Publications (256)1613.52 Total impact
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Article: Plasma adiponectin levels and endometrial cancer risk in pre-and postmenopausal women
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ABSTRACT: Background: Adiponectin, an adipocytokine secreted by adipose tis-sue, is decreased in obesity, insulin resistance, type 2 diabetes, and polycystic ovary syndrome, all of which are well-established risk fac-tors for endometrial cancer.Epidemiology Unit (F.Be.), Istituto Nazionale Tumori Cancer Registry Julius Center for Health Sciences and Primary Care The Netherlands Clinical Gerontology. ; 69372(3508). -
Article: Fruit and Vegetable Consumption and Mortality: European Prospective Investigation Into Cancer and Nutrition.
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ABSTRACT: In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death.American journal of epidemiology 04/2013; · 5.59 Impact Factor -
Article: Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study.
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ABSTRACT: BACKGROUND: In 2007, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued recommendations on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence. OBJECTIVE: We investigated whether concordance with WCRF/AICR recommendations is related to risk of death. DESIGN: The current study included 378,864 participants from 9 European countries enrolled in the European Prospective Investigation into Cancer and Nutrition study. At recruitment (1992-1998), dietary, anthropometric, and lifestyle information was collected. A WCRF/AICR score, which incorporated 6 of the WCRF/AICR recommendations for men [regarding body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, and alcoholic drinks (score range: 0-6)] and 7 WCRF/AICR recommendations for women [plus breastfeeding (score range: 0-7)], was constructed. Higher scores indicated greater concordance with WCRF/AICR recommendations. Associations between the WCRF/AICR score and risks of total and cause-specific death were estimated by using Cox regression analysis. RESULTS: After a median follow-up time of 12.8 y, 23,828 deaths were identified. Participants within the highest category of the WCRF/AICR score (5-6 points in men; 6-7 points in women) had a 34% lower hazard of death (95% CI: 0.59, 0.75) compared with participants within the lowest category of the WCRF/AICR score (0-2 points in men; 0-3 points in women). Significant inverse associations were observed in all countries. The WCRF/AICR score was also significantly associated with a lower hazard of dying from cancer, circulatory disease, and respiratory disease. CONCLUSION: Results of this study suggest that following WCRF/AICR recommendations could significantly increase longevity.American Journal of Clinical Nutrition 04/2013; · 6.67 Impact Factor -
Article: Latitude and ultraviolet radiation dose in the birthplace in relation to menarcheal age in a large cohort of French women.
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ABSTRACT: BACKGROUND: Age at menarche is an important determinant of hormonal-related neoplasia and other chronic diseases. Spatial and temporal variations in age at menarche have been observed in industrialised countries and several environmental factors were reported to have an influence. Method We examined geographical variations in self-reported age at menarche and explored the effects of both latitude and ultraviolet radiation (UVR) dose on the onset of menarche in 88 278 women from the French E3N cohort (aged 40-65 years at inclusion). RESULTS: The mean age at menarche was 12.8 years. After adjustment for potential confounders (birth cohort, prematurity, birth weight and length, father's income index, body silhouette in childhood, food deprivation during World War II, population of birthplace, number of siblings, breastfeeding exposure and indoor exposure to passive smoking during childhood), latitude and UVR dose (annual or spring/summer) in county of birth were significantly associated with age at menarche (Ptrend < 0.0001). Women born at lower latitudes or in regions with higher annual or spring/summer UVR dose had a 3- to 4-month earlier menarche than women born at higher latitudes or in regions with lower UVR. On a continuous scale, a 1° increment in latitude resulted in a 0.04-year older age at menarche [95% confidence interval (CI): 0.03, 0.05], whereas a 1-kJ/m(2) increment in annual UVR dose resulted in a 0.42-year younger age at menarche (95% CI: -0.55, -0.29). CONCLUSION: These data further suggest that light exposure in childhood may influence sexual maturation in women.International Journal of Epidemiology 04/2013; 42(2):590-600. · 6.41 Impact Factor -
Article: Genome-wide association studies identify four ER negative-specific breast cancer risk loci.
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ABSTRACT: Estrogen receptor (ER)-negative tumors represent 20-30% of all breast cancers, with a higher proportion occurring in younger women and women of African ancestry. The etiology and clinical behavior of ER-negative tumors are different from those of tumors expressing ER (ER positive), including differences in genetic predisposition. To identify susceptibility loci specific to ER-negative disease, we combined in a meta-analysis 3 genome-wide association studies of 4,193 ER-negative breast cancer cases and 35,194 controls with a series of 40 follow-up studies (6,514 cases and 41,455 controls), genotyped using a custom Illumina array, iCOGS, developed by the Collaborative Oncological Gene-environment Study (COGS). SNPs at four loci, 1q32.1 (MDM4, P = 2.1 × 10(-12) and LGR6, P = 1.4 × 10(-8)), 2p24.1 (P = 4.6 × 10(-8)) and 16q12.2 (FTO, P = 4.0 × 10(-8)), were associated with ER-negative but not ER-positive breast cancer (P > 0.05). These findings provide further evidence for distinct etiological pathways associated with invasive ER-positive and ER-negative breast cancers.Nature Genetics 03/2013; 45(4):392-398. · 35.53 Impact Factor -
Article: A structural equation modelling approach to explore the role of B vitamins and immune markers in lung cancer risk.
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ABSTRACT: The one-carbon metabolism (OCM) is considered key in maintaining DNA integrity and regulating gene expression, and may be involved in the process of carcinogenesis. Several B-vitamins and amino acids have been implicated in lung cancer risk, via the OCM directly as well as immune system activation. However it is unclear whether these factors act independently or through complex mechanisms. The current study applies structural equations modelling (SEM) to further disentangle the mechanisms involved in lung carcinogenesis. SEM allows simultaneous estimation of linear relations where a variable can be the outcome in one equation and the predictor in another, as well as allowing estimation using latent variables (factors estimated by correlation matrix). A large number of biomarkers have been analysed from 891 lung cancer cases and 1,747 controls nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Four putative mechanisms in the OCM and immunity were investigated in relation to lung cancer risk: methionine-homocysteine metabolism, folate cycle, transsulfuration, and mechanisms involved in inflammation and immune activation, all adjusted for tobacco exposure. The hypothesized SEM model confirmed a direct and protective effect for factors representing methionine-homocysteine metabolism (p = 0.020) and immune activation (p = 0.021), and an indirect protective effect of folate cycle (p = 0.019), after adjustment for tobacco smoking. In conclusion, our results show that in the investigation of the involvement of the OCM, the folate cycle and immune system in lung carcinogenesis, it is important to consider complex pathways (by applying SEM) rather than the effects of single vitamins or nutrients (e.g. using traditional multiple regression). In our study SEM were able to suggest a greater role of the methionine-homocysteine metabolism and immune activation over other potential mechanisms.European Journal of Epidemiology 03/2013; · 4.71 Impact Factor -
Article: Plasma 25(OH)vitamin D and the risk of breast cancer in the european prospective investigation into cancer and nutrition (EPIC): A nested case-control study.
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ABSTRACT: Experimental evidence suggests that vitamin D might play a role in the development of breast cancer. While the results of case-control studies indicate that circulating 25-hydroxyvitamin D (25(OH)D) is inversely associated with the risk of breast cancer, the results of prospective studies are inconsistent. A case-control study embedded in the European Prospective Investigation into Cancer and Nutrition (EPIC) was carried out comprising 1391 incident breast cancer cases and 1391 controls. Multivariable conditional logistic regression models did not reveal a significant overall association between season-standardized 25(OH)D levels and the risk of breast cancer (ORQ4- Q1 [95% CI]: 1.07 [0.85-1.36], ptrend =0.67). Moreover, 25(OH)D levels were not related to the risks of ER+ tumors (ORQ4- Q1 [95% CI]: 0.97 [0.67-1.38], ptrend =0.90) and ER- tumors (ORQ4- Q1 [95% CI]: 0.97 [0.66-1.42], ptrend =0.98). In HRT users, 25(OH)D was significantly inversely associated with incident breast cancer (ORlog2 [95% CI]: 0.62 [0.42-0.90], p=0.01), whereas no significant association was found in HRT non-users (ORlog2 [95% CI]: 1.14 [0.80-1.62], p=0.48). Further, a non-significant inverse association was found in women with BMIs <25 kg/m(2) (ORlog2 [95% CI]: 0.83 [0.67-1.03], p=0.09), as opposed to a borderline significant positive association in women with BMIs ≥25 kg/m(2) (ORlog2 [95% CI]: 1.30 [1.0-1.69], p=0.05). Overall, pre-diagnostic levels of circulating 25(OH)D were not related to the risk of breast cancer in the EPIC study. This result is in line with findings in the majority of prospective studies and does not support a role of vitamin D in the development of breast cancer. © 2013 Wiley Periodicals, Inc.International Journal of Cancer 03/2013; · 5.44 Impact Factor -
Article: Menopausal hormone therapy and risk of cholecystectomy: a prospective study based on the French E3N cohort.
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ABSTRACT: BACKGROUND:Studies in the United States and the United Kingdom have reported an increased risk of cholecystectomy among women exposed to menopausal hormone therapy, but with substantial heterogeneity between types of hormone treatments. We evaluated the risk of cholecystectomy associated with different regimens of menopausal hormone therapy in a large prospective cohort study. METHODS:Between 1992 and 2008, 70 928 menopausal women from the French E3N study cohort were sent questionnaires assessing their use of menopausal hormone therapy, medical history and lifestyle characteristics. The primary outcome was cholecystectomy. We analyzed the risk of cholecystectomy associated with use of menopausal hormone therapy using Cox proportional models, with age as time-scale. RESULTS:During follow-up, 45 984 (64.8%) of the participants were exposed to menopausal hormone therapy, and 2819 cholecystectomies were recorded. The use of menopausal hormone therapy was associated with an increased risk of cholecystectomy (adjusted hazard ratio [HR] 1.10, 95% confidence interval [CI] 1.01-1.20) compared with women who were not exposed to menopausal hormone therapy. The association was restricted to unopposed oral estrogen therapy (adjusted HR 1.38, 95% CI 1.14-1.67). Over 5 years, about 1 cholecystectomy in excess would be expected in every 150 women using oral estrogen therapy without progestagens, compared with women not exposed to meno pausal hormone therapy. INTERPRETATION:The risk of cholecystectomy was increased among women exposed to oral estrogen meno pausal hormone therapy, especially oral regimens without a progestagen. Complicated gallstone disease should be added to the list of potential adverse events to be considered when balancing the benefits and risks associated with menopausal hormone therapy.Canadian Medical Association Journal 03/2013; · 8.22 Impact Factor -
Article: Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition
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ABSTRACT: Background: Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Included in the analysis were 448,568 men and women without prevalent cancer, stroke, or myocardial infarction, and with complete information on diet, smoking, physical activity and body mass index, who were between 35 and 69 years old at baseline. Cox proportional hazards regression was used to examine the association of meat consumption with all-cause and cause-specific mortality. Results: As of June 2009, 26,344 deaths were observed. After multivariate adjustment, a high consumption of red meat was related to higher all-cause mortality (hazard ratio (HR) = 1.14, 95% confidence interval (CI) 1.01 to 1.28, 160+ versus 10 to 19.9 g/day), and the association was stronger for processed meat (HR = 1.44, 95% CI 1.24 to 1.66, 160+ versus 10 to 19.9 g/day). After correction for measurement error, higher all-cause mortality remained significant only for processed meat (HR = 1.18, 95% CI 1.11 to 1.25, per 50 g/d). We estimated that 3.3% (95% CI 1.5% to 5.0%) of deaths could be prevented if all participants had a processed meat consumption of less than 20 g/day. Significant associations with processed meat intake were observed for cardiovascular diseases, cancer, and 'other causes of death'. The consumption of poultry was not related to all-cause mortality. Conclusions: The results of our analysis support a moderate positive association between processed meat consumption and mortality, in particular due to cardiovascular diseases, but also to cancer.BMC Medicine 03/2013; 18192021(19). · 6.03 Impact Factor -
Article: Impact of lymphovascular space invasion on a nomogram for predicting lymph node metastasis in endometrial cancer.
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ABSTRACT: OBJECTIVE: The aim of this study is to evaluate the impact of lymphovascular space invasion (LVSI) on nomogram-based predictions of lymph node (LN) metastasis in endometrial cancer. METHODS: The data from 485 patients with presumed stage I or II endometrial cancer who underwent hysterectomy and lymphadenectomy were analyzed. Calibration curves were designed and compared for three different subgroups: LVSI-positive tumors (n=113), LVSI-negative tumors (n=213) and LVSI-undetermined tumors (n=159). RESULTS: In the entire population, the nomogram showed good discrimination with an area under the receiver operating characteristic curve (AUC) of 0.80 and was well calibrated. In the subgroup analyses, in LVSI-positive, LVSI-negative and LVSI-undetermined patients, the nomogram was not well calibrated (p of the U index of 0.028, 0.087 and 0.011, respectively) with underestimation in LVSI-positive patients and overestimation in LVSI-negative and LVSI-undetermined patients of LN metastasis. In the univariate analysis and after adjusting for the LN metastasis probability provided by the nomogram, LVSI-positive tumors were associated with an increased risk for LN metastasis compared with LVSI-negative tumors (RR=7.29 [3.87-13.7] and 5.04 [2.30-11.08], respectively). In contrast, the univariate analysis and after adjusting for the LN metastasis probability provided by the nomogram showed that LVSI-undetermined tumors were not associated with an increased risk for LN metastasis compared with LVSI-negative tumors (RR=0.73 [0.32-1.69] and 1.26 [0.47-3.37], respectively). CONCLUSIONS: Our results suggested that LVSI should be considered to be an independent risk factor for LN metastasis. In this multicenter study, the risk for LN metastasis is similar when the LVSI is negative or is not detailed in the pathological report.Gynecologic Oncology 02/2013; · 3.89 Impact Factor -
Article: Dealing with missing data in the Center for Epidemiologic Studies Depression self-report scale: a study based on the French E3N cohort.
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ABSTRACT: BACKGROUND: The Center for Epidemiologic Studies - Depression scale (CES-D) is a validated tool commonly used to screen depressive symptoms. As with any self-administered questionnaire, missing data are frequently observed and can strongly bias any inference. The objective of this study was to investigate the best approach for handling missing data in the CES-D scale. METHODS: Among the 71,412 women from the French E3N prospective cohort (Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale) who returned the questionnaire comprising the CES-D scale in 2005, 45% had missing values in the scale. The reasons for failure to complete certain items were investigated by semi-directive interviews on a random sample of 204 participants. The prevalence of high depressive symptoms (score>=16, hDS) was estimated after applying various methods for ignorable missing data including multiple imputation using imputation models with CES-D items with or without covariates. The accuracy of imputation models was investigated. Various scenarios of nonignorable missing data mechanisms were investigated by a sensitivity analysis based on the mixture modelling approach. RESULTS: The interviews showed that participants were not reluctant to answer the CES-D scale. Possible reasons for nonresponse were identified. The prevalence of hDS among complete responders was 26.1%. After multiple imputation, the prevalence was 28.6%, 29.8% and 31.7% for women presenting up to 4, 10 and 20 missing values, respectively. The estimates were robust to the various imputation models investigated and to the scenarios of nonignorable missing data. CONCLUSIONS: The CES-D scale can easily be used in large cohorts even in the presence of missing data. Based on the results from both a qualitative study and a sensitivity analysis under various scenarios of missing data mechanism in a population of women, missing data mechanism does not appear to be nonignorable and estimates are robust to departures from ignorability. Multiple imputation is recommended to reliably handle missing data in the CES-D scale.BMC Medical Research Methodology 02/2013; 13(1):28. · 2.67 Impact Factor -
Article: Prediagnostic body fat and risk of death from amyotrophic lateral sclerosis: The EPIC cohort.
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ABSTRACT: OBJECTIVES: The aim of this study was to investigate for the first time the association between body fat and risk of amyotrophic lateral sclerosis (ALS) with an appropriate prospective study design. METHODS: The EPIC (European Prospective Investigation into Cancer and Nutrition) study included 518,108 individuals recruited from the general population across 10 Western European countries. At recruitment, information on lifestyle was collected and anthropometric characteristics were measured. Cox hazard models were fitted to investigate the associations between anthropometric measures and ALS mortality. RESULTS: Two hundred twenty-two ALS deaths (79 men and 143 women) occurred during the follow-up period (mean follow-up = 13 years). There was a statistically significant interaction between categories of body mass index and sex regarding ALS risk (p = 0.009): in men, a significant linear decrease of risk per unit of body mass index was observed (hazard ratio = 0.93, 95% confidence interval 0.86-0.99 per kg/m(2)); among women, the risk was more than 3-fold increased for underweight compared with normal-weight women. Among women, a significant risk reduction increasing the waist/hip ratio was also evident: women in the top quartile had less than half the risk of ALS compared with those in the bottom quartile (hazard ratio = 0.48, 95% confidence interval 0.25-0.93) with a borderline significant p value for trend across quartiles (p = 0.056). CONCLUSION: Increased prediagnostic body fat is associated with a decreased risk of ALS mortality.Neurology 02/2013; · 8.31 Impact Factor -
Article: Hemochromatosis (HFE) gene mutations and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.
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ABSTRACT: Hereditary hemochromatosis (HH) is a strong risk factor for hepatocellular cancer, and mutations in the HFE gene associated with HH and iron overload may be related to other tumors, but no studies have been reported for gastric cancer (GC). A nested case-control study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) including 365 incident gastric adenocarcinoma and 1284 controls matched by center, sex, age, and date of blood collection. Genotype analysis was performed for two functional polymorphisms (C282Y/rs1800562 and H63D/rs1799945) and seven tagSNPs of the HFE genomic region. Association with all gastric adenocarcinoma, and according to anatomical localization and histological sub-type, was assessed by means of the odds ratio (OR) and 95% confidence interval (CI) estimated by unconditional logistic regression adjusted for the matching variables. We observed a significant association for H63D, with OR (per rare allele) of 1.32 (CI 1.03-1.69). In sub-group analyses, the association was stronger for noncardia anatomical sub-site (OR=1.60, CI 1.16-2.21) and intestinal histological sub-type (OR=1.82, CI 1.27-2.62). Among intestinal cases two tagSNPs (rs1572982, rs6918586) also showed a significant association that disappeared after adjustment for H63D. No association with tumors located in the cardia or of diffuse sub-type was found for any of the nine SNPs analyzed. Our results suggest that H63D variant in HFE gene seems to be associated with GC risk of the noncardia region and intestinal type, possibly due to its association with iron overload, although a role for other mechanisms cannot be entirely ruled out.Carcinogenesis 02/2013; · 5.70 Impact Factor -
Article: Consumption of artificially and sugar-sweetened beverages and incident type 2 diabetes in the Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale-European Prospective Investigation into Cancer and Nutrition cohort.
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ABSTRACT: BACKGROUND: It has been extensively shown, mainly in US populations, that sugar-sweetened beverages (SSBs) are associated with increased risk of type 2 diabetes (T2D), but less is known about the effects of artificially sweetened beverages (ASBs). OBJECTIVE: We evaluated the association between self-reported SSB, ASB, and 100% fruit juice consumption and T2D risk over 14 y of follow-up in the French prospective Etude Epidémiologique auprès des femmes de la Mutuelle Générale de l'Education Nationale-European Prospective Investigation into Cancer and Nutrition cohort. DESIGN: A total of 66,118 women were followed from 1993, and 1369 incident cases of T2D were diagnosed during the follow-up. Cox regression models were used to estimate HRs and 95% CIs for T2D risk. RESULTS: The average consumption of sweetened beverages in consumers was 328 and 568 mL/wk for SSBs and ASBs, respectively. Compared with nonconsumers, women in the highest quartiles of SSB and ASB consumers were at increased risk of T2D with HRs (95% CIs) of 1.34 (1.05, 1.71) and 2.21 (1.56, 3.14) for women who consumed >359 and >603 mL/wk of SSBs and ASBs, respectively. Strong positive trends in T2D risk were also observed across quartiles of consumption for both types of beverage (P = 0.0088 and P < 0.0001, respectively). In sensitivity analyses, associations were partly mediated by BMI, although there was still a strong significant independent effect. No association was observed for 100% fruit juice consumption. CONCLUSIONS: Both SSB consumption and ASB consumption were associated with increased T2D risk. We cannot rule out that factors other than ASB consumption that we did not control for are responsible for the association with diabetes, and randomized trials are required to prove a causal link between ASB consumption and T2D.American Journal of Clinical Nutrition 01/2013; · 6.67 Impact Factor -
Article: Childhood and Adolescent Exposures and the Risk of Endometriosis.
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ABSTRACT: BACKGROUND:: Because endometriosis is diagnosed predominantly in young women, exposures occurring during childhood or adolescence may have a major impact on the disease. However, potential risk factors during this time period have received little attention. Our objective was to investigate relationships between childhood and adolescent exposures and the risk of endometriosis. METHODS:: E3N is a prospective cohort of 98,995 French women aged 40-65 at enrollment in 1990. Follow-up questionnaires were sent every 2-3 years. Using a nested case-control design, we computed odds ratios (ORs) and 95% confidence intervals using unconditional logistic regression models. RESULTS:: A total of 2684 endometriosis cases were reported as surgically ascertained among the 75,918 included women. There were inverse relationships of endometriosis risk with menarcheal age (test for trend, P < 0.0001) and with menstrual cycle length before 17 years of age (test for trend, P = 0.06), whereas menstrual cycle regularity before 17 years of age was not associated with risk. There were modest associations of endometriosis risk with exposure to pet animals (OR = 1.12 [95% confidence interval =1.02-1.22]) or living in a farm for 3 or more consecutive months during childhood (1.12 [1.02-1.24]), although with no link to any specific type of farm animal. In addition, there were positive linear associations between endometriosis risk and level of indoor exposure to passive smoking during childhood (up to 1.34 [1.09-1.64] with several hours exposure a day), experiencing food deprivation during World War II (1.34 [0.94-1.91]), and walking activity at 8-15 years of age (1.17 [1.05-1.31] for 5+ hours a week). CONCLUSIONS:: This large study suggests that some exposures during childhood or adolescence may influence the risk of endometriosis. Further research is needed to confirm and better understand these relationships.Epidemiology (Cambridge, Mass.) 01/2013; · 5.51 Impact Factor -
Dataset: Sabine Rohrmann Meat Pancreas IJC 2012
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Article: Anthropometric characteristics and risk of lymphoid and myeloid leukemia in the European Prospective Investigation into Cancer and Nutrition (EPIC).
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ABSTRACT: PURPOSE: Overweight and obesity have been suggested as a risk factor for leukemia. Impaired immune function associated with obesity, increased insulin-like growth factor-I activity and stimulating effects of leptin suggest a possible biological link between anthropometric measures and leukemia. However, evidence from epidemiological studies has been inconsistent. We examined the potential association between prospective measurements of body size and risk of leukemia among participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: During follow-up (mean = 11.52 years, standard deviation = 2.63), 671 leukemia (lymphoid leukemia = 50.1 %, myeloid leukemia = 43.2 %) cases were identified. Anthropometric measures including weight, height, body mass index (BMI), waist circumference (WC), hip circumference, and waist-to-hip ratio (WHR) were measured. Cox proportional hazard models were used to explore the association between anthropometric measures and risk of leukemia. RESULTS: No associations were observed between anthropometric measures and total leukemia, and lymphoid leukemia. Risk of myeloid leukemia significantly increased for higher categories of BMI and WC among women. Analyses by subtype of myeloid leukemia showed an increased risk of acute myeloid leukemia (AML) for higher categories of WHR among women. This association seemed to be reversed for chronic myeloid leukemia. No association between anthropometric measures and myeloid leukemia were observed among men except an increased risk of AML with height. CONCLUSION: The study showed no associations between anthropometric measures and total leukemia, and lymphoid leukemia among men and women. A possible association between BMI as general obesity and WC as abdominal obesity and increased risk of myeloid leukemia among women were observed.Cancer Causes and Control 01/2013; · 2.88 Impact Factor -
Article: Macronutrient Composition of the Diet and Prospective Weight Change in Participants of the EPIC-PANACEA Study.
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ABSTRACT: The effect of the macronutrient composition of the usual diet on long term weight maintenance remains controversial. 373,803 subjects aged 25-70 years were recruited in 10 European countries (1992-2000) in the PANACEA project of the EPIC cohort. Diet was assessed at baseline using country-specific validated questionnaires and weight and height were measured at baseline and self-reported at follow-up in most centers. The association between weight change after 5 years of follow-up and the iso-energetic replacement of 5% of energy from one macronutrient by 5% of energy from another macronutrient was assessed using multivariate linear mixed-models. The risk of becoming overweight or obese after 5 years was investigated using multivariate Poisson regressions stratified according to initial Body Mass Index. A higher proportion of energy from fat at the expense of carbohydrates was not significantly associated with weight change after 5 years. However, a higher proportion of energy from protein at the expense of fat was positively associated with weight gain. A higher proportion of energy from protein at the expense of carbohydrates was also positively associated with weight gain, especially when carbohydrates were rich in fibre. The association between percentage of energy from protein and weight change was slightly stronger in overweight participants, former smokers, participants ≥60 years old, participants underreporting their energy intake and participants with a prudent dietary pattern. Compared to diets with no more than 14% of energy from protein, diets with more than 22% of energy from protein were associated with a 23-24% higher risk of becoming overweight or obese in normal weight and overweight subjects at baseline. Our results show that participants consuming an amount of protein above the protein intake recommended by the American Diabetes Association may experience a higher risk of becoming overweight or obese during adult life.PLoS ONE 01/2013; 8(3):e57300. · 4.09 Impact Factor -
Article: Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition.
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ABSTRACT: Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). Included in the analysis were 448,568 men and women without prevalent cancer, stroke, or myocardial infarction, and with complete information on diet, smoking, physical activity and body mass index, who were between 35 and 69 years old at baseline. Cox proportional hazards regression was used to examine the association of meat consumption with all-cause and cause-specific mortality. As of June 2009, 26,344 deaths were observed. After multivariate adjustment, a high consumption of red meat was related to higher all-cause mortality (hazard ratio (HR) = 1.14, 95% confidence interval (CI) 1.01 to 1.28, 160+ versus 10 to 19.9 g/day), and the association was stronger for processed meat (HR = 1.44, 95% CI 1.24 to 1.66, 160+ versus 10 to 19.9 g/day). After correction for measurement error, higher all-cause mortality remained significant only for processed meat (HR = 1.18, 95% CI 1.11 to 1.25, per 50 g/d). We estimated that 3.3% (95% CI 1.5% to 5.0%) of deaths could be prevented if all participants had a processed meat consumption of less than 20 g/day. Significant associations with processed meat intake were observed for cardiovascular diseases, cancer, and 'other causes of death'. The consumption of poultry was not related to all-cause mortality. The results of our analysis support a moderate positive association between processed meat consumption and mortality, in particular due to cardiovascular diseases, but also to cancer.BMC Medicine 01/2013; 11:63. · 6.03 Impact Factor -
Article: Dietary fiber intake and risk of hormonal receptor defined breast cancer in the European Prospective Investigation into Cancer and Nutrition study.
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ABSTRACT: BACKGROUND: Limited scientific evidence has characterized the association between dietary fiber intake and risk of breast cancer (BC) by menopausal status and hormone receptor expression in tumors. OBJECTIVE: We investigated the relation between total dietary fiber and its main food sources (vegetables, fruit, cereals, and legumes) and BC risk by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN: A total of 11,576 invasive BC cases in 334,849 EPIC women mostly aged 35-70 y at baseline were identified over a median follow up of 11.5 y. Dietary fiber was estimated from country-specific dietary questionnaires. Multivariable Cox proportional hazards regression models were used to quantify the association between dietary variables and BC risk with energy adjustment by using the residual method. Subgroup analyses were performed by menopausal status and estrogen receptor (ER) and progesterone receptor (PR) expression in tumors. RESULTS: BC risk was inversely associated with intakes of total dietary fiber (HR(Q5-Q1): 0.95; 95% CI: 0.89, 1.01; P-trend = 0.03) and fiber from vegetables (0.90; 0.84, 0.96; P-trend < 0.01) but not with fiber from fruit, cereals, or legumes. Overall, associations were homogeneous by menopausal status and ER and PR expression in tumors. For vegetable fiber, stronger associations were observed for estrogen receptor-negative and progesterone receptor-negative (HR(Q5-Q1):0.74; 95% CI: 0.59, 0.93; P-trend = 0.01) than for estrogen receptor-positive and progesterone receptor-positive tumors (0.92: 0.81, 1.03; P-trend = 0.05), with P-heterogeneity = 0.09. CONCLUSION: Diets rich in dietary fiber and, particularly, fiber from vegetables may be associated with a small reduction in risk of BC, independently of menopausal status.American Journal of Clinical Nutrition 12/2012; · 6.67 Impact Factor
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2010–2013
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Universidade de São Paulo
- • Departmento de Epidemologia (FSP) (São Paulo)
- • Faculdade de Medicina de Ribeirão Preto (FMRP)
Ribeirão Preto, Estado de Sao Paulo, Brazil -
French National Centre for Scientific Research
Lyon, Rhone-Alpes, France -
Mount Sinai School of Medicine
Manhattan, NY, USA
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2009–2013
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Imperial College London
- Department of Epidemiology and Biostatistics
London, ENG, United Kingdom -
Fondazione IRCCS Istituto Nazionale dei Tumori di Milano
Milano, Lombardy, Italy -
Universität Bremen
- Bremen Institute for Prevention Research and Social Medicine (BIPS)
Bremen, Bremen, Germany
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2005–2013
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Institut national de la santé et de la recherche médicale
- Centre de Recherche en Épidémiologie et Santé des Populations CESP U1018
Paris, Ile-de-France, France
-
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2003–2013
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Institut de Cancérologie Gustave Roussy
Villejuif, Ile-de-France, France
-
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2012
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Emory University
Atlanta, GA, USA -
Brown University
- Division of Biology and Medicine
Providence, RI, USA
-
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2011–2012
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Institute of Bellvitge Biomedical Research (IDIBELL)
Barcelona, Catalonia, Spain -
INSERM, GIP CYCERON
Caen, Basse-Normandie, France -
INRAN - Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione
Roma, Latium, Italy -
Christian-Albrechts-Universität zu Kiel
- Institut für Experimentelle Medizin
Kiel, Schleswig-Holstein, Germany -
National Institutes of Health
- Division of Cancer Epidemiology and Genetics
Bethesda, MD, USA -
Harvard University
- Department of Epidemiology
Boston, MA, USA
-
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2010–2012
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RIVM
- Centre for Nutrition and Health
Utrecht, Provincie Utrecht, Netherlands
-
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2009–2012
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Umeå University
Umeå, Vaesterbotten, Sweden
-
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2008–2012
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Université Paris-Sud 11
Paris, Ile-de-France, France -
Polytech Paris-UPMC
Paris, Ile-de-France, France -
Hellenic Health Foundation
Athens, Attiki, Greece
-
-
2006–2012
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University of Oxford
- • Nuffield Department of Clinical Medicine
- • Division of Medical Sciences
Oxford, ENG, United Kingdom -
Deutsches Krebsforschungszentrum
- Division of Cancer Epidemiology
Heidelberg, Baden-Wuerttemberg, Germany -
Catalan Institute of Oncology
- • Cancer Epidemiology Research Programme (PREC)
- • Translational Research Laboratory
Badalona, Catalonia, Spain
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2005–2012
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Universitair Medisch Centrum Utrecht
- Julius Center for Health Sciences and Primary Care
Utrecht, Provincie Utrecht, Netherlands
-
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2004–2012
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Deutsches Institut für Ernährungsforschung
- Department of Epidemiology
Potsdam, Brandenburg, Germany
-
-
2007–2011
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University of Cambridge
- • MRC Epidemiology Unit
- • Department of Public Health and Primary Care
Cambridge, ENG, United Kingdom -
Cambridge University
Sydney, New South Wales, Australia -
Addenbrooke's Hospital
Cambridge, ENG, United Kingdom -
University of North Carolina at Chapel Hill
- Department of Epidemiology
Chapel Hill, NC, USA -
Danish Cancer Society
Copenhagen, Capital Region, Denmark -
Harokopion University of Athens
Athens, Attiki, Greece
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2003–2011
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International Agency for Research on Cancer
Lyon, Rhone-Alpes, France
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2007–2010
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University of Bergen
- Institute of Medicine
Bergen, Hordaland Fylke, Norway
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2005–2008
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National and Kapodistrian University of Athens
- Division of Hygiene - Epidemiology
Athens, Attiki, Greece
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2005–2006
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Universitetet i Tromsø
- Department of Community Medicine
Tromsø, Troms Fylke, Norway
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