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5 results on '"Inflammatory potential of the diet"'

1. The association between the adapted dietary inflammatory index and colorectal cancer recurrence and all-cause mortality

Author

Ernst Jan Spillenaar Bilgen, Johannes H. W. de Wilt, Evertine Wesselink, Ellen Kampman, Fränzel J.B. van Duijnhoven, Ewout A. Kouwenhoven, Anne J.M.R. Geijsen, Flip M. Kruyt, Renzo P. Veenstra, Moniek van Zutphen, Laura E. Staritsky, and Dieuwertje E. Kok

Subjects
0301 basic medicine, Oncology, Male, medicine.medical_specialty, Nutrition and Disease, Colorectal cancer, Inflammatory markers, 030209 endocrinology & metabolism, Inflammation, Critical Care and Intensive Care Medicine, 03 medical and health sciences, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, All institutes and research themes of the Radboud University Medical Center, Interquartile range, Recurrence, Internal medicine, Voeding en Ziekte, medicine, Humans, Mortality, Inflammatory potential of the diet, Prospective cohort study, Aged, VLAG, 030109 nutrition & dietetics, Nutrition and Dietetics, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Middle Aged, medicine.disease, All-cause mortality, Cancer registry, Diet, Clinical trial, Interleukin 10, C-Reactive Protein, Human and Animal Physiology, Fysiologie van Mens en Dier, Cytokines, Observational study, Female, medicine.symptom, Neoplasm Recurrence, Local, business, Colorectal Neoplasms
Abstract

Background & aims: The inflammatory potential of the diet has been linked to colorectal cancer (CRC) development and mortality. However, it is unknown whether it is also associated with CRC recurrence. Therefore, the aim of this study was to investigate the associations between the inflammatory potential of the diet and plasma inflammation markers as well as recurrence and all-cause mortality in CRC patients. Methods: Data of the Colorectal cancer, Observational, LONgitudinal (COLON) study, a prospective cohort study, was used. Dietary intake, assessed using a semi-quantitative food frequency questionnaire, was available for 1478 patients at diagnosis and for 1334 patients six months after diagnosis. Dietary intake data were used to calculate the adapted dietary inflammatory index (ADII). Data about cancer recurrence and all-cause mortality, were assessed through linkage with the Netherlands Cancer Registry and the Municipal Personal Records Database, respectively. The association between the ADII (continuous) and inflammation markers (Interleukin (IL)6, IL8, IL10, Tumor Necrosis Factor (TNF)α, high sensitivity C-reactive protein (hsCRP) and a summary inflammatory z-score), measured with a multiplex assay using electrochemiluminiscence detection, was assessed using quantile regression analyses. Restricted cubic splines (RCS) analyses and multivariable Cox proportional hazard models were used to explore the relationship between the ADII and CRC outcomes. Results: During a median follow-up time of 3.2 years (Interquartile range (IQR) 2.0–4.1) for recurrence and 4.8 years (IQR 3.5–5.9) for all-cause mortality, 228 recurrences and 279 deaths occurred. A more pro-inflammatory diet at diagnosis as well as six months after diagnosis was associated with higher levels of TNFα, hsCRP and the summary inflammatory z-score. Results of RCS showed no relationship between the ADII and CRC outcomes at both time points. Also results of the Cox proportional hazard models showed no associations between the ADII at both time points and recurrence (HR (95%CI) 0.98 (0.94–1.04) & 0.96 (0.91–1.02) or all-cause mortality (HR (95%CI) 1.03 (0.98–1.07) & 1.00 (0.95–1.05)). Conclusion: Our study did not show an association between the ADII and recurrence and all-cause mortality in CRC patients. Further research should also take into account molecular tumor subtypes, as the effect of the inflammatory potential of the diet on cancer recurrence and mortality is more likely to be present in tumors with an inflammatory signature. Clinical Trial Registry numbers and website: The colon study: NCT03191110; clinical trials.gov.

Published
2021

2. Inflammatory potential of the diet and risk of breast cancer in the European Investigation into Cancer and Nutrition (EPIC) study

Author

Verena Katzke, Anne M. May, Carlota Castro-Espin, Paula Jakszyn, Christina C. Dahm, Elisabete Weiderpass, Matthias B. Schulze, Guri Skeie, María José Sánchez, Catalina Bonet, Maria Dolores Chirlaque, Sanam Shah, Nasser Laouali, Dagfinn Aune, José Ramón Quirós, Sabina Sieri, Eva Ardanaz, Salvatore Panico, Gianluca Severi, Carlotta Sacerdote, Antonio Agudo, Stina Bodén, Melissa A. Merritt, Iger T Gram, Rosario Tumino, Krasimira Aleksandrova, Giovanna Masala, Elio Riboli, Renée Turzanski-Fortner, Pilar Amiano, Anne Tjønneland, Laure Dossus, Manon Cairat, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Institut Gustave Roussy (IGR), Kræftens Bekæmpelse, DCS, Deutsches Krebsforschungszentrum, DKFZ, Centre International de Recherche sur le Cancer, CIRC, National Research Council, NRC, University of Maryland School of Public Health, SPH, Medical Research Council, MRC: MR/M012190/1, Cancer Research UK, CRUK: C8221/A29017, World Cancer Research Fund, WCRF, Imperial College London, Institut National de la Santé et de la Recherche Médicale, Inserm, Bundesministerium für Bildung und Forschung, BMBF, Cancerfonden, Ministerie van Volksgezondheid, Welzijn en Sport, VWS, Ligue Contre le Cancer, Vetenskapsrådet, VR, Instituto de Salud Carlos III, ISCIII: PI15/00639, European Social Fund, ESF, Associazione Italiana per la Ricerca sul Cancro, AIRC, Deutsche Krebshilfe, Rijksinstituut voor Volksgezondheid en Milieu, RIVM, Institut Gustave-Roussy, Mutuelle Générale de l'Education Nationale, MGEN, European Regional Development Fund, ERDF: FI19/00197, NIHR Imperial Biomedical Research Centre, BRC, This work was funded by Instituto de Salud Carlos III through the project PI15/00639 (Co-funded by European Regional Development Fund [ERDF], a way to build Europe). C. Castro-Espin was funded by Instituto de Salud Carlos III through the Grant FI19/00197 (Co-funded by European Social Fund. ESF investing in your future). The coordination of EPIC is financially supported by International Agency for Research on Cancer (IARC) and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are supported by: Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany), Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, Compagnia di SanPaolo 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), Health Research Fund (FIS)—Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology—ICO (Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden), Cancer Research UK (14136 to EPIC-Norfolk, C8221/A29017 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (United Kingdom). The funders of this study had no role in the decisions about the analysis or interpretation of the data, or preparation, review or approval of the manuscript., and We thank CERCA Programme/Generalitat de Catalunya for institutional support. We also thank the National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands, for their contribution and ongoing support to the EPIC Study.

Subjects
Adult, medicine.medical_specialty, Epidemiology, Nutritional Status, Breast Neoplasms, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Risk Factors, Internal medicine, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Inflammatory potential of the diet, Prospective study, Prospective cohort study, Life Style, Inflammation, 2. Zero hunger, business.industry, Proportional hazards model, Hazard ratio, Chronic inflammation, Middle Aged, medicine.disease, Obesity, Diet, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Cohort, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Body mass index
Abstract

International audience; The role of chronic inflammation on breast cancer (BC) risk remains unclear beyond as an underlying mechanism of obesity and physical activity. We aimed to evaluate the association between the inflammatory potential of the diet and risk of BC overall, according to menopausal status and tumour subtypes. Within the European Prospective Investigation into Cancer and Nutrition cohort, 318,686 women were followed for 14 years, among whom 13,246 incident BC cases were identified. The inflammatory potential of the diet was characterized by an inflammatory score of the diet (ISD). Multivariable Cox regression models were used to assess the potential effect of the ISD on BC risk by means of hazard ratios (HR) and 95% confidence intervals (CI). ISD was positively associated with BC risk. Each increase of one standard deviation (1-Sd) of the score increased by 4% the risk of BC (HR = 1.04; 95% CI 1.01–1.07). Women in the highest quintile of the ISD (indicating a most pro-inflammatory diet) had a 12% increase in risk compared with those in the lowest quintile (HR = 1.12; 95% CI 1.04–1.21) with a significant trend. The association was strongest among premenopausal women, with an 8% increased risk for 1-Sd increase in the score (HR = 1.08; 95% CI 1.01–1.14). The pattern of the association was quite homogeneous by BC subtypes based on hormone receptor status. There were no significant interactions between ISD and body mass index, physical activity, or alcohol consumption. Women consuming more pro-inflammatory diets as measured by ISD are at increased risk for BC, especially premenopausal women.

Published
2021

3. Inflammatory Potential of the Diet and Incidence of Crohn’s Disease and Ulcerative Colitis in the EPIC-Spain Cohort

Author

Estrella Miqueleiz, Eva Ardanaz, Elena Salamanca-Fernández, José María Huerta, Jesús Castilla, Marcela Guevara, Antonio Agudo, Diana Gavrila, María José Sánchez, Catalina Bonet, María Dolores Chirlaque, Pilar Amiano, Miguel Rodríguez-Barranco, and Luis Bujanda

Subjects
Male, Crohn’s disease, Inflammatory bowel disease, Gastroenterology, 0302 clinical medicine, Crohn Disease, Risk Factors, Neoplasms, Surveys and Questionnaires, TX341-641, Prospective Studies, Prospective cohort study, Crohn's disease, Nutrition and Dietetics, Incidence, Hazard ratio, Middle Aged, Ulcerative colitis, Inflamació, European Prospective Investigation into Cancer and Nutrition, inflammatory potential of the diet, 030220 oncology & carcinogenesis, Cohort, Female, 030211 gastroenterology & hepatology, Dieta, Adult, medicine.medical_specialty, Inflammatory bowel diseases, Risk Assessment, Article, 03 medical and health sciences, Malaltia de Crohn, inflammatory bowel disease, Internal medicine, medicine, Humans, Inflammatory potential of the diet, Aged, Proportional Hazards Models, ulcerative colitis, Inflammation, prospective cohort study, Proportional hazards model, business.industry, Nutrition. Foods and food supply, Inflammatory Bowel Diseases, medicine.disease, Diet, Nutrition Assessment, Spain, inflammation, Colitis, Ulcerative, business, Food Science
Abstract

Diet may influence the development of inflammatory bowel disease through the modulation of inflammation. We investigated whether the inflammatory potential of the diet is associated with the risk of Crohn’s disease (CD) and ulcerative colitis (UC) in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). The study included 32,633 participants aged 29–69 years. The inflammatory potential of the diet was measured by using an inflammatory score of the diet (ISD) based on a baseline dietary history questionnaire. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 21 years (674,547 person-years) of follow-up, 32 and 57 participants developed CD and UC, respectively. In multivariable analysis, a one-standard deviation (SD) increment in the ISD (two-unit increase) was associated with a higher risk of CD (HR of 1.71; 95% CI: 1.05–2.80; p = 0.031). By contrast, ISD was not associated with UC (HR for one-SD increment of 0.89; 95% CI: 0.66–1.19; p = 0.436). Our results suggest that consuming a more pro-inflammatory diet may contribute to the risk of CD, supporting that a healthy diet might be beneficial in its prevention. Further, larger studies are needed to verify these findings., Instituto de Salud Carlos III (PIE14/00045), Crohn’s and Colitis UK (M2017-2), e Intra-CIBERESP mobility program (ESPF60/2017), International Agency for Research on Cancer (IARC), Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, NIHR Imperial Biomedical Research Centre (BRC), Health Research Fund (FIS)-Instituto de Salud Carlos III (ISCIII), e Regional Governments of Andalusia, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology-ICO (Spain)

Published
2021

4. Inflammatory potential of the diet and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition study

Author

Fulvio Ricceri, Tilman Kühn, Marc J. Gunter, Guri Skeie, Roel Vermeulen, Sabina Sieri, Elio Riboli, Aurora Perez-Cornago, Heather Ward, Amanda J. Cross, Verena Katzke, José María Huerta, Manuela M. Bergmann, Konstantinos K. Tsilidis, Yahya Mahamat-Saleh, Eva Ardanaz, Antonia Trichopoulou, Salvatore Panico, Elisabete Weiderpass, Cecilie Kyrø, Rosario Tumino, Antonio Agudo, María José Sánchez, Alexandra Vulcan, Valerie Cayssials, Giovanna Masala, Pilar Amiano, Dorthe Nyvang, Genevieve Buckland, Paula Jakszyn, Eleni Peppa, Mazda Jenab, Bodil Ohlsson, Marie-Christine Boutron-Ruault, Anne Tjønneland, Anna Karakatsani, Heiner Boeing, Franck Carbonnel, Christina C. Dahm, Cristina Lasheras, Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Institut Gustave Roussy (IGR), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Ministerie van Volksgezondheid, Welzijn en Sport, VWS Deutsche Krebshilfe Cancer Research UK, CRUK: C8221/A19170, 14136 VetenskapsrÃ¥det, VR Ministerie van Volksgezondheid, Welzijn en Sport, VWS Ligue Contre le Cancer German Cancer Research Center, DKFZ Bundesministerium für Bildung und Forschung, BMBF Bundesministerium für Bildung und Frauen, BMBF Institut National de la Santé et de la Recherche Médicale, Inserm Kræftens Bekæmpelse, DCS Instituto de Salud Carlos III, ISCIII: PI15/00639 German Cancer Research Center, DKFZ National Research Council, NRC 6236 Generalitat de Catalunya European Commission, EC European Regional Development Fund, FEDER Centre International de Recherche sur le Cancer, CIRC RD06/0020 Deutsche Krebshilfe German Cancer Research Center, DKFZ PI13/01162, PI13/00061 Cancerfonden World Cancer Research Fund, WCRF: ERC-2009-AdG 232997 NordForsk Associazione Italiana per la Ricerca sul Cancro, AIRC Medical Research Council, MRC: MR/M012190/1 European Regional Development Fund, FEDER, Our study has been funded by Instituto de Salud Carlos III through the project PI15/00639 (Co-funded by European Regional Development Fund [ERDF], a way to build Europe). We thank CERCA Programme/Generalitat de Catalunya for institutional support. Regional Government of Asturias, German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF). 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 G?n?rale de l'Education Nationale, Institut National de la Sant? et de la Recherche M?dicale (INSERM, France), German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), 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), ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway), Health Research Fund (FIS), PI13/00061 to Granada, PI13/01162 to EPIC-Murcia), Regional Governments of Andaluc?a, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020, Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Sk?ne and V?sterbotten (Sweden), Cancer Research UK (14136 to EPICNorfolk, and C8221/A19170 to EPIC-Oxford), Medical Research Council (1000143 to EPICNorfolk, MR/M012190/1 to EPIC-Oxford, United Kingdom).

Subjects
Oncology, Male, Cancer Research, Colorectal cancer, Cohort Studies, 0302 clinical medicine, MARKERS, Risk Factors, ATHEROSCLEROSIS MAASTRICHT CODAM, Prospective Studies, LOW-GRADE INFLAMMATION, Prospective cohort study, INDEX, Abdominal obesity, biology, Hazard ratio, GLUCOSE-METABOLISM, Middle Aged, C-REACTIVE PROTEIN, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, inflammatory potential of the diet, 030220 oncology & carcinogenesis, Cohort, Adenocarcinoma, Regression Analysis, Female, epidemiology, medicine.symptom, Colorectal Neoplasms, Life Sciences & Biomedicine, Adult, medicine.medical_specialty, prospective cohort, [SDV.CAN]Life Sciences [q-bio]/Cancer, colorectal cancer, MECHANISMS, Association, 03 medical and health sciences, COLON, Internal medicine, medicine, Humans, 1112 Oncology and Carcinogenesis, Oncology & Carcinogenesis, Obesity, Exercise, Inflammation, Science & Technology, business.industry, association, C-reactive protein, Feeding Behavior, medicine.disease, digestive system diseases, Diet, PHYSICAL-ACTIVITY, Nutrition Assessment, Multivariate Analysis, biology.protein, business
Abstract

Pro-inflammatory diets are associated with risk of developing colorectal cancer (CRC), however inconsistencies exist in subsite- and sex-specific associations. The relationship between CRC and combined lifestyle-related factors that contribute towards a low-grade inflammatory profile has not yet been explored. We examined the association between the dietary inflammatory potential and an inflammatory profile and CRC risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. This cohort included 476,160 participants followed-up of 14 years and 5,991 incident CRC cases (3,897 colon and 2,094 rectal tumours). Dietary inflammatory potential was estimated using an Inflammatory Score of the Diet (ISD). An Inflammatory Profile Score (IPS) was constructed, incorporating the ISD, physical activity level and abdominal obesity. The associations between the ISD and CRC and IPS and CRC were assessed using multivariable regression models. More pro- inflammatory diets were related to a higher CRC risk, particularly for colon cancer; Hazar Ratio (HR) for highest versus lowest ISD quartile was 1.15 (95% confidence interval (CI) 1.04-1.27) for CRC, 1.24 (95% CI 1.09-1.41) for colon cancer and 0.99 (95% CI 0.83-1.17) for rectal cancer. Associations were more pronounced in men and not significant in women. The IPS was associated with CRC risk, particularly colon cancer among men; HRs for the highest versus lowest IPS were 1.62 (95% CI 1.31- 2.01) for colon cancer overall and 2.11 (95% CI 1.50-2.97) for colon cancer in men. This study shows that more pro-inflammatory diets and a more inflammatory profile are associated with higher risk of CRC, principally colon cancer and in men. This article is protected by copyright. All rights reserved.

Published
2020

5. Inflammatory potential of the diet & risk of gastric cancer in the European Investigation into Cancer & Nutrition

Author

Agudo, A, Cayssials, V, Bonet, C, Tjønneland, A, Overvad, K, Boutron-Ruault, M-C, Affret, A, Fagherazzi, G, Katzke, V, Schubel, R, Trichopoulou, A, Karakatsani, A, La Vecchia, C, Palli, D, Grioni, S, Tumino, R, Ricceri, F, Panico, S, Bueno-de-Mesquita, B, Peeters, PH, Weiderpass, E, Skeie, G, Nøst, TH, Lasheras, C, Rodríguez-Barranco, M, Amiano, P, Chirlaque, M-D, Ardanaz, E, Ohlsson, B, Dias, JA, Nilsson, LM, Myte, R, Khaw, K-T, Perez-Cornago, A, Gunter, M, Huybrechts, I, Cross, AJ, Tsilidis, K, Riboli, E, Jakszyn, P, and Commission of the European Communities

Subjects
Adult, Inflammation, Science & Technology, Epidemiology, Nutritional Status, Breast Neoplasms, Chronic inflammation, Middle Aged, Diet, 1117 Public Health and Health Services, Breast cancer, Risk Factors, PATTERNS, Humans, Female, Prospective Studies, Prospective study, Inflammatory potential of the diet, Life Sciences & Biomedicine, Life Style, INDEX, Public, Environmental & Occupational Health
Abstract

The role of chronic inflammation on breast cancer (BC) risk remains unclear beyond as an underlying mechanism of obesity and physical activity. We aimed to evaluate the association between the inflammatory potential of the diet and risk of BC overall, according to menopausal status and tumour subtypes. Within the European Prospective Investigation into Cancer and Nutrition cohort, 318,686 women were followed for 14 years, among whom 13,246 incident BC cases were identified. The inflammatory potential of the diet was characterized by an inflammatory score of the diet (ISD). Multivariable Cox regression models were used to assess the potential effect of the ISD on BC risk by means of hazard ratios (HR) and 95% confidence intervals (CI). ISD was positively associated with BC risk. Each increase of one standard deviation (1-Sd) of the score increased by 4% the risk of BC (HR = 1.04; 95% CI 1.01–1.07). Women in the highest quintile of the ISD (indicating a most pro-inflammatory diet) had a 12% increase in risk compared with those in the lowest quintile (HR = 1.12; 95% CI 1.04–1.21) with a significant trend. The association was strongest among premenopausal women, with an 8% increased risk for 1-Sd increase in the score (HR = 1.08; 95% CI 1.01–1.14). The pattern of the association was quite homogeneous by BC subtypes based on hormone receptor status. There were no significant interactions between ISD and body mass index, physical activity, or alcohol consumption. Women consuming more pro-inflammatory diets as measured by ISD are at increased risk for BC, especially premenopausal women.

Published
2018

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