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Search Result (484 REFERENCES)

2007

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

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

Variations in plasma phytoestrogen concentrations in European adults

Peeters P.H., Slimani N., van der Schouw Y.T., Grace P.B., Navarro C., Tjonneland A., Olsen A., Clavel-Chapelon F., Touillaud M., Boutron-Ruault M.C., Jenab M., Kaaks R., Linseisen J., Trichopoulou A., Trichopoulos D., Dilis V., Boeing H., Weikert C., Overvad K., Pala V., Palli D., Panico S., Tumino R., Vineis P., Bueno-de-Mesquita H.B., Van Gils C.H., Skeie G., Jakszyn P., Hallmans G., Berglund G., Key T.J., Travis R., Riboli E., Bingham S.A.

J Nutr; 2007; 137(5): 1294-1300

Abstract as provided by PubMed

Dietary phytoestrogens may play a role in chronic disease occurrence. The aim of our study was to assess the variability of plasma concentrations in European populations. We included 15 geographical regions in 9 European countries (Denmark, France, Germany, Greece, Italy, Spain, Sweden, The Netherlands, and UK) and a 16th region, Oxford, UK, where participants were recruited from among vegans and vegetarians. All subjects were participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). Plasma concentrations of 3 isoflavones (daidzein, genistein, and glycitein), 2 metabolites of daidzein [O-desmethylangolensin (O-DMA) and equol] and 2 mammalian lignans (enterodiol and enterolactone) were measured in 1414 participants. We computed geometric means for each region and used multivariate regression analysis to assess the influence of region, adjusted for gender, age, BMI, alcohol intake, smoking status, and laboratory batch. Many subjects had concentrations below the detection limit [0.1 microg/L (0.4 nmol/L)] for glycitein (80%), O-DMA (73%) and equol (62%). Excluding subjects from Oxford, UK, the highest concentrations of isoflavones were in subjects from the Netherlands and Cambridge, UK [2-6 microg/L (7-24 nmol/L); P < 0.05], whereas concentrations for lignans were highest in Denmark [8 microg/L (27 nmol/L); P < 0.05]. Isoflavones varied 8- to 13-fold, whereas lignans varied 4-fold. In the vegetarian/vegan cohort of Oxford, concentrations of isoflavones were 5-50 times higher than in nonvegetarian regions. Region was the most important determinant of plasma concentrations for all 7 phytoestrogens. Despite the fact that plasma concentrations of phytoestrogens in Europe were low compared with Asian populations, they varied substantially among subjects from the 16 different regions

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

Endogenous androgens and risk of epithelial ovarian cancer: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)

Rinaldi S., Dossus L., Lukanova A., Peeters P.H., Allen N.E., Key T., Bingham S., Khaw K.T., Trichopoulos D., Trichopoulou A., Oikonomou E., Pera G., Larranaga N., Martinez-Garcia C., Ardanaz E., Quiros J.R., Tormo M.J., Tjonneland A., Olsen A., Overvad K., Chang-Claude J., Linseisen J., Schulz M., Boeing H., Van Gils C.H., Bueno-de-Mesquita B.H., Pala V., Palli D., Panico S., Tumino R., Vineis P., Clavel-Chapelon F., Mesrine S., Boutron-Ruault M.C., Lundin E., Agren A., Berglund G., Manjer J., Kumle M., Lund E., Slimani N., Saracci R., Riboli E., Kaaks R.

Cancer Epidemiol Biomarkers Prev; 2007; 16(1): 23-29

Abstract as provided by PubMed

Few epidemiologic studies have examined the hypothesis that circulating androgens are involved in the development of ovarian cancer. We investigated the association between prediagnostic serum levels of androgens and sex hormone-binding globulin (SHBG) and ovarian cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort. One hundred and ninety-two ovarian cancer cases and 346 matched controls not using exogenous hormones at baseline blood donation were eligible for the study. Serum levels of testosterone, androstenedione, dehydroepiandrosterone sulfate, and SHBG were measured by direct immunoassays. Free testosterone (fT) was calculated according to mass action laws. Multivariate conditional logistic regression was used to estimate odds ratios adjusted for possible confounders. Overall, there was no association between serum concentrations of androgens or SHBG and ovarian cancer risk. In postmenopausal women, fT concentrations were inversely related to risk [highest versus lowest tertile odds ratio 0.45 (0.24-0.86); P(trend) = 0.01]. Among women diagnosed before the age of 55 years, there was a negative association with SHBG and a positive association with fT and ovarian cancer risk, although these associations were not statistically significant. The present study suggests that circulating androgens and SHBG levels are not strongly associated with ovarian cancer risk, although levels of fT may be associated with an increased risk among women diagnosed at relatively young age. The heterogeneity of results on the associations of fT with ovarian cancer risk in postmenopausal women deserves further investigation

Fruit and vegetable consumption and lymphoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

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

Cancer Causes Control; 2007; 18(5): 537-549

Abstract as provided by PubMed

INTRODUCTION: Lymphomas are a heterogeneous group of malignant diseases of cells of the immune system. The best-established risk factors are related to dys-regulation of immune function, and evidence suggests that factors such as dietary or lifestyle habits may be involved in the etiology. MATERIAL AND METHODS: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 849 lymphoma cases were identified in a median follow-up period of 6.4 years. Fruit and vegetable consumption was estimated from validated dietary questionnaires. Cox proportional hazard models were used to examine the association between fruit and vegetable intake with the risk of lymphomas overall and subentities. RESULTS: There was no overall association between total fruit and vegetable consumption and risk of lymphoma [hazard ratio (HR) = 0.95, 95% confidence interval (CI) 0.78-1.15 comparing highest with lowest quartile]. However, the risk of diffuse large B-cell lymphomas (DLBCL) tended to be lower in participants with a high intake of total vegetables (HR = 0.49, 95% CI 0.23-1.02). CONCLUSION: In this large prospective study, an inverse associations between fruit and vegetable consumption and risk of lymphomas overall could not be confirmed. Associations with lymphoma subentities such as DLBCL warrant further investigation

Haplotype-Based Analysis of Common Variation in the Acetyl-CoA Carboxylase {alpha} Gene and Breast Cancer Risk: A Case-Control Study Nested within the European Prospective Investigation into Cancer and Nutrition

Sinilnikova O.M., McKay J.D., Tavtigian S.V., Canzian F., DeSilva D., Biessy C., Monnier S., Dossus L., Boillot C., Gioia L., Hughes D.J., Jensen M.K., Overvad K., Tjonneland A., Olsen A., Clavel-Chapelon F., Chajes V., Joulin V., Linseisen J., Chang-Claude J., Boeing H., Dahm S., Trichopoulou A., Trichopoulos D., Koliva M., Khaw K.T., Bingham S., Allen N.E., Key T., Palli D., Panico S., Berrino F., Tumino R., Vineis P., Bueno-de-Mesquita H.B., Peeters P.H., Van Gils C.H., Lund E., Pera G., Quiros J.R., Dorronsoro M., Martinez Garcia C., Tormo M.J., Ardanaz E., Hallmans G., Lenner P., Berglund G., Manjer J., Riboli E., Lenoir G.M., Kaaks R.

Cancer Epidemiol Biomarkers Prev; 2007; 16(3): 409-415

Abstract as provided by PubMed

A key fatty acid synthesis enzyme, acetyl-CoA carboxylase alpha (ACC-alpha), has been shown to be highly expressed in human breast cancer and other tumor types and also to specifically interact with the protein coded by one of two major breast cancer susceptibility genes BRCA1. We used a comprehensive haplotype analysis to examine the contribution of the ACC-alpha common genetic variation (allele frequency >5%) to breast cancer in a case-control study (1,588 cases/2,600 controls) nested within the European Prospective Investigation into Cancer and Nutrition. We identified 21 haplotype-tagging polymorphisms efficiently capturing common variation within 325 kb of ACC-alpha and surrounding sequences using genotype data from the HapMap project and our resequencing data. We found an effect on overall risk of breast cancer in homozygous carriers of one common haplotype [odds ratio (OR), 1.74; 95% confidence interval (95% CI), 1.03-2.94]. When the data were subdivided by menopausal status, we found statistical evidence of heterogeneity for two other common haplotypes (P value for heterogeneity = 0.016 and 0.045). In premenopausal women, the carriers of these haplotypes, compared with noncarriers, had an altered risk of breast cancer (OR, 0.70; 95% CI, 0.53-0.92 and OR, 1.35; 95% CI, 1.04-1.76). These findings were not significant after adjustment for multiple testing and therefore should be considered as preliminary and evaluated in larger independent studies. However, they suggest a possible role of the ACC-alpha common sequence variants in susceptibility to breast cancer and encourage studies of other genes involved in fatty acid synthesis. (Cancer Epidemiol Biomarkers Prev 2007;16(3):409-15)

The EPIC nutrient database project (ENDB): a first attempt to standardize nutrient databases across the 10 European countries participating in the EPIC study

Slimani N., Deharveng G., Unwin I., Southgate D.A., Vignat J., Skeie G., Salvini S., Parpinel M., Moller A., Ireland J., Becker W., Farran A., Westenbrink S., Vasilopoulou E., Unwin J., Borgejordet A., Rohrmann S., Church S., Gnagnarella P., Casagrande C., van Bakel M., Niravong M., Boutron-Ruault M.C., Stripp C., Tjonneland A., Trichopoulou A., Georga K., Nilsson S., Mattisson I., Ray J., Boeing H., Ocke M., Peeters P.H., Jakszyn P., Amiano P., Engeset D., Lund E., de Magistris M.S., Sacerdote C., Welch A., Bingham S., Subar A.F., Riboli E.

Eur J Clin Nutr; 2007; 61(9): 1037-1056

Abstract as provided by PubMed

OBJECTIVE: This paper describes the ad hoc methodological concepts and procedures developed to improve the comparability of Nutrient databases (NDBs) across the 10 European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). This was required because there is currently no European reference NDB available. DESIGN: A large network involving national compilers, nutritionists and experts on food chemistry and computer science was set up for the 'EPIC Nutrient DataBase' (ENDB) project. A total of 550-1500 foods derived from about 37,000 standardized EPIC 24-h dietary recalls (24-HDRS) were matched as closely as possible to foods available in the 10 national NDBs. The resulting national data sets (NDS) were then successively documented, standardized and evaluated according to common guidelines and using a DataBase Management System specifically designed for this project. The nutrient values of foods unavailable or not readily available in NDSs were approximated by recipe calculation, weighted averaging or adjustment for weight changes and vitamin/mineral losses, using common algorithms. RESULTS: The final ENDB contains about 550-1500 foods depending on the country and 26 common components. Each component value was documented and standardized for unit, mode of expression, definition and chemical method of analysis, as far as possible. Furthermore, the overall completeness of NDSs was improved (>or=99%), particularly for beta-carotene and vitamin E. CONCLUSION: The ENDB constitutes a first real attempt to improve the comparability of NDBs across European countries. This methodological work will provide a useful tool for nutritional research as well as end-user recommendations to improve NDBs in the future

Alcohol intake and breast cancer risk: the European Prospective Investigation into Cancer and Nutrition (EPIC)

Tjonneland A., Christensen J., Olsen A., Stripp C., Thomsen B.L., Overvad K., Peeters P.H., Van Gils C.H., Bueno-de-Mesquita H.B., Ocke M.C., Thiebaut A., Fournier A., Clavel-Chapelon F., Berrino F., Palli D., Tumino R., Panico S., Vineis P., Agudo A., Ardanaz E., Martinez-Garcia C., Amiano P., Navarro C., Quiros J.R., Key T.J., Reeves G., Khaw K.T., Bingham S., Trichopoulou A., Trichopoulos D., Naska A., Nagel G., Chang-Claude J., Boeing H., Lahmann P.H., Manjer J., Wirfalt E., Hallmans G., Johansson I., Lund E., Skeie G., Hjartaker A., Ferrari P., Slimani N., Kaaks R., Riboli E.

Cancer Causes Control; 2007; 18(4): 361-373

Abstract as provided by PubMed

OBJECTIVE: Most epidemiologic studies have suggested an increased risk of breast cancer with increasing alcohol intake. Using data from 274,688 women participating in the European Prospective Investigation into Cancer and Nutrition study (EPIC), we investigated the relation between alcohol intake and the risk of breast cancer. METHODS: Incidence rate ratios (IRRs) based on Cox proportional hazard models were calculated using reported intake of alcohol, recent (at baseline) and lifetime exposure. We adjusted for known risk factors and stratified according to study center as well as potentially modifying host factors. RESULTS: During 6.4 years of follow up, 4,285 invasive cases of breast cancer within the age group 35-75 years were identified. For all countries together the IRR per 10 g/day higher recent alcohol intake (continuous) was 1.03 (95% confidence interval (CI): 1.01-1.05). When adjusted, no association was seen between lifetime alcohol intake and risk of breast cancer. No difference in risk was shown between users and non-users of HRT, and there was no significant interaction between alcohol intake and BMI, HRT or dietary folate. CONCLUSION: This large European study supports previous findings that recent alcohol intake increases the risk of breast cancer

Serum androgens and prostate cancer among 643 cases and 643 controls in the European Prospective Investigation into Cancer and Nutrition

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

Int J Cancer; 2007; 121(6): 1331-1338

Abstract as provided by PubMed

We examined the hypothesis that serum concentrations of circulating androgens and sex hormone binding globulin (SHBG) are associated with risk for prostate cancer in a case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC). Concentrations of androstenedione, testosterone, androstanediol glucuronide and SHBG were measured in serum samples for 643 prostate cancer cases and 643 matched control participants, and concentrations of free testosterone were calculated. Conditional logistic regression models were used to calculate odds ratios for risk of prostate cancer in relation to the serum concentration of each hormone. After adjustment for potential confounders, there was no significant association with overall risk for prostate cancer for serum total or free testosterone concentrations (highest versus the lowest thirds: OR, 1.02; 95% CI, 0.73-1.41 and OR, 1.07, 95% CI, 0.74-1.55, respectively) or for other androgens or SHBG. Subgroup analyses showed significant heterogeneity for androstenedione by cancer stage, with a significant inverse association of androstenedione concentration and risk for advanced prostate cancer. There were also weak positive associations between free testosterone concentration and risk for total prostate cancer among younger men and risk for high-grade disease. In summary, in this large nested case-control study, concentrations of circulating androgens or SHBG were not strongly associated with risk for total prostate cancer. However, our findings are compatible with a positive association of free testosterone with risk in younger men and possible heterogeneity in the association with androstenedione concentration by stage of disease; these findings warrant further investigation. (c) 2007 Wiley-Liss, Inc

Modified Mediterranean diet and survival after myocardial infarction: the EPIC-Elderly study

Trichopoulou A., Bamia C., Norat T., Overvad K., Schmidt E.B., Tjonneland A., Halkjaer J., Clavel-Chapelon F., Vercambre M.N., Boutron-Ruault M.C., Linseisen J., Rohrmann S., Boeing H., Weikert C., Benetou V., Psaltopoulou T., Orfanos P., Boffetta P., Masala G., Pala V., Panico S., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., Ocke M.C., Peeters P.H., van der Schouw Y.T., Gonzalez C., Sanchez M.J., Chirlaque M.D., Moreno C., Larranaga N., Van Guelpen B., Jansson J.H., Bingham S., Khaw K.T., Spencer E.A., Key T., Riboli E., Trichopoulos D.

Eur J Epidemiol; 2007; 22(12): 871-881

Abstract as provided by PubMed

Mediterranean diet is associated with lower incidence of coronary heart disease, and two randomised trials indicated that it improves prognosis of coronary patients. These trials, however, relied on a total of 100 deaths and evaluated designer diets in the clinical context. We have evaluated the association of adherence to the modified Mediterranean diet, in which unsaturates were substituted for monounsaturates, with survival among elderly with previous myocardial infarction within the European Prospective Investigation into Cancer and nutrition (EPIC) study. As of December 2003, after a median follow-up of 6.7 years, 2671 EPIC participants from nine countries were 60 years or older and had prevalent myocardial infarction but no stroke or cancer at enrolment, complete information on dietary intakes and important covariates and known survival status. Adherence to the modified Mediterranean diet was assessed through a 10-unit-scale. Mortality ratio in relation to modified Mediterranean diet was estimated through Cox regression controlling for possible confounding. Increased adherence to modified Mediterranean diet by two units was associated with 18% lower overall mortality rate (95% confidence interval 7-27%, fixed effects model). There was no significant heterogeneity by sex, age at enrolment, or country, although the association tended to be less evident among northern Europeans. Associations between food groups contributing to the modified Mediterranean diet and mortality were generally weak. A diet inspired by the Mediterranean pattern that can be easily adopted by Western populations is associated with substantial reduction of total mortality of coronary patients in the community

Lung cancers attributable to environmental tobacco smoke and air pollution in non-smokers in different European countries: a prospective study

Vineis P., Hoek G., Krzyzanowski M., Vigna-Taglianti F., Veglia F., Airoldi L., 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 H.B., Peeters P.H., Lund E.E., Agudo A., Martinez C., Dorronsoro M., Barricarte A., Cirera L., Quiros J.R., Berglund G., Manjer J., Forsberg B., Day N.E., Key T.J., Kaaks R., Saracci R., Riboli E.

Environ Health; 2007; 7

Abstract as provided by PubMed

BACKGROUND: Several countries are discussing new legislation on the ban of smoking in public places, and on the acceptable levels of traffic-related air pollutants. It is therefore useful to estimate the burden of disease associated with indoor and outdoor air pollution. METHODS: We have estimated exposure to Environmental Tobacco Smoke (ETS) and to air pollution in never smokers and ex-smokers in a large prospective study in 10 European countries (European Prospective Investigation into Cancer and Nutrition)(N = 520,000). We report estimates of the proportion of lung cancers attributable to ETS and air pollution in this population. RESULTS: The proportion of lung cancers in never- and ex-smokers attributable to ETS was estimated as between 16 and 24%, mainly due to the contribution of work-related exposure. We have also estimated that 5-7% of lung cancers in European never smokers and ex-smokers are attributable to high levels of air pollution, as expressed by NO2 or proximity to heavy traffic roads. NO2 is the expression of a mixture of combustion (traffic-related) particles and gases, and is also related to power plants and waste incinerator emissions. DISCUSSION: We have estimated risks of lung cancer attributable to ETS and traffic-related air pollution in a large prospective study in Europe. Information bias can be ruled out due to the prospective design, and we have thoroughly controlled for potential confounders, including restriction to never smokers and long-term ex-smokers. Concerning traffic-related air pollution, the thresholds for indicators of exposure we have used are rather strict, i.e. they correspond to the high levels of exposure that characterize mainly Southern European countries (levels of NO2 in Denmark and Sweden are closer to 10-20 ug/m3, whereas levels in Italy are around 30 or 40, or higher).Therefore, further reduction in exposure levels below 30 ug/m3 would correspond to additional lung cancer cases prevented, and our estimate of 5-7% is likely to be an underestimate. Overall, our prospective study draws attention to the need for strict legislation concerning the quality of air in Europe

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