R Peto's research while affiliated with University of Oxford and other places
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Publications (295)
Background
Previous studies of high-income populations have found that physical activity is associated with reduced mortality risk. We investigated the association of recreational physical activity intensity with cause-specific mortality at ages 35-74 in a Mexican population with high levels of adiposity and diabetes.
Methods
Between 1998 and 2004...
Background
The Global Burden of Disease and Risk Factor models assess alcohol to be a leading cause of premature death both globally and in Mexico, but direct epidemiological evidence from Mexico is limited. We investigated the relevance of alcohol to mortality at ages 35-74 in a large prospective study of Mexican adults followed for nearly two dec...
Rupture of an intracranial aneurysm leads to subarachnoid hemorrhage, a severe type of stroke. To discover new risk loci and the genetic architecture of intracranial aneurysms, we performed a cross-ancestry, genome-wide association study in 10,754 cases and 306,882 controls of European and East Asian ancestry. We discovered 17 risk loci, 11 of whic...
Background
Higher body-mass index is associated with increased mortality from vascular disease, renal disease and other metabolic causes. However, body mass reflects both fat and lean mass, which may have very different effects on risk. We investigated the individual and joint relevance of fat and lean mass to mortality from these causes, using dat...
Background
Cardiovascular disease (CVD) is a leading cause of premature death in Cuba, accounting for about one third of all deaths under age 70 years. Substantial uncertainty remains, however, about the relevance of major metabolic risk factors to CVD mortality in this population.
Purpose
To relate body-mass index (BMI), systolic blood pressure (...
Increased blood pressure is the leading risk factor for death worldwide, leads to the greatest disease burden in low-income to middle-income countries (LMICs), and prevalence is increasing. 1,2 By contrast, the age-adjusted prevalence of hypertension is decreasing in high-income countries. 2 The global data on hypertension are daunting: four in ten...
Objectives To explore how the concept of randomization is described by clinicians and understood by patients in randomized controlled trials (RCTs) and how it contributes to patient understanding and recruitment. Study Design and Setting Qualitative analysis of 73 audio recordings of recruitment consultations from five, multicenter, UK-based RCTs w...
2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other...
Background:
Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as...
Background: Much contemporary adjuvant chemotherapy uses conventional 3-weekly scheduling. Yet, cytokinetic modelling suggests that increasing the dose density of cytotoxic therapy by shortening the intervals between courses, or by using sequential rather than concurrent treatment schedules may enhance efficacy.¹ At least 15 randomised trials have...
BACKGROUND: Neoadjuvant chemotherapy (NACT) for early breast cancer can make breast-conserving surgery more feasible and might be more likely to eradicate micrometastatic disease than might the same chemotherapy given after surgery. We investigated the long-term benefits and risks of NACT and the influence of tumour characteristics on outcome with...
s: Thirty-Ninth Annual CTRC-AACR San Antonio Breast Cancer Symposium; December 6-10, 2016; San Antonio, Texas
Loss of insulin growth factor (IGF) signaling in the mammary gland at puberty leads to delayed elongation and defects in terminal end bud (TEB) proliferation. Moreover, IGF signaling is essential for epithelial mesenchymal interactions in...
Background
Worldwide 350 million people suffer from major depression, with the majority of cases occurring in low- and middle-income countries. We examined the patterns, correlates and care-seeking behaviour of adults suffering from major depressive episode (MDE) in China.
Method
A nationwide study recruited 512 891 adults aged 30–79 years from 10...
Introduction
Breast cancer radiotherapy cures many women, but, as with other therapies, can cause late side-effects.
Methods
We undertook meta-analyses of individual patient data from the trials of breast cancer radiotherapy, relating various characteristics of the regimens tested to cause-specific mortality rate ratios (RRs) and second cancer inci...
Background:
Bisphosphonates have profound effects on bone physiology, and could modify the process of metastasis. We undertook collaborative meta-analyses to clarify the risks and benefits of adjuvant bisphosphonate treatment in breast cancer.
Methods:
We sought individual patient data from all unconfounded trials in early breast cancer that ran...
Bisphosphonates have profound effects on bone physiology, and could modify the process of metastasis. We undertook collaborative meta-analyses to clarify the risks and benefits of adjuvant bisphosphonate treatment in breast cancer. Methods We sought individual patient data from all unconfounded trials in early breast cancer that randomised between...
Background:
Half the epidemiological studies with information about menopausal hormone therapy and ovarian cancer risk remain unpublished, and some retrospective studies could have been biased by selective participation or recall. We aimed to assess with minimal bias the effects of hormone therapy on ovarian cancer risk.
Methods:
Individual part...
Background:
Postmastectomy radiotherapy was shown in previous meta-analyses to reduce the risks of both recurrence and breast cancer mortality in all women with node-positive disease considered together. However, the benefit in women with only one to three positive lymph nodes is uncertain. We aimed to assess the effect of radiotherapy in these wo...
Postmastectomy radiotherapy was shown in previous meta-analyses to reduce the risks of both recurrence and breast cancer mortality in all women with node-positive disease considered together. However, the benefit in women with only one to three positive lymph nodes is uncertain. We aimed to assess the effect of radiotherapy in these women after mas...
To examine the relationship of self-reported diabetes, and of random blood glucose levels among individuals without known diabetes, with the prevalence of cardiovascular disease in Chinese adults.
We examined cross-sectional data from the China Kadoorie Biobank of 0.5 million people aged 30-79 years recruited from 10 diverse regions of China in the...
OBJECTIVES:
ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization.
METHODS:
Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both p...
Aims:
Niacin has potentially favourable effects on lipids, but its effect on cardiovascular outcomes is uncertain. HPS2-THRIVE is a large randomized trial assessing the effects of extended release (ER) niacin in patients at high risk of vascular events.
Methods and results:
Prior to randomization, 42 424 patients with occlusive arterial disease...
Background: In ER+ early breast cancer, 5 years of tamoxifen greatly reduces recurrence throughout the first decade (years 0–9) with little further gain later, and reduces breast cancer mortality (BCM) substantially throughout years 0–14 (EBCTCG, Lancet 2011; 378: 771–84 – see Table). It is not known how 10 years TAM compares with the current stand...
To investigate the impact of smoking on overall mortality and life expectancy in a large Japanese population, including some who smoked throughout adult life.
The Life Span Study, a population-based prospective study, initiated in 1950.
Hiroshima and Nagasaki, Japan.
Smoking status for 27 311 men and 40 662 women was obtained during 1963-92. Mortal...
Smoking has been linked to mucinous ovarian cancer, but its effects on other ovarian cancer subtypes and on overall ovarian cancer risk are unclear, and the findings from most studies with relevant data are unpublished. To assess these associations, we review the published and unpublished evidence.
Eligible epidemiological studies were identified b...
Background
Only about half the studies that have collected information on the relevance of women's height and body mass index to their risk of developing ovarian cancer have published their results, and findings are inconsistent. Here, we bring together the worldwide evidence, published and unpublished, and describe these relationships.Methods and...
The 3-yearly World Congress of Epidemiology is the premier, international, scientific conference organised under the auspices of the International Epidemiological Association (in open competition). This paper explores the justification for seeking to host the Congress and reflects on the structures and processes adopted in making the XIXth Congress...
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Similar to many other developing countries, China is facing a double burden of disease as a result of epidemiological transition. Non-communicable diseases (NCDs) represent a major challenge, having an adverse effect on the health of the Chinese population and increasing the economic burden of health care. In today’s era of evidence-based medicine...
Moderate differences in efficacy between adjuvant chemotherapy regimens for breast cancer are plausible, and could affect treatment choices. We sought any such differences.
We undertook individual-patient-data meta-analyses of the randomised trials comparing: any taxane-plus-anthracycline-based regimen versus the same, or more, non-taxane chemother...
Findings of large randomised trials have shown that lowering LDL cholesterol with statins reduces vascular morbidity and mortality rapidly, but limited evidence exists about the long-term efficacy and safety of statin treatment. The aim of the extended follow-up of the Heart Protection Study (HPS) is to assess long-term efficacy and safety of lower...
After breast-conserving surgery, radiotherapy reduces recurrence and breast cancer death, but it may do so more for some groups of women than for others. We describe the absolute magnitude of these reductions according to various prognostic and other patient characteristics, and relate the absolute reduction in 15-year risk of breast cancer death t...
Introduction
Seasonal variation in blood pressure and its association with outdoor air temperature has been reported in several studies. However, large population-based studies are few and data from developing countries such as China are limited.
Methods
Cross-sectional data from the Kadoorie Biobank Study were used to relate seasonal variation in...
Introduction
Physical activity is associated with cardiovascular risk in Western populations but evidence from the Chinese population is limited.
Methods
We examined baseline data on over 500 000 people aged 30–79 years who, during 2004–2008, were recruited into a prospective study from 10 regions in China. Information on physical activity was col...
Introduction
Long-term storage of blood samples in large prospective epidemiological studies enables future biochemical measurements. However, samples may be stored for more than 10 years before analysis, and information is scarce on the long-term stability of biomarkers in frozen plasma. We have investigated the stability of six lipid analytes and...
Introduction Raised blood pressure (BP) is a leading cause of premature death in China, but its determinants are not well understood. One likely determinant, adiposity, is increasing rapidly in much of China. We assessed the extent to which differences in BP can be accounted for by differences in body mass index (BMI) and in waist circumference (WC...
Introduction
Light-to-moderate alcohol consumption is associated with decreased mortality from cardiovascular diseases in most studies in the West. Data on the health effects of alcohol drinking in China, which involves mainly distilled spirit, are limited.
Methods
A nationally representative prospective cohort study included 220?000 Chinese men a...
Background
Over the past few decades, there has been a rapid increase in cigarette consumption in China. Large prospective studies are needed to monitor the evolution over the next few decades of the resultant epidemic of tobacco-related deaths in China.
Methods
During 2004–2008 the Kadoorie Biobank Study recruited 510 000 adults aged 30–79 from 1...
Introduction
Diet, lifestyle and disease patterns vary greatly from one part of China to another. Data on the prevalence and patterns of alcohol consumption in different parts of China are limited.
Methods
Self-reported questionnaire data from the Kadoorie Biobank Study were used to describe the prevalence and patterns of alcohol consumption in 51...
As many other developing countries, China now is facing a double burden of disease as a result of epidemiological transition and Non-communicable disease (NCD) will be a major factor (challenge) which caused quality decline of Chinese population health and growth of economic burden in healthcare. In the era of evidence-based medicine and decision m...
As trials of 5 years of tamoxifen in early breast cancer mature, the relevance of hormone receptor measurements (and other patient characteristics) to long-term outcome can be assessed increasingly reliably. We report updated meta-analyses of the trials of 5 years of adjuvant tamoxifen.
We undertook a collaborative meta-analysis of individual patie...
Lowering of LDL cholesterol with standard statin regimens reduces the risk of occlusive vascular events in a wide range of individuals. We aimed to assess the safety and efficacy of more intensive lowering of LDL cholesterol with statin therapy.
We undertook meta-analyses of individual participant data from randomised trials involving at least 1000...
As long as doctors start with a healthy scepticism about the many apparently striking claims and counter-claims that appear in the medical literature, trial results do make sense. The main enemy of common sense is over-optimism: there are a few striking exceptions where treatments for serious disease work extremely well, but many claims of vast imp...
BACKGROUND.
If carotid artery narrowing remains asymptomatic (ie, has caused no recent stroke or other neurological symptoms), successful carotid endarterectomy (CEA) reduces stroke incidence for some years. We assessed the long-term effects of successful CEA.
METHODS:
Between 1993 and 2003, 3120 asymptomatic patients from 126 centres in 30 countri...
Tranexamic acid can reduce bleeding in patients undergoing elective surgery. We assessed the effects of early administration of a short course of tranexamic acid on death, vascular occlusive events, and the receipt of blood transfusion in trauma patients.
This randomised controlled trial was undertaken in 274 hospitals in 40 countries. 20 211 adult...
If carotid artery narrowing remains asymptomatic (ie, has caused no recent stroke or other neurological symptoms), successful carotid endarterectomy (CEA) reduces stroke incidence for some years. We assessed the long-term effects of successful CEA. Methods Between 1993 and 2003,3120 asymptomatic patients from 126 centres in 30 countries were alloca...
Individual patient data were available for all four of the randomized trials that began before 1995, and that compared adjuvant radiotherapy vs no radiotherapy following breast-conserving surgery for ductal carcinoma in situ (DCIS). A total of 3729 women were eligible for analysis. Radiotherapy reduced the absolute 10-year risk of any ipsilateral b...
Backround: 5 yrs of adjuvant tamoxifen (Tam) substantially reduces recurrence and mortality in ER+ breast cancer. Two to five years of late extended AI (anastrozole, exemestane or letrozole) adjuvant therapy after ∼ 5 years of Tam has been studied in prospective trials in postmenopausal patients (pts) in comparison with placebo or observation.Metho...
BACKGROUND: Tranexamic acid can reduce bleeding in patients undergoing elective surgery. We assessed the effects of early administration of a short course of tranexamic acid on death, vascular occlusive events, and the receipt of blood transfusion in trauma patients. METHODS: This randomised controlled trial was undertaken in 274 hospitals in 40 co...
Although much is known about the effects of smoking, there is limited reliable information on the effects of stopping smoking on mortality.
To investigate the association between stopping smoking and the risk of all-cause mortality and of cause specific mortality, including deaths due to cancer and vascular disease. In particular, to investigate h...
Summary— A total of 277 patients with apparently localised prostatic cancer (T2-T4 NXMO) were allocated at random to receive radiotherapy alone (88), orchiectomy alone (90) and combined therapy (99) between 1980 and 1985. The main outcome measures were survival, time to appearance of metastases and treatment of local disease progression by further...
Oral contraceptives were introduced almost 50 years ago, and over 100 million women currently use them. Oral contraceptives can reduce the risk of ovarian cancer, but the eventual public-health effects of this reduction will depend on how long the protection lasts after use ceases. We aimed to assess these effects.
Individual data for 23,257 women...
Although statin therapy reduces the risk of occlusive vascular events in people with diabetes mellitus, there is uncertainty about the effects on particular outcomes and whether such effects depend on the type of diabetes, lipid profile, or other factors. We undertook a prospective meta-analysis to help resolve these uncertainties.
We analysed data...
The long-term effects of adjuvant polychemotherapy regimens in oestrogen-receptor-poor (ER-poor) breast cancer, and the extent to which these effects are modified by age or tamoxifen use, can be assessed by an updated meta-analysis of individual patient data from randomised trials.
Collaborative meta-analyses of individual patient data for about 60...
Background Oral contraceptives were introduced almost 50 years ago, and over 100 million women currently use them. Oral contraceptives can reduce the risk of ovarian cancer, but the eventual public-health effects of this reduction will depend on how long the protection lasts after use ceases. We aimed to assess these effects. Methods Individual dat...
Age, sex, and blood pressure could modify the associations of total cholesterol (and its main two fractions, HDL and LDL cholesterol) with vascular mortality. This meta-analysis combined prospective studies of vascular mortality that recorded both blood pressure and total cholesterol at baseline, to determine the joint relevance of these two risk f...