Current Research Topics:
The European Prospective Investigation into Cancer and Nutrition (EPIC)
The Group is active in cancer site-specific EPIC working groups. For colorectal cancer, major recent publications include blood vitamin D levels and risk of colorectal cancer, showing a strong inverse risk association, and blood levels of parathyroid hormone which show a positive colorectal cancer risk association at very high levels. For liver cancer, biomarker and data analyses are on-going for several studies exploring dietary, lifestyle and hormonal determinants of risk. Preliminary findings indicate a positive risk association for intake of simple sugars, and an inverse association with dietary fibre consumption. For breast cancer, studies are being conducted to explore the role of fatty acids, folate, glycemic load/index and polyphenols, and the effect of physical activity on hormone levels
Other recent Group publications relate to inflammation and risk of colorectal cancer, B vitamins and risk of colorectal, lung and gastric cancers and phytanic acid and prostate cancer risk.
Gene-nutrient interactionsExploration of gene-nutrient interactions is of interest for the Group. Recent activities include involvement in the Micronutrient Genomics Project, an international collaboration on micronutrient genomic studies. Studies are currently on-going on body iron status, hemochromatosis gene mutations and risk of colorectal cancer. The interaction of folate and other B vitamins with alcohol and folate metabolism genes, particularly for breast cancer, is also an area of active study.
Alcohol and Cancer
The Group is continuing its contribution to a programme of systematic meta-analyses on alcohol consumption and risk of various cancers. Recent results show a dose-response increased risk for colorectal, laryngeal and esophageal cancers.
Determinants of Healthy Aging
The Group leads the cancer-specific work package as a partner in the European project entitled ÒConsortium on Health and Ageing Network of Cohorts in Europe and the United StatesÓ (CHANCES). The project brings together 13 international cohorts and aims to conduct pooled analyses of determinants of cancer risk and survival in elderly populations.
To partially control for measurement errors in self-reported dietary assessment, linear calibration procedures were implemented and their performance assessed in the EPIC study. In addition, the use of latent factors modelling in a Bayesian framework was explored as an alternative way to deal with measurement errors. Current research focuses on the search and application of methods to exploit the complex nature of dietary data, both in terms of dimension reduction in the search of dietary patterns, and in the context of nutrigenomic data.
Recently, the Group has identified metabolomics as a key future horizon for the field of dietary biomarkers and is leading a large collaboration to explore metabolomic profiles specific to dietary patterns and lifestyle habits. The Group is also involved in conducting nested case-control studies of NMR metabolomic analyses for pancreatic and liver cancers in collaboration with a leading centre in Lyon, the Center for High Field NMR (CRMN), CRNS.
Studies in Low and Middle Resource Settings
Breast cancer is the major female cancer in developed countries and is rising in incidence and mortality in lower resource countries. The group is using large cohorts and multicenter case-control studies to identify the role and mechanisms by which diet, physical activity, obesity and metabolic disorders affect breast cancer incidence and survival.
Life style, metabolic and hormonal determinants of breast cancer and mammographic density in Mexican women
The group is collaborating with the National Institute of Public Health (INSP) and the National Institute of Cancerology (INCAN) in Mexico on a breast cancer case-control
study (CAMA) of 2000 Mexican women and a large cohort of Mexican Teachers (EsMaestras) selected in 9 Mexican states including close to 85,000 women age 25 to 70 years. As a first approach, determinants of mammographic density, a strong breast cancer risk factor, are being evaluated.
Molecular Subtypes of Premenopausal Breast Cancer in Latin American Women: a multicenter population based case-control study
One major activity of the Group is the development of a multi-center population based case-control study including five Latin American countries (Brazil, Chile, Colombia, Costa Rica and Mexico) on the molecular subtypes of premenopausal breast cancer in Latin American women with the objective to evaluate the distribution of specific molecular cancer sub types and identify the role/mechanisms of diet, physical activity, obesity and metabolic disorders in breast cancer incidence/survival.
A standard protocol has been developed and will be applied in all centers. A total of 300 cases and control will be recruited by centers. This project has 4 major components: 1) Collection of biological samples (blood and urine) and information on risk factors including detailed dietary data, physical activity, and anthropometric measurements. 2) Collection of tumor samples and determination of cancer subtype, receptors status and epigenetic changes.
3) Identification of risk factors associated with specific types of breast cancer and their interaction with genetic factors. 4) Transfer of knowledge with training of local scientists in epidemiology (in particular nutritional),
laboratory techniques for biomarkers analyses and tumor specifications.
Influence of diet, physical activity, body size on breast cancer in South Africa: a Study in African women in transition
A population-based case-control study of breast cancer (BC) will be conducted in black South African women, in Soweto, Johannesburg, home to high-density black urban population of South Africa (SA). The study will enroll 500 cases and controls over 2.5 years and obtain dietary and lifestyle questionnaire data, biological and tumor samples. This study will be the largest study to date on breast cancer risk among women in South Africa and will provide extremely valuable information on the distribution of molecular subtypes of
breast tumors and risk factors to support preventive actions.
Dietary and lifestyle factors and oesophageal cancer in Kashmir India
The Group is conducting a pilot study on the feasibility to establish a large scale study on dietary/lifestyle factors and oesophageal cancer risk in Kashmir, India, a high risk region. A dietary questionnaire and a validation study design have been formulated and will be applied shortly.
Early life and metabolic disordersFoetal/early life appears to be one of the major determinants of health later in life. The "Healthy Growth" Latin American Birth Cohort Consortium is being established to evaluate the effects of maternal and infant nutrition and its interaction with environmental and genetic factors on early markers of cancer risk, epigenetic changes, biological and metabolic profiles in children and as predictors of disease status at different life stages.