Showing papers by "Petra H.M. Peeters published in 2016"
Mariachiara Di Cesare1, Mariachiara Di Cesare2, James Bentham2, Gretchen A Stevens3 +738 more•Institutions (60)
TL;DR: The posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue, is calculated.
3,766 citations
James Bentham1, Mariachiara Di Cesare1, Mariachiara Di Cesare2, Gretchen A Stevens3 +787 more•Institutions (246)
TL;DR: The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
Abstract: Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3–19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8–144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
1,348 citations
International Agency for Research on Cancer1, Aarhus University2, Institut Gustave Roussy3, South University4, German Cancer Research Center5, Academy of Athens6, Prevention Institute7, Utrecht University8, Imperial College London9, University of Tromsø10, University of Oslo11, University of Granada12, Lund University13, Umeå University14, Swedish University of Agricultural Sciences15, Karolinska Institutet16, University of Oxford17, University of Cambridge18
TL;DR: The large number of dietary individual polyphenols consumed and the high variability of their intakes between European populations, particularly between MED and non-MED countries are described.
Abstract: Polyphenols are plant secondary metabolites with a large variability in their chemical structure and dietary occurrence that have been associated with some protective effects against several chronic diseases. To date, limited data exist on intake of polyphenols in populations. The current cross-sectional analysis aimed at estimating dietary intakes of all currently known individual polyphenols and total intake per class and subclass, and to identify their main food sources in the European Prospective Investigation into Cancer and Nutrition cohort.
297 citations
Aarhus University1, Utrecht University2, University of Copenhagen3, University of Düsseldorf4, National and Kapodistrian University of Athens5, University of Ulm6, Imperial College London7, University of Turin8, Swiss Tropical and Public Health Institute9, Cancer Epidemiology Unit10, University Medical Center Utrecht11, Norwegian Institute of Public Health12, Karolinska Institutet13, Karolinska University Hospital14, Netherlands Organisation for Applied Scientific Research15, Finnish Meteorological Institute16, University of Hertfordshire17
TL;DR: This study indicates that the association between PM in air pollution and lung cancer can be attributed to various PM components and sources, and PM containing S and Ni might be particularly important.
232 citations
TL;DR: This study comprehensively cataloged the smoking-associated DNA methylation alterations and showed that these alterations are reversible after smoking cessation, although specific genes remained differentially methylated up to 22 years after cessation.
Abstract: Aim: Epigenetic changes may occur in response to environmental stressors, and an altered epigenome pattern may represent a stable signature of environmental exposure. Materials & methods: Here, we examined the potential of DNA methylation changes in 910 prediagnostic peripheral blood samples as a marker of exposure to tobacco smoke in a large multinational cohort. Results: We identified 748 CpG sites that were differentially methylated between smokers and nonsmokers, among which we identified novel regionally clustered CpGs associated with active smoking. Importantly, we found a marked reversibility of methylation changes after smoking cessation, although specific genes remained differentially methylated up to 22 years after cessation. Conclusion: Our study has comprehensively cataloged the smoking-associated DNA methylation alterations and showed that these alterations are reversible after smoking cessation.
175 citations
TL;DR: In conclusion, physical exercise during adjuvant breast cancer treatment has beneficial effects on general fatigue, physical fatigue, 'reduced activity' and 'red reduced motivation', but did not show effects on cognitive and affective fatigue.
159 citations
German Cancer Research Center1, Autonomous University of Barcelona2, Karolinska Institutet3, University of Tromsø4, Prevention Institute5, University of Cambridge6, Aarhus University7, University of Paris-Sud8, French Institute of Health and Medical Research9, Institut Gustave Roussy10, National and Kapodistrian University of Athens11, Harvard University12, Cancer Epidemiology Unit13, University of Turin14, University of Naples Federico II15, Imperial College London16, Utrecht University17, University of Granada18, University of Murcia19, Lund University20, Umeå University21, International Agency for Research on Cancer22
TL;DR: The results suggest that several hormonal factors are risk factors for cervical carcinogenesis and adherence to current cervical cancer screening guidelines should minimize the increased risk of CC associated with these hormonal risk factors.
Abstract: Background: In addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC). However, most of the evidence comes from retrospective case-control studies. ...
102 citations
Lunenfeld-Tanenbaum Research Institute1, Max Planck Society2, University of Cambridge3, Institute of Cancer Research4, National Institutes of Health5, University of Southern California6, University of Virginia7, Harvard University8, International Agency for Research on Cancer9, University of Göttingen10, University of Salzburg11, German Cancer Research Center12, Karolinska Institutet13, Brigham and Women's Hospital14, University of Manchester15, University of Warwick16, American Cancer Society17, Mayo Clinic18, Yale University19, Ontario Institute for Cancer Research20, Fred Hutchinson Cancer Research Center21, University of Pittsburgh22, University of Utah23, VU University Medical Center24, University of Chicago25, Helsinki University Central Hospital26, University of Melbourne27, University of London28, University of Hamburg29, University of Cologne30, Erasmus University Rotterdam31, Genome Institute of Singapore32, Umeå University33, Technische Universität München34, Utrecht University35, University of Granada36, Cancer Epidemiology Unit37, Stanford University38, Vanderbilt University39, University of Hawaii40, Memorial University of Newfoundland41, deCODE genetics42, Nanjing Medical University43, National Cancer Research Institute44, Laval University45, University of British Columbia46, Merck & Co.47, University Medical Center Groningen48, Xiamen University49, Dartmouth College50
TL;DR: In this paper, a two-stage approach to conduct genome-wide association studies for lung, ovary, breast, prostate, and colorectal cancer from the GAME-ON/GECCO Network (61,851 cases, 61,820 controls) to identify pleiotropic loci was proposed.
Abstract: Identifying genetic variants with pleiotropic associations can uncover common pathways influencing multiple cancers. We took a two-stage approach to conduct genome-wide association studies for lung, ovary, breast, prostate, and colorectal cancer from the GAME-ON/GECCO Network (61,851 cases, 61,820 controls) to identify pleiotropic loci. Findings were replicated in independent association studies (55,789 cases, 330,490 controls). We identified a novel pleiotropic association at 1q22 involving breast and lung squamous cell carcinoma, with eQTL analysis showing an association with ADAM15/THBS3 gene expression in lung. We also identified a known breast cancer locus CASP8/ALS2CR12 associated with prostate cancer, a known cancer locus atCDKN2B-AS1 with different variants associated with lung adenocarcinoma and prostate cancer, and confirmed the associations of a breast BRCA2 locus with lung and serous ovarian cancer. This is the largest study to date examining pleiotropy across multiple cancer-associated loci, identifying common mechanisms of cancer development and progression. (C) 2016 AACR.
89 citations
TL;DR: The Physical Activity During Cancer Treatment trial shows that an 18-wk supervised exercise program in colon cancer patients during chemotherapy is safe and feasible and significantly reduced physical fatigue at 18 wk and general fatigue at 36 wk.
Abstract: AB Purpose: Fatigue is a common problem among colon cancer patients and typically increases during chemotherapy. Exercise during chemotherapy might have beneficial effects on fatigue. To investigate the short- and long-term effects of an exercise program in colon cancer patients during adjuvant treatment, the Physical Activity During Cancer Treatment study was conducted. Methods: In this multicenter randomized controlled trial, 33 colon cancer patients undergoing chemotherapy (21 men and 12 women) were randomly assigned to either a group receiving an 18-wk supervised exercise program (n = 17) or to usual care (n = 16). The primary outcome was fatigue as measured by the Multidimensional Fatigue Inventory and the Fatigue Quality List. Secondary outcomes were quality of life, physical fitness, anxiety, depression, body weight, and chemotherapy completion rate. Outcome assessment took place at baseline, postintervention (18 wk) and at 36 wk. Results: Intention-to-treat mixed linear model analyses showed that patients in the intervention group experienced significantly less physical fatigue at 18 wk and general fatigue at 36 wk (mean between group differences, -3.2; 95% confidence interval [CI], -6.2 to -0.2; effect size [ES], -0.9 and -2.7; 95% CI, -5.2 to -0.1; ES, -0.8, respectively), and reported higher physical functioning (12.3; 95% CI, 3.3-21.4; ES, 1.0) compared with patients in the usual care group. Conclusion: The Physical Activity During Cancer Treatment trial shows that an 18-wk supervised exercise program in colon cancer patients during chemotherapy is safe and feasible. The intervention significantly reduced physical fatigue at 18 wk and general fatigue at 36 wk. Considering the number of patients included in the present study, replication in a larger study population is required.
88 citations
Imperial College London1, International Agency for Research on Cancer2, Institut Gustave Roussy3, French Institute of Health and Medical Research4, University of Paris-Sud5, German Cancer Research Center6, Aarhus University7, University of Cambridge8, Medical Research Council9, University of Oxford10, National and Kapodistrian University of Athens11, Academy of Athens12, Harvard University13, University of Naples Federico II14, Utrecht University15, Lund University16, Umeå University17, University of Tromsø18, University of Ioannina19
TL;DR: The results support the idea that individuals with the metabolically healthy/overweight phenotype (with normal insulin levels) are at lower colorectal cancer risk than those with hyperinsulinaemia.
Abstract: The coordination of EPIC is financially
supported by the European Commission (DGSANCO);
and the International Agency for Research
on Cancer. The national cohorts are supported by
Danish Cancer Society (Denmark); Ligue Contre le
Cancer; Institut Gustave Roussy; Mutuelle Generale
de l’Education Nationale; and Institut National de la
Sante et de la Recherche Medicale (INSERM)
(France); Deutsche Krebshilfe, Deutsches
Krebsforschungszentrum; and Federal Ministry of
Education and Research (Germany); Hellenic Health
Foundation; Stavros Niarchos Foundation; and the
Hellenic Ministry of Health and Social Solidarity
(Greece); Italian Association for Research on Cancer
(AIRC); National Research Council; and
Associazione Iblea per la Ricerca Epidemiologica
(AIRE-ONLUS) Ragusa, Associazione Volontari
Italiani Sangu (AVIS) Ragusa, Sicilian Government
(Italy); Dutch Ministry of Public Health, Welfare and
Sports (VWS); Netherlands Cancer Registry (NKR);
LK Research Funds; Dutch Prevention Funds; Dutch
ZON (Zorg Onderzoek Nederland); World Cancer
Research Fund (WCRF); and Statistics Netherlands
(the Netherlands); European Research Council
(ERC) (grant number ERC-2009-AdG 232997) and
Nordforsk; and Nordic Center of Excellence
Programme on Food, Nutrition and Health (Norway);
Health Research Fund (FIS); Regional Governments
of Andalucia, Asturias, Basque Country, Murcia (No.
6236) and Navarra; and the Centro de Investigacion
Biomedica en Red en Epidemiologia y Salud Publica
and Instituto de Salud Carlos II (ISCIII RETIC) (RD06/
0020) (Spain); Swedish Cancer Society; Swedish
Scientific Council; and Regional Government of
Skane and Vasterbotten (Sweden); Cancer Research
UK; Medical Research Council; Stroke Association;
British Heart Foundation; Department of Health; Food
Standards Agency; Wellcome Trust (UK); and
National Cancer Institute (USA) (grant number:
1RO1CA102460) (PI, Professor Rudolf Kaaks). The
funders had no role in study design, data collection
and analysis, decision to publish, or preparation of
the manuscript.
83 citations
Journal Article•
TL;DR: This is the largest study to date examining pleiotropy across multiple cancer-associated loci, identifying common mechanisms of cancer development and progression.
Abstract: Identifying genetic variants with pleiotropic associations can uncover common pathways influencing multiple cancers. We took a two-stage approach to conduct genome-wide association studies for lung, ovary, breast, prostate, and colorectal cancer from the GAME-ON/GECCO Network (61,851 cases, 61,820 controls) to identify pleiotropic loci. Findings were replicated in independent association studies (55,789 cases, 330,490 controls). We identified a novel pleiotropic association at 1q22 involving breast and lung squamous cell carcinoma, with eQTL analysis showing an association with ADAM15/THBS3 gene expression in lung. We also identified a known breast cancer locus CASP8/ALS2CR12 associated with prostate cancer, a known cancer locus atCDKN2B-AS1 with different variants associated with lung adenocarcinoma and prostate cancer, and confirmed the associations of a breast BRCA2 locus with lung and serous ovarian cancer. This is the largest study to date examining pleiotropy across multiple cancer-associated loci, identifying common mechanisms of cancer development and progression. (C) 2016 AACR.
Utrecht University1, Oklahoma State University Center for Health Sciences2, Imperial College London3, Wageningen University and Research Centre4, Aarhus University5, International Agency for Research on Cancer6, French Institute of Health and Medical Research7, German Cancer Research Center8, National and Kapodistrian University of Athens9, Harvard University10, Academy of Athens11, University of Naples Federico II12, Prevention Institute13, University of Tromsø14, University of Murcia15, Andalusian School of Public Health16, Lund University17, Umeå University18, Cancer Epidemiology Unit19, University of Cambridge20
TL;DR: It is indicated that higher concentrations of plasma β-carotene and α- carotene are associated with lower breast cancer risk of ER- tumors and no statistically significant interaction between smoking, alcohol, or BMI is observed.
Harvard University1, German Cancer Research Center2, Brigham and Women's Hospital3, Aarhus University4, University of Paris-Sud5, University of Melbourne6, International Agency for Research on Cancer7, National and Kapodistrian University of Athens8, University of Ferrara9, Utrecht University10, University of Tromsø11, University of Murcia12, Umeå University13, Lund University14, Medical Research Council15, University of Cambridge16, Cancer Epidemiology Unit17, Imperial College London18
TL;DR: Evaluating the most promising ovarian cancer screening biomarkers in prospectively collected samples from the European Prospective Investigation into Cancer and Nutrition study finds CA125 remains the single best marker for the early detection of invasive epithelial ovarian cancer, but can be slightly improved by combining with other markers.
Abstract: Purpose: About 60% of ovarian cancers are diagnosed at late stage, when 5-year survival is less than 30% in contrast to 90% for local disease. This has prompted search for early detection biomarker ...
International Agency for Research on Cancer1, Emory University2, Aarhus University3, University of Paris4, French Institute of Health and Medical Research5, German Cancer Research Center6, Academy of Athens7, National and Kapodistrian University of Athens8, University of Naples Federico II9, Utrecht University10, University of Granada11, Lund University12, Umeå University13, University of Cambridge14, University of Oxford15, Imperial College London16
TL;DR: In conclusion, imbalances of specific AA and biogenic amines may be involved in HCC development.
Abstract: Perturbations in levels of amino acids (AA) and their derivatives are observed in hepatocellular carcinoma (HCC). Yet, it is unclear whether these alterations precede or are a consequence of the disease, nor whether they pertain to anatomically related cancers of the intrahepatic bile duct (IHBC), and gallbladder and extrahepatic biliary tract (GBTC). Circulating standard AA, biogenic amines and hexoses were measured (Biocrates AbsoluteIDQ-p180Kit) in a case-control study nested within a large prospective cohort (147 HCC, 43 IHBC and 134 GBTC cases). Liver function and hepatitis status biomarkers were determined separately. Multivariable conditional logistic regression was used to calculate odds ratios and 95% confidence intervals (OR; 95%CI) for log-transformed standardised (mean = 0, SD = 1) serum metabolite levels and relevant ratios in relation to HCC, IHBC or GBTC risk. Fourteen metabolites were significantly associated with HCC risk, of which seven metabolites and four ratios were the strongest predictors in continuous models. Leucine, lysine, glutamine and the ratio of branched chain to aromatic AA (Fischer's ratio) were inversely, while phenylalanine, tyrosine and their ratio, glutamate, glutamate/glutamine ratio, kynurenine and its ratio to tryptophan were positively associated with HCC risk. Confounding by hepatitis status and liver enzyme levels was observed. For the other cancers no significant associations were observed. In conclusion, imbalances of specific AA and biogenic amines may be involved in HCC development.
Royal College of Surgeons in Ireland1, International Agency for Research on Cancer2, Charité3, National and Kapodistrian University of Athens4, Aarhus University5, French Institute of Health and Medical Research6, German Cancer Research Center7, Harvard University8, Prevention Institute9, University of Turin10, Imperial College London11, Utrecht University12, University of Tromsø13, University of Granada14, University of Murcia15, Umeå University16, University of Cambridge17, Cancer Epidemiology Unit18
TL;DR: Findings from a large prospective cohort provide evidence that suboptimal selenium status in Europeans may be associated with an appreciably increased risk of HCC development.
International Agency for Research on Cancer1, National and Kapodistrian University of Athens2, Leibniz Association3, University of Bremen4, First Faculty of Medicine, Charles University in Prague5, University of Turin6, University of Padua7, University of Aberdeen8, Newcastle University9, University of Glasgow10, Trinity College, Dublin11, Lund University12, German Cancer Research Center13, Umeå University14, Uppsala University15, Imperial College London16, University Medical Center Utrecht17, Cancer Epidemiology Unit18, Prevention Institute19, Academy of Athens20, Harvard University21, University of Murcia22, University of Granada23, University of Melbourne24, Cancer Council Victoria25, Institut Gustave Roussy26, French Institute of Health and Medical Research27, University of Paris-Sud28, University of Naples Federico II29, Health Science University30
TL;DR: The impact of smoking on HPV16-positive oropharyngeal cancer highlights the continued need for smoking cessation programmes for primary prevention of head and neck cancer.
Abstract: Background: Although smoking and HPV infection are recognized as important risk factors for oropharyngeal cancer, how their joint exposure impacts on oropharyngeal cancer risk is unclear. Specifica ...
International Agency for Research on Cancer1, Aarhus University2, Université Paris-Saclay3, National and Kapodistrian University of Athens4, Academy of Athens5, Harvard University6, Utrecht University7, Imperial College London8, University of Granada9, University of Murcia10, Lund University11, University of Oxford12
TL;DR: Findings suggest simple behavior modifications could have a sizeable impact on cancer prevention, especially for men, according to a healthy lifestyle index score generated to investigate the joint effect of modifiable factors.
TL;DR: A 16-week randomized intervention inducing comparable weight loss by a hypocaloric diet or mainly exercise resulted in favorable effects on serum hsCRP and leptin, which might be associated with a lower breast cancer risk.
Abstract: Background: We investigated the effect of equivalent weight loss, by a hypocaloric diet or mainly exercise, on inflammatory markers and adipokines in overweight postmenopausal women.
Methods: Women were randomized to a diet ( n = 97), mainly exercise ( n = 98), or control group ( n = 48). Goal of both interventions was to lose 5 to 6 kg bodyweight by a hypocaloric diet or an exercise program (4 hours/week) combined with a small caloric intake restriction. Outcomes after 16 weeks included serum high-sensitive C–reactive protein (hsCRP), IL6, adiponectin, and leptin.
Results: Both intervention groups achieved the target weight loss. Controls remained weight stable. Compared with control, hsCRP decreased with mainly exercise [treatment effect ratio (TER) = 0.64] and borderline statistically significant with diet (TER = 0.77). There was a suggestively larger effect of exercise, directly compared with diet (TER = 0.83). Leptin decreased with both interventions: mainly exercise (TER = 0.55) and diet (TER = 0.59), versus control. Effects attenuated and lost significance after adjusting for change in body fat percentage, and to a lesser extent when adjusting for fitness. No effects were seen on IL6 and adiponectin.
Conclusions: A 16-week randomized intervention inducing comparable weight loss by a hypocaloric diet or mainly exercise, resulted in favorable effects on serum hsCRP and leptin. We found a possible more beneficial effect on hsCRP with mainly exercise versus diet. These effects of exercise were established by changes in body fat percentage and physical fitness.
Impact: A modest amount of weight loss in postmenopausal women reduces hsCRP and leptin levels which might be associated with a lower breast cancer risk. Cancer Epidemiol Biomarkers Prev; 25(5); 799–806. ©2016 AACR .
Imperial College London1, Queen Mary University of London2, Utrecht University3, University of Cambridge4, University of London5, International Agency for Research on Cancer6, Umeå University7, German Cancer Research Center8, University of Oxford9, Andalusian School of Public Health10, Lund University11, National and Kapodistrian University of Athens12, Prevention Institute13, Institut Gustave Roussy14
TL;DR: The present study shows a slightly decreased—not increased like in case–control studies—risk of dying from ALS in those with high levels of total PA at enrolment, and this association does not appear confounded by age, gender, anthropometry, smoking, and education.
Abstract: Previous case-control studies have suggested a possible increased risk of Amyotrophic Lateral Sclerosis (ALS) with physical activity (PA), but this association has never been studied in prospective cohort studies. We therefore assessed the association between PA and risk of death from ALS in the European Prospective Investigation into Cancer and Nutrition. A total of 472,100 individuals were included in the analysis, yielding 219 ALS deaths. At recruitment, information on PA was collected thorough standardised questionnaires. Total PA was expressed by the Cambridge Physical Activity Index (CPAI) and analysed in relation to ALS mortality, using Cox hazard models. Interactions with age, sex, and anthropometric measures were assessed. Total PA was weakly inversely associated with ALS mortality with a borderline statistically significant trend across categories (p = 0.042), with those physically active being 33% less likely to die from ALS compared to those inactive: HR = 0.67 (95% CI 0.42-1.06). Anthropometric measures, sex, and age did not modify the association with CPAI. The present study shows a slightly decreased-not increased like in case-control studies-risk of dying from ALS in those with high levels of total PA at enrolment. This association does not appear confounded by age, gender, anthropometry, smoking, and education. Ours was the first prospective cohort study on ALS and physical activity.
Utrecht University1, Imperial College London2, Aarhus University3, International Agency for Research on Cancer4, Institut Gustave Roussy5, French Institute of Health and Medical Research6, University of Melbourne7, German Cancer Research Center8, National and Kapodistrian University of Athens9, Academy of Athens10, Harvard University11, Prevention Institute12, University of Naples Federico II13, RMIT University14, University of Granada15, Umeå University16, University of Gothenburg17, University of Cambridge18, Cancer Epidemiology Unit19
TL;DR: Evidence is provided that a high vegetable intake is associated with lower (mainly hormone receptor-negative) breast cancer risk and the test for heterogeneity by hormone receptor status was not significant.
International Agency for Research on Cancer1, Imperial College London2, University of Ioannina3, Institut Gustave Roussy4, French Institute of Health and Medical Research5, University of Paris-Sud6, German Cancer Research Center7, Aarhus University8, University of Granada9, University of Murcia10, University of Cambridge11, University of Oxford12, National and Kapodistrian University of Athens13, Prevention Institute14, University of Naples Federico II15, Utrecht University16, Lund University17, Malmö University18, Umeå University19, University of Tromsø20
TL;DR: While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially.
Abstract: This work was supported by the French Social Affairs & Health Ministry, Department of Health (Direction Generale de la Sante). The work undertaken by David C Muller for this project was performed during the tenure of an IARC-Australia fellowship supported by Cancer Council Australia. Elio Riboli was supported by the Imperial College Biomedical Research Centre funded by the National Institute of Health Research of UK. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Generale de l’Education Nationale, Institut National de la Sante et de la Recherche Medicale (INSERM) (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway); Health Research Fund (FIS), PI13/00061 to Granada, Regional Governments of Andalucia, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and County Councils of Skane and Vasterbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk) (United Kingdom).
TL;DR: Only among low educated participants, current smokers reported an unhealthier dietary pattern in comparison to never smokers, which can be used in the development of targeted health promotion strategies.
Abstract: Background : Unhealthy dietary patterns have been associated with other unhealthy lifestyle factors such as smoking and physical inactivity. Whether these associations are similar in high- and low-educated individuals is currently unknown. Methods : We used information of the EPIC-NL cohort, a prospective cohort of 39 393 men and women, aged 20–70 years at recruitment. A lifestyle questionnaire and a validated food frequency questionnaire were administered at recruitment (1993–97). Low adherence to a Mediterranean-style diet was used to determine an unhealthy dietary pattern. Lifestyle-related factors included body mass index, waist circumference, smoking status, physical activity level, dietary supplement use and daily breakfast consumption. Multivariate logistic regression analyses were performed for the total population and by strata of educational level. Results : In total 30% of the study population had an unhealthy dietary pattern: 39% in the lowest educated group and 20% in the highest educated group. Physical inactivity, a large waist circumference, no dietary supplement use and skipping breakfast were associated with an unhealthy dietary pattern in both low and high educated participants. Among low educated participants, current smokers had a greater odds of an unhealthy diet compared with never smokers: OR 1.42 (95% CI: 1.25; 1.61). This association was not observed in the high educated group. Conclusions : Most associations between lifestyle-related factors and unhealthy diet were consistent across educational levels, except for smoking. Only among low educated participants, current smokers reported an unhealthier dietary pattern in comparison to never smokers. These results can be used in the development of targeted health promotion strategies.
TL;DR: Limited support is provided for the hypothesis that vitamin D may have a major role in cancer development and prevention among European older adults by meta-analyses with individual participant data from three large population-based cohort studies.
Abstract: The associations of circulating 25-hydroxyvitamin D [25(OH)D] concentrations with total and site-specific cancer incidence have been examined in several epidemiological studies with overall inconclusive findings. Very little is known about the association of vitamin D with cancer incidence in older populations. We assessed the association of pre-diagnostic serum 25(OH)D levels with incidence of all cancers combined and incidence of lung, colorectal, breast, prostate and lymphoid malignancies among older adults. Pre-diagnostic 25(OH)D concentrations and cancer incidence were available in total for 15,486 older adults (mean age 63, range 50–84 years) participating in two cohort studies: ESTHER (Germany) and TROMSO (Norway); and a subset of previously published nested-case control data from a another cohort study: EPIC-Elderly (Greece, Denmark, Netherlands, Spain and Sweden) from the CHANCES consortium on health and aging. Cox proportional hazards or logistic regression were used to derive multivariable adjusted hazard and odds ratios, respectively, and their 95 % confidence intervals across 25(OH)D categories. Meta-analyses with random effects models were used to pool study-specific risk estimates. Overall, lower 25(OH)D concentrations were not significantly associated with increased incidence of most of the cancers assessed. However, there was some evidence of increased breast cancer and decreased lymphoma risk with higher 25(OH)D concentrations. Our meta-analyses with individual participant data from three large European population-based cohort studies provide at best limited support for the hypothesis that vitamin D may have a major role in cancer development and prevention among European older adults.
International Agency for Research on Cancer1, University of Texas MD Anderson Cancer Center2, Karolinska Institutet3, Aarhus University4, University of Melbourne5, Cancer Council Victoria6, Institut Gustave Roussy7, French Institute of Health and Medical Research8, German Cancer Research Center9, National and Kapodistrian University of Athens10, University of Naples Federico II11, Imperial College London12, Utrecht University13, Umeå University14, Lund University15, University of Cambridge16, University of Oxford17, University of Grenoble18
TL;DR: The best predictive model for HCC in this low-risk population is OPN in combination with liver function tests, suggesting that measuring OPN and AFP could identify high-risk groups independently of a liver disease diagnosis.
Abstract: We previously identified osteopontin (OPN) as a promising marker for the early detection of hepatocellular carcinoma (HCC). In this study, we investigated the association between prediagnostic circulating OPN levels and HCC incidence in a large population-based cohort. A nested case-control study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. During a mean follow-up of 4.8 years, 100 HCC cases were identified. Each case was matched to two controls and OPN levels were measured in baseline plasma samples. Viral hepatitis, liver function, and α-fetoprotein (AFP) tests were also conducted. Conditional logistic regression models were used to calculate multivariable odds ratio (OR) and 95% confidence intervals (95% CI) for OPN levels in relation to HCC. Receiver operating characteristics curves were constructed to determine the discriminatory accuracy of OPN alone or in combination with other liver biomarkers in the prediction of HCC. OPN levels were positively associated with HCC risk (per 10% increment, ORmultivariable = 1.30; 95% CI, 1.14-1.48). The association was stronger among cases diagnosed within 2 years of follow-up. Adding liver function tests to OPN improved the discriminatory performance for subjects who developed HCC (AUC = 0.86). For cases diagnosed within 2 years, the combination of OPN and AFP was best able to predict HCC risk (AUC = 0.88). The best predictive model for HCC in this low-risk population is OPN in combination with liver function tests. Within 2 years of diagnosis, the combination of OPN and AFP best predicted HCC development, suggesting that measuring OPN and AFP could identify high-risk groups independently of a liver disease diagnosis. Cancer Prev Res; 9(9); 758-65. ©2016 AACR.
International Agency for Research on Cancer1, Emory University2, National and Kapodistrian University of Athens3, Harvard University4, Aarhus University5, Institut Gustave Roussy6, French Institute of Health and Medical Research7, Cancer Council Victoria8, University of Melbourne9, Prevention Institute10, University Medical Center Utrecht11, Imperial College London12, Utrecht University13, University of Tromsø14, Norwegian Institute of Public Health15, Lund University16, Umeå University17, University of Cambridge18, University of Oxford19
TL;DR: Daily intake of combined soft drinks is positively associated with HCC, but a differential association between sugar and artificially sweetened cannot be discounted, and this study provides some insight into possible associations of HCC with sugary drinks intake.
Abstract: The aim of the study was to assess associations between intake of combined soft drinks (sugar sweetened and artificially sweetened) and fruit and vegetable juices and the risk of hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBC) and biliary tract cancers (GBTC) using data from the European Prospective Investigation into Cancer and Nutrition cohort of 477,206 participants from 10 European countries. After 11.4 years of follow-up, 191 HCC, 66 IHBC and 236 GBTC cases were identified. Hazard ratios and 95 % confidence intervals (HR; 95 % CI) were estimated with Cox regression models with multivariable adjustment (baseline total energy intake, alcohol consumption and intake pattern, body mass index, physical activity, level of educational attainment and self-reported diabetes status). No risk associations were observed for IHBC or GBTC. Combined soft drinks consumption of >6 servings/week was positively associated with HCC risk: HR 1.83; 95 % CI 1.11–3.02, p
trend = 0.01 versus non-consumers. In sub-group analyses available for 91 % of the cohort artificially sweetened soft drinks increased HCC risk by 6 % per 1 serving increment (HR 1.06, 95 % CI 1.03–1.09, n
cases = 101); for sugar-sweetened soft drinks, this association was null (HR 1.00, 95 % CI 0.95–1.06; n
cases = 127, p
heterogeneity = 0.07). Juice consumption was not associated with HCC risk, except at very low intakes (<1 serving/week: HR 0.60; 95 % CI 0.38–0.95; p
trend = 0.02 vs. non-consumers). Daily intake of combined soft drinks is positively associated with HCC, but a differential association between sugar and artificially sweetened cannot be discounted. This study provides some insight into possible associations of HCC with sugary drinks intake. Further exploration in other settings is required.
International Agency for Research on Cancer1, Emory University2, National and Kapodistrian University of Athens3, University of Tromsø4, Aarhus University5, Institut Gustave Roussy6, Harvard University7, Prevention Institute8, University Medical Center Utrecht9, Utrecht University10, University of Granada11, Lund University12, Umeå University13, University of Cambridge14, Cancer Epidemiology Unit15, Imperial College London16
TL;DR: Positive associations between circulating liver biomarkers in sera collected prior to cancer diagnoses and the risks of developing HCC or IHBC, but not GBTC are shown.
German Cancer Research Center1, International Agency for Research on Cancer2, University of Melbourne3, Cancer Council Victoria4, Academy of Athens5, National and Kapodistrian University of Athens6, Prevention Institute7, University of Naples Federico II8, Utrecht University9, Imperial College London10, University Medical Center Utrecht11, University of Tromsø12, University of Murcia13, University of Granada14, University of Oxford15, University of Cambridge16
TL;DR: A step-wise model selection process was used to select confirmed predictive epidemiologic risk factors and a large-scale cohort-consortium approach would be needed to assess and adjust for population variation.
Abstract: Endometrial cancer (EC) is the fourth most frequent cancer in women in Europe, and as its incidence is increasing, prevention strategies gain further pertinence Risk prediction models can be a useful tool for identifying women likely to benefit from targeted prevention measures On the basis of data from 201,811 women (mostly aged 30-65 years) including 855 incident EC cases from eight countries in the European Prospective Investigation into Cancer and Nutrition cohort, a model to predict EC was developed A step-wise model selection process was used to select confirmed predictive epidemiologic risk factors Piece-wise constant hazard rates in 5-year age-intervals were estimated in a cause-specific competing risks model, five-fold-cross-validation was applied for internal validation Risk factors included in the risk prediction model were body-mass index (BMI), menopausal status, age at menarche and at menopause, oral contraceptive use, overall and by different BMI categories and overall duration of use, parity, age at first full-term pregnancy, duration of menopausal hormone therapy and smoking status (specific for pre, peri- and post-menopausal women) These variables improved the discriminating capacity to predict risk over 5 years from 71% for a model based on age alone to 77% (overall C statistic), and the model was well-calibrated (ratio of expected to observed cases = 099) Our model could be used for the identification of women at increased risk of EC in Western Europe To achieve an EC-risk model with general validity, a large-scale cohort-consortium approach would be needed to assess and adjust for population variation
International Agency for Research on Cancer1, University of Lyon2, German Cancer Research Center3, University of Tromsø4, Aarhus University5, French Institute of Health and Medical Research6, Academy of Athens7, National and Kapodistrian University of Athens8, University of Turin9, Utrecht University10, University of Gothenburg11, Umeå University12, University of Cambridge13, University of Oxford14, Imperial College London15
TL;DR: The results suggest that participants with a nutrient pattern high in micronutrients found in vegetables, fruits and cereals had a lower risk of BC.
Abstract: Objective Pattern analysis has emerged as a tool to depict the role of multiple nutrients/foods in relation to health outcomes. The present study aimed at extracting nutrient patterns with respect ...
Carlos III Health Institute1, Tufts University2, Imperial College London3, University of Malaya4, Aarhus University5, German Cancer Research Center6, Institut Gustave Roussy7, Academy of Athens8, Prevention Institute9, University of Naples Federico II10, Utrecht University11, University of Tromsø12, Norwegian Institute of Public Health13, Medical Research Council14, University of Cambridge15, University of Oxford16, International Agency for Research on Cancer17
TL;DR: Soft-drink consumption does not seem to be associated with pancreatic cancer risk, and juice and nectar consumption might beassociated with a modest decreased pancreaticcancer risk.
International Agency for Research on Cancer1, University of Bergen2, Norwegian Institute of Public Health3, Newcastle University4, Imperial College London5, University of Tromsø6, Utrecht University7, University of Paris-Sud8, French Institute of Health and Medical Research9, Institut Gustave Roussy10, University of Oviedo11, University of Oxford12, University of Cambridge13, Cardiff University14, National and Kapodistrian University of Athens15, Harvard University16, Academy of Athens17, German Cancer Research Center18, Umeå University19
TL;DR: Study participants with elevated circulating concentrations of 25(OH)D3 had decreased risk of HNC, as well as improved survival following diagnosis, and no clear association was seen with risk or survival for oesophageal cancer.
Abstract: World Cancer Research Fund (UK) funded the biochemical analyses for the current study. The funding
organization had no role in design and conduct of the study; collection, management, analysis, and interpretation
of the data; preparation, review, or approval of the manuscript. Dr Ueland reports that he is a member of the
steering board of the nonprofit Foundation to Promote Research Into Functional Vitamin B12 Deficiency. No
other disclosures were reported. The EPIC study has been supported by the Europe Against Cancer Program
of the European Commission (SANCO); Deutsche Krebshilfe; Deutsches Krebsforschungszentrum; German
Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish
Ministry of Health; Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra;
Catalan Institute of Oncology, Spain; the ISCIII of the Spanish Ministry of Health (RETICC DR06/0020);
Cancer Research UK; Medical Research Council, United Kingdom; Greek Ministry of Health; Stavros Niarchos
Foundation; Hellenic Health Foundation; Italian Association for Research on Cancer (AIRC); Italian National
Research Council; Fondazione-Istituto Banco Napoli, Italy; Associazione Italiana per la Ricerca sul Cancro-
AIRC-Milan; Compagnia di San Paolo; Dutch Ministry of Public Health, Welfare and Sports; World Cancer
Research Fund; Swedish Cancer Society; Swedish Scientific Council; Regional Government of Vasterbotten,
Sweden; NordForsk (Centre of excellence programme HELGA), Norway; French League against Cancer (LNCC),
France; National Institute for Health and Medical Research (INSERM), France; Mutuelle Generale de l’Education
Nationale (MGEN), France; 3M Co, France; Gustave Roussy Institute (IGR), France; and General Councils of
France.