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Search Result (493 REFERENCES)

2015

Pre-diagnostic polyphenol intake and breast cancer survival: the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Kyro C., Zamora-Ros R., Scalbert A., Tjonneland A., Dossus L., Johansen C., Bidstrup P. E., Weiderpass E., Christensen J., Ward H., Aune D., Riboli E., His M., Clavel-Chapelon F., Baglietto L., Katzke V., Kuhn T., Boeing H., Floegel A., Overvad K., Lasheras C., Travier N., Sanchez M. J., Amiano P., Chirlaque M. D., Ardanaz E., Khaw K. T., Wareham N., Perez-Cornago A., Trichopoulou A., Lagiou P., Vasilopoulou E., Masala G., Grioni S., Berrino F., Tumino R., Sacerdote C., Mattiello A., Bueno-de-Mesquita H. B., Peeters P. H., van Gils C., Borgquist S., Butt S., Zeleniuch-Jacquotte A., Sund M., Hjartaker A., Skeie G., Olsen A., Romieu I.

Breast Cancer Res Treat; 2015; 154(2): 389-401

PMID:26531755

Abstract as provided by PubMed

The aim was to investigate the association between pre-diagnostic intakes of polyphenol classes (flavonoids, lignans, phenolic acids, stilbenes, and other polyphenols) in relation to breast cancer survival (all-cause and breast cancer-specific mortality). We used data from the European Prospective Investigation into Cancer and Nutrition cohort. Pre-diagnostic usual diet was assessed using dietary questionnaires, and polyphenol intakes were estimated using the Phenol-Explorer database. We followed 11,782 breast cancer cases from time of diagnosis until death, end of follow-up or last day of contact. During a median of 6 years, 1482 women died (753 of breast cancer). We related polyphenol intake to all-cause and breast cancer-specific mortality using Cox proportional hazard models with time since diagnosis as underlying time and strata for age and country. Among postmenopausal women, an intake of lignans in the highest versus lowest quartile was related to a 28 % lower risk of dying from breast (adjusted model: HR, quartile 4 vs. quartile 1, 0.72, 95 % CI 0.53; 0.98). In contrast, in premenopausal women, a positive association between lignan intake and all-cause mortality was found (adjusted model: HR, quartile 4 vs. quartile 1, 1.63, 95 % CI 1.03; 2.57). We found no association for other polyphenol classes. Intake of lignans before breast cancer diagnosis may be related to improved survival among postmenopausal women, but may on the contrary worsen the survival for premenopausal women. This suggests that the role of phytoestrogens in breast cancer survival is complex and may be dependent of menopausal status.

Subtypes of fruit and vegetables, variety in consumption and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition

Leenders M., Siersema P.D., Overvad K., Tjonneland A., Olsen A., Boutron-Ruault M.C., Bastide N., Fagherazzi G., Katzke V., Kuhn T., Boeing H., Aleksandrova K., Trichopoulou A., Lagiou P., Klinaki E., Masala G., Grioni S., Santucci de Magistris M., Tumino R., Ricceri F., Peeters P.H., Lund E., Skeie G., Weiderpass E., Quiros J.R., Agudo A., Sanchez M.J., Dorronsoro M., Navarro C., Ardanaz E., Ohlsson B., Jirstrom K., Van Guelpen B., Wennberg M., Khaw K.T., Wareham N., Key T.J., Romieu I., Huybrechts I., Cross A.J., Murphy N., Riboli E., Bueno-de-Mesquita H.B.

Int J Cancer; 2015; 137(11): 2705-2714

PMID:26077137

Abstract as provided by PubMed

Previously, a lower risk of colorectal cancer was observed with fruit and vegetable consumption in the European Prospective Investigation into Cancer and Nutrition within a follow-up period of 9 years which was not fully supported by a recent meta-analysis. Therefore, we were interested in the relation with extended follow-up, also focusing on single subtypes and a variety of intake of fruit and vegetables. Fruit and vegetable consumption was assessed at baseline. After an average of 13 years of follow-up, 3,370 participants were diagnosed with colon or rectal cancer. Diet diversity scores were constructed to quantify variety in fruit and vegetable consumption. A lower risk of colon cancer was observed with higher self-reported consumption of fruit and vegetable combined (HR Q4 vs. Q1 0.87, 95% CI 0.75-1.01, p for trend 0.02), but no consistent association was observed for separate consumption of fruits and vegetables. No associations with risk of rectal cancer were observed. The few observed associations for some fruit and vegetable subtypes with colon cancer risk may have been due to chance. Variety in consumption of fruits and vegetables was not associated with a lower risk of colon or rectal cancer. Although a lower risk of colon cancer is suggested with high consumption of fruit and vegetables, this study does not support a clear inverse association between fruit and vegetable consumption and colon or rectal cancer beyond a follow-up of more than 10 years. Attenuation of the risk estimates from dietary changes over time cannot be excluded, but appears unlikely

An epidemiologic risk prediction model for ovarian cancer in Europe: the EPIC study

Li K., Husing A., Fortner R.T., Tjonneland A., Hansen L., Dossus L., Chang-Claude J., Bergmann M., Steffen A., Bamia C., Trichopoulos D., Trichopoulou A., Palli D., Mattiello A., Agnoli C., Tumino R., Onland-Moret N.C., Peeters P.H., Bueno-de-Mesquita H.B., Gram I.T., Weiderpass E., Sanchez-Cantalejo E., Chirlaque M.D., Duell E.J., Ardanaz E., Idahl A., Lundin E., Khaw K.T., Travis R.C., Merritt M.A., Gunter M.J., Riboli E., Ferrari P., Terry K., Cramer D., Kaaks R.

Br J Cancer; 2015; 1257-1265

PMID:25742479

Abstract as provided by PubMed

BACKGROUND: Ovarian cancer has a high case-fatality ratio, largely due to late diagnosis. Epidemiologic risk prediction models could help identify women at increased risk who may benefit from targeted prevention measures, such as screening or chemopreventive agents. METHODS: We built an ovarian cancer risk prediction model with epidemiologic risk factors from 202 206 women in the European Prospective Investigation into Cancer and Nutrition study. RESULTS: Older age at menopause, longer duration of hormone replacement therapy, and higher body mass index were included as increasing ovarian cancer risk, whereas unilateral ovariectomy, longer duration of oral contraceptive use, and higher number of full-term pregnancies were decreasing risk. The discriminatory power (overall concordance index) of this model, as examined with five-fold cross-validation, was 0.64 (95% confidence interval (CI): 0.57, 0.70). The ratio of the expected to observed number of ovarian cancer cases occurring in the first 5 years of follow-up was 0.90 (293 out of 324, 95% CI: 0.81-1.01), in general there was no evidence for miscalibration. CONCLUSION: Our ovarian cancer risk model containing only epidemiological data showed modest discriminatory power for a Western European population. Future studies should consider adding informative biomarkers to possibly improve the predictive ability of the model

Healthy lifestyle and risk of breast cancer among postmenopausal women in the European Prospective Investigation into Cancer and Nutrition cohort study

McKenzie F., Ferrari P., Freisling H., Chajes V., Rinaldi S., de Batlle J., Dahm C.C., Overvad K., Baglietto L., Dartois L., Dossus L., Lagiou P., Trichopoulos D., Trichopoulou A., Krogh V., Panico S., Tumino R., Rosso S., Bueno-de-Mesquita H.B., May A., Peeters P.H., Weiderpass E., Buckland G., Sanchez M.J., Navarro C., Ardanaz E., Andersson A., Sund M., Ericson U., Wirfalt E., Key T.J., Travis R.C., Gunter M., Riboli E., Vergnaud A.C., Romieu I.

Int. J Cancer; 2015; 136(11): 2640-2648

PMID:25379993

Abstract as provided by PubMed

Breast cancer is the most common cancer among women and prevention strategies are needed to reduce incidence worldwide. A healthy lifestyle index score (HLIS) was generated to investigate the joint effect of modifiable lifestyle factors on postmenopausal breast cancer risk. The study included 242,918 postmenopausal women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, with detailed information on diet and lifestyle assessed at baseline. The HLIS was constructed from five factors (diet, physical activity, smoking, alcohol consumption and anthropometry) by assigning scores of 0-4 to categories of each component, for which higher values indicate healthier behaviours. Hazard ratios (HR) were estimated by Cox proportional regression models. During 10.9 years of median follow-up, 7,756 incident breast cancer cases were identified. There was a 3% lower risk of breast cancer per point increase of the HLIS. Breast cancer risk was inversely associated with a high HLIS when fourth versus second (reference) categories were compared [adjusted HR = 0.74; 95% confidence interval (CI): 0.66-0.83]. The fourth versus the second category of the HLIS was associated with a lower risk for hormone receptor double positive (adjusted HR = 0.81, 95% CI: 0.67-0.98) and hormone receptor double negative breast cancer (adjusted HR = 0.60, 95% CI: 0.40-0.90). Findings suggest having a high score on an index of combined healthy behaviours reduces the risk of developing breast cancer among postmenopausal women. Programmes which engage women in long term health behaviours should be supported

Reproductive factors and risk of mortality in the European Prospective Investigation into Cancer and Nutrition; a cohort study

Merritt M. A., Riboli E., Murphy N., Kadi M., Tjonneland A., Olsen A., Overvad K., Dossus L., Dartois L., Clavel-Chapelon F., Fortner R. T., Katzke V. A., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Sieri S., Tumino R., Sacerdote C., Panico S., Bueno-de-Mesquita H. B., Peeters P. H., Lund E., Nakamura A., Weiderpass E., Quiros J. R., Agudo A., Molina-Montes E., Larranaga N., Dorronsoro M., Cirera L., Barricarte A., Olsson A., Butt S., Idahl A., Lundin E., Wareham N. J., Key T. J., Brennan P., Ferrari P., Wark P. A., Norat T., Cross A. J., Gunter M. J.

BMC Med; 2015; 252

PMID:26515238

Abstract as provided by PubMed

BACKGROUND: Reproductive events are associated with important physiologic changes, yet little is known about how reproductive factors influence long-term health in women. Our objective was to assess the relation of reproductive characteristics with all-cause and cause-specific mortality risk. METHODS: The analysis was performed within the European Investigation into Cancer and Nutrition prospective cohort study, which enrolled >500,000 women and men from 1992 to 2000, who were residing in a given town/geographic area in 10 European countries. The current analysis included 322,972 eligible women aged 25-70 years with 99 % complete follow-up for vital status. We assessed reproductive characteristics reported at the study baseline including parity, age at the first birth, breastfeeding, infertility, oral contraceptive use, age at menarche and menopause, total ovulatory years, and history of oophorectomy/hysterectomy. Hazard ratios (HRs) and 95 % confidence intervals (CIs) for mortality were determined using Cox proportional hazards regression models adjusted for menopausal status, body mass index, physical activity, education level, and smoking status/intensity and duration. RESULTS: During a mean follow-up of 12.9 years, 14,383 deaths occurred. The HR (95 % CI) for risk of all-cause mortality was lower in parous versus nulliparous women (0.80; 0.76-0.84), in women who had ever versus never breastfed (0.92; 0.87-0.97), in ever versus never users of oral contraceptives (among non-smokers; 0.90; 0.86-0.95), and in women reporting a later age at menarche (>/=15 years versus <12; 0.90; 0.85-0.96; P for trend = 0.038). CONCLUSIONS: Childbirth, breastfeeding, oral contraceptive use, and a later age at menarche were associated with better health outcomes. These findings may contribute to the development of improved strategies to promote better long-term health in women.

Investigation of Dietary Factors and Endometrial Cancer Risk Using a Nutrient-wide Association Study Approach in the EPIC and Nurses' Health Study (NHS) and NHSII

Merritt M.A., Tzoulaki I., Tworoger S.S., De Vivo I, Hankinson S.E., Fernandes J., Tsilidis K.K., Weiderpass E., Tjonneland A., Petersen K.E., Dahm C.C., Overvad K., Dossus L., Boutron-Ruault M.C., Fagherazzi G., Fortner R.T., Kaaks R., Aleksandrova K., Boeing H., Trichopoulou A., Bamia C., Trichopoulos D., Palli D., Grioni S., Tumino R., Sacerdote C., Mattiello A., Bueno-de-Mesquita H.B., Onland-Moret N.C., Peeters P.H., Gram I.T., Skeie G., Quiros J.R., Duell E.J., Sanchez M.J., Salmeron D., Barricarte A., Chamosa S., Ericson U., Sonestedt E., Nilsson L.M., Idahl A., Khaw K.T., Wareham N., Travis R.C., Rinaldi S., Romieu I., Patel C.J., Riboli E., Gunter M.J.

Cancer Epidemiol. Biomarkers Prev; 2015; 24(2): 466-471

PMID:25662427

Abstract as provided by PubMed

Data on the role of dietary factors in endometrial cancer development are limited and inconsistent. We applied a "nutrient-wide association study" approach to systematically evaluate dietary risk associations for endometrial cancer while controlling for multiple hypothesis tests using the false discovery rate (FDR) and validating the results in an independent cohort. We evaluated endometrial cancer risk associations for dietary intake of 84 foods and nutrients based on dietary questionnaires in three prospective studies, the European Prospective Investigation into Cancer and Nutrition (EPIC; N = 1,303 cases) followed by validation of nine foods/nutrients (FDR </= 0.10) in the Nurses' Health Studies (NHS/NHSII; N = 1,531 cases). Cox regression models were used to estimate HRs and 95% confidence intervals (CI). In multivariate adjusted comparisons of the extreme categories of intake at baseline, coffee was inversely associated with endometrial cancer risk (EPIC, median intake 750 g/day vs. 8.6; HR, 0.81; 95% CI, 0.68-0.97, Ptrend = 0.09; NHS/NHSII, median intake 1067 g/day vs. none; HR, 0.82; 95% CI, 0.70-0.96, Ptrend = 0.04). Eight other dietary factors that were associated with endometrial cancer risk in the EPIC study (total fat, monounsaturated fat, carbohydrates, phosphorus, butter, yogurt, cheese, and potatoes) were not confirmed in the NHS/NHSII. Our findings suggest that coffee intake may be inversely associated with endometrial cancer risk. Further data are needed to confirm these findings and to examine the mechanisms linking coffee intake to endometrial cancer risk to develop improved prevention strategies. Cancer Epidemiol Biomarkers Prev; 24(2); 466-71. (c)2015 AACR

Association of CRP genetic variants with blood concentrations of C-reactive protein and colorectal cancer risk

Nimptsch K., Aleksandrova K., Boeing H., Janke J., Lee Y.A., Jenab M., Bueno-de-Mesquita H.B., Jansen E.H., Tsilidis K.K., Trichopoulou A., Weiderpass E., Wu C., Overvad K., Tjonneland A., Boutron-Ruault M.C., Dossus L., Racine A., Kaaks R., Canzian F., Lagiou P., Trichopoulos D., Palli D., Agnoli C., Tumino R., Vineis P., Panico S., Johansson A., Van Guelpen B., Khaw K.T., Wareham N., Peeters P.H., Quiros J.R., Vencesla Garcia A., Molina-Montes E., Dorronsoro M., Chirlaque M.D., Barricarte Gurrea A., Key T.J., Duarte-Salles T., Stepien M., Gunter M.J., Riboli E., Pischon T.

Int J Cancer; 2015; 136(5): 1181-1192

Abstract as provided by PubMed

High blood concentrations of C-reactive protein (CRP) have been associated with elevated risk of colorectal cancer in several prospective studies including the European Prospective Investigation into Cancer and Nutrition (EPIC), but it is unknown whether these observations reflect a causal relationship. We aimed to investigate whether CRP genetic variants associated with lifelong higher CRP concentrations translate into higher colorectal cancer risk. We conducted a prospective nested case-control study within EPIC including 727 cases diagnosed between 1992 and 2003 and 727 matched controls selected according to an incidence-density sampling protocol. Baseline CRP concentrations were measured in plasma samples by a high sensitivity assay. Tagging single nucleotide polymorphisms (SNPs) in the CRP gene (rs1205, rs1800947, rs1130864, rs2808630, rs3093077) were identified via HapMap. The causal effect of CRP on colorectal cancer risk was examined in a Mendelian Randomization approach utilizing multiple CRP genetic variants as instrumental variables. The SNPs rs1205, rs1800947, rs1130864 and rs3093077 were significantly associated with CRP concentrations and were incorporated in a CRP allele score which was associated with 13% higher CRP concentrations per allele count (95% confidence interval 8-19%). Using the CRP-score as instrumental variable, genetically twofold higher CRP concentrations were associated with higher risk of colorectal cancer (odds ratio 1.74, 95% confidence interval 1.06-2.85). Similar observations were made using alternative definitions of instrumental variables. Our findings give support to the hypothesis that elevated circulating CRP may play a direct role in the etiology of colorectal cancer

Plasma fetuin-A concentration, genetic variation in the AHSG gene and risk of colorectal cancer

Nimptsch K., Aleksandrova K., Boeing H., Janke J., Lee Y.A., Jenab M., Kong S.Y., Tsilidis K.K., Weiderpass E., Bueno-de-Mesquita H.B., Siersema P.D., Jansen E.H., Trichopoulou A., Tjonneland A., Olsen A., Wu C., Overvad K., Boutron-Ruault M.C., Racine A., Freisling H., Katzke V., Kaaks R., Lagiou P., Trichopoulos D., Severi G., Naccarati A., Mattiello A., Palli D., Grioni S., Tumino R., Peeters P.H., Ljuslinder I., Nystrom H., Brandstedt J., Sanchez M.J., Gurrea A.B., Bonet C.B., Chirlaque M.D., Dorronsoro M., Quiros J.R., Travis R.C., Khaw K.T., Wareham N., Riboli E., Gunter M.J., Pischon T.

Int. J Cancer; 2015; 137(4): 911-920

PMID:25611809

Abstract as provided by PubMed

Fetuin-A, also referred to as alpha2-Heremans-Schmid glycoprotein (AHSG), is a liver protein known to inhibit insulin actions. Hyperinsulinemia is a possible risk factor for colorectal cancer; however, the role of fetuin-A in the development of colorectal cancer is unclear. We investigated the association between circulating fetuin-A and colorectal cancer risk in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition. Fetuin-A concentrations were measured in prediagnostic plasma samples from 1,367 colorectal cancer cases and 1,367 matched controls. In conditional logistic regression models adjusted for potential confounders, the estimated relative risk (95% confidence interval) of colorectal cancer per 40 microg/mL higher fetuin-A concentrations (approximately one standard deviation) was 1.13 (1.02-1.24) overall, 1.21 (1.05-1.39) in men, 1.06 (0.93-1.22) in women, 1.13 (1.00-1.27) for colon cancer and 1.12 (0.94-1.32) for rectal cancer. To improve causal inference in a Mendelian Randomization approach, five tagging single nucleotide polymorphisms of the AHSG gene were genotyped in a subset of 456 case-control pairs. The AHSG allele-score explained 21% of the interindividual variation in plasma fetuin-A concentrations. In instrumental variable analysis, genetically raised fetuin-A was not associated with colorectal cancer risk (relative risk per 40 microg/mL genetically determined higher fetuin-A was 0.98, 95% confidence interval: 0.73-1.33). The findings of our study indicate a modest linear association between fetuin-A concentrations and risk of colorectal cancer but suggest that fetuin-A may not be causally related to colorectal cancer development

Dietary intake of acrylamide and epithelial ovarian cancer risk in the european prospective investigation into cancer and nutrition (EPIC) cohort

Obon-Santacana M., Peeters P.H., Freisling H., Dossus L., Clavel-Chapelon F., Baglietto L., Schock H., Fortner R.T., Boeing H., Tjonneland A., Olsen A., Overvad K., Menendez V., Sanchez M.J., Larranaga N., Huerta Castano J.M., Barricarte A., Khaw K.T., Wareham N., Travis R.C., Merritt M.A., Trichopoulou A., Trichopoulos D., Orfanos P., Masala G., Sieri S., Tumino R., Vineis P., Mattiello A., Bueno-de-Mesquita H.B., Onland-Moret N.C., Wirfalt E., Stocks T., Idahl A., Lundin E., Skeie G., Gram I.T., Weiderpass E., Riboli E., Duell E.J.

Cancer Epidemiol. Biomarkers Prev; 2015; 24(1): 291-297

PMID:25300475

Abstract as provided by PubMed

Acrylamide, classified in 1994 by the International Agency for Research on Cancer (IARC) as "probably carcinogenic" to humans, was discovered in 2002 in some heat-treated, carbohydrate-rich foods. The association between dietary acrylamide intake and epithelial ovarian cancer risk (EOC) has been previously studied in one case-control and three prospective cohort studies which obtained inconsistent results and could not further examine histologic subtypes other than serous EOC. The present study was carried out in the European Prospective Investigation into Cancer and Nutrition (EPIC) subcohort of women (n = 325,006). Multivariate Cox proportional hazards models were used to assess the association between questionnaire-based acrylamide intake and EOC risk. Acrylamide was energy-adjusted using the residual method and was evaluated both as a continuous variable (per 10 mug/d) and in quintiles; when subgroups by histologic EOC subtypes were analyzed, acrylamide intake was evaluated in quartiles. During a mean follow-up of 11 years, 1,191 incident EOC cases were diagnosed. At baseline, the median acrylamide intake in EPIC was 21.3 mug/d. No associations and no evidence for a dose-response were observed between energy-adjusted acrylamide intake and EOC risk (HR10mug/d,1.02; 95% CI, 0.96-1.09; HRQ5vsQ1, 0.97; 95% CI, 0.76-1.23). No differences were seen when invasive EOC subtypes (582 serous, 118 endometrioid, and 79 mucinous tumors) were analyzed separately. This study did not provide evidence that acrylamide intake, based on food intake questionnaires, was associated with risk for EOC in EPIC. Additional studies with more reliable estimates of exposure based on biomarkers may be needed

Insulin-like growth factor I and risk of epithelial invasive ovarian cancer by tumour characteristics: results from the EPIC cohort

Ose J., Fortner R.T., Schock H., Peeters P.H., Onland-Moret N.C., Bueno-de-Mesquita H.B., Weiderpass E., Gram I.T., Overvad K., Tjonneland A., Dossus L., Fournier A., Baglietto L., Trichopoulou A., Benetou V., Trichopoulos D., Boeing H., Masala G., Krogh V., Matiello A., Tumino R., Popovic M., Obon-Santacana M., Larranaga N., Ardanaz E., Sanchez M., Menendez V., Chirlaque M., Travis R.C., Khaw K., Brandstedt J., Idahl A., Lundin E., Rinaldi S., Kuhn E., Romieu I., Gunter M.J., Merritt M.A., Riboli E., Kaaks R.

Br J Cancer; 2015; 112(1): 162-166

PMID:25349976

Abstract as provided by PubMed

Background:Prospective studies on insulin-like growth factor I (IGF-I) and epithelial ovarian cancer (EOC) risk are inconclusive. Data suggest risk associations vary by tumour characteristics.Methods:We conducted a nested case-control study in the European Prospective Investigation into Cancer and Nutrition (EPIC) to evaluate IGF-I concentrations and EOC risk by tumour characteristics (n=565 cases). Multivariable conditional logistic regression models were used to estimate associations.Results:We observed no association between IGF-I and EOC overall or by tumour characteristics.Conclusions:In the largest prospective study to date was no association between IGF-I and EOC risk. Pre-diagnostic serum IGF-I concentrations may not influence EOC risk

Inflammatory Markers and Risk of Epithelial Ovarian Cancer by Tumor Subtypes: The EPIC Cohort

Ose J., Schock H., Tjonneland A., Hansen L., Overvad K., Dossus L., Clavel-Chapelon F., Baglietto L., Boeing H., Trichopolou A., Benetou V., Lagiou P., Masala G., Tagliabue G., Tumino R., Sacerdote C., Mattiello A., Bueno-de-Mesquita H.B., Peeters P.H., Onland-Moret N.C., Weiderpass E., Gram I.T., Sanchez S., Obon-Santacana M., Sanchez-Perez M.J., Larranaga N., Castano J.M., Ardanaz E., Brandstedt J., Lundin E., Idahl A., Travis R.C., Khaw K.T., Rinaldi S., Romieu I., Merritt M.A., Gunter M.J., Riboli E., Kaaks R., Fortner R.T.

Cancer Epidemiol. Biomarkers Prev; 2015; 24(6): 951-961

PMID:25855626

Abstract as provided by PubMed

BACKGROUND: Evidence suggests an etiologic role for inflammation in ovarian carcinogenesis and heterogeneity between tumor subtypes and anthropometric indices. Prospective studies on circulating inflammatory markers and epithelial invasive ovarian cancer (EOC) have predominantly investigated overall risk; data characterizing risk by tumor characteristics (histology, grade, stage, dualistic model of ovarian carcinogenesis) and anthropometric indices are sparse. METHODS: We conducted a nested case-control study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to evaluate C-reactive protein (CRP), IL6, and EOC risk by tumor characteristics. A total of 754 eligible EOC cases were identified; two controls (n = 1,497) were matched per case. We used multivariable conditional logistic regression to assess associations. RESULTS: CRP and IL6 were not associated with overall EOC risk. However, consistent with prior research, CRP >10 versus CRP </=1 mg/L was associated with higher overall EOC risk [OR, 1.67 (1.03-2.70)]. We did not observe significant associations or heterogeneity in analyses by tumor characteristics. In analyses stratified by waist circumference, inflammatory markers were associated with higher risk among women with higher waist circumference; no association was observed for women with normal waist circumference [e.g., IL6: waist </=80: ORlog2, 0.97 (0.81-1.16); waist >88: ORlog2, 1.78 (1.28-2.48), Pheterogeneity </= 0.01]. CONCLUSIONS: Our data suggest that high CRP is associated with increased risk of overall EOC, and that IL6 and CRP may be associated with EOC risk among women with higher adiposity. IMPACT: Our data add to global evidence that ovarian carcinogenesis may be promoted by an inflammatory milieu. Cancer Epidemiol Biomarkers Prev; 24(6); 951-61. (c)2015 AACR

Endogenous androgens and risk of epithelial invasive ovarian cancer by tumor characteristics in the European Prospective Investigation into Cancer and Nutrition

Ose J., Fortner R.T., Rinaldi S., Schock H., Overvad K., Tjonneland A., Hansen L., Dossus L., Fournier A., Baglietto L., Romieu I., Kuhn E., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Masala G., Sieri S., Tumino R., Sacerdote C., Mattiello A., Ramon Quiros J., Obon-Santacana M., Larranaga N., Chirlaque M.D., Sanchez M.J., Barricarte A., Peeters P.H., Bueno-de-Mesquita H.B., Onland-Moret N.C., Brandstedt J., Lundin E., Idahl A., Weiderpass E., Gram I.T., Lund E., Kaw K.T., Travis R.C., Merritt M.A., Gunther M.J., Riboli E., Kaaks R.

Int. J Cancer; 2015; 136(2): 399-410

Abstract as provided by PubMed

The role of endogenous androgens and sex hormone-binding globulin (SHBG) in ovarian carcinogenesis is poorly understood. Epithelial invasive ovarian cancer (EOC) is a heterogeneous disease and there are no prospective data on endogenous androgens and EOC risk by tumor characteristics (histology, grade, stage) or the dualistic model of ovarian carcinogenesis (i.e. type I vs. type II, leading to less or more aggressive tumors). We conducted a nested case-control study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort evaluating androgens and SHBG and invasive EOC risk by tumor characteristics. Female participants who provided a blood sample and were not using exogenous hormones at blood donation were eligible (n = 183,257). A total of 565 eligible women developed EOC; two controls (n = 1,097) were matched per case. We used multivariable conditional logistic regression models. We observed no association between androgens, SHBG and EOC overall. A doubling of androstenedione reduced risk of serous carcinomas by 21% (odds ratio (OR)log2 = 0.79, 95% confidence interval [CI] = [0.64-0.97]). Moreover, associations differed for low-grade and high-grade carcinomas, with positive associations for low-grade and inverse associations for high-grade carcinomas (e.g. androstenedione: low grade: ORlog2 = 1.99 [0.98-4.06]; high grade: ORlog2 = 0.75 [0.61-0.93], phet </= 0.01), similar associations were observed for type I/II tumors. This is the first prospective study to evaluate androgens, SHBG and EOC risk by tumor characteristics and type I/II status. Our findings support a possible role of androgens in ovarian carcinogenesis. Additional studies exploring this association are needed

Risk of second primary malignancies in women with breast cancer: Results from the European prospective investigation into cancer and nutrition (EPIC)

Ricceri F., Fasanelli F., Giraudo M.T., Sieri S., Tumino R., Mattiello A., Vagliano L., Masala G., Quiros J.R., Travier N., Sanchez M.J., Larranaga N., Chirlaque M.D., Ardanaz E., Tjonneland A., Olsen A., Overvad K., Chang-Claude J., Kaaks R., Boeing H., Clavel-Chapelon F., Kvaskoff M., Dossus L., Trichopoulou A., Benetou V., Adarakis G., Bueno-de-Mesquita H.B., Peeters P.H., Sund M., Andersson A., Borgquist S., Butt S., Weiderpass E., Skeie G., Khaw K.T., Travis R.C., Rinaldi S., Romieu I., Gunter M., Kadi M., Riboli E., Vineis P., Sacerdote C.

Int. J Cancer; 2015; 137(4): 940-948

PMID:25650288

Abstract as provided by PubMed

Women with a diagnosis of breast cancer are at increased risk of second primary cancers, and the identification of risk factors for the latter may have clinical implications. We have followed-up for 11 years 10,045 women with invasive breast cancer from a European cohort, and identified 492 second primary cancers, including 140 contralateral breast cancers. Expected and observed cases and Standardized Incidence Ratios (SIR) were estimated using Aalen-Johansen Markovian methods. Information on various risk factors was obtained from detailed questionnaires and anthropometric measurements. Cox proportional hazards regression models were used to estimate the role of risk factors. Women with breast cancer had a 30% excess risk for second malignancies (95% confidence interval-CI 18-42) after excluding contralateral breast cancers. Risk was particularly elevated for colorectal cancer (SIR, 1.71, 95% CI 1.43-2.00), lymphoma (SIR 1.80, 95% CI 1.31-2.40), melanoma (2.12; 1.63-2.70), endometrium (2.18; 1.75-2.70) and kidney cancers (2.40; 1.57-3.52). Risk of second malignancies was positively associated with age at first cancer, body mass index and smoking status, while it was inversely associated with education, post-menopausal status and a history of full-term pregnancy. We describe in a large cohort of women with breast cancer a 30% excess of second primaries. Among risk factors for breast cancer, a history of full-term pregnancy was inversely associated with the risk of second primary cancer

Meat and fish consumption and the risk of renal cell carcinoma in the European prospective investigation into cancer and nutrition

Rohrmann S., Linseisen J., Overvad K., Lund Wurtz A.M., Roswall N., Tjonneland A., Boutron-Ruault M.C., Racine A., Bastide N., Palli D., Agnoli C., Panico S., Tumino R., Sacerdote C., Weikert S., Steffen A., Kuhn T., Li K., Khaw K.T., Wareham N.J., Bradbury K.E., Peppa E., Trichopoulou A., Trichopoulos D., Bueno-de-Mesquita H.B., Peeters P.H., Hjartaker A., Skeie G., Weiderpass E., Jakszyn P., Dorronsoro M., Barricarte A., Santiuste de Pablos C., Molina-Montes E., de la Torre R.A., Ericson U., Sonestedt E., Johansson M., Ljungberg B., Freisling H., Romieu I., Cross A.J., Vergnaud A.C., Riboli E., Boeing H.

Int J Cancer; 2015; 136(5): E423-E431

Abstract as provided by PubMed

Renal cell cancer (RCC) incidence varies worldwide with a higher incidence in developed countries and lifestyle is likely to contribute to the development of this disease. We examined whether meat and fish consumption were related to the risk of RCC in the European Prospective Investigation into Cancer and Nutrition (EPIC). The analysis included 493,179 EPIC participants, recruited between 1992 and 2000. Until December 2008, 691 RCC cases have been identified. Meat and fish consumption was assessed at baseline using country-specific dietary assessment instruments; 24-hour recalls were applied in an 8% subsample for calibration purposes. Cox proportional hazards regression was used to calculate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI). Women with a high consumption of red meat (HR = 1.36, 95% CI 1.14-1.62; calibrated, per 50 g/day) and processed meat (HR = 1.78, 95% CI 1.05-3.03; calibrated, per 50 g/day) had a higher risk of RCC, while no association existed in men. For processed meat, the association with RCC incidence was prominent in premenopausal women and was lacking in postmenopausal women (p interaction = 0.02). Neither poultry nor fish consumption were statistically significantly associated with the risk of RCC. The results show a distinct association of red and processed meat consumption with incident RCC in women but not in men. A biological explanation for these findings remains unclear

Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study

Romaguera D., Ward H., Wark P.A., Vergnaud A.C., Peeters P.H., Van Gils C.H., Ferrari P., Fedirko V., Jenab M., Boutron-Ruault M.C., Dossus L., Dartois L., Hansen C.P., Dahm C.C., Buckland G., Sanchez M.J., Dorronsoro M., Navarro C., Barricarte A., Key T.J., Trichopoulou A., Tsironis C., Lagiou P., Masala G., Pala V., Tumino R., Vineis P., Panico S., Bueno-de-Mesquita H.B., Siersema P.D., Ohlsson B., Jirstrom K., Wennberg M., Nilsson L.M., Weiderpass E., Kuhn T., Katzke V., Khaw K.T., Wareham N.J., Tjonneland A., Boeing H., Quiros J.R., Gunter M.J., Riboli E., Norat T.

BMC Med; 2015; 13(1): 107

Abstract as provided by PubMed

BACKGROUND: Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients. METHODS: The association between the WCRF/AICR score (score range 0-6 in men and 0-7 in women; higher scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872) and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. RESULTS: The HRs (95% CIs) for CRC-specific mortality among participants in the second (score range in men/women: 2.25-2.75/3.25-3.75), third (3-3.75/4-4.75), and fourth (4-6/5-7) categories of the score were 0.87 (0.72-1.06), 0.74 (0.61-0.90), and 0.70 (0.56-0.89), respectively (P for trend <0.0001), compared to participants with the lowest concordance with the recommendations (category 1 of the score: 0-2/0-3). Similar HRs for overall mortality were observed (P for trend 0.004). Meeting the recommendations on body fatness and plant food consumption were associated with improved survival among CRC cases in mutually adjusted models. CONCLUSIONS: Greater concordance with the WCRF/AICR recommendations on diet, physical activity, and body fatness prior to CRC diagnosis is associated with improved survival among CRC patients

Alcohol intake and breast cancer in the European prospective investigation into cancer and nutrition

Romieu I., Scoccianti C., Chajes V., de Batlle J., Biessy C., Dossus L., Baglietto L., Clavel-Chapelon F., Overvad K., Olsen A., Tjonneland A., Kaaks R., Lukanova A., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Sieri S., Tumino R., Vineis P., Panico S., Bueno-de-Mesquita H.B., Van Gils C.H., Peeters P.H., Lund E., Skeie G., Weiderpass E., Quiros Garcia J.R., Chirlaque M.D., Ardanaz E., Sanchez M.J., Duell E.J., Amiano P., Borgquist S., Wirfalt E., Hallmans G., Johansson I., Nilsson L.M., Khaw K.T., Wareham N., Key T.J., Travis R.C., Murphy N., Wark P.A., Ferrari P., Riboli E.

Int. J Cancer; 2015; 137(8): 1921-1930

PMID:25677034

Abstract as provided by PubMed

Alcohol intake has been associated to breast cancer in pre and postmenopausal women; however results are inconclusive regarding tumor hormonal receptor status, and potential modifying factors like age at start drinking. Therefore, we investigated the relation between alcohol intake and the risk of breast cancer using prospective observational data from the European Prospective Investigation into Cancer and Nutrition (EPIC). Up to 334,850 women, aged 35-70 years at baseline, were recruited in ten European countries and followed up an average of 11 years. Alcohol intake at baseline and average lifetime alcohol intake were calculated from country-specific dietary and lifestyle questionnaires. The study outcomes were the Hazard ratios (HR) of developing breast cancer according to hormonal receptor status. During 3,670,439 person-years, 11,576 incident breast cancer cases were diagnosed. Alcohol intake was significantly related to breast cancer risk, for each 10 g/day increase in alcohol intake the HR increased by 4.2% (95% CI: 2.7-5.8%). Taking 0 to 5 g/day as reference, alcohol intake of >5 to 15 g/day was related to a 5.9% increase in breast cancer risk (95% CI: 1-11%). Significant increasing trends were observed between alcohol intake and ER+/PR+, ER-/PR-,

Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk: results from the EPIC cohort study

Sanikini H., Dik V.K., Siersema P.D., Bhoo-Pathy N., Uiterwaal C.S., Peeters P.H., Gonzalez C.A., Zamora-Ros R., Overvad K., Tjonneland A., Roswall N., Boutron-Ruault M.C., Fagherazzi G., Racine A., Kuhn T., Katzke V., Boeing H., Trichopoulou A., Trichopoulos D., Lagiou P., Palli D., Grioni S., Vineis P., Tumino R., Panico S., Weiderpass E., Skeie G., Braaten T., Huerta J.M., Sanchez-Cantalejo E., Barricarte A., Sonestedt E., Wallstrom P., Nilsson L.M., Johansson I., Bradbury K.E., Khaw K.T., Wareham N., Huybrechts I., Freisling H., Cross A.J., Riboli E., Bueno-de-Mesquita H.B.

Int. J Cancer; 2015; 136(6): E720-E730

Abstract as provided by PubMed

Prospective studies examining the association between coffee and tea consumption and gastric cancer risk have shown inconsistent results. We investigated the association between coffee (total, caffeinated and decaffeinated) and tea consumption and the risk of gastric cancer by anatomical site and histological type in the European Prospective Investigation into Cancer and Nutrition study. Coffee and tea consumption were assessed by dietary questionnaires at baseline. Adjusted hazard ratios (HRs) were calculated using Cox regression models. During 11.6 years of follow up, 683 gastric adenocarcinoma cases were identified among 477,312 participants. We found no significant association between overall gastric cancer risk and consumption of total coffee (HR 1.09, 95%-confidence intervals [CI]: 0.84-1.43; quartile 4 vs. non/quartile 1), caffeinated coffee (HR 1.14, 95%-CI: 0.82-1.59; quartile 4 vs. non/quartile 1), decaffeinated coffee (HR 1.07, 95%-CI: 0.75-1.53; tertile 3 vs. non/tertile 1) and tea (HR 0.81, 95%-CI: 0.59-1.09; quartile 4 vs. non/quartile 1). When stratified by anatomical site, we observed a significant positive association between gastric cardia cancer risk and total coffee consumption per increment of 100 mL/day (HR 1.06, 95%-CI: 1.03-1.11). Similarly, a significant positive association was observed between gastric cardia cancer risk and caffeinated coffee consumption (HR 1.98, 95%-CI: 1.16-3.36, p-trend=0.06; quartile 3 vs. non/quartile 1) and per increment of 100 mL/day (HR 1.09, 95%-CI: 1.04-1.14). In conclusion, consumption of total, caffeinated and decaffeinated coffee and tea is not associated with overall gastric cancer risk. However, total and caffeinated coffee consumption may be associated with an increased risk of gastric cardia cancer. Further prospective studies are needed to rule out chance or confounding

Metabolic profiles of male meat eaters, fish eaters, vegetarians, and vegans from the EPIC-Oxford cohort

Schmidt J. A., Rinaldi S., Ferrari P., Carayol M., Achaintre D., Scalbert A., Cross A. J., Gunter M. J., Fensom G. K., Appleby P. N., Key T. J., Travis R. C.

Am J Clin Nutr; 2015; 102(6): 1518-26

PMID:26511225

Abstract as provided by PubMed

BACKGROUND: Human metabolism is influenced by dietary factors and lifestyle, environmental, and genetic factors; thus, men who exclude some or all animal products from their diet might have different metabolic profiles than meat eaters. OBJECTIVE: We aimed to investigate differences in concentrations of 118 circulating metabolites, including acylcarnitines, amino acids, biogenic amines, glycerophospholipids, hexose, and sphingolipids related to lipid, protein, and carbohydrate metabolism between male meat eaters, fish eaters, vegetarians, and vegans from the Oxford arm of the European Prospective Investigation into Cancer and Nutrition. DESIGN: In this cross-sectional study, concentrations of metabolites were measured by mass spectrometry in plasma from 379 men categorized according to their diet group. Differences in mean metabolite concentrations across diet groups were tested by using ANOVA, and a false discovery rate-controlling procedure was used to account for multiple testing. Principal component analysis was used to investigate patterns in metabolic profiles. RESULTS: Concentrations of 79% of metabolites differed significantly by diet group. In the vast majority of these cases, vegans had the lowest concentration, whereas meat eaters most often had the highest concentrations of the acylcarnitines, glycerophospholipids, and sphingolipids, and fish eaters or vegetarians most often had the highest concentrations of the amino acids and a biogenic amine. A clear separation between patterns in the metabolic profiles of the 4 diet groups was seen, with vegans being noticeably different from the other groups because of lower concentrations of some glycerophospholipids and sphingolipids. CONCLUSIONS: Metabolic profiles in plasma could effectively differentiate between men from different habitual diet groups, especially vegan men compared with men who consume animal products. The difference in metabolic profiles was mainly explained by the lower concentrations of glycerophospholipids and sphingolipids in vegans.

Baseline and lifetime alcohol consumption and risk of differentiated thyroid carcinoma in the EPIC study

Sen A., Tsilidis K.K., Allen N.E., Rinaldi S., Appleby P.N., Almquist M., Schmidt J.A., Dahm C.C., Overvad K., Tjonneland A., Rostgaard-Hansen A.L., Clavel-Chapelon F., Baglietto L., Boutron-Ruault M.C., Kuhn T., Katze V.A., Boeing H., Trichopoulou A., Tsironis C., Lagiou P., Palli D., Pala V., Panico S., Tumino R., Vineis P., Bueno-de-Mesquita H.A., Peeters P.H., Hjartaker A., Lund E., Weiderpass E., Quiros J.R., Agudo A., Sanchez M.J., Arriola L., Gavrila D., Gurrea A.B., Tosovic A., Hennings J., Sandstrom M., Romieu I., Ferrari P., Zamora-Ros R., Khaw K.T., Wareham N.J., Riboli E., Gunter M., Franceschi S.

Br J Cancer; 2015; 113(5): 840-847

Abstract as provided by PubMed

BACKGROUND: Results from several cohort and case-control studies suggest a protective association between current alcohol intake and risk of thyroid carcinoma, but the epidemiological evidence is not completely consistent and several questions remain unanswered. METHODS: The association between alcohol consumption at recruitment and over the lifetime and risk of differentiated thyroid carcinoma was examined in the European Prospective Investigation into Cancer and Nutrition. Among 477 263 eligible participants (70% women), 556 (90% women) were diagnosed with differentiated thyroid carcinoma over a mean follow-up of 11 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards models. RESULTS: Compared with participants consuming 0.1-4.9 g of alcohol per day at recruitment, participants consuming 15 or more grams (approximately 1-1.5 drinks) had a 23% lower risk of differentiated thyroid carcinoma (HR=0.77; 95% CI=0.60-0.98). These findings did not differ greatly when analyses were conducted for lifetime alcohol consumption, although the risk estimates were attenuated and not statistically significant anymore. Similar results were observed by type of alcoholic beverage, by differentiated thyroid carcinoma histology or according to age, sex, smoking status, body mass index and diabetes. CONCLUSIONS: Our study provides some support to the hypothesis that moderate alcohol consumption may be associated with a lower risk of papillary and follicular thyroid carcinomas

A Mendelian Randomization Study of Circulating Uric Acid and Type 2 Diabetes

Sluijs I., Holmes M.V., van der Schouw Y.T., Beulens J.W., Asselbergs F.W., Huerta J.M., Palmer T.M., Arriola L., Balkau B., Barricarte A., Boeing H., Clavel-Chapelon F., Fagherazzi G., Franks P.W., Gavrila D., Kaaks R., Khaw K.T., Kuhn T., Molina-Montes E., Mortensen L.M., Nilsson P.M., Overvad K., Palli D., Panico S., Quiros J.R., Rolandsson O., Sacerdote C., Sala N., Schmidt J.A., Scott R.A., Sieri S., Slimani N., Spijkerman A.M., Tjonneland A., Travis R.C., Tumino R., van der A.DL, Sharp S.J., Forouhi N.G., Langenberg C., Riboli E., Wareham N.J.

Diabetes; 2015; 64(8): 3028-3036

Abstract as provided by PubMed

We aimed to investigate the causal effect of circulating uric acid concentrations on type 2 diabetes risk. A Mendelian randomization study was performed using a genetic score with 24 uric acid-associated loci. We used data of the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study, comprising 24,265 individuals of European ancestry from eight European countries. During a mean (SD) follow-up of 10 (4) years, 10,576 verified incident case subjects with type 2 diabetes were ascertained. Higher uric acid was associated with a higher diabetes risk after adjustment for confounders, with a hazard ratio (HR) of 1.20 (95% CI 1.11, 1.30) per 59.48 micromol/L (1 mg/dL) uric acid. The genetic score raised uric acid by 17 micromol/L (95% CI 15, 18) per SD increase and explained 4% of uric acid variation. By using the genetic score to estimate the unconfounded effect, we found that a 59.48 micromol/L higher uric acid concentration did not have a causal effect on diabetes (HR 1.01 [95% CI 0.87, 1.16]). Including data from the Diabetes Genetics Replication And Meta-analysis (DIAGRAM) consortium, increasing our dataset to 41,508 case subjects with diabetes, the summary odds ratio estimate was 0.99 (95% CI 0.92, 1.06). In conclusion, our study does not support a causal effect of circulating uric acid on diabetes risk. Uric acid-lowering therapies may therefore not be beneficial in reducing diabetes risk

General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition

Steffen A., Huerta J.M., Weiderpass E., Bueno-de-Mesquita H.B., May A.M., Siersema P.D., Kaaks R., Neamat-Allah J., Pala V., Panico S., Saieva C., Tumino R., Naccarati A., Dorronsoro M., Sanchez-Cantalejo E., Ardanaz E., Quiros J.R., Ohlsson B., Johansson M., Wallner B., Overvad K., Halkjaer J., Tjonneland A., Fagherazzi G., Racine A., Clavel-Chapelon F., Key T.J., Khaw K.T., Wareham N., Lagiou P., Bamia C., Trichopoulou A., Ferrari P., Freisling H., Lu Y., Riboli E., Cross A.J., Gonzalez C.A., Boeing H.

Int. J Cancer; 2015; 137(3): 646-657

PMID:25598323

Abstract as provided by PubMed

General obesity, as reflected by BMI, is an established risk factor for esophageal adenocarcinoma (EAC), a suspected risk factor for gastric cardia adenocarcinoma (GCC) and appears unrelated to gastric non-cardia adenocarcinoma (GNCC). How abdominal obesity, as commonly measured by waist circumference (WC), relates to these cancers remains largely unexplored. Using measured anthropometric data from 391,456 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) study and 11 years of follow-up, we comprehensively assessed the association of anthropometric measures with risk of EAC, GCC and GNCC using multivariable proportional hazards regression. One hundred twenty-four incident EAC, 193 GCC and 224 GNCC were accrued. After mutual adjustment, BMI was unrelated to EAC, while WC showed a strong positive association (highest vs. lowest quintile HR = 1.19; 95% CI, 0.63-2.22 and HR = 3.76; 1.72-8.22, respectively). Hip circumference (HC) was inversely related to EAC after controlling for WC, while WC remained positively associated (HR = 0.35; 0.18-0.68, and HR=4.10; 1.94-8.63, respectively). BMI was not associated with GCC or GNCC. WC was related to higher risks of GCC after adjustment for BMI and more strongly after adjustment for HC (highest vs. lowest quintile HR = 1.91; 1.09-3.37, and HR = 2.23; 1.28-3.90, respectively). Our study demonstrates that abdominal, rather than general, obesity is an indisputable risk factor for EAC and also provides evidence for a protective effect of gluteofemoral (subcutaneous) adipose tissue in EAC. Our study further shows that general obesity is not a risk factor for GCC and GNCC, while the role of abdominal obesity in GCC needs further investigation

Circulating prolactin and in situ breast cancer risk in the European EPIC cohort: a case-control study

Tikk K., Sookthai D., Fortner R.T., Johnson T., Rinaldi S., Romieu I., Tjonneland A., Olsen A., Overvad K., Clavel-Chapelon F., Baglietto L., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Masala G., Krogh V., Tumino R., Ricceri F., Mattiello A., Agudo A., Menendez V., Sanchez M.J., Amiano P., Chirlaque M.D., Barricarte A., Bueno-de-Mesquita H.B., Monninkhof E.M., Onland-Moret N.C., Andresson A., Sund M., Weiderpass E., Khaw K.T., Key T.J., Travis R.C., Merritt M.A., Riboli E., Dossus L., Kaaks R.

Breast Cancer Res; 2015; 49

PMID:25887963

Abstract as provided by PubMed

INTRODUCTION: The relationship between circulating prolactin and invasive breast cancer has been investigated previously, but the association between prolactin levels and in situ breast cancer risk has received less attention. METHODS: We analysed the relationship between pre-diagnostic prolactin levels and the risk of in situ breast cancer overall, and by menopausal status and use of postmenopausal hormone therapy (HT) at blood donation. Conditional logistic regression was used to assess this association in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, including 307 in situ breast cancer cases and their matched control subjects. RESULTS: We found a significant positive association between higher circulating prolactin levels and risk of in situ breast cancer among all women [pre-and postmenopausal combined, ORlog2=1.35 (95% CI 1.04-1.76), Ptrend=0.03]. No statistically significant heterogeneity was found between prolactin levels and in situ cancer risk by menopausal status (Phet=0.98) or baseline HT use (Phet=0.20), although the observed association was more pronounced among postmenopausal women using HT compared to non-users (Ptrend=0.06 vs Ptrend=0.35). In subgroup analyses, the observed positive association was strongest in women diagnosed with in situ breast tumors<4 years compared to >/=4 years after blood donation (Ptrend=0.01 vs Ptrend=0.63; Phet=0.04) and among nulliparous women compared to parous women (Ptrend=0.03 vs Ptrend=0.15; Phet=0.07). CONCLUSIONS: Our data extends prior research linking prolactin and invasive breast cancer to the outcome of in situ breast tumours and shows that higher circulating prolactin is associated with increased risk of in situ breast cancer

Diabetes mellitus and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition

Tsilidis K.K., Allen N.E., Appleby P.N., Rohrmann S., Nothlings U., Arriola L., Gunter M.J., Chajes V., Rinaldi S., Romieu I., Murphy N., Riboli E., Tzoulaki I., Kaaks R., Lukanova A., Boeing H., Pischon T., Dahm C.C., Overvad K., Quiros J.R., Fonseca-Nunes A., Molina-Montes E., Gavrila Chervase D., Ardanaz E., Khaw K.T., Wareham N.J., Roswall N., Tjonneland A., Lagiou P., Trichopoulos D., Trichopoulou A., Palli D., Pala V., Tumino R., Vineis P., Bueno-de-Mesquita H.B., Malm J., Orho-Melander M., Johansson M., Stattin P., Travis R.C., Key T.J.

Int J Cancer; 2015; 136(2): 372-381

PMID:24862312

Abstract as provided by PubMed

The current epidemiologic evidence suggests that men with type 2 diabetes mellitus may be at lower risk of developing prostate cancer, but little is known about its association with stage and grade of the disease. The association between self-reported diabetes mellitus at recruitment and risk of prostate cancer was examined in the European Prospective Investigation into Cancer and Nutrition (EPIC). Among 139,131 eligible men, 4,531 were diagnosed with prostate cancer over an average follow-up of 12 years. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models stratified by EPIC-participating center and age at recruitment, and adjusted for education, smoking status, body mass index, waist circumference, and physical activity. In a subset of men without prostate cancer, the cross-sectional association between circulating concentrations of androgens and insulin-like growth factor proteins with diabetes status was also investigated using linear regression models. Compared to men with no diabetes, men with diabetes had a 26% lower risk of prostate cancer (HR, 0.74; 95% CI, 0.63-0.86). There was no evidence that the association differed by stage (p-heterogeneity, 0.19) or grade (p-heterogeneity, 0.48) of the disease, although the numbers were small in some disease subgroups. In a subset of 626 men with hormone measurements, circulating concentrations of androstenedione, total testosterone and insulin-like growth factor binding protein-three were lower in men with diabetes compared to men without diabetes. This large European study has confirmed an inverse association between self-reported diabetes mellitus and subsequent risk of prostate cancer

Alcohol consumption and the risk of renal cancers in the European prospective investigation into cancer and nutrition (EPIC)

Wozniak M.B., Brennan P., Brenner D.R., Overvad K., Olsen A., Tjonneland A., Boutron-Ruault M.C., Clavel-Chapelon F., Fagherazzi G., Katzke V., Kuhn T., Boeing H., Bergmann M.M., Steffen A., Naska A., Trichopoulou A., Trichopoulos D., Saieva C., Grioni S., Panico S., Tumino R., Vineis P., Bueno-de-Mesquita H.B., Peeters P.H., Hjartaker A., Weiderpass E., Arriola L., Molina-Montes E., Duell E.J., Santiuste C., Alonso de la Torre, Barricarte Gurrea A., Stocks T., Johansson M., Ljungberg B., Wareham N., Khaw K.T., Travis R.C., Cross A.J., Murphy N., Riboli E., Scelo G.

Int. J Cancer; 2015; 137(8): 1953-1966

PMID:25866035

Abstract as provided by PubMed

Epidemiologic studies have reported that moderate alcohol consumption is inversely associated with the risk of renal cancer. However, there is no information available on the associations in renal cancer subsites. From 1992 through to 2010, 477,325 men and women in the European Prospective Investigation into Cancer and Nutrition cohort were followed for incident renal cancers (n = 931). Baseline and lifetime alcohol consumption was assessed by country-specific, validated dietary questionnaires. Information on past alcohol consumption was collected by lifestyle questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox proportional hazard models. In multivariate analysis, total alcohol consumption at baseline was inversely associated with renal cancer; the HR and 95% CI for the increasing categories of total alcohol consumption at recruitment versus the light drinkers category were 0.78 (0.62-0.99), 0.82 (0.64-1.04), 0.70 (0.55-0.90), 0.91 (0.63-1.30), respectively, (ptrend = 0.001). A similar relationship was observed for average lifetime alcohol consumption and for all renal cancer subsites combined or for renal parenchyma subsite. The trend was not observed in hypertensive individuals and not significant in smokers. In conclusion, moderate alcohol consumption was associated with a decreased risk of renal cancer

Reproductive and menstrual factors and risk of differentiated thyroid carcinoma: The EPIC study

Zamora-Ros R., Rinaldi S., Biessy C., Tjonneland A., Halkjaer J., Fournier A., Boutron-Ruault M.C., Mesrine S., Tikk K., Fortner R.T., Boeing H., Forster J., Trichopoulou A., Trichopoulos D., Papatesta E.M., Masala G., Tagliabue G., Panico S., Tumino R., Polidoro S., Peeters P.H., Bueno-de-Mesquita H.B., Weiderpass E., Lund E., Arguelles M., Agudo A., Molina-Montes E., Navarro C., Barricarte A., Larranaga N., Manjer J., Almquist M., Sandstrom M., Hennings J., Tsilidis K.K., Schmidt J.A., Khaw K.T., Wareham N.J., Romieu I., Byrnes G., Gunter M.J., Riboli E., Franceschi S.

Int J Cancer; 2015; 136(5): 1218-1227

PMID:25041790

Abstract as provided by PubMed

Differentiated thyroid carcinoma (TC) is threefold more common in women than in men and, therefore, a role of female hormones in the etiology of differentiated TC has been suggested. We assessed these hypotheses in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 345,157 women (mean age 51) followed for an average of 11 years, 508 differentiated TC cases were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. No significant associations were observed between differentiated TC risk and number of pregnancies, breast feeding, menopausal status, and age at menarche and at menopause. Significant associations were found with history of infertility problems (HR 1.70; 95% CI 1.12-2.60), a recent pregnancy (HR for </=5 vs. >5 years before recruitment 3.87; 95% CI 1.43-10.46), menopause type (HR for surgical vs. natural menopause: 2.16; 95% CI 1.41-3.31), oral contraceptive (OC) use at recruitment (HR: 0.48; 95% CI 0.25-0.92) and duration of OC use (HR for >/=9 vs. </=1 year: 0.66; 95% CI: 0.50-0.89). An increased risk was also found with hormone replacement therapy use at recruitment (HR = 1.30, 95% CI 1.02-1.67), but this was not significant after adjustment for type of menopause (HR = 1.22, 95% CI 0.95-1.57). Overall, our findings do not support a strong role of reproductive and menstrual factors, and female hormone use in the etiology of differentiated TC. The few observed associations may be real or accounted for by increased surveillance in women who had infertility problems, recent pregnancies or underwent surgical menopause

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