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2006

A comprehensive analysis of the androgen receptor gene and risk of breast cancer: results from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium (BPC3)

Cox D.G., Blanche H., Pearce C.L., Calle E.E., Colditz G.A., Pike M.C., Albanes D., Allen N.E., Amiano P., Berglund G., Boeing H., Buring J., Burtt N., Canzian F., Chanock S., Clavel-Chapelon F., Feigelson H.S., Freedman M., Haiman C.A., Hankinson S.E., Henderson B.E., Hoover R., Hunter D.J., Kaaks R., Kolonel L., Kraft P., Le Marchand L., Lund E., Palli D., Peeters P.H., Riboli E., Stram D.O., Thun M., Tjonneland A., Trichopoulos D., Yeager M.

Breast Cancer Res; 2006; 8(5): R54

Abstract as provided by PubMed

ABSTRACT: INTRODUCTION: Androgens have been hypothesised to influence risk of breast cancer through several possible mechanisms, including their conversion to estradiol or their binding to the oestrogen receptor and/or androgen receptor (AR) in the breast. Here, we report on the results of a large and comprehensive study of the association between genetic variation in the AR gene and risk of breast cancer in the National Cancer Institute Breast and Prostate Cancer Cohort Consortium (BPC3). METHODS: The underlying genetic variation was determined by first sequencing the coding regions of the AR gene in a panel of 95 advanced breast cancer cases. Second, a dense set of markers from the public database was genotyped in a panel of 349 healthy women. The linkage disequilibrium relationships (blocks) across the gene were then identified, and haplotype-tagging single nucleotide polymorphisms (htSNPs) were selected to capture the common genetic variation across the locus. The htSNPs were then genotyped in the nested breast cancer cases and controls from the Cancer Prevention Study II, European Prospective Investigation into Cancer and Nutrition, Multiethnic Cohort, Nurses' Health Study, and Women's Health Study cohorts (5,603 breast cancer cases and 7,480 controls). RESULTS: We found no association between any genetic variation (SNP, haplotype, or the exon 1 CAG repeat) in the AR gene and risk of breast cancer, nor were any statistical interactions with known breast cancer risk factors observed. CONCLUSION: Among postmenopausal Caucasian women, common variants of the AR gene are not associated with risk of breast cancer

Fish consumption and breast cancer risk. The European Prospective Investigation into Cancer and Nutrition (EPIC)

Engeset D., Alsaker E., Lund E., Welch A., Khaw K.T., Clavel-Chapelon F., Thiebaut A., Chajes V., Key T.J., Allen N.E., Amiano P., Dorronsoro M., Tjonneland A., Stripp C., Peeters P.H., Van Gils C.H., Chirlaque M.D., Nagel G., Linseisen J., Ocke M.C., Bueno-de-Mesquita H.B., Sacerdote C., Tumino R., Ardanaz E., Sanchez M.J., Panico S., Palli D., Trichopoulou A., Kalapothaki V., Benetou V., Quiros J.R., Agudo A., Overvad K., Bjerregaard L., Wirfalt E., Schulz M., Boeing H., Slimani N., Riboli E.

Int J Cancer; 2006; 119(1): 175-182

Abstract as provided by PubMed

There is current interest in fish consumption and marine omega-3 (n-3) fatty acids and breast cancer risk. Some in vitro and animal studies have suggested an inhibitory effect of marine n-3 fatty acids on breast cancer growth, but the results from epidemiological studies that have examined the association between fish consumption and breast cancer risk in humans are inconsistent. We examined fish consumption and breast cancer risk in 310,671 women aged between 25 and 70 yr at recruitment into the European Prospective Investigation Into Cancer and Nutrition (EPIC). The participants completed a dietary questionnaire between 1992-98 and were followed up for incidence of breast cancer for a median of 6.4 yr. Hazard ratio for breast cancer by intake of total and lean and fatty fish were estimated, stratified by study centre and adjusted for established breast cancer risk factors. During follow-up, 4,776 invasive incident breast cancers were reported. No significant associations between intake of total fish and breast cancer risk were observed, hazard ratio (HR) 1.01 (95% confidence interval [CI] 0.99-1.02; p = 0.28 per 10 g fish/day). When examining lean and fatty fish separately, we found a positive significant association only in the highest quintile for fatty fish (HR 1.13, 95% CI 1.01-1.26), but test for trend was not significant (p = 0.10). No associations with breast cancer risk were observed when the study participants were subdivided by menopausal status. Although the period of follow-up is relatively short, the results provide no evidence for an association between fish intake and breast cancer risk

Physical activity and risk of colon and rectal cancers: the European prospective investigation into cancer and nutrition

Friedenreich C., Norat T., Steindorf K., Boutron-Ruault M.C., Pischon T., Mazuir M., Clavel-Chapelon F., Linseisen J., Boeing H., Bergman M., Johnsen N.F., Tjonneland A., Overvad K., Mendez M., Quiros J.R., Martinez C., Dorronsoro M., Navarro C., Gurrea A.B., Bingham S., Khaw K.T., Allen N., Key T., Trichopoulou A., Trichopoulos D., Orfanou N., Krogh V., Palli D., Tumino R., Panico S., Vineis P., Bueno-de-Mesquita H.B., Peeters P.H., Monninkhof E., Berglund G., Manjer J., Ferrari P., Slimani N., Kaaks R., Riboli E.

Cancer Epidemiol Biomarkers Prev; 2006; 15(12): 2398-2407

PMID:17164362

Abstract as provided by PubMed

We investigated several aspects of the role of physical activity in colon and rectal cancer etiology that remain unclear in the European Prospective Investigation into Nutrition and Cancer. This cohort of 413,044 men and women had 1,094 cases of colon and 599 cases of rectal cancer diagnosed during an average of 6.4 years of follow-up. We analyzed baseline data on occupational, household, and recreational activity to examine associations by type of activity, tumor subsite, body mass index (BMI), and energy intake. The multivariate hazard ratio for colon cancer was 0.78 [95% confidence interval (95% CI), 0.59-1.03] among the most active participants when compared with the inactive, with evidence of a dose-response effect (P(trend) = 0.04). For right-sided colon tumors, the risk was 0.65 (95% CI, 0.43-1.00) in the highest quartile of activity with evidence of a linear trend (P(trend) = 0.004). Active participants with a BMI under 25 had a risk of 0.63 (95% CI, 0.39-1.01) for colon cancer compared with the inactive. Finally, an interaction between BMI and activity (P(interaction) = 0.03) was observed for right-sided colon cancers; among moderately active and active participants with a BMI under 25, a risk of 0.38 (95% CI, 0.21-0.68) was found as compared with inactive participants with BMI >30. No comparable decreased risks were observed for rectal cancer for any type of physical activity for any subgroup analyses or interactions considered. We found that physical activity reduced colon cancer risk, specifically for right-sided tumors and for lean participants, but not rectal cancer

Fruit and vegetable intake and the risk of stomach and oesophagus adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST)

Gonzalez C.A., Pera G., Agudo A., Bueno-de-Mesquita H.B., Ceroti M., Boeing H., Schulz M., Del Giudice G., Plebani M., Carneiro F., Berrino F., Sacerdote C., Tumino R., Panico S., Berglund G., Siman H., Hallmans G., Stenling R., Martinez C., Dorronsoro M., Barricarte A., Navarro C., Quiros J.R., Allen N., Key T.J., Bingham S., Day N.E., Linseisen J., Nagel G., Overvad K., Jensen M.K., Olsen A., Tjonneland A., Buchner F.L., Peeters P.H., Numans M.E., Clavel-Chapelon F., Boutron-Ruault M.C., Roukos D., Trichopoulou A., Psaltopoulou T., Lund E., Casagrande C., Slimani N., Jenab M., Riboli E.

Int J Cancer; 2006; 118(10): 2559-2566

Abstract as provided by PubMed

It is considered that fruit and vegetable (F&V) protect against oesophagus and gastric cancer (GC). However, 2 recent meta-analyses suggest that the strength of association on GC seems to be weaker for vegetables than for fruit and weaker in cohort than in case-control studies. No evidence exists from cohort studies about adenocarcinoma of oesophagus (ACO). In 521,457 men and women participating in the EPIC cohort in 10 European countries, information of diet and lifestyle was collected at baseline. After an average of 6.5 years of follow-up, a total of 330 GC and 65 ACO, confirmed and classified by a panel of pathologists, was used for the analysis. We examined the relation between F&V intake and GC and ACO. A calibration study in a sub-sample was used to control diet measurement errors. In a sub-sample of cases and a random sample of controls, antibodies against Helicobacter pylori (Hp) were measured and interactions with F&V were examined in a nested case-control study. We observed no association with total vegetable intake or specific groups of vegetables and GC risk, except for the intestinal type, where a negative association is possible regarding total vegetable (calibrated HR 0.66; 95% CI 0.35-1.22 per 100 g increase) and onion and garlic intake (calibrated HR 0.70; 95% CI 0.38-1.29 per 10 g increase). No evidence of association between fresh fruit intake and GC risk was observed. We found a negative but non significant association between citrus fruit intake and the cardia site (calibrated HR 0.77; 95% CI 0.47-1.22 per 100 g increase) while no association was observed with the non-cardia site. Regarding ACO, we found a non significant negative association for vegetable intake and for citrus intake (calibrated HRs 0.72; 95% CI 0.32-1.64 and 0.77; 95% CI 0.46-1.28 per 100 and 50 g increase, respectively). It seems that Hp infection does not modify the effect of F&V intake. Our study supports a possible protective role of vegetable intake in the intestinal type of GC and the ACO. Citrus fruit consumption may have a role in the protection against cardia GC and ACO

Meat intake and risk of stomach and esophageal adenocarcinoma within the European Prospective Investigation Into Cancer and Nutrition (EPIC)

Gonzalez Carlos A., Jakszyn Paula, Pera Guillem, Agudo Antonio, Bingham Sheila, Palli Domenico, Ferrari Pietro, Boeing Heiner, del Giudice Giuseppe, Plebani Mario, Carneiro Fatima, Nesi Gabriella, Berrino Franco, Sacerdote Carlotta, Tumino Rosario, Panico Salvatore, Berglund Goran, Siman Henrik, Nyren Olof, Hallmans Goran, Martinez Carmen, Dorronsoro Miren, Barricarte Aurelio, Navarro Carmen, Quiros Jose R., Allen Naomi, Key Timothy J., Day Nicholas E., Linseisen Jakob, Nagel Gabriele, Bergmann Manuela M., Overvad Kim, Jensen Majken K., Tjonneland Anne, Olsen Anja, Bueno-De-Mesquita H.Bas, Ocke Marga, Peeters Petra H.M., Numans Mattijs E., Clavel-Chapelon Francoise, Boutron-Ruault Marie Christine, Trichopoulou Antonia, Psaltopoulou Theodora, Roukos Dimitrios, Lund Eiliv, Hemon Bertrand, Kaaks Rudolf, Norat Teresa, Riboli Elio

J Natl Cancer Inst; 2006; 98(5): 345-354

Abstract as provided by PubMed

BACKGROUND: Dietary factors are thought to have an important role in gastric and esophageal carcinogenesis, but evidence from cohort studies for such a role is lacking. We examined the risks of gastric cancer and esophageal adenocarcinoma associated with meat consumption within the European Prospective Investigation Into Cancer and Nutrition (EPIC) cohort. METHODS: A total of 521,457 men and women aged 35-70 years in 10 European countries participated in the EPIC cohort. Dietary and lifestyle information was collected at recruitment. Cox proportional hazard models were used to examine associations between meat intake and risks of cardia and gastric non-cardia cancers and esophageal adenocarcinoma. Data from a calibration substudy were used to correct hazard ratios (HRs) and 95% confidence intervals (CIs) for diet measurement errors. In a nested case-control study, we examined interactions between Helicobacter pylori infection status (i.e., plasma H. pylori antibodies) and meat intakes. All statistical tests were two-sided. RESULTS: During a mean follow-up of 6.5 years, 330 gastric adenocarcinoma and 65 esophageal adenocarcinomas were diagnosed. Gastric non-cardia cancer risk was statistically significantly associated with intakes of total meat (calibrated HR per 100-g/day increase = 3.52; 95% CI = 1.96 to 6.34), red meat (calibrated HR per 50-g/day increase = 1.73; 95% CI = 1.03 to 2.88), and processed meat (calibrated HR per 50-g/day increase = 2.45; 95% CI = 1.43 to 4.21). The association between the risk of gastric non-cardia cancer and total meat intake was especially large in H. pylori-infected subjects (odds ratio per 100-g/day increase = 5.32; 95% CI = 2.10 to 13.4). Intakes of total, red, or processed meat were not associated with the risk of gastric cardia cancer. A positive but non-statistically significant association was observed between esophageal adenocarcinoma cancer risk and total and processed meat intake in the calibrated model. In this study population, the absolute risk of development of gastric adenocarcinoma within 10 years for a study subject aged 60 years was 0.26% for the lowest quartile of total meat intake and 0.33% for the highest quartile of total meat intake. CONCLUSION: Total, red, and processed meat intakes were associated with an increased risk of gastric non-cardia cancer, especially in H. pylori antibody-positive subjects, but not with cardia gastric cancer

TP53 and KRAS2 mutations in plasma DNA of healthy subjects and subsequent cancer occurrence: a prospective study

Gormally E., Vineis P., Matullo G., Veglia F., Caboux E., Le Roux E., Peluso M., Garte S., Guarrera S., Munnia A., Airoldi L., Autrup H., Malaveille C., Dunning A., Overvad K., Tjonneland A., Lund E., Clavel-Chapelon F., Boeing H., Trichopoulou A., Palli D., Krogh V., Tumino R., Panico S., Bueno-de-Mesquita H.B., Peeters P.H., Pera G., Martinez C., Dorronsoro M., Barricarte A., Navarro C., Quiros J.R., Hallmans G., Day N.E., Key T.J., Saracci R., Kaaks R., Riboli E., Hainaut P.

Cancer Res; 2006; 66(13): 6871-6876

Abstract as provided by PubMed

In cancer patients, plasma often contains mutant DNA released by cancer cells. We have assessed the significance of plasma DNA mutations for subsequent cancer development in healthy subjects in a large longitudinal prospective study. The European Prospective Investigation into Cancer and Nutrition study was analyzed with a nested case-control design. Cases were nonsmokers or ex-smokers for >10 years and newly diagnosed with lung, bladder, or upper aerodigestive tract cancers or leukemia accrued after a median follow-up of 6.3 years. Controls were matched 2:1 for follow-up, age, sex, area of recruitment, and smoking status. KRAS2 mutations were detected by mutant-enriched PCR and sequencing (n = 1,098). TP53 mutations were detected by denaturing high-performance liquid chromatography, temporal temperature gradient electrophoresis, and sequencing (n = 550). KRAS2 or TP53 mutations were detected in 13 of 1,098 (1.2%) and 20 of 550 (3.6%) subjects, respectively, 16 of whom developed cancer on average after 18.3 months of follow-up. Among 137 subjects who developed bladder cancer, 5 had KRAS2 mutations [odds ratio (OR), 4.25; 95% confidence interval (95% CI), 1.27-14.15] and 7 had TP53 mutations (OR, 1.81; 95% CI, 0.66-4.97). There was a nonsignificant trend for association between TP53 mutations and bulky adducts in lymphocyte DNA (OR, 2.78; 95% CI, 0.64-12.17). This is the first report of TP53 or KRAS2 mutations in the plasma of healthy subjects in a prospective study, suggesting that KRAS2 mutation is detectable ahead of bladder cancer diagnosis. TP53 mutation may be associated with environmental exposures. These observations have implications for monitoring early steps of carcinogenesis

Endogenous versus exogenous exposure to N-nitroso compounds and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST) study

Jakszyn P., Bingham S., Pera G., Agudo A., Luben R., Welch A., Boeing H., Del Giudice G., Palli D., Saieva C., Krogh V., Sacerdote C., Tumino R., Panico S., Berglund G., Siman H., Hallmans G., Sanchez M.J., Larranaga N., Barricarte A., Chirlaque M.D., Quiros J.R., Key T.J., Allen N., Lund E., Carneiro F., Linseisen J., Nagel G., Overvad K., Tjonneland A., Olsen A., Bueno-de-Mesquita H.B., Ocke M.O., Peeters P.H., Numans M.E., Clavel-Chapelon F., Trichopoulou A., Fenger C., Stenling R., Ferrari P., Jenab M., Norat T., Riboli E., Gonzalez C.A.

Carcinogenesis; 2006; 27(7): 1497-1501

Abstract as provided by PubMed

The risk of gastric cancer (GC) associated with dietary intake of nitrosodimethylamine (NDMA) and endogenous formation of nitroso compounds (NOCs) was investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC). The study included 521 457 individuals and 314 incident cases of GC that had occurred after 6.6 average years of follow-up. An index of endogenous NOC (ENOC) formation was estimated using data of the iron content from meat intake and faecal apparent total NOC formation according to previous published studies. Antibodies to Helicobacter pylori and vitamin C levels were measured in a sub-sample of cases and matched controls included in a nested case-control within the cohort. Exposure to NDMA was <1 mug on average compared with 93 mug on average from ENOC. There was no association between NDMA intake and GC risk (HR, 1.00; 95% CI, 0.7-1.43). ENOC was significantly associated with non-cardia cancer risk (HR, 1.42; 95% CI, 1.14-1.78 for an increase of 40 mug/day) but not with cardia cancer (HR, 0.96; 95% CI, 0.69-1.33). Although the number of not infected cases is low, our data suggest a possible interaction between ENOC and H.pylori infection (P for interaction = 0.09). Moreover, we observed an interaction between plasma vitamin C and ENOC (P < 0.02). ENOC formation may account for our previously reported association between red and processed meat consumption and gastric cancer risk

Consumption and portion sizes of tree nuts, peanuts and seeds in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries

Jenab M., Sabate J., Slimani N., Ferrari P., Mazuir M., Casagrande C., Deharveng G., Tjonneland A., Olsen A., Overvad K., Boutron-Ruault M.C., Clavel-Chapelon F., Boeing H., Weikert C., Linseisen J., Rohrmann S., Trichopoulou A., Naska A., Palli D., Sacerdote C., Tumino R., Mattiello A., Pala V., Bueno-de-Mesquita H.B., Ocke M.C., Peeters P.H., Engeset D., Skeie G., Jakszyn P., Ardanaz E., Quiros J.R., Chirlaque M.D., Martinez C., Amiano P., Berglund G., Palmqvist R., Guelpen B., Bingham S., Key T., Riboli E.

Br J Nutr; 2006; S12-S23

Abstract as provided by PubMed

Tree nuts, peanuts and seeds are nutrient dense foods whose intake has been shown to be associated with reduced risk of some chronic diseases. They are regularly consumed in European diets either as whole, in spreads or from hidden sources (e.g. commercial products). However, little is known about their intake profiles or differences in consumption between European countries or geographic regions. The objective of this study was to analyse the population mean intake and average portion sizes in subjects reporting intake of nuts and seeds consumed as whole, derived from hidden sources or from spreads. Data was obtained from standardised 24-hour dietary recalls collected from 36 994 subjects in 10 different countries that are part of the European Prospective Investigation into Cancer and Nutrition (EPIC). Overall, for nuts and seeds consumed as whole, the percentage of subjects reporting intake on the day of the recall was: tree nuts=4. 4%, peanuts=2.3 % and seeds=1.3 %. The data show a clear northern (Sweden: mean intake=0.15 g/d, average portion size=15.1 g/d) to southern (Spain: mean intake=2.99 g/d, average portion size=34.7 g/d) European gradient of whole tree nut intake. The three most popular tree nuts were walnuts, almonds and hazelnuts, respectively. In general, tree nuts were more widely consumed than peanuts or seeds. In subjects reporting intake, men consumed a significantly higher average portion size of tree nuts (28.5 v. 23.1 g/d, P<0.01) and peanuts (46.1 v. 35.1 g/d, P<0.01) per day than women. These data may be useful in devising research initiatives and health policy strategies based on the intake of this food group

Plasma and dietary vitamin C levels and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST)

Jenab M., Riboli E., Ferrari P., Sabate J., Slimani N., Norat T., Friesen M., Tjonneland A., Olsen A., Overvad K., Boutron-Ruault M.C., Clavel-Chapelon F., Touvier M., Boeing H., Schulz M., Linseisen J., Nagel G., Trichopoulou A., Naska A., Oikonomou E., Krogh V., Panico S., Masala G., Sacerdote C., Tumino R., Peeters P.H., Numans M.E., Bueno-de-Mesquita H.B., Buchner F.L., Lund E., Pera G., Sanchez C.N., Sanchez M.J., Arriola L., Barricarte A., Quiros J.R., Hallmans G., Stenling R., Berglund G., Bingham S., Khaw K.T., Key T., Allen N., Carneiro F., Mahlke U., Del Giudice G., Palli D., Kaaks R., Gonzalez C.A.

Carcinogenesis; 2006; 27(11): 2250-2257

Abstract as provided by PubMed

Vitamin C is an antioxidant and inhibitor of carcinogenic N-nitroso compound production in the stomach. Higher dietary vitamin C consumption is associated with decreased risk of gastric cancer (GC) in numerous case-control studies but data from prospective studies is limited, particularly so for blood measures of vitamin C. The objective of this study was to determine the association of plasma and dietary vitamin C levels with the risk of GC in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 European countries. Using a fluorometric method, vitamin C was measured in pre-diagnostic plasma from 215 GC cases (matched controls=416). Conditional logistic regression models adjusted by body mass index, total energy intake, smoking status/duration/intensity and Helicobacter pylori (Hp) infection status were used to estimate relative cancer risks. No association with GC risk was observed for dietary vitamin C whereas an inverse GC risk was observed in the highest versus lowest quartile of plasma vitamin C (OR=0.55, 95%CI=0.31-0.97, Ptrend=0.043) which was maintained after exclusion of cases with </=2yrs follow-up (OR=0.40, 95%CI=0.19-0.83, Ptrend=0.064). The inverse association was more pronounced in subjects consuming higher levels of red and processed meats, a factor that may increase endogenous N-nitroso compound production. The effect of plasma vitamin C was not different by GC anatomical sub-site (cardia/non-cardia) or histological sub-type (diffuse/intestinal) and there was no significant interaction of effect with Hp. The results of this study show, in a prospective setting, an inverse association of GC risk with high levels of plasma vitamin C and suggest an interaction with the intake of red and processed meats, whose consumption may elevate endogenous N-nitroso compound production

Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition

Jenab M., Riboli E., Ferrari P., Friesen M., Sabate J., Norat T., Slimani N., Tjonneland A., Olsen A., Overvad K., Boutron-Ruault M.C., Clavel-Chapelon F., Boeing H., Schulz M., Linseisen J., Nagel G., Trichopoulou A., Naska A., Oikonomou E., Berrino F., Panico S., Palli D., Sacerdote C., Tumino R., Peeters P.H., Numans M.E., Bueno-de-Mesquita H.B., Buchner F.L., Lund E., Pera G., Chirlaque M.D., Sanchez M.J., Arriola L., Barricarte A., Quiros J.R., Johansson I., Johansson A., Berglund G., Bingham S., Khaw K.T., Allen N., Key T., Carneiro F., Save V., Giudice G.D., Plebani M., Kaaks R., Gonzalez C.A.

Br J Cancer; 2006; 95(3): 406-415

Abstract as provided by PubMed

Despite declining incidence rates, gastric cancer (GC) is a major cause of death worldwide. Its aetiology may involve dietary antioxidant micronutrients such as carotenoids and tocopherols. The objective of this study was to determine the association of plasma levels of seven common carotenoids, their total plasma concentration, retinol and alpha- and gamma-tocopherol, with the risk of gastric adenocarcinoma in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 countries. A secondary objective was to determine the association of total sum of carotenoids, retinol and alpha-tocopherol on GCs by anatomical subsite (cardia/noncardia) and histological subtype (diffuse/intestinal). Analytes were measured by high-performance liquid chromatography in prediagnostic plasma from 244 GC cases and 645 controls matched by age, gender, study centre and date of blood donation. Conditional logistic regression models adjusted by body mass index, total energy intake, smoking and Helicobacter pylori infection status were used to estimate relative cancer risks. After an average 3.2 years of follow-up, a negative association with GC risk was observed in the highest vs the lowest quartiles of plasma beta-cryptoxanthin (odds ratio (OR)=0.53, 95% confidence intervals (CI)=0.30-0.94, P(trend)=0.006), zeaxanthin (OR=0.39, 95% CI=0.22-0.69, P(trend)=0.005), retinol (OR=0.55, 95% CI=0.33-0.93, P(trend)=0.005) and lipid-unadjusted alpha-tocopherol (OR=0.59, 95% CI=0.37-0.94, P(trend)=0.022). For all analytes, no heterogeneity of risk estimates or significant associations were observed by anatomical subsite. In the diffuse histological subtype, an inverse association was observed with the highest vs lowest quartile of lipid-unadjusted alpha-tocopherol (OR=0.26, 95% CI=0.11-0.65, P(trend)=0.003). These results show that higher plasma concentrations of some carotenoids, retinol and alpha-tocopherol are associated with reduced risk of GC.British Journal of Cancer (2006) 95, 406-415. doi:10.1038/sj.bjc.6603266 www.bjcancer.com Published online 11 July 2006

Dietary intake of different types and characteristics of processed meat which might be associated with cancer risk--results from the 24-hour diet recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Linseisen J., Rohrmann S., Norat T., Gonzalez C.A., Dorronsoro Iraeta M., Morote Gomez P., Chirlaque M.D., Pozo B.G., Ardanaz E., Mattisson I., Pettersson U., Palmqvist R., Van Guelpen B., Bingham S.A., McTaggart A., Spencer E.A., Overvad K., Tjonneland A., Stripp C., Clavel-Chapelon F., Kesse E., Boeing H., Klipstein-Grobusch K., Trichopoulou A., Vasilopoulou E., Bellos G., Pala V., Masala G., Tumino R., Sacerdote C., Del Pezzo M., Bueno-de-Mesquita H.B., Ocke M.C., Peeters P.H., Engeset D., Skeie G., Slimani N., Riboli E.

Public Health Nutr; 2006; 9(4): 449-464

Abstract as provided by PubMed

OBJECTIVE: There is increasing evidence for a significant effect of processed meat (PM) intake on cancer risk. However, refined knowledge on how components of this heterogeneous food group are associated with cancer risk is still missing. Here, actual data on the intake of PM subcategories is given; within a food-based approach we considered preservation methods, cooking methods and nutrient content for stratification, in order to address most of the aetiologically relevant hypotheses. DESIGN AND SETTING: Standardised computerised 24-hour diet recall interviews were collected within the framework of the European Prospective Investigation into Cancer and Nutrition (EPIC), a prospective cohort study in 27 centres across 10 European countries. SUBJECTS: Subjects were 22,924 women and 13,031 men aged 35-74 years. RESULTS: Except for the so-called 'health-conscious' cohort in the UK, energy-adjusted total PM intake ranged between 11.1 and 47.9 g day(-1) in women and 18.8 and 88.5 g day(-1) in men. Ham, salami-type sausages and heated sausages contributed most to the overall PM intake. The intake of cured (addition of nitrate/nitrite) PM was highest in the German, Dutch and northern European EPIC centres, with up to 68.8 g day(-1) in men. The same was true for smoked PM (up to 51.8 g day(-1)). However, due to the different manufacturing practice, the highest average intake of NaNO2 through PM consumption was found for the Spanish centres (5.4 mg day(-1) in men) as compared with German and British centres. Spanish centres also showed the highest intake of NaCl-rich types of PM; most cholesterol- and iron-rich PM was consumed in central and northern European centres. Possibly hazardous cooking methods were more often used for PM preparation in central and northern European centres. CONCLUSIONS: We applied a food-based categorisation of PM that addresses aetiologically relevant mechanisms for cancer development and found distinct differences in dietary intake of these categories of PM across European cohorts. This predisposes EPIC to further investigate the role of PM in cancer aetiology

Associations between dietary pattern and lifestyle, anthropometry and other health indicators in the elderly participants of the EPIC-Italy cohort

Pala Valeria, Sieri Sabina, Masala Giovanna, Palli Domenico, Panico Salvatore, Vineis Paolo, Sacerdote Carlotta, Mattiello Amalia, Galasso Rocco, Salvini Simonetta, Ceroti Marco, Berrino Franco, Fusconi Elisabetta, Tumino Rosario, Frasca Graziella, Riboli Elio, Trichopoulou Antonia, Baibas Nikolaos, Krogh Vittorio

Nutr Metab Cardiovasc Dis; 2006; 16(3): 186-201

Abstract as provided by PubMed

INTRODUCTION: Epidemiological studies have shown that dietary behaviour is an important aetiological factor in various chronic diseases. We used principal component factor analysis to identify dietary patterns and to examine the associations of these patterns with health-related variables in a sample of elderly (>/=60years) Italians participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS AND RESULTS: Exploratory factor analysis was applied to the intake of food groups as estimated by semi-quantitative food questionnaires. Individual participants were assigned factor scores, indicating the extent to which their diet conformed to each of the four dietary patterns identified: prudent (cooked vegetables, pulses, cabbage, seed oil and fish); pasta & meat (pasta, tomato sauce, red meat, processed meat, bread and wine); olive oil & salad (raw vegetables, olive oil, soup and chicken); and sweet & dairy (sugar, cakes, ice cream, coffee and dairy). Highly educated people had high scores on prudent and low scores on pasta & meat. The pasta & meat and prudent patterns were strongly positively associated with body mass index (BMI) and waist-to-hip ratio (WHR) in men and women. Hyperlipidaemic men and women consumed more of the prudent and olive oil & salad patterns and less of the sweet & dairy pattern than those with normal lipids. The olive oil & salad was significantly higher and the pasta & meat and sweet & dairy patterns significantly lower in men and women who had dieted over the previous year, suggesting awareness of the health consequences of these patterns. CONCLUSIONS: Dietary pattern analysis provides a characterization of recurrent dietary behaviour in elderly people, and can be used to provide tangible dietary advice to elderly people

Body size and risk of renal cell carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Pischon T., Lahmann P.H., Boeing H., Tjonneland A., Halkjaer J., Overvad K., Klipstein-Grobusch K., Linseisen J., Becker N., Trichopoulou A., Benetou V., Trichopoulos D., Sieri S., Palli D., Tumino R., Vineis P., Panico S., Monninkhof E., Peeters P.H., Bueno-de-Mesquita H.B., Buchner F.L., Ljungberg B., Hallmans G., Berglund G., Gonzalez C.A., Dorronsoro M., Gurrea A.B., Navarro C., Martinez C., Quiros J.R., Roddam A., Allen N., Bingham S., Khaw K.T., Kaaks R., Norat T., Slimani N., Riboli E.

Int J Cancer; 2006; 118(3): 728-738

PMID:16094628

Abstract as provided by PubMed

Previous studies suggest that obesity is related to increased risk of renal cell carcinoma (RCC); however, only a few studies report on measures of central vs. peripheral adiposity. We examined the association between anthropometric measures, including waist and hip circumference and RCC risk among 348,550 men and women free of cancer at baseline from 8 countries of the European Prospective Investigation into Cancer and Nutrition (EPIC). During 6.0 years of follow-up we identified 287 incident cases of RCC. Relative risks were calculated using Cox regression, stratified by age and study center and adjusted for smoking status, education, alcohol consumption, physical activity, menopausal status, and hormone replacement therapy use. Among women, an increased risk of RCC was conferred by body weight (relative risk [RR] in highest vs. lowest quintile = 2.13; 95% confidence interval [CI] = 1.16-3.90; p-trend = 0.003), body mass index (BMI) (RR = 2.25; 95% CI = 1.14-4.44; p-trend = 0.009), and waist (RR = 1.67; 95% CI = 0.94-2.98; p-trend = 0.003) and hip circumference (RR = 2.30; 95% CI = 1.22-4.34; p-trend = 0.01); however, waist and hip circumference were no longer significant after controlling for body weight. Among men, hip circumference (RR = 0.44; 95% CI = 0.20-0.98; p-trend = 0.03) was related significantly to decreased RCC risk only after accounting for body weight. Height was not related significantly to RCC risk. Our findings suggest that obesity is related to increased risk of RCC irrespective of fat distribution among women, whereas low hip circumference is related to increased RCC risk among men. Our data give further credence to public health efforts aiming to reduce the prevalence of obesity to prevent RCC, in addition to other chronic diseases. (c) 2005 Wiley-Liss, Inc

Body size and risk of colon and rectal cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC)

Pischon T., Lahmann P.H., Boeing H., Friedenreich C., Norat T., Tjonneland A., Halkjaer J., Overvad K., Clavel-Chapelon F., Boutron-Ruault M.C., Guernec G., Bergmann M.M., Linseisen J., Becker N., Trichopoulou A., Trichopoulos D., Sieri S., Palli D., Tumino R., Vineis P., Panico S., Peeters P.H., Bueno-de-Mesquita H.B., Boshuizen H.C., Van Guelpen B., Palmqvist R., Berglund G., Gonzalez C.A., Dorronsoro M., Barricarte A., Navarro C., Martinez C., Quiros J.R., Roddam A., Allen N., Bingham S., Khaw K.T., Ferrari P., Kaaks R., Slimani N., Riboli E.

J Natl Cancer Inst; 2006; 98(13): 920-931

PMID:16818856

Abstract as provided by PubMed

BACKGROUND: Body weight and body mass index (BMI) are positively related to risk of colon cancer in men, whereas weak or no associations exist in women. This discrepancy may be related to differences in fat distribution between sexes or to the use of hormone replacement therapy (HRT) in women. METHODS: We used multivariable adjusted Cox proportional hazards models to examine the association between anthropometric measures and risks of colon and rectal cancer among 368 277 men and women who were free of cancer at baseline from nine countries of the European Prospective Investigation Into Cancer and Nutrition. All statistical tests were two-sided. RESULTS: During 6.1 years of follow-up, we identified 984 and 586 patients with colon and rectal cancer, respectively. Body weight and BMI were statistically significantly associated with colon cancer risk in men (highest versus lowest quintile of BMI, relative risk [RR] = 1.55, 95% confidence interval [CI] = 1.12 to 2.15; P(trend) = .006) but not in women. In contrast, comparisons of the highest to the lowest quintile showed that several anthropometric measures, including waist circumference (men, RR = 1.39, 95% CI = 1.01 to 1.93; P(trend) = .001; women, RR = 1.48, 95% CI = 1.08 to 2.03; P(trend) = .008), waist-to-hip ratio (WHR; men, RR = 1.51, 95% CI = 1.06 to 2.15; P(trend) = .006; women, RR = 1.52, 95% CI = 1.12 to 2.05; P(trend) = .002), and height (men, RR = 1.40, 95% CI = 0.99 to 1.98; P(trend) = .04; women, RR = 1.79, 95% CI = 1.30 to 2.46; P(trend)<.001) were related to colon cancer risk in both sexes. The estimated absolute risk of developing colon cancer within 5 years was 203 and 131 cases per 100,000 men and 129 and 86 cases per 100,000 women in the highest and lowest quintiles of WHR, respectively. Upon further stratification, no association of waist circumference and WHR with risk of colon cancer was observed among postmenopausal women who used HRT. None of the anthropometric measures was statistically significantly related to rectal cancer. CONCLUSIONS: Waist circumference and WHR, indicators of abdominal obesity, were strongly associated with colon cancer risk in men and women in this population. The association of abdominal obesity with colon cancer risk may vary depending on HRT use in postmenopausal women; however, these findings require confirmation in future studies

Breast cancer risk in relation to abortion: Results from the EPIC study

Reeves G.K., Kan S.W., Key T., Tjonneland A., Olsen A., Overvad K., Peeters P.H., Clavel-Chapelon F., Paoletti X., Berrino F., Krogh V., Palli D., Tumino R., Panico S., Vineis P., Gonzalez C.A., Ardanaz E., Martinez C., Amiano P., Quiros J.R., Tormo M.R., Khaw K.T., Trichopoulou A., Psaltopoulou T., Kalapothaki V., Nagel G., Chang-Claude J., Boeing H., Lahmann P.H., Wirfalt E., Kaaks R., Riboli E.

Int J Cancer; 2006; 119(7): 1741-1745

Abstract as provided by PubMed

The role of spontaneous and induced abortion on breast cancer risk is examined among 267,361 women recruited into the European Prospective Investigation into Cancer and nutrition between 1992 and 2000. The data were collected from 20 centers, across 9 countries, and included information on a total of 4,805 women with breast cancer, of whom 1,657 reported having ever had any type of abortion. Overall, the relative risk of breast cancer in women who reported ever having had a spontaneous abortion was not significantly elevated when compared with women who reported never having had such an abortion (RR = 1.07, 95% CI = 0.99-1.14). However, there was some evidence of a slight increase in the risk of breast cancer among women who reported having had 2 or more spontaneous abortions (1.20, 1.07-1.35). The relative risk of breast cancer among women who reported ever having had an induced abortion when compared to women who reported never having had an induced abortion was 0.95 (0.87-1.03). Overall, the findings provide further unbiased evidence of the lack of an adverse effect of induced abortion on breast cancer risk

Relationship of alcohol intake and sex steroid concentrations in blood in pre- and post-menopausal women: the European Prospective Investigation into Cancer and Nutrition

Rinaldi S., Peeters P.H., Bezemer I.D., Dossus L., Biessy C., Sacerdote C., Berrino F., Panico S., Palli D., Tumino R., Khaw K.T., Bingham S., Allen N.E., Key T., Jensen M.K., Overvad K., Olsen A., Tjonneland A., Amiano P., Ardanaz E., Agudo A., Martinez-Garcia C., Quiros J.R., Tormo M.J., Nagel G., Linseisen J., Boeing H., Schulz M., Grobbee D.E., Bueno-de-Mesquita H.B., Koliva M., Kyriazi G., Thrichopoulou A., Boutron-Ruault M.C., Clavel-Chapelon F., Ferrari P., Slimani N., Saracci R., Riboli E., Kaaks R.

Cancer Causes Control; 2006; 17(8): 1033-1043

Abstract as provided by PubMed

OBJECTIVE: Women with a moderate intake of alcohol have higher concentrations of sex steroids in serum, and higher risk of developing breast cancer, compared to non-drinkers. In the present study, we investigate the relationships between alcohol consumption and serum levels of sex steroids and sex-hormone binding globulin (SHBG) in 790 pre- and 1,291 post-menopausal women, who were part of the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: Serum levels of testosterone (T), androstenedione (Delta(4)), dehydroepiandrosterone sulphate (DHEAS), estrone (E(1)), estradiol (E(2)) and SHBG were measured by direct immunoassays. Free T (fT) and free E(2) (fE(2)) were calculated according to mass action laws. Current alcohol intake exposure to alcohol was assessed from dietary questionnaires. RESULTS: Pre-menopausal women who consumed more than 25 g/day of alcohol had about 30% higher DHEAS, T and fT, 20% higher Delta(4) and about 40% higher E(1), concentrations compared to women who were non-consumers. E(2), fE(2) and SHBG concentrations showed no association with current alcohol intake. In post-menopausal women, DHEAS, fT, T, Delta(4), and E(1) concentrations were between 10% and 20% higher in women who consumed more than 25 g/day of alcohol compared to non-consumers. E(2) or fE(2) were not associated with alcohol intake at all. SHBG levels were about 15% lower in alcohol consumers compared to non-consumers. CONCLUSION: This study supports the hypothesis of an influence of alcohol intake on sex hormone concentrations in blood

IGF-I, IGFBP-3 and breast cancer risk in women: The European Prospective Investigation into Cancer and Nutrition (EPIC)

Rinaldi S., Peeters P.H., Berrino F., Dossus L., Biessy C., Olsen A., Tjonneland A., Overvad K., Clavel-Chapelon F., Boutron-Ruault M.C., Tehard B., Nagel G., Linseisen J., Boeing H., Lahmann P.H., Trichopoulou A., Trichopoulos D., Koliva M., Palli D., Panico S., Tumino R., Sacerdote C., Van Gils C.H., van Noord P., Grobbee D.E., Bueno-de-Mesquita H.B., Gonzalez C.A., Agudo A., Chirlaque M.D., Barricarte A., Larranaga N., Quiros J.R., Bingham S., Khaw K.T., Key T., Allen N.E., Lukanova A., Slimani N., Saracci R., Riboli E., Kaaks R.

Endocr Relat Cancer; 2006; 13(2): 593-605

Abstract as provided by PubMed

Blood concentrations of insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) have recently been associated with breast cancer risk, notably in women who developed breast cancer at a young age. Prospective studies published so far, however, were relatively small and odds ratio (OR) estimates imprecise. We present the results of a large prospective case-control study nested within the European Prospective Investigation into Cancer and Nutrition on total IGF-I, IGFBP-3 and breast cancer risk including 1081 incident cases of invasive breast cancer and 2098 matched control subjects. Increasing IGF-I and IGFBP-3 concentrations were associated with a significant increase in breast cancer risk in women who developed breast cancer after 50 years of age (highest vs lowest quintile OR 1.38 (95% confidence interval (CI) 1.02-1.86), P = 0.01, and 1.44 (95% CI 1.04-1.98), P = 0.01, respectively), but no relationship was observed in younger women (OR = 1.03 (95% CI 0.60-1.77), P = 0.81 for IGF-I, and OR = 0.92 (95% CI 0.50-1.70), P = 0.69 for IGFBP-3). There was, however, significant heterogeneity in the relationship of breast cancer with serum IGF-I and IGFBP-3 levels depending on the time interval between blood donation and tumor diagnosis. A reduction in breast cancer risk with increasing IGF-I concentrations was observed in cases with a diagnosis of cancer less than 2 years after blood donation, (OR = 0.76 (95% CI 0.57-1.03)), while an increase in risk was observed for women with a later diagnosis (above or equal to two years after blood collection, OR = 1.51 (95% CI 1.19-1.91)). A similar pattern was observed for IGFBP-3. This study confirms previous findings for an association of serum IGF-I and IGFBP-3 concentrations with breast cancer risk, particularly for women with a later diagnosis of cancer, but it does not support the hypothesis of an involvement of IGF-I in younger women

Ethanol Intake and Risk of Lung Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Rohrmann S., Linseisen J., Boshuizen H.C., Whittaker J., Agudo A., Vineis P., Boffetta P., Jensen M.K., Olsen A., Overvad K., Tjonneland A., Boutron-Ruault M.C., Clavel-Chapelon F., Bergmann M.M., Boeing H., Allen N., Key T., Bingham S., Khaw K.T., Kyriazi G., Soukara S., Trichopoulou A., Panico S., Palli D., Sieri S., Tumino R., Peeters P.H., Bueno-de-Mesquita H.B., Buchner F.L., Gram I.T., Lund E., Ardanaz E., Chirlaque M.D., Dorronsoro M., Perez M.J., Quiros J.R., Berglund G., Janzon L., Rasmuson T., Weinehall L., Ferrari P., Jenab M., Norat T., Riboli E.

Am J Epidemiol; 2006; 164(11): 1103-1114

Abstract as provided by PubMed

Within the European Prospective Investigation into Cancer and Nutrition (EPIC), the authors examined the association of ethanol intake at recruitment (1,119 cases) and mean lifelong ethanol intake (887 cases) with lung cancer. Information on baseline and past alcohol consumption, lifetime tobacco smoking, diet, and the anthropometric characteristics of 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. Overall, neither ethanol intake at recruitment nor mean lifelong ethanol intake was significantly associated with lung cancer. However, moderate intake (5-14.9 g/day) at recruitment (hazard ratio (HR) = 0.76, 95% confidence interval (CI): 0.63, 0.90) and moderate mean lifelong intake (HR = 0.80, 95% CI: 0.66, 0.97) were associated with a lower lung cancer risk in comparison with low consumption (0.1-4.9 g/day). Compared with low intake, a high (>/=60 g/day) mean lifelong ethanol intake tended to be related to a higher risk of lung cancer (HR = 1.29, 95% CI: 0.93, 1.74), but high intake at recruitment was not. Although there was no overall association between ethanol intake and risk of lung cancer, the authors cannot rule out a lower risk for moderate consumption and a possibly increased risk for high lifelong consumption

Physical activity and lung cancer risk in the European Prospective Investigation into Cancer and Nutrition Cohort

Steindorf K., Friedenreich C., Linseisen J., Rohrmann S., Rundle A., Veglia F., Vineis P., Johnsen N.F., Tjonneland A., Overvad K., Raaschou-Nielsen O., Clavel-Chapelon F., Boutron-Ruault M.C., Schulz M., Boeing H., Trichopoulou A., Kalapothaki V., Koliva M., Krogh V., Palli D., Tumino R., Panico S., Monninkhof E., Peeters P.H., Boshuizen H.C., Bueno-de-Mesquita H.B., Chirlaque M.D., Agudo A., Larranaga N., Quiros J.R., Martinez C., Barricarte A., Janzon L., Berglund G., Bingham S., Khaw K.T., Key T.J., Norat T., Jenab M., Cust A., Riboli E.

Int J Cancer; 2006; 119(10): 2389-2397

PMID:16894558

Abstract as provided by PubMed

Research conducted predominantly in male populations on physical activity and lung cancer has yielded inconsistent results. We examined this relationship among 416,277 men and women from the European Prospective Investigation into Cancer and Nutrition (EPIC). Detailed information on recent recreational, household and occupational physical activity, smoking habits and diet was assessed at baseline between 1992 and 2000. Relative risks (RR) were estimated using Cox regression. During 6.3 years of follow-up we identified 607 men and 476 women with incident lung cancer. We did not observe an inverse association between recent occupational, recreational or household physical activity and lung cancer risk in either males or females. However, we found some reduction in lung cancer risk associated with sports in males (adjusted RR = 0.71; 95% confidence interval 0.50-0.98; highest tertile vs. inactive group), cycling (RR = 0.73; 0.54-0.99) in females and non-occupational vigorous physical activity. For occupational physical activity, lung cancer risk was increased for unemployed men (adjusted RR = 1.57; 1.20-2.05) and men with standing occupations (RR = 1.35; 1.02-1.79) compared with sitting professions. There was no evidence of heterogeneity of physical activity associations across countries, or across any of the considered cofactors. For some histologic subtypes suggestive sex-specific reductions, limited by subgroup sizes, were observed, especially with vigorous physical activity. In total, our study shows no consistent protective associations of physical activity with lung cancer risk. It can be assumed that the elevated risks found for occupational physical activity are not produced mechanistically by physical activity itself but rather reflect exposure to occupation-related lung cancer risk factors

Serum C-peptide levels and breast cancer risk: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)

Verheus M., Peeters P.H., Rinaldi S., Dossus L., Biessy C., Olsen A., Tjonneland A., Overvad K., Jeppesen M., Clavel-Chapelon F., Tehard B., Nagel G., Linseisen J., Boeing H., Lahmann P.H., Arvaniti A., Psaltopoulou T., Trichopoulou A., Palli D., Tumino R., Panico S., Sacerdote C., Sieri S., Van Gils C.H., Bueno-de-Mesquita B.H., Gonzalez C.A., Ardanaz E., Larranaga N., Garcia C.M., Navarro C., Quiros J.R., Key T., Allen N., Bingham S., Khaw K.T., Slimani N., Riboli E., Kaaks R.

Int J Cancer; 2006; 119(3): 659-667

Abstract as provided by PubMed

It has been hypothesized that chronic hyperinsulinemia, a major metabolic consequence of physical inactivity and excess weight, might increase breast cancer risk by direct effects on breast tissue or indirectly by increasing bioavailable levels of testosterone and estradiol. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), we measured serum levels of C-peptide--a marker for pancreatic insulin secretion--in a total of 1,141 incident cases of breast cancer and 2,204 matched control subjects. Additional measurements were made of serum sex hormone binding globulin (SHBG) and sex steroids. Conditional logistic regression models were used to estimate breast cancer risk for different levels of C-peptide. C-peptide was inversely correlated with SHBG and hence directly correlated with free testosterone among both pre and postmenopausal women. C-peptide and free estradiol also correlated positively, but only among postmenopausal women. Elevated serum C-peptide levels were associated with a nonsignificant reduced risk of breast cancer diagnosed up to the age of 50 years [odds ratio (OR)=0.70, (95% confidence interval (CI), 0.39-1.24); ptrend=0.05]. By contrast, higher levels of C-peptide were associated with an increase of breast cancer risk among women above 60 years of age, however only among those women who had provided a blood sample under nonfasting conditions [OR=2.03, (95% CI, 1.20-3.43); ptrend=0.01]. Our results do not support the hypothesis that chronic hyperinsulinemia generally increases breast cancer risk, independently of age. Nevertheless, among older, postmenopausal women, hyperinsulinemia might contribute to increasing breast cancer risk

Dietary patterns and survival in older Dutch women

Waijers P.M., Ocke M.C., van Rossum C.T., Peeters P.H., Bamia C., Chloptsios Y., van der Schouw Y.T., Slimani N., Bueno-de-Mesquita H.B.

Am J Clin Nutr; 2006; 83(5): 1170-1176

PMID:16685062

Abstract as provided by PubMed

BACKGROUND: The need to gain insight into prevailing eating patterns and their health effects is evident. OBJECTIVE: This study aimed to identify dietary patterns and their relation to total mortality in older Dutch women. DESIGN: A principal component analysis of 22 food groups was used to identify dietary patterns in 5427 women aged 60-69 y who were included in the Dutch European Prospective Investigation into Cancer and Nutrition-Elderly cohort (follow-up: approximately 8.2 y). Mortality ratios for 3 major principal components were assessed by using Cox proportional hazard analysis. RESULTS: The most relevant principal components were a Mediterranean-like dietary pattern (high intakes of vegetable oils, pasta and rice, sauces, fish, and wine), a Traditional Dutch dinner dietary pattern (high intakes of meat, potatoes, vegetables, and alcoholic beverages), and a Healthy Traditional Dutch dietary pattern (healthy variant of the Traditional Dutch dinner dietary pattern; high intakes of vegetables, fruit, nonalcoholic drinks, dairy products, and potatoes). Differences in mean intakes between the highest and lowest tertiles of the 3 patterns were greatest for fruit, dairy products, potatoes, and alcoholic beverages. Consumption of Mediterranean foods, such as fish and oils, was relatively low overall. Two hundred seventy-seven deaths occurred in 44,667 person-years. Independent of age, education, and other lifestyle factors, only the Healthy Traditional dietary pattern score was associated with a lower mortality rate. Women in the highest tertile of this pattern experienced a 30% reduction in mortality risk. CONCLUSION: A Healthy Traditional Dutch diet, rather than a Mediterranean diet, appears beneficial for longevity and feasible for health promotion in older Dutch women. This diet is comparable with other reported healthy or prudent diets that have been shown to be protective against morbidity or mortality

Fruits and vegetables and renal cell carcinoma: findings from the European prospective investigation into cancer and nutrition (EPIC)

Weikert S., Boeing H., Pischon T., Olsen A., Tjonneland A., Overvad K., Becker N., Linseisen J., Lahmann P.H., Arvaniti A., Kassapa C., Trichoupoulou A., Sieri S., Palli D., Tumino R., Vineis P., Panico S., Van Gils C.H., Peeters P.H., Bueno-de-Mesquita H.B., Buchner F.L., Ljungberg B., Hallmans G., Berglund G., Wirfalt E., Pera G., Dorronsoro M., Gurrea A.B., Navarro C., Martinez C., Quiros J.R., Allen N., Roddam A., Bingham S., Jenab M., Slimani N., Norat T., Riboli E.

Int J Cancer; 2006; 118(12): 3133-3139

Abstract as provided by PubMed

We examined the association between fruits and vegetables and risk of renal cell carcinoma (RCC) in the European Prospective Investigation into Cancer and Nutrition (EPIC). Dietary intake data and complete follow-up information on cancer incidence were available for 375,851 participants recruited in EPIC centers of 8 countries. During an average follow-up of 6.2 years, 306 incident cases of RCC were identified. The associations of consumption of total vegetables, total fruits, combined total fruits and vegetables and specific subtypes of vegetables with RCC risk were analyzed using Cox proportional hazards, stratified by centre and adjusted for potential confounders. No significant associations between fruit and vegetable consumption and RCC risk were observed despite a wide range of intake. The estimated relative risks (95% confidence intervals [CI]) in men and women combined were 0.97 (0.85-1.11) per 40 g increase in vegetable intake, 1.03 (0.97-1.08) per 40 g increase in fruit intake and 1.02 (0.93-1.11) per 80 g increase in fruit and vegetable intake combined. Among the vegetable subtypes, an inverse association was observed for root vegetables (RR per 8 g increase: 0.88; 95% CI: 0.78-0.99). These results suggest that total consumption of fruits and vegetables is not related to risk of RCC, although we cannot exclude the possibility that very low consumption is related to higher risk. The relationship of specific fruit and vegetable subgroups with RCC risk warrant further investigation

Dietary fish intake and plasma phospholipid n-3 polyunsaturated fatty acid concentrations in men and women in the European Prospective Investigation into Cancer-Norfolk United Kingdom cohort

Welch A.A., Bingham S.A., Ive J., Friesen M.D., Wareham N.J., Riboli E., Khaw K.T.

Am J Clin Nutr; 2006; 84(6): 1330-1339

Abstract as provided by PubMed

BACKGROUND: The n-3 polyunsaturated fatty acids (n-3 PUFAs) docosahexaenoic acid and eicosapentaenoic acid, found in fish and fish-oil supplements and also formed by conversion of alpha-linolenic acid in soy and rapeseed (canola) oils, are thought to have cardioprotective effects. OBJECTIVE: Because the relative feasibility and measurement error of dietary methods varies, this study compared fish and fish-oil intakes obtained from 4 dietary methods with plasma n-3 PUFAs in men and women in a general population. DESIGN: The study participants were 4949 men and women aged 40-79 y from the European Prospective Investigation into Cancer-Norfolk United Kingdom cohort. Measurements of plasma phospholipid n-3 PUFA concentrations and fish intakes were made with the use of 4 dietary methods (food-frequency questionnaire, health and lifestyle questionnaire, 7-d diary, and first-day recall from the 7-d diary). RESULTS: Amounts of fish consumed and relations with plasma phospholipid n-3 PUFAs were not substantially different between the 4 dietary methods. Plasma n-3 PUFA concentrations were significantly higher in women than in men, were 20% higher in fish-oil consumers than in non-fish-oil consumers, and were twice as high in fatty fish consumers as in total fish consumers. Only approximately 25% of the variation in plasma n-3 PUFA was explained by fish and fish-oil consumption. CONCLUSIONS: This large study found no substantial differences between dietary methods and observed clear sex differences in plasma n-3 PUFAs. Because variation in n-3 PUFA was only partially determined by fish and fish-oil consumption, this could explain the inconsistent results of observational and intervention studies on coronary artery disease protection

2005

4-Aminobiphenyl-hemoglobin adducts and risk of smoking-related disease in never smokers and former smokers in the European Prospective Investigation into Cancer and Nutrition prospective study

Airoldi L., Vineis P., Colombi A., Olgiati L., Dell\'Osta C., Fanelli R., Manzi L., Veglia F., Autrup H., Dunning A., Garte S., Hainaut P., Hoek G., Krzyzanowski M., Malaveille C., Matullo G., Overvad K., Tjonneland A., Clavel-Chapelon F., Linseisen J., Boeing H., et al.

Cancer Epidemiol Biomarkers Prev; 2005; 14(9): 2118-2124

PMID:16172219

Abstract as provided by PubMed

The aim of this study was to evaluate whether biomarkers of environmental tobacco smoke exposure [i.e., 4-aminobiphenyl-hemoglobin (4-ABP-Hb) adducts] were predictive of the risk of tobacco-related cancers and diseases. We did a case-control study nested within the European Prospective Investigation into Cancer and Nutrition, involving 190 controls and 149 cases (incident cancer of the lung, bladder, pharynx, larynx, oral cavity, leukemias, and chronic obstructive pulmonary disease or emphysema deaths). All individuals were never smokers or ex smokers for >10 years. 4-ABP-Hb adducts were analyzed in peripheral blood collected before the onset of the disease (median, 7 years). Overall, 4-ABP-Hb adducts were higher, although not statistically significantly so, in cases (as a whole) than controls. In the control population, high fruit and vegetable consumption significantly lowered the frequency of detectable adducts (Fisher's exact test, P = 0.025). Restricting the analysis to women, 4-ABP-Hb adducts were higher in cases than controls (Mann-Whitney P = 0.036) and the odds ratio (OR) for the presence/absence of adducts was 2.42 [95% confidence interval (95% CI), 1.18-4.98]. Moreover, the association of adducts with the individual cancer types was stronger in women than in the whole study population, although statistically significant only for leukemias (OR, 2.77; 95% CI, 1.06-7.20). The results provide some evidence that women may be more susceptible to environmental tobacco smoke, as suggested by their higher adduct levels. The most important finding of this prospective study is that, at least in women, 4-ABP-Hb adducts may help identify subjects at high risk of cancers related to environmental tobacco smoke exposure

Plasma carotenoids as biomarkers of intake of fruits and vegetables. Ecological level correlations in the European Prospective Investigation into Cancer and Nutrition

Al-Delaimy W.K., Slimani N., Ferrari P., Key T., Spencer E., Johansson I., Johansson G., Mattisson I., Wirfalt E., Sieri S, Agudo A., Celentano E., Palli D, Sacerdote C, Tumino R, Dorronsoro M., Ocke M.C., Bueno-de-Mesquita HB, Overvad K, Chirlaque M.D., Trichopoulou A, Naska A., Tjonneland A, Olsen A., Lund E., Skeie G., Ardanaz E., Kesse E., Boutron-Ruault M.C., Clavel-Chapelon F., Bingham S., Welch A.A., Martinez-Garcia C., Nagel G., Linseisen J, Quiros J.R., Peeters P.H.M., Van Gils C.H., Boeing H, Riboli E

Eur J Clin Nutr; 2005; 59(12): 1397-1408

PMID:16160701

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