Cancer Epidemiology Unit

About: Cancer Epidemiology Unit is a based out in . It is known for research contribution in the topics: Population & Cancer. The organization has 669 authors who have published 1725 publications receiving 93979 citations.

Reproducibility of dietary intakes of macronutrients, specific food groups, and dietary patterns in 211 050 adults in the UK Biobank study.

Abstract: To detect modest associations of dietary intake with disease risk, observational studies need to be large and control for moderate measurement errors. The reproducibility of dietary intakes of macronutrients, food groups and dietary patterns (vegetarian and Mediterranean) was assessed in adults in the UK Biobank study on up to five occasions using a web-based 24-h dietary assessment (n 211 050), and using short FFQ recorded at baseline (n 502 655) and after 4 years (n 20 346). When the means of two 24-h assessments were used, the intra-class correlation coefficients (ICC) for macronutrients varied from 0·63 for alcohol to 0·36 for polyunsaturated fat. The ICC for food groups also varied from 0·68 for fruit to 0·18 for fish. The ICC for the FFQ varied from 0·66 for meat and fruit to 0·48 for bread and cereals. The reproducibility was higher for vegetarian status (κ > 0·80) than for the Mediterranean dietary pattern (ICC = 0·45). Overall, the reproducibility of pairs of 24-h dietary assessments and single FFQ used in the UK Biobank were comparable with results of previous prospective studies using conventional methods. Analyses of diet-disease relationships need to correct for both measurement error and within-person variability in dietary intake in order to reliably assess any such associations with disease in the UK Biobank.

Hip fractures in women with breast cancer

Abstract: The authors investigated whether the incidence of first hip fracture, an indicator of osteoporosis, is lower in breast cancer patients, who are assumed to have higher levels of endogenous estrogens, than in other women. A population-based Swedish cohort comprising 9,673 women with invasive breast cancer diagnosed from 1958 through 1983 was followed up with respect to the occurrence of a first hip fracture during the period 1965-1983. Overall, the number of observed acute fractures (n = 387) was slightly higher than expected (n = 348.6) (standardized incidence ratio (SIR) = 1.1, 95% confidence interval (CI) 1.0-1.2). Risk for trochanteric fractures was slightly higher than expected (SIR = 1.2, 95% CI 1.0-1.4), but risk for cervical fractures was not (SIR = 1.0, 95% CI 0.9-1.1). Risk for trochanteric fracture decreased with increasing age at breast cancer diagnosis, reaching standardized incidence ratios close to unity after the age of 70 years. Duration of follow-up appeared to be unrelated to the risk of either type of fracture. The authors conclude that the incidence of first hip fracture is not lower in breast cancer patients than in other women.

Social isolation and risk of heart disease and stroke: analysis of two large UK prospective studies

Abstract: Summary Background Social isolation has been associated with increased risk of coronary heart disease and stroke. However, it is unclear whether the associations differ between fatal and non-fatal events or by the type of isolation (living alone or having few social contacts). We aimed to examine these associations in two large UK prospective cohorts. Methods Million Women Study and UK Biobank participants without previous coronary heart disease or stroke who provided data in median year 2010 (IQR 2009–2011) on social contacts were included in this prospective analysis. Participants were followed up to median year 2017 (2017–2017) by electronic linkage to national hospital and death records. Risk ratios (RRs) were calculated using Cox regression for first coronary heart disease and stroke event (overall, and separately for hospital admission as the first event and for death without an associated hospital admission as the first event) by three levels of social isolation (based on living alone, contact with family or friends, and group participation) adjusted for age, sex, study, region, deprivation, smoking, alcohol intake, body-mass index, physical activity, and self-rated health. Findings 938 558 participants were included in our analyses (mean age 63 years [SD 9]): 481 946 participants from the Million Women Study (mean age 68 years [5]) and 456 612 participants (mean age 57 years [8]) from UK Biobank. During a mean follow-up period of 7 years (2), 42 402 first coronary heart disease events (of which 1834 were fatal without an associated hospital admission) and 19 999 first stroke events (of which 529 were fatal without an associated hospital admission) occurred. Little, if any, association was found between social isolation and hospital admission for a first coronary heart disease or stroke event (combined RR for both studies 1·01 [95% CI 0·98–1·04] for coronary heart disease and 1·13 [1·08–1·18] for stroke, when comparing the most isolated group with the least isolated group). However, the risk of death without an associated hospital admission was substantially higher in the most isolated group than the least isolated group for coronary heart disease (1·86 [1·63–2·12]) and stroke (1·91 [1·48–2·46]). For coronary heart disease or stroke death as the first event, RRs were substantially higher (test for heterogeneity, p=0·002) for participants living alone versus those not living alone (1·60 [1·46–1·75]) than for those with fewer versus more contact with family, friends, or groups (1·27 [1·16–1·38]). These findings did not differ greatly between studies, or by self-rated health. Interpretation Social isolation seems to have little direct effect on the risk of developing a first coronary heart disease or stroke. By contrast, social isolation substantially increases the risk that the first such event is fatal before reaching hospital, particularly among people who live alone, perhaps because of the absence of immediate help in responding to an acute heart attack or stroke. Funding UK Medical Research Council, Cancer Research UK.

Micronutrients and cancer aetiology: the epidemiological evidence

Abstract: Micronutrient deficiencies occur most commonly in poor countries and, therefore, are most likely to be associated with cancers common in these countries. Epidemiological studies are hampered by inaccurate measurement of micronutrient intake and by the correlations between intakes of many nutrients. The strongest evidence for a protective effect of micronutrients is for oesophageal cancer. The identity of the micronutrients is not certain, but may include retinol, riboflavin, ascorbic acid and Zn; alcohol, smoking and dietary nitrosamines increase the risk for oesophageal cancer. For stomach cancer there is good evidence that fruit and vegetables are protective. The protective effect of these foods might be largely due to ascorbic acid, but other nutrients and non-nutrients may also be important; the risk for stomach cancer is increased by salt, some types of preserved foods, and by infection of the stomach with the bacterium Helicobacter pylori. The risk for lung cancer appears to be reduced by a high intake of fruit and vegetables, but it is not clear which agents are responsible and the major cause of lung cancer is cigarette smoking. Diet is probably the major determinant of the risk for colo-rectal cancer; there is evidence that fruit and vegetables and fibre reduce risk and that meat and animal fat increase risk, but there is no convincing evidence that these relationships are mediated by micronutrients. The risk for cervical cancer is inversely related to fruit and vegetable consumption and, therefore, to consumption of carotenoids and ascorbic acid, but the major cause of this cancer is human papillomavirus and it is not yet clear whether the dietary associations indicate a true protective effect or whether they are due to confounding by other variables. The evidence that micronutrients are important in the aetiology of either breast cancer or prostate cancer is weak, but the possible roles of 1,25-dihydroxycholecalciferol and alpha-tocopherol in prostate cancer require further study.