95%CI = 0.98-1.09). In this large European cohort, both lifetime and baseline alcohol consumption increase colon and rectum cancer risk, with more apparent risk increases for alcohol intakes greater than 30 g/day. (c) 2007 Wiley-Liss, Inc

Anthropometric factors and risk of endometrial cancer: the European prospective investigation into cancer and nutrition

Friedenreich C., Cust A., Lahmann P.H., Steindorf K., Boutron-Ruault M.C., Clavel-Chapelon F., Mesrine S., Linseisen J., Rohrmann S., Boeing H., Pischon T., Tjonneland A., Halkjaer J., Overvad K., Mendez M., Redondo M.L., Garcia C.M., Larranaga N., Tormo M.J., Gurrea A.B., Bingham S., Khaw K.T., Allen N., Key T., Trichopoulou A., Vasilopoulou E., Trichopoulos D., Pala V., Palli D., Tumino R., Mattiello A., Vineis P., Bueno-de-Mesquita H.B., Peeters P.H., Berglund G., Manjer J., Lundin E., Lukanova A., Slimani N., Jenab M., Kaaks R., Riboli E.

Cancer Causes Control; 2007; 18(4): 399-413

Abstract as provided by PubMed

OBJECTIVE: To examine the association between anthropometry and endometrial cancer, particularly by menopausal status and exogenous hormone use subgroups. METHODS: Among 223,008 women in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, there were 567 incident endometrial cancer cases during 6.4 years of follow-up. The analysis was performed with Cox proportional hazards modeling. RESULTS: Weight, body mass index (BMI), waist and hip circumferences and waist-hip ratio (WHR) were strongly associated with increased risk of endometrial cancer. The relative risk (RR) for obese (BMI 30- < 40 kg/m(2)) compared to normal weight (BMI < 25) women was 1.78, 95% CI = 1.41-2.26, and for morbidly obese women (BMI > or = 40) was 3.02, 95% CI = 1.66-5.52. The RR for women with a waist circumference of > or =88 cm vs. <80 cm was 1.76, 95% CI = 1.42-2.19. Adult weight gain of > or =20 kg compared with stable weight (+/-3 kg) increased risk independent of body weight at age 20 (RR = 1.75, 95% CI = 1.11-2.77). These associations were generally stronger for postmenopausal than premenopausal women, and oral contraceptives never-users than ever-users, and much stronger among never-users of hormone replacement therapy compared to ever-users. CONCLUSION: Obesity, abdominal adiposity, and adult weight gain were strongly associated with endometrial cancer risk. These associations were particularly evident among never-users of hormone replacement therapy

Physical activity and risk of endometrial cancer: the European prospective investigation into cancer and nutrition

Friedenreich C., Cust A., Lahmann P.H., Steindorf K., Boutron-Ruault M.C., Clavel-Chapelon F., Mesrine S., Linseisen J., Rohrmann S., Pischon T., Schulz M., Tjonneland A., Johnsen N.F., Overvad K., Mendez M., Arguelles M.V., Garcia C.M., Larranaga N., Chirlaque M.D., Ardanaz E., Bingham S., Khaw K.T., Allen N., Key T., Trichopoulou A., Dilis V., Trichopoulos D., Pala V., Palli D., Tumino R., Panico S., Vineis P., Bueno-de-Mesquita H.B., Peeters P.H., Monninkhof E., Berglund G., Manjer J., Slimani N., Ferrari P., Kaaks R., Riboli E.

Int J Cancer; 2007; 121(2): 347-355

Abstract as provided by PubMed

The etiologic role of physical activity in endometrial cancer risk remains unclear given the few epidemiologic studies that have been conducted. To investigate this relation more fully, an analysis was undertaken in the European prospective investigation into cancer and nutrition (EPIC). During an average 6.6 years of follow-up, 689 incident endometrial cancer cases were identified from an analytic cohort within EPIC of 253,023 women. Cox proportional hazards models were used to estimate the associations between type of activity (total, occupational, household, recreational) and endometrial cancer risk. For total activity, women in the highest compared with the lowest quartile of activity had a risk of 0.88 (95% confidence interval (95% CI=0.61-1.27). No clear associations between each type of activity and endometrial cancer risk were found for the total study population combined. Associations were more evident in the stratified results, with premenopausal women who were active versus inactive experiencing a risk of 0.66 (95% CI=0.38-1.14) overall. Among premenopausal women, for household and recreational activities the risk estimates in the highest as compared with the lowest quartiles were, respectively, 0.48 (95% CI=0.23-0.99) and 0.78 (95% CI=0.44-1.39). No effect modification by body mass index, hormone replacement therapy, oral contraceptive use or energy intake was found. This study provides no evidence of a protective effect of increased physical activity in endometrial cancer risk in all women but some support for a benefit among premenopausal women. The relative risk reductions are most apparent for household activities

Serum C-peptide, IGFBP-1 and IGFBP-2 and risk of colon and rectal cancers in the European Prospective Investigation into Cancer and Nutrition

Jenab M., Riboli E., Cleveland R.J., Norat T., Rinaldi S., Nieters A., Biessy C., Tjonneland A., Olsen A., Overvad K., Gronbaek H., Clavel-Chapelon F., Boutron-Ruault M.C., Linseisen J., Boeing H., Pischon T., Trichopoulos D., Oikonomou E., Trichopoulou A., Panico S., Vineis P., Berrino F., Tumino R., Masala G., Peters P.H., Van Gils C.H., Bueno-de-Mesquita H.B., Ocke M.C., Lund E., Mendez M.A., Tormo M.J., Barricarte A., Martinez-Garcia C., Dorronsoro M., Quiros J.R., Hallmans G., Palmqvist R., Berglund G., Manjer J., Key T., Allen N.E., Bingham S., Khaw K.T., Cust A., Kaaks R.

Int J Cancer; 2007; 121(2): 368-376

Abstract as provided by PubMed

Western style diets and lifestyles are associated with increasing rates of obesity, diabetes and insulin resistance. Higher circulating insulin levels may modulate cell proliferation and apoptosis either directly or indirectly by increasing the bioactivity of IGF-I and decreasing the bioactivity of some of its binding proteins. The objective of this study was to determine the association of increasing levels of serum C-peptide, a biomarker of pancreatic insulin secretion, and IGF binding proteins (IGFBP) -1 and -2 with colorectal cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 Western European countries. A total of 1,078 colorectal cancer cases were matched (age, date of blood donation, fasting status, gender, study center) to an equal number of control subjects. Relative cancer risks were estimated using conditional logistic regression models. Serum C-peptide concentration was positively associated with an increased colorectal cancer risk for the highest versus the lowest quintile (OR = 1.56, 95% CI = 1.16-2.09, p(trend) < 0.01), which was slightly attenuated after adjustment for BMI and physical activity (OR = 1.37, 95% CI = 1.00-1.88, p(trend) = 0.10). When stratified by anatomical site, the cancer risk was stronger in the colon (OR = 1.67, 95% CI = 1.14-2.46, p(trend) < 0.01) than in the rectum (OR = 1.42, 95% CI = 0.90-2.25, p(trend) = 0.35). The cancer risk estimates were not heterogeneous by gender or fasting status. No clear colorectal cancer risk associations were observed for IGFBP-1 or -2. This large prospective study confirms that hyperinsulinemia, as determined by C-peptide levels, is associated with an increased colorectal cancer risk. (c) 2007 Wiley-Liss, Inc

Plasma carotenoids, retinol, and tocopherols and the risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition study

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

Am J Clin Nutr; 2007; 86(3): 672-681

Abstract as provided by PubMed

BACKGROUND: Previous studies suggest that high plasma concentrations of carotenoids, retinol, or tocopherols may reduce the risk of prostate cancer. OBJECTIVE: We aimed to examine the associations between plasma concentrations of 7 carotenoids, retinol, alpha-tocopherol, and gamma-tocopherol and prostate cancer risk. DESIGN: A total of 137 001 men in 8 European countries participated. After a mean of 6 y, 966 incident cases of prostate cancer with plasma were available. A total of 1064 control subjects were selected and were matched for study center, age, and date of recruitment. The relative risk of prostate cancer was estimated by conditional logistic regression, which was adjusted for smoking status, alcohol intake, body mass index, marital status, physical activity, and education level. RESULTS: Overall, none of the micronutrients examined were significantly associated with prostate cancer risk. For lycopene and the sum of carotenoids, there was evidence of heterogeneity between the associations with risks of localized and advanced disease. These carotenoids were not associated with the risk of localized disease but were inversely associated with the risk of advanced disease. The risk of advanced disease for men in the highest fifth of plasma concentrations compared with men in the lowest fifth was 0.40 (95% CI: 0.19, 0.88) for lycopene and 0.35 (95% CI: 0.17, 0.78) for the sum of carotenoids. CONCLUSIONS: We observed no associations between plasma concentrations of carotenoids, retinol, or tocopherols and overall prostate cancer risk. The inverse associations of lycopene and the sum of carotenoids with the risk of advanced disease may involve a protective effect, an association of dietary choice with delayed detection of prostate cancer, reverse causality, or other factors

Physical activity and breast cancer risk: the European Prospective Investigation into Cancer and Nutrition

Lahmann P.H., Friedenreich C., Schuit A.J., Salvini S., Allen N.E., Key T.J., Khaw K.T., Bingham S., Peeters P.H., Monninkhof E., Bueno-de-Mesquita H.B., Wirfalt E., Manjer J., Gonzales C.A., Ardanaz E., Amiano P., Quiros J.R., Navarro C., Martinez C., Berrino F., Palli D., Tumino R., Panico S., Vineis P., Trichopoulou A., Bamia C., Trichopoulos D., Boeing H., Schulz M., Linseisen J., Chang-Claude J., Chapelon F.C., Fournier A., Boutron-Ruault M.C., Tjonneland A., Fons Johnson N., Overvad K., Kaaks R., Riboli E.

Cancer Epidemiol Biomarkers Prev; 2007; 16(1): 36-42

Abstract as provided by PubMed

There is convincing evidence for a decreased risk of breast cancer with increased physical activity. Uncertainties remain, however, about the role of different types of physical activity on breast cancer risk and the potential effect modification for these associations. We used data from 218,169 premenopausal and postmenopausal women from nine European countries, ages 20 to 80 years at study entry into the European Prospective Investigation into Cancer and Nutrition. Hazard ratios (HR) from multivariate Cox regression models were calculated using metabolic equivalent value-based physical activity variables categorized in quartiles, adjusted for age, study center, education, body mass index, smoking, alcohol use, age at menarche, age at first pregnancy, parity, current oral contraceptive use, and hormone replacement therapy use. The physical activity assessment included recreational, household, and occupational activities. A total physical activity index was estimated based on cross-tabulation of these separate types of activity. During 6.4 years of follow-up, 3,423 incident invasive breast cancers were identified. Overall, increasing total physical activity was associated with a reduction in breast cancer risk among postmenopausal women (P(trend) = 0.06). Specifically, household activity was associated with a significantly reduced risk in postmenopausal (HR, 0.81; 95% confidence interval, 0.70-0.93, highest versus the lowest quartile; P(trend) = 0.001) and premenopausal (HR, 0.71; 95% confidence interval, 0.55-0.90, highest versus lowest quartile; P(trend) = 0.003) women. Occupational activity and recreational activity were not significantly related to breast cancer risk in both premenopausal and postmenopausal women. This study provides additional evidence for a protective effect of physical activity on breast cancer risk

Fruit and vegetable consumption and lung cancer risk: Updated information from the European Prospective Investigation into Cancer and Nutrition (EPIC)

Linseisen J., Rohrmann S., Miller A.B., Bueno-de-Mesquita H.B., Buchner F.L., Vineis P., Agudo A., Gram I.T., Janson L., Krogh V., Overvad K., Rasmuson T., Schulz M., Pischon T., Kaaks R., Nieters A., Allen N.E., Key T.J., Bingham S., Khaw K.T., Amiano P., Barricarte A., Martinez C., Navarro C., Quiros R., Clavel-Chapelon F., Boutron-Ruault M.C., Touvier M., Peeters P.H., Berglund G., Hallmans G., Lund E., Palli D., Panico S., Tumino R., Tjonneland A., Olsen A., Trichopoulou A., Trichopoulos D., Autier P., Boffetta P., Slimani N., Riboli E.

Int J Cancer; 2007; 121(5): 1103-1114

Abstract as provided by PubMed

The association of fruit and vegetable consumption and lung cancer incidence was evaluated using the most recent data from the European Prospective Investigation into Cancer and Nutrition (EPIC), applying a refined statistical approach (calibration) to account for measurement error potentially introduced by using food frequency questionnaire data. Between 1992 and 2000, detailed information on diet and life-style of 478,590 individuals participating in EPIC was collected. During a median follow-up of 6.4 years, 1,126 lung cancer cases were observed. Multivariate Cox proportional hazard models were applied for statistical evaluation. In the whole study population, fruit consumption was significantly inversely associated with lung cancer risk while no association was found for vegetable consumption. In current smokers, however, lung cancer risk significantly decreased with higher vegetable consumption; this association became more pronounced after calibration, the hazard ratio (HR) being 0.78 (95% CI 0.62-0.98) per 100 g increase in daily vegetable consumption. In comparison, the HR per 100 g fruit was 0.92 (0.85-0.99) in the entire cohort and 0.90 (0.81-0.99) in smokers. Exclusion of cases diagnosed during the first 2 years of follow-up strengthened these associations, the HR being 0.71 (0.55-0.94) for vegetables (smokers) and 0.86 (0.78-0.95) for fruit (entire cohort). Cancer incidence decreased with higher consumption of apples and pears (entire cohort) as well as root vegetables (smokers). In addition to an overall inverse association with fruit intake, the results of this evaluation add evidence for a significant inverse association of vegetable consumption and lung cancer incidence in smokers. (c) 2007 Wiley-Liss, Inc

Cereal fiber intake may reduce risk of gastric adenocarcinomas: The EPIC-EURGAST study

Mendez M.A., Pera G., Agudo A., Bueno-de-Mesquita H.B., Palli D., Boeing H., Carneiro F., Berrino F., Sacerdote C., Tumino R., Panico S., Berglund G., Manjer J., Johansson I., Stenling R., Martinez C., Dorronsoro M., Barricarte A., Tormo M.J., Quiros J.R., Allen N., Key T.J., Bingham S., Linseisen J., Kaaks R., Overvad K., Jensen M., Olsen A., Tjonneland A., Peeters P.H., Numans M.E., Ocke M.C., Clavel-Chapelon F., Boutron-Ruault M.C., Trichopoulou A., Lund E., Slimani N., Jenab M., Ferrari P., Riboli E., Gonzalez C.A.

Int J Cancer; 2007; 121(7): 1618-1623

Abstract as provided by PubMed

Numerous case-control studies suggest dietary fiber may reduce risk of gastric cancer, but this has not been confirmed prospectively. A previous case-control study reported reduced risk of gastric cardia adenocarcinomas associated with cereal fiber, but not with fruit or vegetable fiber. To date, different food sources of fiber have not been examined with respect to noncardia tumors or diverse histologic sub-types. This study prospectively examines associations between fiber from different food sources and incident gastric adenocarcinomas (GC) among more than 435,000 subjects from 10 countries participating in the European Prospective Investigation into Cancer and Nutrition study. Subjects aged 25-70 years completed dietary questionnaires in 1992-98, and were followed up for a median of 6.7 years. About 312 incident GCs were observed. The relative risk of GC was estimated based on cohort-wide sex-specific fiber intake quartiles using proportional hazards models to estimate hazards ratios (HRs) and 95% confidence intervals (CIs). Intakes of cereal fiber, but not total, fruit or vegetable fiber, were associated with reduced GC risk [adjusted HR for the highest vs. lowest quartile of cereal fiber 0.69, 0.48-0.99]. There was a strong inverse association for diffuse [HR 0.43, 0.22-0.86], but not intestinal type [HR 0.98, 0.54-1.80] tumors. Associations for cardia vs. noncardia tumors were similar to those for overall GC, although cardia associations did not reach significance. Cereal fiber consumption may help to reduce risk of GC, particularly diffuse type tumors. Further study on different food sources of fiber in relation to GC risk is warranted to confirm these relationships. (c) 2007 Wiley-Liss, Inc

Socioeconomic position and the risk of gastric and oesophageal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST)

Nagel G., Linseisen J., Boshuizen H.C., Pera G., Del Giudice G., Westert G.P., Bueno-de-Mesquita H.B., Allen N.E., Key T.J., Numans M.E., Peeters P.H., Sieri S., Siman H., Berglund G., Hallmans G., Stenling R., Martinez C., Arriola L., Barricarte A., Chirlaque M.D., Quiros J.R., Vineis P., Masala G., Palli D., Panico S., Tumino R., Bingham S., Boeing H., Bergmann M.M., Overvad K., Boutron-Ruault M.C., Clavel-Chapelon F., Olsen A., Tjonneland A., Trichopoulou A., Bamia C., Soukara S., Sabourin J.C., Carneiro F., Slimani N., Jenab M., Norat T., Riboli E., Gonzalez C.A.

Int J Epidemiol; 2007; 36(1): 66-76

Abstract as provided by PubMed

OBJECTIVES: To evaluate the association of socioeconomic position with adenocarcinoma of the oesophagus and stomach. METHODS: The European Prospective Investigation into Cancer and Nutrition (EPIC) cohort comprises about 520 000 participants mostly aged 35-70 years. Information on diet and lifestyle was collected at recruitment. After an average follow-up of 6.5 years, 268 cases with adenocarcinoma of the stomach and 56 of the oesophagus were confirmed. We examined the effect of socioeconomic position on cancer risk by means of educational data and a computed Relative Index of Inequality (RII). In a nested case-control study, adjustment for Helicobacter pylori (H. pylori) infection was performed. RESULTS: Higher education was significantly associated with a reduced risk of gastric cancer [vs lowest level of education, hazard ratio (HR): 0.64, 95% Confidence intervals (CI): 0.43-0.98]. This effect was more pronounced for cancer of the cardia (HR: 0.42, 95% CI: 0.20-0.89) as compared to non-cardia gastric cancer (HR: 0.66, 95% CI: 0.36-1.22). Additionally, the inverse association of educational level and gastric cancer was stronger for cases with intestinal (extreme categories, HR: 0.13, 95% CI: 0.04-0.44) rather than diffuse histological subtype (extreme categories, HR: 0.71 95% CI: 0.37-1.40). In the nested case-control study, inverse but statistically non-significant associations were found after additional adjustment for H. pylori infection [highest vs lowest level of education: Odds ratio (OR) 0.53, 95% CI: 0.24-1.18]. Educational level was non-significantly, inversely associated with carcinoma of the oesophagus. CONCLUSION: A higher socioeconomic position was associated with a reduced risk of gastric adenocarcinoma, which was strongest for cardia cancer or intestinal histological subtype, suggesting different risk profiles according to educational level. These effects appear to be explained only partially by established risk factors

Diet, serum insulin-like growth factor-I and IGF-binding protein-3 in European women

Norat T., Dossus L., Rinaldi S., Overvad K., Gronbaek H., Tjonneland A., Olsen A., Clavel-Chapelon F., Boutron-Ruault M.C., Boeing H., Lahmann P.H., Linseisen J., Nagel G., Trichopoulou A., Trichopoulos D., Kalapothaki V., Sieri S., Palli D., Panico S., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., Peeters P.H., Van Gils C.H., Agudo A., Amiano P., Ardanoz E., Martinez C., Quiros R., Tormo M.J., Bingham S., Key T.J., Allen N.E., Ferrari P., Slimani N., Riboli E., Kaaks R.

Eur J Clin Nutr; 2007; 61(1): 91-98

Abstract as provided by PubMed

OBJECTIVE: The aim of this study was to examine the relationship of diet with serum insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 in women. DESIGN: Cross-sectional study. SETTING AND SUBJECTS: The population are 2109 women who were control subjects in a case-control study of breast cancer nested in the European Prospective Investigation into Cancer and Nutrition. Control subjects were randomly chosen among risk sets consisting of female cohort members alive and free of cancer (except non-melanoma skin cancer) at the time of diagnosis of the index case. Matching criteria were age at enrolment, follow-up time, time of the day of blood collection and study centre. Diet was measured through validated questionnaires. Serum hormone concentrations were measured by enzyme-linked immunosorbent assays. The relationship between serum IGF-I, IGFBP-3, and intake of nutrients and foods was explored by linear regression in models adjusted for energy intake, age, body mass index, smoking, physical activity, centre and laboratory batch. RESULTS: Serum IGF-I levels were positively related to protein intake (P(trend)<0.001), but not related to energy, fat or carbohydrate intake. Positive relationships were observed with the intake of milk (P(trend)=0.007), calcium (P(trend)<0.001), magnesium (P(trend)=0.003), phosphorus (P(trend)<0.001), potassium (P(trend)=0.002), vitamin B6 (P(trend)=0.03), vitamin B2 (P(trend)=0.001) and inverse relationships with vegetables (P(trend)=0.02) and beta-carotene (P(trend)=0.02). IGFBP-3 was not related with most of the nutrients and foods in this study. CONCLUSIONS: In this population, circulating IGF-I is modestly related with the intake of protein and minerals, and with milk and cheese, while IGFBP-3 does not appear to be related with diet

Eating out of home and its correlates in 10 European countries. The European Prospective Investigation into Cancer and Nutrition (EPIC) study

Orfanos P., Naska A., Trichopoulos D., Slimani N., Ferrari P., van Bakel M., Deharveng G., Overvad K., Tjonneland A., Halkjaer J., Santucci de Magistris M., Tumino R., Pala V., Sacerdote C., Masala G., Skeie G., Engeset D., Lund E., Jakszyn P., Barricarte A., Chirlaque M.D., Martinez-Garcia C., Amiano P., Quiros J.R., Bingham S., Welch A., Spencer E.A., Key T.J., Rohrmann S., Linseisen J., Ray J., Boeing H., Peeters P.H., Bueno-de-Mesquita H.B., Ocke M., Johansson I., Johansson G., Berglund G., Manjer J., Boutron-Ruault M.C., Touvier M., Clavel-Chapelon F., Trichopoulou A.

Public Health Nutr; 2007; 10(12): 1515-1525

Abstract as provided by PubMed

OBJECTIVE: To compare the average out-of-home (OH) consumption of foods and beverages, as well as energy intake, among populations from 10 European countries and to describe the characteristics of substantial OH eaters, as defined for the purpose of the present study, in comparison to other individuals. DESIGN: Cross-sectional study. Dietary data were collected through single 24-hour dietary recalls, in which the place of consumption was recorded. For the present study, substantial OH eaters were defined as those who consumed more than 25% of total daily energy intake at locations other than the household premises. Mean dietary intakes and the proportion of substantial OH eaters are presented by food group and country. Logistic regression analyses were used to estimate the odds of being a substantial OH eater in comparison to not being one, using mutually adjusted possible non-dietary determinants. SETTING: Ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). SUBJECTS: The subjects were 34 270 individuals, 12 537 men and 21 733 women, aged 35-74 years. RESULTS: The fraction of energy intake during OH eating was generally higher in northern European countries than in the southern ones. Among the food and beverage groups, those selectively consumed outside the home were coffee/tea/waters and sweets and, to a lesser extent, cereals, meats, added lipids and vegetables. Substantial OH eating was positively associated with energy intake and inversely associated with age and physical activity. Substantial OH eating was less common among the less educated compared with the more educated, and more common during weekdays in central and north Europe and during the weekend in south Europe. CONCLUSIONS: Eating outside the home was associated with sedentary lifestyle and increased energy intake; it was more common among the young and concerned in particular coffee/tea/waters and sweets

CagA+ Helicobacter pylori infection and gastric cancer risk in the EPIC-EURGAST study

Palli D., Masala G., Del Giudice G., Plebani M., Basso D., Berti D., Numans E., Ceroti M., Peeters P.H., Bueno de Mesquita H.B., Buchner F.L., Clavel-Chapelon F., Boutron-Ruault M.C., Krogh V., Saieva C., Vineis P., Panico S., Tumino R., Nyren O., Siman H., Berglund G., Hallmans G., Sanchez M.J., Larranaga N., Barricarte A., Navarro C., Quiros J.R., Key T., Allen N., Bingham S., Khaw K.T., Boeing H., Weikert C., Linseisen J., Nagel G., Overvad K., Thomsen R.W., Tjonneland A., Olsen A., Trichoupoulou A., Trichopoulos D., Arvaniti A., Pera G., Kaaks R., Jenab M., Ferrari P., Nesi G., Carneiro F., Riboli E., Gonzalez C.A.

Int J Cancer; 2007; 120(4): 859-867

Abstract as provided by PubMed

Helicobacter pylori (H. pylori), atrophic gastritis, dietary and life-style factors have been associated with gastric cancer (GC). These factors have been evaluated in a large case-control study nested in the European Prospective Investigation into Cancer and Nutrition carried out in 9 countries, including the Mediterranean area. Participants, enrolled in 1992-1998, provided life-style and dietary information and a blood sample (360,000; mean follow-up: 6.1 years). For 233 GC cases diagnosed after enrolment and their 910 controls individually-matched by center, gender, age and blood donation date H. pylori antibodies (antilysate and antiCagA) and plasma Pepsinogen A (PGA) were measured by ELISA methods. Severe chronic atrophic gastritis (SCAG) was defined as PGA circulating levels <22 mug/l. Overall, in a conditional logistic regression analysis adjusted for education, smoke, weight and consumption of total vegetables, fruit, red and preserved meat, H. pylori seropositivity was associated with GC risk. Subjects showing only antibodies anti-H. pylori lysate, however, were not at increased risk, while those with antiCagA antibodies had a 3.4-fold increased risk. Overall, the odds ratio associated with SCAG was 3.3 (95% CI 2.2-5.2). According to site, the risk of noncardia GC associated with CagA seropositivity showed a further increase (OR 6.5; 95% CI 3.3-12.6); on the other hand, a ten-fold increased risk of cardia GC was associated with SCAG (OR 11.0; 95% CI 3.0-40.9). These results support the causal relationship between H. pylori CagA+ strains infection, and GC in these European populations even after taking into account dietary habits. This association was limited to distal GC, while serologically defined SCAG was strongly associated with cardia GC, thus suggesting a divergent risk pattern for these 2 sites. (c) 2006 Wiley-Liss, Inc

Serum IGF-I, its major binding protein (IGFBP-3) and epithelial ovarian cancer risk: the European Prospective Investigation into Cancer and Nutrition (EPIC)

Peeters P.H., Lukanova A., Allen N., Berrino F., Key T., Dossus L., Rinaldi S., Van Gils C.H., Bueno-de-Mesquita H.B., Boeing H., Schulz M., Chang-Claude J., Linseisen J., Panico S., Sacerdote C., Palli D., Tumino R., Trichopoulou A., Trichopolos D., Bamia C., Larranaga N., Ardanaz E., Pera G., Quiros J.R., Martinez-Garcia C., Navarro C., Bingham S.A., Khaw K.T., Clavel F., Tjonneland A., Olsen A., Overvad K., Tetsche M.S., Lund E., Lundin E., Berglund G., Riboli E., Kaaks R.

Endocr Relat Cancer; 2007; 14(1): 81-90

Abstract as provided by PubMed

We set out to study the relationship between circulating levels of IGF-I and its major binding protein (IGFBP-3) in relation to ovarian cancer risk. We conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition. Levels of IGF-I and IGFBP-3 were measured in prediagnostic serum samples of 214 women who subsequently developed ovarian cancer, and 388 matched control subjects. Conditional logistic regression models were used to estimate relative risks of ovarian cancer by tertiles of IGF-I and IGFBP-3 levels. For all women, there was no association between the circulating IGF-I or IGFBP-3 levels and the risk of ovarian cancer. However, among women diagnosed with ovarian cancer aged 55 or younger, the relative risk was higher in the middle or top tertiles of serum IGF-I, when compared with women in the lowest tertile (odds ratios (OR) = 1.8 (95%CI 0.7-4.3) and OR = 2.4 (95%CI 0.9-6.4); P(trend) = 0.08) respectively. These results were adjusted for body mass index, previous hormone use, fertility problems, and parity. Restricting the analysis to women who were premenopausal at blood donation, relative risks for ovarian cancer diagnosed before age 55 were higher (OR = 5.1 (95%CI 1.5-18.2) and OR = 5.6 (95%CI 1.5-20.8) respectively, for second and third tertiles; P(trend) = 0.02). Adjustment for serum IGFBP-3 levels only slightly attenuated relative risk estimates. Relations between IGFBP-3 and ovarian cancer before age 55 were in the same direction as for IGF-I, but less strong and statistically not significant. In women aged over 55, there was no association between serum IGF-I or IGFBP-3 and ovarian cancer risk. Our results suggest that the circulating levels of IGF-I may play a potentially important role in the development of ovarian cancer in women of a pre- or perimenopausal age

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