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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

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

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


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

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: individual-level correlations in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Al-Delaimy W.K., Ferrari P., Slimani N., Pala V., Johansson I., Nilsson S., Mattisson I., Wirfalt E., Galasso R., Palli D., Vineis P., Tumino R., Dorronsoro M., Pera G., Ocke M.C., Bueno-de-Mesquita H.B., Overvad K., Chirlaque M., Trichopoulou A., Naska A., Tjonneland A., Olsen A., Lund E., Alsaker E.H., Barricarte A., Kesse E., Boutron-Ruault M.C., Clavel-Chapelon F., Key T.J., Spencer E., Bingham S., Welch A.A., Sanchez-Perez M.J., Nagel G., Linseisen J., Quiros J.R., Peeters P.H., Van Gils C.H., Boeing H., van Kappel A.L., Steghens J.P., Riboli E.

Eur J Clin Nutr; 2005; 59(12): 1387-1396

Abstract as provided by PubMed

OBJECTIVE: The aim in this study was to assess the association between individual plasma carotenoid levels (alpha-carotene, beta-carotene, lycopene, beta-cryptoxanthin, lutein, zeaxanthin) and fruit and vegetable intakes recorded by a calibrated food questionnaire (FQ) and 24-h dietary recall records (24HDR) in nine different European countries with diverse populations and widely varying intakes of plant foods. DESIGN: A stratified random subsample of 3089 men and women from nine countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC), who had provided blood samples and dietary and other lifestyle information between 1992 and 2000, were included. RESULTS: beta-Cryptoxanthin was most strongly correlated with total fruits (FQ r = 0.52, 24HDR r = 0.39), lycopene with tomato and tomato products (FQ r = 0.38, 24HDR r = 0.25), and alpha-carotene with intake of root vegetables (r = 0.39) and of total carrots (r = 0.38) for FQ only. Based on diet measured by FQ and adjusting for possible confounding by body mass index (BMI), age, gender, smoking status, alcohol intake, and energy intake, the strongest predictors of individual plasma carotenoid levels were fruits (R(partial)(2) = 17.2%) for beta-cryptoxanthin, total carrots ((partial)(2) = 13.4%) and root vegetables (R(partial)(2) = 13.3%) for alpha-carotene, and tomato products (R(partial)(2) = 13.8%) for lycopene. For 24HDR, the highest R(partial)(2) was for fruits in relation to beta-cryptoxanthin (7.9%). CONCLUSIONS: Intakes of specific fruits and vegetables as measured by food questionnaires are good predictors of certain individual plasma carotenoid levels in our multicentre European study. At individual subject levels, FQ measurements of fruits, root vegetables and carrots, and tomato products are, respectively, good predictors of beta-cryptoxanthin, alpha-carotene, and lycopene in plasma

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
Dietary patterns among older Europeans: the EPIC-Elderly study

Bamia Christina, Orfanos Philippos, Ferrari Pietro, Overvad Kim, Hundborg Heidi H., Tjonneland Anne, Olsen Anja, Kesse Emmanuelle, Boutron-Ruault Marie Christine, Clavel-Chapelon Francoise, Nagel Gabriele, Boffetta Paolo, Boeing Heiner, Hoffmann Kurt, Trichopoulos Dimitrios, Baibas Nikos, Psaltopoulou Theodora, Norat Teresa, Slimani Nadia, Palli Domenico, Krogh Vittorio, Panico Salvatore, Tumino Rosario, Sacerdote Carlotta, Bueno-de-Mesquita H.B., Ocke Marga C., Peeters Petra H., van Rossum Caroline T., Quiros Jose Ramon, Sanchez Maria Jose, Navarro Carmen, Barricarte Aurelio, Dorronsoro Miren, Berglund Goran, Wirfalt Elisabet, Hallmans Goran, Johansson Ingegerd, Bingham Sheila, Khaw Kay Tee, Spencer Elizabeth A., Roddam Andrew W., Riboli Elio, Trichopoulou Antonia

Br J Nutr; 2005; 94(1): 100-113

Abstract as provided by PubMed

Overall dietary patterns have been associated with health and longevity. We used principal component (PC) and cluster analyses to identify the prevailing dietary patterns of 99 744 participants, aged 60 years or older, living in nine European countries and participating in the European Prospective Investigation into Cancer and Nutrition (EPIC-Elderly cohort) and to examine their socio-demographic and lifestyle correlates. Two PC were identified: PC1 reflects a 'vegetable-based' diet with an emphasis on foods of plant origin, rice, pasta and other grain rather than on margarine, potatoes and non-alcoholic beverages. PC2 indicates a 'sweet- and fat-dominated' diet with a preference for sweets, added fat and dairy products but not meat, alcohol, bread and eggs. PC1 was associated with a younger age, a higher level of education, physical activity, a higher BMI, a lower waist:hip ratio and never and past smoking. PC2 was associated with older age, less education, never having smoked, a lower BMI and waist:hip ratio and lower levels of physical activity. Elderly individuals in southern Europe scored positively on PC1 and about zero on PC2, whereas the elderly in northern Europe scored negatively on PC1 and variably on PC2. The results of cluster analysis were compatible with the indicated dietary patterns. 'Vegetable-based' and a 'sweet- and fat-dominated' diets are prevalent among the elderly across Europe, and there is a north-south gradient regarding their dietary choices. Our study contributes to the identification of groups of elderly who are likely to have different prospects for long-term disease occurrence and survival

C-peptide, IGF-I, sex-steroid hormones and adiposity: a cross-sectional study in healthy women within the European Prospective Investigation into Cancer and Nutrition (EPIC)

Bezemer I.D., Rinaldi S., Dossus L., Gils C.H., Peeters P.H.M., Noord P.A.H., Bueno-de-Mesquita H.B., Johnsen S.P., Overvad K., Olsen A., Tjonneland A., Boeing H., Lahmann P.H., Linseisen J., Nagel G., Allen N., Roddam A., Bingham S., Khaw K.T., Kesse E., Tehard B., Clavel-Chapelon F., Agudo A., Ardanaz E., Quiros J.R., Amiano P., Martinez G., Tormo M.J., Pala V., Panico S., Vineis P., Palli D., Tumino R., Trichopoulou A., Baibas N., Zilis D., Hemon B., Norat T., Riboli E., Kaaks R.

Cancer Causes Control; 2005; 16(5): 561-572
Genetic variation in the growth hormone synthesis pathway in relation to circulating insulin-like growth factor-I, insulin-like growth factor binding protein-3, and breast cancer risk: results from the European prospective investigation into cancer and nutrition study.

Cancer Epidemiol Biomarkers Prev; 2005; 14(10):
An approach to estimate between- and within-group correlation coefficients in multicenter studies: plasma carotenoids as biomarkers of intake of fruits and vegetables

Ferrari P., Al Delaimy W.K., Slimani N., Boshuizen H.C., Roddam A., Orfanos P., Skeie G., Rodriguez-Barranco M., Thiebaut A., Johansson G., Palli D., Boeing H., Overvad K., Riboli E.

American journal of epidemiology; 2005; 162(6): 591-598

Abstract as provided by PubMed

In a multicenter study, the overall correlation between two variables can be broken down into a within- and a between-group correlation reflecting associations at the individual and aggregate levels, respectively. A random-effects model is used to estimate variance components of nutrition-related variables and the within- and between-group correlation coefficients. Using data from the European Prospective Investigation into Cancer and Nutrition (EPIC), the authors analyzed the association between levels of three plasma carotenoids (alpha-carotene, beta-cryptoxanthin, and lycopene) and dietary intake of three items (total fruits, carrots, and tomatoes), assessed through dietary questionnaire and single 24-hour dietary recall measurements, in a cross-sectional study involving 3,089 subjects from nine European countries. Intraclass correlation coefficients were 0.178 for alpha-carotene, 0.216 for beta-cryptoxanthin, and 0.299 for lycopene. The between-group correlation coefficients were higher than the within-group coefficients for all three carotenoids. For beta-cryptoxanthin and fruit intake, the between-group versus the within-group correlations were 0.78 and 0.26 for the dietary questionnaire and 0.85 and 0.19 for the 24-hour dietary recall. Results indicate that variability of exposure is driven mainly by the individual compared with the aggregate variation and that biomarker levels perform fairly accurately in discriminating population-level consumption of fruits and vegetables

Long term cryoconservation and stability of vitamin C in serum samples of the European prospective investigation into cancer and nutrition

Jenab M., Bingham S., Ferrari P., Friesen M.D., Al-Delaimy W., Luben R., Wareham N., Khaw K.T., Riboli E.

Cancer Epidemiol Biomarkers Prev; 2005; 14(7): 1837-1840
Variations in lycopene blood levels and tomato consumption across European countries based on the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Jenab M., Ferrari Pietro, Mazuir Mathieu, Tjonneland Anne, Clavel-Chapelon Francoise, Linseisen Jakob, Trichopoulou Antonia, Tumino Rosario, Bueno-De-Mesquita Hendrik B., Lund Eiliv, Gonzalez Carlos A., Johansson Gerd, Key Timothy J., Riboli Elio

J Nutr; 2005; 135(8): 2032S-2036S
Serum sex steroids in premenopausal women and breast cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC)

J Natl Cancer Inst; 2005; 97(10): 755-765
Postmenopausal serum androgens, oestrogens and breast cancer risk: the European prospective investigation into cancer and nutrition

Kaaks R., Rinaldi S., Key T.J., Berrino F., Peeters P.H.M., Biessy C., Dossus L., Lukanova A., Bingham S., Khaw K.T., Allen N.E., Bueno-de-Mesquita H.B., Van Gils C.H., Grobbee D., Boeing H., Lahmann P.H., Nagel G., Chang-Claude J., Clavel-Chapelon F., Fournier A., Thiebaut A., Gonzalez C.A., Quiros J.R., Tormo M.J., Ardanaz E., Amiano P., Krogh V., Palli D., Panico S., Tumino R., Vineis P., Trichopoulou A., Kalapothaki V., Trichopoulos D., Ferrari P., Norat T., Saracci R., Riboli E.

Endocr Relat Cancer; 2005; 12(4): 1071-1082

Abstract as provided by PubMed

Considerable experimental and epidemiological evidence suggests that elevated endogenous sex steroids -- notably androgens and oestrogens -- promote breast tumour development. In spite of this evidence, postmenopausal androgen replacement therapy with dehydroepiandrosterone (DHEA) or testosterone has been advocated for the prevention of osteoporosis and improved sexual well-being. We have conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition. Levels of DHEA sulphate (DHEAS), ({Delta}4-androstenedione), testosterone, oestrone, oestradiol and sex-hormone binding globulin (SHBG) were measured in prediagnostic serum samples of 677 postmenopausal women who subsequently developed breast cancer and 1309 matched control subjects. Levels of free testosterone and free oestradiol were calculated from absolute concentrations of testosterone, oestradiol and SHBG. Logistic regression models were used to estimate relative risks of breast cancer by quintiles of hormone concentrations. For all sex steroids -the androgens as well as the oestrogens - elevated serum levels were positively associated with breast cancer risk, while SHBG levels were inversely related to risk. For the androgens, relative risk estimates (95% confidence intervals) between the top and bottom quintiles of the exposure distribution were: DHEAS 1.69 (1.23-2.33), androstenedione 1.94 (1.40-2.69), testosterone 1.85 (1.33-2.57) and free testosterone 2.50 (1.76-3.55). For the oestrogens, relative risk estimates were: oestrone 2.07 (1.42-3.02), oestradiol 2.28 (1.61-3.23) and free oestradiol (odds ratios 2.13 (1.52-2.98)). Adjustments for body mass index or other potential confounding factors did not substantially alter any of these relative risk estimates. Our results have shown that, among postmenopausal women, not only elevated serum oestrogens but also serum androgens are associated with increased breast cancer risk. Since DHEAS and androstenedione are largely of adrenal origin in postmenopausal women, our results indicated that elevated adrenal androgen synthesis is a risk factor for breast cancer. The results from this study caution against the use of DHEA(S), or other androgens, for postmenopausal androgen replacement therapy

Long-term weight change and breast cancer risk: the European prospective investigation into cancer and nutrition (EPIC)

Lahmann P.H., Schulz M., Hoffmann K., Boeing H., Tjonneland A., Olsen A., Overvad K., Key T.J., Allen N.E., Khaw K.T., Bingham S., Berglund G., Wirfalt E., Berrino F., Krogh V., Trichopoulou A., Lagiou P., Trichopoulos D., Kaaks R., Riboli E.

Br J Cancer; 2005; 93(5): 582-589

Abstract as provided by PubMed

We examined prospectively the association between weight change during adulthood and breast cancer risk, using data on 1358 incident cases that developed during 5.8 years of follow-up among 40,429 premenopausal and 57,923 postmenopausal women from six European countries, taking part in the European prospective investigation into cancer and nutrition study. Multivariate Cox regression models were used to calculate hazard ratios according to weight change (kg), defined as the weight difference between age at enrollment and age 20 adjusted for other risk factors. Changes in weight were not associated with premenopausal breast cancer risk. In postmenopausal women, weight gain was positively associated with breast cancer risk only among noncurrent hormone replacement therapy (HRT) users (P-trend < or = 0.0002). Compared to women with a stable weight (+/-2 kg), the relative risk for women who gained 15-20 kg was 1.50 (95% confidence interval (CI) 1.06-2.13). The pooled RR per weight gain increment of 5 kg was 1.08 (95% CI 1.04-1.12). Weight gain was not associated with breast cancer risk in current HRT users, although, overall, these women experienced a much higher risk of breast cancer compared with nonusers. Our findings suggest that large adult weight gain was a significant predictor of breast cancer in postmenopausal women not taking exogenous hormones

Meat and fish consumption, and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition (EPIC)

J Natl Cancer Inst; 2005; 97(12): 906-916
Re: Meat, fish, and colorectal cancer risk: The European prospective investigation into cancer and nutrition - Reply

Norat T., Bingham S., Riboli E.

J Natl Cancer Inst; 2005; 97(23): 1788-1789
DNA adducts and lung cancer risk: a prospective study

Peluso M., Munnia Armelle, Hoek Gerard, Krzyzanowski Michal, Veglia Fabrizio, Airoldi Luisa, Autrup Herman, Dunning Alison, Garte Seymour, Hainaut Pierre, Malaveille Christian, Gormally Emmanuelle, Matullo Giuseppe, Overvad Kim, Raaschou-Nielsen Ole, Clavel-Chapelon Francoise, Linseisen Jacob, Boeing Heiner, Trichopoulou Antonia, Trichopoulos Dimitrios, Kaladidi Anna, Palli Domenico, Krogh Vittorio, Tumino Rosario, Panico Salvatore, Bueno-De-Mesquita H.Bas, Peeters Petra H., Kumle Merethe, Gonzalez Carlos A., Martinez Carmen, Dorronsoro Miren, Barricarte Aurelio, Navarro Carmen, Quiros J.Ramon, Berglund Goran, Janzon Lars, Jarvholm Bengt, Day Nicholas E., Key Tim J., Saracci Rodolfo, Kaaks Rudolf, Riboli Elio, Vineis Paolo

Cancer Res; 2005; 65(17): 8042-8048

Abstract as provided by PubMed

Objectives were to investigate prospectively the ability of DNA adducts to predict cancer and to study the determinants of adducts, especially air pollutants. DNA adducts were measured in a case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC) investigation. Cases included newly diagnosed lung cancer (n = 115), upper respiratory cancers (pharynx and larynx; n = 82), bladder cancer (n = 124), leukemia (n = 166), and chronic obstructive pulmonary disease or emphysema deaths (n = 77) accrued after a median follow-up of 7 years among the EPIC former smokers and never-smokers. Three controls per case were matched for questionnaire analyses and two controls per case for laboratory analyses. Matching criteria were gender, age, smoking status, country of recruitment, and follow-up time. Individual exposure to air pollution was assessed using concentration data from monitoring stations in routine air quality monitoring networks. Leukocyte DNA adducts were analyzed blindly using 32P postlabeling technique. Adducts were associated with the subsequent risk of lung cancer, with an odds ratio (OR) of 1.86 [95% confidence interval (95% CI), 0.88-3.93] when comparing detectable versus nondetectable adducts. The association with lung cancer was stronger in never-smokers (OR, 4.04; 95% CI, 1.06-15.42) and among the younger age groups. After exclusion of the cancers occurring in the first 36 months of follow-up, the OR was 4.16 (95% CI, 1.24-13.88). A positive association was found between DNA adducts and ozone (O3) concentration. Our prospective study suggests that leukocyte DNA adducts may predict lung cancer risk of never-smokers. Besides, the association of DNA adduct levels with O3 indicates a possible role for photochemical smog in determining DNA damage

Fruit and vegetable consumption and risk of epithelial ovarian cancer: the European Prospective Investigation into Cancer and Nutrition

Schulz M., Lahmann P.H., Boeing H., Hoffmann K., Allen N., Key T.J., Bingham S., Wirfalt E., Berglund G., Lundin E., Hallmans G., Lukanova A., Martinez Garcia C., Gonzalez C.A., Tormo M.J., Quiros J.R., Ardanaz E., Larranaga N., Lund E., Gram I.T., Skeie G., Peeters P.H., Van Gils C.H., Bueno-de-Mesquita H.B., Buchner F.L., Pasanisi P., Galasso R., Palli D., Tumino R., Vineis P., Trichopoulou A., Kalapothaki V., Trichopoulos D., Chang-Claude J., Linseisen J., Boutron-Ruault M.C., Touillaud M., Clavel-Chapelon F., Olsen A., Tjonneland A., Overvad K., Tetsche M., Jenab M., Norat T., Kaaks R., Riboli E.

Cancer Epidemiol Biomarkers Prev; 2005; 14(11): 2531-2535

Abstract as provided by PubMed

OBJECTIVE: The association between consumption of fruit and vegetables and risk of ovarian cancer is still unclear from a prospective point of view. METHODS: Female participants (n = 325,640) of the European Prospective Investigation into Cancer and Nutrition study, free of any cancer at baseline, were followed on average for 6.3 years to develop ovarian cancer. During 2,049,346 person-years, 581 verified cases of primary, invasive epithelial ovarian cancer were accrued. Consumption of fruits and vegetables as well as subgroups of vegetables, estimated from validated dietary questionnaires and calibrated thereafter, was related to ovarian cancer incidence in multivariable hazard regression models. Histologic subtype specific analyses were done. RESULTS: Total intake of fruit and vegetables, separately or combined, as well as subgroups of vegetables (fruiting, root, leafy vegetables, cabbages) was unrelated to risk of ovarian cancer. A high intake of garlic/onion vegetables was associated with a borderline significant reduced risk of this cancer. The examination by histologic subtype indicated some differential effects of fruit and vegetable intake on ovarian cancer risk. CONCLUSION: Overall, a high intake of fruits and vegetables did not seem to protect from ovarian cancer. Garlic/onion vegetables may exert a beneficial effect. The study of the histologic subtype of the tumor warrants further investigation


Plasma levels of six carotenoids in nine European countries: report from the European Prospective Investigation into Cancer and Nutrition (EPIC).

Public Health Nutr; 2004; 7(6): 713-722
Diet and cancer - the European Prospective Investigation into Cancer and Nutrition

Bingham S., Riboli E.

Nat Rev Cancer; 2004; 4(3): 206-215
Association of nut and seed intake with colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Cancer Epidemiol Biomarkers Prev; 2004; 13(10): 1595-1603
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