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2008

Smoking and lymphoma risk in the European prospective investigation into cancer and nutrition

Nieters A., Rohrmann S., Becker N., Linseisen J., Ruediger T., Overvad K., Tjonneland A., Olsen A., Allen N.E., Travis R.C., Bingham S., Khaw K.T., Ardanaz E., Redondo M.L., Basterrechea M., Martinez C., Tormo M.J., Rosso S., Tagliabue G., Masala G., Mattiello A., Tumino R., Boeing H., Bergmann M., Kaaks R., Trichopoulou A., Trichopoulos D., Peeters P.H., Bueno-de-Mesquita B., Boffetta P., Brennan P., Ferrari P., Neasham D., Lund E., Berglund G., Manjer J., Hallmans G., Johansson I., Vineis P., Riboli E.

Am J Epidemiol; 2008; 167(9): 1081-1089

PMID:18321867

Abstract as provided by PubMed

Lymphomas are one of the few cancers that have been increasing in incidence over the past decades. So far, only a few established risk factors have been identified, including immunosuppression and viral infections. Recent evidence suggests etiologic heterogeneity of different lymphoma subtypes. Smoking may affect risk differently, depending on the lymphoma entity. The European Prospective Investigation into Cancer and Nutrition was used to study the role of smoking in the etiology of lymphomas and individual subtypes within a prospective study. Information on baseline and lifetime tobacco smoking by 478,590 participants was collected between 1992 and 2000. Cox proportional hazards regression was used to calculate multivariate-adjusted hazard ratios and 95% confidence intervals. During 3,567,410 person-years of follow-up, 1,371 lymphoma cases (1,304 non-Hodgkin's lymphomas and 67 Hodgkin's lymphomas) were identified. Relative risk for smokers at recruitment was more than twofold higher for Hodgkin's lymphoma (hazard ratio = 2.14, 95% confidence interval: 1.18, 3.87) but was not elevated for non-Hodgkin's lymphoma (hazard ratio = 1.06, 95% confidence interval: 0.94, 1.19) and individual B-cell non-Hodgkin's lymphoma subtypes. In this prospective study, smoking appeared to increase Hodgkin's lymphoma risk consistently in both genders, whereas B-cell non-Hodgkin's lymphoma risk was not associated. Future analysis should involve viral biomarkers and genetic susceptibility markers to elucidate potential mechanisms of smoking-induced carcinogenesis, particularly for Hodgkin's lymphoma

Intake of vegetables, legumes, and fruit, and risk for all-cause, cardiovascular, and cancer mortality in a European diabetic population

Nothlings U., Schulze M.B., Weikert C., Boeing H., van der Schouw Y.T., Bamia C., Benetou V., Lagiou P., Krogh V., Beulens J.W., Peeters P.H., Halkjaer J., Tjonneland A., Tumino R., Panico S., Masala G., Clavel-Chapelon F., de Lauzon B., Boutron-Ruault M.C., Vercambre M.N., Kaaks R., Linseisen J., Overvad K., Arriola L., Ardanaz E., Gonzalez C.A., Tormo M.J., Bingham S., Khaw K.T., Key T.J., Vineis P., Riboli E., Ferrari P., Boffetta P., Bueno-de-Mesquita H.B., van der A D.L., Berglund G., Wirfalt E., Hallmans G., Johansson I., Lund E., Trichopoulo A.

J Nutr; 2008; 138(4): 775-781

PMID:18356334

Abstract as provided by PubMed

We examined the associations of intake of vegetables, legumes and fruit with all-cause and cause-specific mortality in a population with prevalent diabetes in Europe. A cohort of 10,449 participants with self-reported diabetes within the European Prospective Investigation into Cancer and Nutrition study was followed for a mean of 9 y. Intakes of vegetables, legumes, and fruit were assessed at baseline between 1992 and 2000 using validated country-specific questionnaires. A total of 1346 deaths occurred. Multivariate relative risks (RR) for all-cause mortality were estimated in Cox regression models and RR for cause-specific mortality were derived in a competing risk model. An increment in intake of total vegetables, legumes, and fruit of 80 g/d was associated with a RR of death from all causes of 0.94 [95% CI 0.90-0.98]. Analyzed separately, vegetables and legumes were associated with a significantly reduced risk, whereas nonsignificant inverse associations for fruit intake were observed. Cardiovascular disease (CVD) mortality and mortality due to non-CVD/non-cancer causes were significantly inversely associated with intake of total vegetables, legumes, and fruit (RR 0.88 [95% CI 0.81-0.95] and 0.90 [0.82-0.99], respectively) but not cancer mortality (1.08 [0.99-1.17]). Intake of vegetables, legumes, and fruit was associated with reduced risks of all-cause and CVD mortality in a diabetic population. The findings support the current state of evidence from general population studies that the protective potential of vegetable and fruit intake is larger for CVD than for cancer and suggest that diabetes patients may benefit from a diet high in vegetables and fruits

A food pattern that is predictive of flavonol intake and risk of pancreatic cancer

Nothlings U., Murphy S.P., Wilkens L.R., Boeing H., Schulze M.B., Bueno-de-Mesquita H.B., Michaud D.S., Roddam A., Rohrmann S., Tjonneland A., Clavel-Chapelon F., Trichopoulou A., Sieri S., Rodriguez L., Ye W., Jenab M., Kolonel L.N.

Am J Clin Nutr; 2008; 88(6): 1653-1662

PMID:19064528

Abstract as provided by PubMed

BACKGROUND: In the Multiethnic Cohort (MEC) study, we showed inverse associations between flavonols and pancreatic cancer risk. OBJECTIVE: We aimed to define a food pattern associated with intakes of quercetin, kaempferol, and myricetin; to examine the association of that pattern with pancreatic cancer risk; and to investigate the associations in an independent study. DESIGN: Reduced rank regression was applied to dietary data for 183 513 participants in the MEC. A food group pattern was extracted and simplified and applied to dietary data of 424 978 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Dietary intake in both studies was assessed by using specially developed questionnaires. Multivariate Cox proportional hazards models were used to estimate relative risks for pancreatic cancer in the MEC (610 cases) and the EPIC (517 cases) studies. RESULTS: The food group pattern consisted mainly of tea, fruit, cabbage, and wine. In the MEC, inverse associations with pancreatic cancer in smokers were observed for the food group pattern [relative risk: 0.59 (95% CI: 0.31, 1.12) when extreme quintiles were compared; P for trend = 0.03]. In the EPIC study, the simplified pattern was not associated with pancreatic cancer risk (P for trend = 0.78). CONCLUSIONS: A food pattern associated with the intake of quercetin, kaempferol, and myricetin was associated with lower pancreatic cancer risk in smokers in a US-based population. However, failure to replicate the associations in an independent study weakens the conclusions and raises questions about the utility of food patterns for flavonols across populations

Bulky DNA adducts, 4-aminobiphenyl-haemoglobin adducts and diet in the European Prospective Investigation into Cancer and Nutrition (EPIC) prospective study

Peluso M., Airoldi L., Munnia A., Colombi A., Veglia F., Autrup H., Dunning A., Garte S., Gormally E., Malaveille C., Matullo G., Overvad K., Raaschou-Nielsen O., Clavel-Chapelon F., Linseisen J., Boeing H., Trichopoulou A., Palli D., Krogh V., Tumino R., Panico S., Bueno-de-Mesquita B.H., Peeters P.H., Kumle M., Agudo A., Martinez C., Dorronsoro M., Barricarte A., Tormo M.J., Quiros J.R., Berglund G., Jarvholm B., Day N.E., Key T.J., Saracci R., Kaaks R., Riboli E., Bingham S., Vineis P.

Br J Nutr; 2008; 100(3): 489-495

PMID:18275627

Abstract as provided by PubMed

In contrast to some extensively examined food mutagens, for example, aflatoxins, N-nitrosamines and heterocyclic amines, some other food contaminants, in particular polycyclic aromatic hydrocarbons (PAH) and other aromatic compounds, have received less attention. Therefore, exploring the relationships between dietary habits and the levels of biomarkers related to exposure to aromatic compounds is highly relevant. We have investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort the association between dietary items (food groups and nutrients) and aromatic DNA adducts and 4-aminobiphenyl-Hb adducts. Both types of adducts are biomarkers of carcinogen exposure and possibly of cancer risk, and were measured, respectively, in leucocytes and erythrocytes of 1086 (DNA adducts) and 190 (Hb adducts) non-smokers. An inverse, statistically significant, association has been found between DNA adduct levels and dietary fibre intake (P = 0.02), vitamin E (P = 0.04) and alcohol (P = 0.03) but not with other nutrients or food groups. Also, an inverse association between fibre and fruit intake, and BMI and 4-aminobiphenyl-Hb adducts (P = 0.03, 0.04, and 0.03 respectively) was observed. After multivariate regression analysis these inverse correlations remained statistically significant, except for the correlation adducts v. fruit intake. The present study suggests that fibre intake in the usual range can modify the level of DNA or Hb aromatic adducts, but such role seems to be quantitatively modest. Fibres could reduce the formation of DNA adducts in different manners, by diluting potential food mutagens and carcinogens in the gastrointestinal tract, by speeding their transit through the colon and by binding carcinogenic substances

Body size and risk of prostate cancer in the European prospective investigation into cancer and nutrition

Pischon T., Boeing H., Weikert S., Allen N., Key T., Johnsen N.F., Tjonneland A., Severinsen M.T., Overvad K., Rohrmann S., Kaaks R., Trichopoulou A., Zoi G., Trichopoulos D., Pala V., Palli D., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., May A., Manjer J., Wallstrom P., Stattin P., Hallmans G., Buckland G., Larranaga N., Chirlaque M.D., Martinez C., Redondo Cornejo M.L., Ardanaz E., Bingham S., Khaw K.T., Rinaldi S., Slimani N., Jenab M., Riboli E.

Cancer Epidemiol Biomarkers Prev; 2008; 17(11): 3252-3261

PMID:18990768

Abstract as provided by PubMed

BACKGROUND: Body size has been hypothesized to influence the risk of prostate cancer; however, most epidemiologic studies have relied on body mass index (BMI) to assess adiposity, whereas only a few studies have examined whether body fat distribution predicts prostate cancer. METHODS: We examined the association of height, BMI, waist and hip circumference, and waist-hip ratio with prostate cancer risk among 129,502 men without cancer at baseline from 8 countries of the European Prospective Investigation into Cancer and Nutrition (EPIC), using Cox regression, with age as time metric, stratifying by study center and age at recruitment, and adjusting for education, smoking status, alcohol consumption, and physical activity. RESULTS: During a mean follow-up of 8.5 years, 2,446 men developed prostate cancer. Waist circumference and waist-hip ratio were positively associated with risk of advanced disease. The relative risk of advanced prostate cancer was 1.06 (95% confidence interval, 1.01-1.1) per 5-cm-higher waist circumference and 1.21 (95% confidence interval, 1.04-1.39) per 0.1-unit-higher waist-hip ratio. When stratified by BMI, waist circumference and waist-hip ratio were positively related to risk of total, advanced, and high-grade prostate cancer among men with lower but not among those with higher BMI (Pinteraction for waist with BMI, 0.25, 0.02, and 0.05, respectively; Pinteraction for waist-hip ratio with BMI, 0.27, 0.22, and 0.14; respectively). CONCLUSIONS: These data suggest that abdominal adiposity may be associated with an increased risk of advanced prostate cancer. This association may be stronger among individuals with lower BMI; however, this finding needs confirmation in future studies

General and abdominal adiposity and risk of death in Europe

Pischon T., Boeing H., Hoffmann K., Bergmann M., Schulze M.B., Overvad K., van der Schouw Y.T., Spencer E., Moons K.G., Tjonneland A., Halkjaer J., Jensen M.K., Stegger J., Clavel-Chapelon F., Boutron-Ruault M.C., Chajes V., Linseisen J., Kaaks R., Trichopoulou A., Trichopoulos D., Bamia C., Sieri S., Palli D., Tumino R., Vineis P., Panico S., Peeters P.H., May A.M., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Hallmans G., Weinehall L., Manjer J., Hedblad B., Lund E., Agudo A., Arriola L., Barricarte A., Navarro C., Martinez C., Quiros J.R., Key T., Bingham S., Khaw K.T., Boffetta P., Jenab M., Ferrari P., Riboli E.

N Engl J Med; 2008; 359(20): 2105-2120

PMID:19005195

Abstract as provided by PubMed

BACKGROUND: Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death. METHODS: We examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). We used a Cox regression analysis, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height. RESULTS: During a mean follow-up of 9.7 years, 14,723 participants died. The lowest risks of death related to BMI were observed at a BMI of 25.3 for men and 24.3 for women. After adjustment for BMI, waist circumference and waist-to-hip ratio were strongly associated with the risk of death. Relative risks among men and women in the highest quintile of waist circumference were 2.05 (95% confidence interval [CI], 1.80 to 2.33) and 1.78 (95% CI, 1.56 to 2.04), respectively, and in the highest quintile of waist-to-hip ratio, the relative risks were 1.68 (95% CI, 1.53 to 1.84) and 1.51 (95% CI, 1.37 to 1.66), respectively. BMI remained significantly associated with the risk of death in models that included waist circumference or waist-to-hip ratio (P<0.001). CONCLUSIONS: These data suggest that both general adiposity and abdominal adiposity are associated with the risk of death and support the use of waist circumference or waist-to-hip ratio in addition to BMI in assessing the risk of death

Glycosylated hemoglobin and risk of colorectal cancer in men and women, the European prospective investigation into cancer and nutrition

Rinaldi S., Rohrmann S., Jenab M., Biessy C., Sieri S., Palli D., Tumino R., Mattiello A., Vineis P., Nieters A., Linseisen J., Pischon T., Boeing H., Hallmans G., Palmqvist R., Manjer J., Wirfalt E., Crowe F.L., Khaw K.T., Bingham S., Tjonneland A., Olsen A., Overvad K., Lund E., Skeie G., Clavel-Chapelon F., Boutron-Ruault M.C., de Lauzon-Guillain B., Ardanaz E., Jakszyn P., Ramon Quiros J., Chirlaque M.D., Sanchez M.J., Dorronsoro M., Trichopoulou A., Lagiou P., Trichopoulos D., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Peeters P.H., Slimani N., Ferrari P., Byrnes G.B., Riboli E., Kaaks R.

Cancer Epidemiol Biomarkers Prev; 2008; 17(11): 3108-3115

PMID:18990751

Abstract as provided by PubMed

Although large-scale prospective cohort studies have related hyperglycemia to increased risk of cancer overall, studies specifically on colorectal cancer have been generally small. We investigated the association between prediagnostic levels of glycosylated hemoglobin (HbA1c), a marker for average glucose level in blood, and colorectal cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort. One thousand and twenty-six incident colorectal cancer cases (561 men and 465 women) and 1,026 matched controls were eligible for the study. Multivariate conditional logistic regression was used to estimate odds ratios (ORS) adjusted for possible confounders. Increasing HbA1c percentages were statistically significantly associated with a mild increase in colorectal cancer risk in the whole population [OR, 1.10; 95% confidence interval (CI), 1.01,1.19 for a 10% increase in HbA1c]. In women, increasing HbA1c percentages were associated with a statistically significant increase in colorectal cancer risk (OR, 1.16; 95% CI, 1.01, 1.32 for a 10% increase in HbA1c) and with a borderline statistically significant increase in rectum cancer (OR, 1.22; 95% CI, 0.99,1.50 for a 10% increase in HbA1c). No significant association with cancer risk was observed in men. The results of the current study suggest a mild implication of hyperglycemia in colorectal cancer, which seems more important in women than in men, and more for cancer of the rectum than of the colon

Alcohol consumption and the risk for prostate cancer in the European prospective investigation into cancer and nutrition

Rohrmann S., Linseisen J., Key T.J., Jensen M.K., Overvad K., Johnsen N.F., Tjonneland A., Kaaks R., Bergmann M.M., Weikert C., Naska A., Trichopoulou A., Trichopoulos D., Pala V., Sacerdote C., Palli D., Tumino R., Bueno-de-Mesquita H.B., Vrieling A., Gonzalez C.A., Larranaga N., Navarro C., Barricarte A., Quiros J.R., Martinez-Garcia C., Hallmans G., Stattin P., Manjer J., Wirfalt E., Bingham S., Khaw K.T., Egevad L., Ferrari P., Jenab M., Riboli E.

Cancer Epidemiol Biomarkers Prev; 2008; 17(5): 1282-1287

PMID:18483352

Abstract as provided by PubMed

Alcohol is a risk factor for several types of cancer. However, the results for prostate cancer have been inconsistent, with most studies showing no association. Within the European Prospective Investigation into Cancer and Nutrition, detailed information were collected from 142,607 male participants on the intake of alcoholic beverages at recruitment (for 100% of the cohort) and over lifetime (for 76% of the cohort) between 1992 and 2000. During a median follow-up of 8.7 years, 2,655 prostate cancer cases were observed. Multivariate Cox proportional hazard models were used to examine the association of alcohol consumption at recruitment and average lifetime alcohol consumption with prostate cancer adjusted for age, center, smoking, height, weight, physical activity, and nonalcohol energy intake. Overall, neither alcohol consumption at baseline nor average lifetime alcohol consumption was associated with the risk for prostate cancer in this cohort of men. Men who consumed >/=60 g alcohol per day had a relative risk of 0.88 [95% confidence interval (95% CI) 0.72-1.08] compared with men with an intake of 0.1-4.9 g/d; the respective relative risk for average lifetime intake was 1.09 (95% CI, 0.86-1.39). For advanced prostate cancer (n = 537), the relative risks for >/=60 and 0.1-4.9 g alcohol per day at baseline were 0.98 (95% CI, 0.66-1.44) and 1.28 (95% CI, 0.79-2-07), respectively, for average lifetime intake. No statistically significant association was observed for alcohol intake from specific alcoholic beverages. Our results indicate no association between the consumption of alcohol and prostate cancer in this cohort of European men. (Cancer Epidemiol Biomarkers Prev 2008;17(5):1282-7)

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

PMID:18996867

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

PMID:18624432

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

PMID:18048375

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

PMID:17548673

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

PMID:17657712

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

PMID:17381929

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

PMID:17454883

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

PMID:17670911

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

PMID:17914105

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

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

PMID:17062769

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

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

PMID:17285578

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

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

PMID:17295097

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

PMID:17640039

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

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

PMID:17357139

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

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

PMID:17297555

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

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

PMID:17372899

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

PMID:17823432

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

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