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Madlen Schütze

Bio: Madlen Schütze is an academic researcher. The author has contributed to research in topics: European Prospective Investigation into Cancer and Nutrition & Prospective cohort study. The author has an hindex of 17, co-authored 20 publications receiving 1714 citations.

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Journal ArticleDOI
07 Apr 2011-BMJ
TL;DR: In western Europe, an important proportion of cases of cancer can be attributable to alcohol consumption, especially consumption higher than the recommended upper limits, which support current political efforts to reduce or to abstain from alcohol consumption to reduce the incidence of cancer.
Abstract: Objective To compute the burden of cancer attributable to current and former alcohol consumption in eight European countries based on direct relative risk estimates from a cohort study. Design Combination of prospective cohort study with representative population based data on alcohol exposure. Setting Eight countries (France, Italy, Spain, United Kingdom, the Netherlands, Greece, Germany, Denmark) participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Participants 109 118 men and 254 870 women, mainly aged 37-70. Main outcome measures Hazard rate ratios expressing the relative risk of cancer incidence for former and current alcohol consumption among EPIC participants. Hazard rate ratios combined with representative information on alcohol consumption to calculate alcohol attributable fractions of causally related cancers by country and sex. Partial alcohol attributable fractions for consumption higher than the recommended upper limit (two drinks a day for men with about 24 g alcohol, one for women with about 12 g alcohol) and the estimated total annual number of cases of alcohol attributable cancer. Results If we assume causality, among men and women, 10% (95% confidence interval 7 to 13%) and 3% (1 to 5%) of the incidence of total cancer was attributable to former and current alcohol consumption in the selected European countries. For selected cancers the figures were 44% (31 to 56%) and 25% (5 to 46%) for upper aerodigestive tract, 33% (11 to 54%) and 18% (−3 to 38%) for liver, 17% (10 to 25%) and 4% (−1 to 10%) for colorectal cancer for men and women, respectively, and 5.0% (2 to 8%) for female breast cancer. A substantial part of the alcohol attributable fraction in 2008 was associated with alcohol consumption higher than the recommended upper limit: 33 037 of 178 578 alcohol related cancer cases in men and 17 470 of 397 043 alcohol related cases in women. Conclusions In western Europe, an important proportion of cases of cancer can be attributable to alcohol consumption, especially consumption higher than the recommended upper limits. These data support current political efforts to reduce or to abstain from alcohol consumption to reduce the incidence of cancer.

279 citations

Journal ArticleDOI
TL;DR: A reduction in risk of endometrial cancer with factors associated with a lower cumulative exposure to estrogen and/or higher exposure to progesterone, such as increasing number of FTPs and shorter menstrual lifespan is confirmed and support an important role of hormonal mechanisms inendometrial carcinogenesis.
Abstract: Endometrial cancer risk has been associated with reproductive factors (age at menarche, age at menopause, parity, age at first and last birth, time since last birth and use of oral contraceptives (OCs)]. However, these factors are closely interrelated and whether they act independently still requires clarification. We conducted a study to examine the association of menstrual and reproductive variables with the risk of endometrial cancer among the European Prospective Investigation into Cancer and Nutrition (EPIC). Among the 302,618 women eligible for the study, 1,017 incident endometrial cancer cases were identified. A reduction in endometrial cancer risk was observed in women with late menarche, early menopause, past OC use, high parity and a shorter time since last full-term pregnancy (FTP). No association was observed for duration of breast feeding after adjustment for number of FTP or for abortion (spontaneous or induced). After mutual adjustment, late age at menarche, early age at menopause and duration of OC use showed similar risk reductions of 7-8% per year of menstrual life, whereas the decreased risk associated with cumulative duration of FTPs was stronger (22% per year). In conclusion, our findings confirmed a reduction in risk of endometrial cancer with factors associated with a lower cumulative exposure to estrogen and/or higher exposure to progesterone, such as increasing number of FTPs and shorter menstrual lifespan and, therefore, support an important role of hormonal mechanisms in endometrial carcinogenesis.

251 citations

Journal ArticleDOI
TL;DR: This study shows a strong protective association of oral contraceptives and parity with ovarian cancer risk, a higher risk with a late age at menopause, and no association with other reproductive factors.
Abstract: BACKGROUND: It is well established that parity and use of oral contraceptives reduce the risk of ovarian cancer, but the associations with other reproductive variables are less clear.METHODS: We ex ...

162 citations

Journal ArticleDOI
TL;DR: Using data on cancer incidence for 2008 and the AF(p) estimates, about 270,000 new cancer diagnoses per year can be considered attributable to cigarette smoking in the eight European countries with available data for both men and women.
Abstract: Purpose Our aim was to assess the impact of cigarette smoking on the risk of the tumors classified by the International Agency for Research on Cancer as causally associated with smoking, referred t ...

140 citations

Journal ArticleDOI
TL;DR: Examination of the associations of C-reactive protein, interleukin 6, and IL1 receptor antagonist with endometrial cancer risk provided epidemiological evidence that chronic inflammation might mediate the association between obesity and endometricrial cancer and that endometrian carcinogenesis could be promoted by an inflammatory milieu.
Abstract: Obesity, a major risk factor for endometrial cancer, is a low-grade inflammatory state characterized by elevated concentrations of cytokines and acute phase reactants. The current study had two aims: first to investigate the associations of C-reactive protein (CRP), interleukin 6 (IL6), and IL1 receptor antagonist (IL1Ra) with endometrial cancer risk and second to examine to which extent these markers can influence the association between obesity and endometrial cancer. We conducted a case-control study, nested within the European Prospective Investigation into Cancer and Nutrition, which comprised 305 incident cases of endometrial cancer and 574 matched controls. CRP, IL6, and IL1Ra were measured in prospectively collected blood specimens by immunoassays. Data were analyzed using conditional logistic regression. All statistical tests were two-sided, and P values <0.05 were considered statistically significant. We observed a significant increase in risk of endometrial cancer with elevated levels of CRP (odds ratio (OR) for top versus bottom quartile: 1.58, 95% confidence interval (CI): 1.03-2.41, P(trend)=0.02), IL6 (OR for top versus bottom quartile: 1.66, 95% CI: 1.08-2.54, P(trend)=0.008), and IL1Ra (OR for top versus bottom quartile: 1.82, 95% CI: 1.22-2.73, P(trend)=0.004). After adjustment for body mass index (BMI), the estimates were strongly reduced and became non-significant. The association between BMI and endometrial cancer was also substantially attenuated (∼10-20%) after adjustment for inflammatory markers, even when the effects of C-peptide or estrone had already been taken into account. We provided epidemiological evidence that chronic inflammation might mediate the association between obesity and endometrial cancer and that endometrial carcinogenesis could be promoted by an inflammatory milieu.

139 citations


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TL;DR: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) as discussed by the authors provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.

5,668 citations

01 Jan 2016
TL;DR: The comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study 2015 was used to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational risks or clusters of risks from 1990 to 2015.
Abstract: BACKGROUND The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. METHODS We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors-the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). FINDINGS Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6-58·8) of global deaths and 41·2% (39·8-42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. INTERPRETATION Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. FUNDING Bill & Melinda Gates Foundation.

3,920 citations

01 Apr 2012
TL;DR: International experts in cancer prevention analyse global research on diet nutrition physical activity cancer and make public health policy recommendations, the fractions of cancer attributable to potentially modifiable factors are analyzed.
Abstract: physical activity and cancer fact sheet national cancer on this page what is physical activity what is known about the relationship between physical activity and cancer risk how might physical activity be, diet and cancer report american institute for cancer the american institute for cancer research aicr is the cancer charity that fosters research on diet and cancer prevention and educates the public about the results, download resources and toolkits world cancer research downloads for scientists from the wcrf aicr third expert report diet nutrition physical activity and cancer a global perspective, nutritional science university of washington school of public health school of public health nutritional science detailed course offerings time schedule are available for spring quarter 2019, 2019 aicr research conference american institute for about aicr we fund cutting edge research and give people practical tools and information to help them prevent and survive cancer more about aicr, agence fruits et l gumes frais aprifel the global fruit and veg newsletter is a monthly newsletter distributing to 29 countries involved in the promotion of the consumption of fruit and vegetable worldwide, world cancer research fund international we are experts in cancer prevention we analyse global research on diet nutrition physical activity cancer and make public health policy recommendations, the fractions of cancer attributable sciencedirect com a proportion of cancers at many body sites are attributable to potentially modifiable factors no global summaries of the preventable cancer burden have been, who controlling the global obesity epidemic more information obesity and overweight fact sheet who global strategy on diet physical activity and health who global database on body mass index, espen guidelines on nutrition in cancer patients gl nutrition in cancer patients outline o methods o1 basic information o2 methods o3 post publication impact a background a1 catabolic alterations in, un news global perspective human stories un news produces daily news content in arabic chinese english french kiswahili portuguese russian and spanish and weekly programmes in hindi urdu and bangla, recommended community strategies and measurements to table continued summary of recommended community strategies and measurements to prevent obesity in the united states strategies to encourage physical, food as medicine preventing treating the most dreaded food as medicine preventing treating the most dreaded diseases with diet, video resources bc cancer these videos help patients learn about their cancer and its treatment, prostate cancer nutrition and dietary supplements pdq nutrition methods and dietary supplements have been studied for prostate cancer prevention or treatment read about the history of research laboratory, who europe food safety food safety ingestion and handling of contaminated food causes significant illness and death worldwide across the who european region foodborne diseases, creating healthy food and eating environments policy and food and eating environments likely contribute to the increasing epidemic of obesity and chronic diseases over and above individual factors such as knowledge skills, health risks obesity prevention source harvard t h obesity and reproduction obesity can influence various aspects of reproduction from sexual activity to conception among women the association between, top nutrition schools undergraduate degree programs ncr want to know the top nutrition schools and best undergraduate degree programs here we review analyze rank rate them figure out which is best for you , overeating caloric restriction and breast cancer risk by this study analyzes the association of excessive energy intake and caloric restriction with breast cancer bc risk taking into account the individual, calcium what s best for your bones and health the possible increased risk of ovarian cancer high levels of galactose a sugar released by the digestion of lactose in milk have been studied as being, cancer protocol nutrition supplements cancer protocol nutrition supplements herbs enzymes note do not email me unless you would like a personalized protocol free with a suggested donation of 250

2,202 citations

Journal ArticleDOI
TL;DR: The observed patterns and trends of bladder cancer incidence worldwide appear to reflect the prevalence of tobacco smoking, although infection with Schistosoma haematobium and other risk factors are major causes in selected populations.

1,719 citations