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1. A Nested Case-Control Study of Metabolically Defined Body Size Phenotypes and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author

Murphy, N, Cross, A, Abubakar, M, Jenab, M, Aleksandrova, K, Boutron-Ruault, M, Dossus, L, Racine, A, Kühn, T, Katzke, V, Tjønneland, A, Petersen, K, Overvad, K, Quirós, JR, Jakszyn, P, Molina-Montes, E, Dorronsoro, M, Huerta, J, Barricarte, A, Khaw, K, Wareham, N, Travis, R, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Masala, G, Krogh, V, Tumino, R, Vineis, P, Panico, S, Bueno-de-Mesquita, H, Siersema, P, Peeters, P, Ohlsson, B, Ericson, U, Palmqvist, R, Nyström, H, Weiderpass, E, Skeie, G, Freisling, H, Kong, S, Tsilidis, K, Muller, D, Riboli, E, Gunter, M, [Murphy,N, Cross,AJ, Vineis,P, Bueno-de-Mesquita,HB, Tsilidis,K, Riboli,E, Gunter,MJ] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.[Abubakar,M] Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom. [Jenab,M, Freisling,M, Kong,SY, Mulle,DC, Gunter,MJ] International Agency for Research on Cancer, World Health Organization, Lyon, France. [Aleksandrova,K] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany. [Boutron-Ruault,M, Dossus,L, Racine,A] Inserm, Nutrition, Hormones and Women’s Health, Centre for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France. Université Paris Sud, UMRS 1018, Villejuif, France. Institut Gustave Roussy, Villejuif, France. [Kühn,T, Katzke,VA] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Tjønneland,A, Petersen,KEN] Danish Cancer Society Research Center, Copenhagen, Denmark. [Overvad,K] Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. [Quirós,JR] Public Health Directorate, Asturias, Spain. [Jakszyn,P] Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, Barcelona, Spain. [Molina-Montes,E] Andalusian School of Public Health, Granada, Spain. [Molina-Montes,E, Huerta,J, Barricarte,A] Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain. [Dorronsoro,M] Public Health Direction and Biodonostia–CIBERESP, Basque Regional Health Department, Vitoria, Spain. [Huerta,J] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Khaw,K] University of Cambridge, Cambridge, United Kingdom. [Wareham,N] MRC Epidemiology Unit, Cambridge, United Kingdom. [Travis,RC] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. [Trichopoulou,A, Trichopoulos,D] Hellenic Health Foundation, Athens, Greece. [Trichopoulou,A, Lagiou,P] Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Trichopoulou,A, Lagiou,P, Trichopoulos,D] Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. [Lagiou,P, Trichopoulos,D] Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America. [Masala,G] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. [Krogh,V] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, Civic–M.P.Arezzo Hospital, Azienda Sanitaria Provinciale di Ragusa, Italy. [Vineis,P] HuGeF Foundation, Torino, Italy. [Panico,S] Dipartimento di Medicina Clinica e Sperimentale, Federico II University, Naples, Italy. [Bueno-de- Mesquita,HB] Department of Determinants of Chronic Diseases, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia [Bueno-de-Mesquita,HB, Siersema,PD] Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands. [Peeters,PH] Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. [Ohlsson,B] Division of Internal Medicine, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden. [Ericson,U] Diabetes and Cardiovascular Disease–Genetic Epidemiology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Lund University, Sweden. [Palmqvist,R, Nyström,H] Medical Bioscience, Umeå University, Umeå, Sweden. [Weiderpass,E, Skeie,G] Department of Community Medicine, Faculty of Health Sciences, University of Tromsø–The Arctic University of Norway, Tromsø, Norway. [Weiderpass,E] Cancer Registry of Norway, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Department of Genetic Epidemiology, Folkhälsan Research Center, Helsinki, Finland. [Tsilidis,K] Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece., Funding: The coordination of EPIC is financially supported by the European Commission (DGSANCO), and the International Agency for Research on Cancer., University Medical Center Utrecht, Imperial College Trust, Murphy, Neil, Cross, Amanda J, Abubakar, Mustapha, Jenab, Mazda, Aleksandrova, Krasimira, Boutron Ruault, Marie Christine, Dossus, Laure, Racine, Antoine, Kühn, Tilman, Katzke, Verena A, Tjønneland, Anne, Petersen, Kristina E. N, Overvad, Kim, Quirós, J. Ramón, Jakszyn, Paula, Molina Montes, Esther, Dorronsoro, Miren, Huerta, José María, Barricarte, Aurelio, Khaw, Kay Tee, Wareham, Nick, Travis, Ruth C, Trichopoulou, Antonia, Lagiou, Pagona, Trichopoulos, Dimitrio, Masala, Giovanna, Krogh, Vittorio, Tumino, Rosario, Vineis, Paolo, Panico, Salvatore, Bueno de Mesquita, H. Ba, Siersema, Peter D, Peeters, Petra H, Ohlsson, Bodil, Ericson, Ulrika, Palmqvist, Richard, Nyström, Hanna, Weiderpass, Elisabete, Skeie, Guri, Freisling, Heinz, Kong, So Yeon, Tsilidis, Kosta, Muller, David C, Riboli, Elio, Gunter, Marc J., Khaw, Kay-Tee [0000-0002-8802-2903], Wareham, Nicholas [0000-0003-1422-2993], and Apollo - University of Cambridge Repository

Subjects
Male, Phenomena and Processes::Genetic Phenomena::Phenotype [Medical Subject Headings], Cell- och molekylärbiologi, Obesidad, Biochemistry, Body Mass Index, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Endocrinology, Odds Ratio, Insulin, Prospective Studies, Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::Overweight [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings], Adiposity, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, C-Peptide, Incidence, 11 Medical And Health Sciences, Oncology, Medicine, Waist Circumference, Fenotipo, Human, Logistic Model, Colon, Risk Assessment, Hyperinsulinism, Gastrointestinal Tumors, Neoplasias Colorrectales, Humans, Comparative Study, Diseases::Cardiovascular Diseases [Medical Subject Headings], Protective Factor, Cancer och onkologi, Chi-Square Distribution, Biology and Life Sciences, nutritional and metabolic diseases, Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [Medical Subject Headings], Biomarker, Hormones, Diseases::Nutritional and Metabolic Diseases::Nutrition Disorders::Overnutrition::Obesity [Medical Subject Headings], Prospective Studie, Logistic Models, Case-Control Studies, Cancer and Oncology, Digestive System, Biomarkers, Cell and Molecular Biology, Metabolic Processes, Physiology, Health Status, Colorectal Neoplasm, Health Statu, Risk Factors, Medicine and Health Sciences, Body Size, Multivariate Analysi, Tamaño Corporal, Enfermedades Cardiovasculares, Medicine(all), Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies [Medical Subject Headings], Research Support, Non-U.S. Gov't, Estudios de Casos y Controles, Estudios Prospectivos, Middle Aged, Multicenter Study, Europe, Phenotype, Physiological Parameters, Female, Anatomy, Colorectal Neoplasms, Case-Control Studie, Research Article, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Body Size [Medical Subject Headings], Rectal Cancer, Research Support, N.I.H., Extramural, General & Internal Medicine, Journal Article, Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Hyperinsulinism [Medical Subject Headings], Obesity, Colorectal Cancer, Diabetic Endocrinology, Obesity, Metabolically Benign, Hiperinsulinismo, Risk Factor, Body Weight, Cancers and Neoplasms, Protective Factors, Gastrointestinal Tract, Metabolism, Sobrepeso, Multivariate Analysis, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, Prevalencia
Abstract

Background Obesity is positively associated with colorectal cancer. Recently, body size subtypes categorised by the prevalence of hyperinsulinaemia have been defined, and metabolically healthy overweight/obese individuals (without hyperinsulinaemia) have been suggested to be at lower risk of cardiovascular disease than their metabolically unhealthy (hyperinsulinaemic) overweight/obese counterparts. Whether similarly variable relationships exist for metabolically defined body size phenotypes and colorectal cancer risk is unknown. Methods and Findings The association of metabolically defined body size phenotypes with colorectal cancer was investigated in a case–control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolic health/body size phenotypes were defined according to hyperinsulinaemia status using serum concentrations of C-peptide, a marker of insulin secretion. A total of 737 incident colorectal cancer cases and 737 matched controls were divided into tertiles based on the distribution of C-peptide concentration amongst the control population, and participants were classified as metabolically healthy if below the first tertile of C-peptide and metabolically unhealthy if above the first tertile. These metabolic health definitions were then combined with body mass index (BMI) measurements to create four metabolic health/body size phenotype categories: (1) metabolically healthy/normal weight (BMI < 25 kg/m2), (2) metabolically healthy/overweight (BMI ≥ 25 kg/m2), (3) metabolically unhealthy/normal weight (BMI < 25 kg/m2), and (4) metabolically unhealthy/overweight (BMI ≥ 25 kg/m2). Additionally, in separate models, waist circumference measurements (using the International Diabetes Federation cut-points [≥80 cm for women and ≥94 cm for men]) were used (instead of BMI) to create the four metabolic health/body size phenotype categories. Statistical tests used in the analysis were all two-sided, and a p-value of, Gunter and colleagues analyse a large European dataset to determine how body size and metabolic profile associates with the risk of developing colorectal cancer., Editors' Summary Background Colorectal cancer is the third most common cancer worldwide and is a leading cause of cancer-related death, killing around 700,000 people every year. It develops when cells in the colon (the final part of the digestive system, which is also known as the large intestine or large bowel) or the rectum (the lower end of the colon) acquire genetic changes that allow them to divide uncontrollably to form a tumor and to move around the body (metastasize). Symptoms of colorectal cancer include blood in the stool, a change in bowel habits, and unexplained weight loss. Treatments for colorectal cancer include surgery, chemotherapy, and radiation. As with other types of cancer, these treatments are more likely to be successful if started when the tumor is very small. Consequently, many countries run screening programs that use colonoscopy, the fecal occult blood test, and other tests to detect the earliest signs of colorectal cancer in apparently healthy people. Why Was This Study Done? Being obese—having too much body fat—is associated with an increased colorectal cancer risk (other risk factors include age, having a family history of colorectal cancer, and eating a high-fat, low-fiber diet). Obesity is also associated with several other chronic diseases, and recent evidence suggests that some obese individuals have a higher risk of developing these diseases than others. For example, overweight/obese individuals who have hyperinsulinemia (abnormally high blood levels of insulin; “metabolically unhealthy”) seem to have a higher risk of cardiovascular disease than their non-hyperinsulinemic (“metabolically healthy”) overweight counterparts. If certain combinations of metabolic health status and body size (“metabolically defined body size phenotypes”) are also associated with colorectal cancer, measurement of insulin levels in conjunction with body fat (adiposity) measurements such as body mass index (BMI; an indicator of body fat calculated by dividing a person’s weight in kilograms by their height in meters squared) might improve colorectal cancer risk assessment. In this nested case–control study, the researchers assess the associations between metabolically defined body size phenotypes and colorectal cancer risk. A nested case–control study identifies everyone in a group (here, participants in the European Prospective Investigation into Cancer and Nutrition [EPIC] study) who has a specific condition, identifies matched individuals in the same group without the condition, and asks whether these controls and the cases differ in terms of a specific characteristic or outcome. What Did the Researchers Do and Find? The researchers matched 737 participants in the EPIC study who developed colorectal cancer after study enrollment with 737 controls and used serum concentrations of C-peptide, a marker of insulin secretion, and BMI measurements to classify each individual as metabolically healthy/normal weight, metabolically healthy/overweight, metabolically unhealthy/normal weight, or metabolically unhealthy/overweight. Specifically, the researchers categorized people as metabolically unhealthy if they had a C-peptide level above an arbitrarily chosen cut-off value based on the distribution of C-peptide levels in the control participants and as overweight if they had a BMI of ≥25 kg/m2 (the standard definition of overweight). Compared to metabolically healthy normal weight individuals, metabolically unhealthy normal weight and overweight individuals had an increased colorectal cancer risk; metabolically healthy overweight individuals had a similar colorectal cancer risk to metabolically healthy normal weight individuals. Among overweight individuals, metabolically healthy individuals had a lower colorectal cancer risk than metabolically unhealthy individuals. Finally, similar associations were seen when the researchers used waist circumference instead of BMI as the measure of adiposity. What Do These Findings Mean? These findings suggest that normal weight individuals with hyperinsulinemia (the metabolically unhealthy normal weight phenotype) have a higher risk of colorectal cancer than normal weight individuals without hyperinsulinemia. They also suggest that metabolically unhealthy overweight individuals have a higher risk of colorectal cancer than metabolically healthy overweight individuals. The accuracy of these findings may be limited by the method the researchers used to classify individuals as hyperinsulinemic—there is no universally accepted clinical definition for using C-peptide level to diagnose hyperinsulinemia. Nevertheless, these findings suggest that the assessment of insulin levels in conjunction with adiposity measures might be a better way to assess an individual’s colorectal cancer risk than simply measuring adiposity, and might help to identify those individuals at high risk of colorectal cancer who are most likely to benefit from targeted interventions designed to prevent the onset of clinical disease. Additional Information This list of resources contains links that can be accessed when viewing the PDF on a device or via the online version of the article at http://dx.doi.org/10.1371/journal.pmed.1001988. The US National Cancer Institute provides information for patients about all aspects of colorectal cancer; it also provides more detailed information colorectal cancer for health professionals and information on cancer risk and obesity The UK National Health Service Choices website has information and personal stories about colorectal cancer and information on obesity The not-for-profit organization Cancer Research UK provides information about colorectal cancer and about the association between cancer and obesity MedlinePlus provides links to further resources about colorectal cancer and about obesity Wikipedia has a page on hyperinsulinemia (note that Wikipedia is a free online encyclopedia that anyone can edit; available in several languages) More information about the EPIC study is available

Published
2016

2. Adiposity, mediating biomarkers and risk of colon cancer in the European prospective investigation into cancer and nutrition study

Author

Aleksandrova, K., Drogan, D., Boeing, H., Jenab, M., Bueno-de-Mesquita, H.B., Jansen, E., van Duijnhoven, F.J.B., Rinaldi, S., Fedirko, V., Romieu, I., Kaaks, R., Riboli, E., Gunter, M.J., Romaguera, D., Westhpal, S., Overvad, K., Tjønneland, A., Halkjaer, J., Boutron-Ruault, M.C., Clavel-Chapelon, F., Lukanova, A., Trichopoulou, A., Trichopoulos, D., Vidalis, P., Panico, S., Agnoli, C., Palli, D., Tumino, R., Vineis, P., Buckland, G., Sánchez-Cruz, J.J., Dorronsoro, M., Tormo Díaz, M.J., Barricarte, A., Quiros, J.R., Peeters, P.H., May, A., Hallmans, G., Palmqvist, R., Crowe, F.L., Khaw, K.T., Wareham, N., Pischon, T., Aleksandrova, K, Drogan, D, Boeing, H, Jenab, M, Bas Bueno de Mesquita, H, Jansen, E, van Duijnhoven, Fj, Rinaldi, S, Fedirko, V, Romieu, I, Kaaks, R, Riboli, E, Gunter, Mj, Romaguera, D, Westhpal, S, Overvad, K, Tj?nneland, A, Halkjaer, J, Boutron Ruault, Mc, Clavel Chapelon, F, Lukanova, A, Trichopoulou, A, Trichopoulos, D, Vidalis, P, Panico, Salvatore, Agnoli, C, Palli, D, Tumino, R, Vineis, P, Buckland, G, S?nchez Cruz, Jj, Dorronsoro, M, D?az, Mj, Barricarte, A, Ramon Quiros, J, Peeters, Ph, May, Am, Hallmans, G, Palmqvist, R, Crowe, Fl, Khaw, Kt, Wareham, N, and Pischon, T.

Subjects
Male, Nutritional Status, Middle Aged, Europe, Cardiovascular and Metabolic Diseases, Risk Factors, Case-Control Studies, Colonic Neoplasms, Biomarkers, Tumor, Humans, Female, Prospective Studies, Adiposity, Aged
Abstract

Adiposity is a risk factor for colon cancer, but underlying mechanisms are not well understood. We evaluated the extent to which eleven biomarkers with inflammatory and metabolic actions mediate the association of adiposity measures, waist circumference (WC) and body mass index (BMI), with colon cancer in men and women. We analysed data from a prospective nested case-control study among 662 incident colon cancer cases matched within risk-sets to 662 controls. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression. The percent effect change and corresponding CI-s were estimated after adjusting for biomarkers shown to be associated with colon cancer risk. After multivariable adjustment, WC was associated with colon cancer risk in men (top vs bottom tertile RR 1.68, 95% CI 1.06 - 2.65; Ptrend = 0.02) and in women (RR 1.67, 95% CI 1.09 - 2.56; Ptrend = 0.03). BMI was associated with risk only in men. The association of WC with colon cancer was accounted mostly for by three biomarkers, high-density lipoprotein cholesterol, non-high-molecular-weight adiponectin and soluble leptin receptor, which in combination explained 46% (95% CI 37 to 57%) of the association in men and 50% (95% CI 40 to 65%) of the association in women. Similar results were observed for the associations with BMI in men. These data suggests that alterations in levels of these metabolic biomarkers may represent a primary mechanism of action in the relation of adiposity with colon cancer. Further studies are warranted to determine whether altering their concentrations may reduce colon cancer risk. © 2013 Wiley Periodicals, Inc.

Published
2014

3. Linoleic acid, a dietary n-6 polyunsaturated fatty acid, and the aetiology of ulcerative colitis: a nested case-control study within a European prospective cohort study

Author

[IBD in EPIC Study Investigators], Tjonneland, A, Overvad, K, Bergmann, M M, Nagel, G, Linseisen, J, Hallmans, G, Palmqvist, R, Sjodin, H, Hagglund, G, Berglund, G, Lindgren, S, Grip, O, Palli, D, Day, N E, Khaw, K-T, Bingham, S, Riboli, E, Kennedy, H, and Hart, A

Subjects
Adult, Male, medicine.medical_specialty, Linoleic acid, Inflammatory bowel disease, Linoleic Acid, chemistry.chemical_compound, Lipoxygenase, Dietary Fats, Unsaturated, Internal medicine, medicine, Humans, Prospective cohort study, Aged, chemistry.chemical_classification, biology, business.industry, Gastroenterology, Feeding Behavior, Middle Aged, medicine.disease, Eicosapentaenoic acid, Diet, Europe, Endocrinology, chemistry, Biochemistry, Nested case-control study, biology.protein, Arachidonic acid, Colitis, Ulcerative, Female, Food Habits, business, Epidemiologic Methods, Polyunsaturated fatty acid
Abstract

Udgivelsesdato: 2009-Dec OBJECTIVE: Dietary linoleic acid, an n-6 polyunsaturated fatty acid, is metabolised to arachidonic acid, a component of colonocyte membranes. Metabolites of arachidonic acid have pro-inflammatory properties and are increased in the mucosa of patients with ulcerative colitis. The aim of this investigation was to conduct the first prospective cohort study investigating if a high dietary intake of linoleic acid increases the risk of developing incident ulcerative colitis. DESIGN AND SETTING: Dietary data from food frequency questionnaires were available for 203 193 men and women aged 30-74 years, resident in the UK, Sweden, Denmark, Germany or Italy and participating in a prospective cohort study, the European Prospective Investigation into Cancer and Nutrition (EPIC). These participants were followed up for the diagnosis of ulcerative colitis. Each case was matched with four controls and the risk of disease calculated by quartile of intake of linoleic acid adjusted for gender, age, smoking, total energy intake and centre. RESULTS: A total of 126 participants developed ulcerative colitis (47% women) after a median follow-up of 4.0 years (range, 1.7-11.3 years). The highest quartile of intake of linoleic acid was associated with an increased risk of ulcerative colitis (odds ratio (OR) = 2.49, 95% confidence interval (CI) = 1.23 to 5.07, p = 0.01) with a significant trend across quartiles (OR = 1.32 per quartile increase, 95% CI = 1.04 to 1.66, p = 0.02 for trend). CONCLUSIONS: The data support a role for dietary linoleic acid in the aetiology of ulcerative colitis. An estimated 30% of cases could be attributed to having dietary intakes higher than the lowest quartile of linoleic acid intake.

Published
2009

4. Alcohol dehydrogenase and aldehyde dehydrogenase gene polymorphisms, alcohol intake and the risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition study

Author

Salvatore Panico, Pamela Ferrari, Elio Riboli, M. Bergmann, Jonas Manjer, Anne Tjønneland, Timothy J. Key, C. H. van Gils, Larraitz Arriola, Paul Brennan, Domenico Palli, Kim Overvad, Carlotta Sacerdote, Françoise Clavel-Chapelon, M-D Chirlaque, Nadia Slimani, Sophie Morois, Federico Canzian, Björn Lindkvist, Mazda Jenab, S. Rinaldi, Naomi E. Allen, K-T Khaw, Alina Vrieling, Antonia Trichopoulou, Heiner Boeing, P. H. Peeters, Dimitrios Trichopoulos, Paolo Boffetta, Dora Romaguera, Rosario Tumino, Antonio Agudo, Isabelle Romieu, Janne Schurmann Tolstrup, Teresa Norat, Ulla Vogel, Laudina Rodríguez Suárez, Göran Hallmans, Richard Palmqvist, Bas Bueno-de-Mesquita, Michail Katsoulis, Vittorio Krogh, M. C. Boutron-Ruault, Rudolf Kaaks, M-J Sanchez, Anette Hjartåker, Eva Ardanaz, Eiliv Lund, James D. McKay, International Prevention Research Institute (IPRI), The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai [New York] (MSSM), Ferrari, P., McKay, J.D., Jenab, M., Brennan, P., Canzian, F., Vogel, U., Tjonneland, A., Overvad, K., Tolstrup, J.S., Boutron-Ruault, M.-C., Clavel-Chapelon, F., Morois, S., Kaaks, R., Boeing, H., Bergmann, M., Trichopoulou, A., Katsoulis, M., Trichopoulos, D., Krogh, V., Panico, S., Sacerdote, C., Palli, D., Tumino, R., Peeters, P.H., Van Gils, C.H., Bueno-De-Mesquita, B., Vrieling, A., Lund, E., Hjartåker, A., Agudo, A., Suarez, L.R., Arriola, L., Chirlaque, M.-D., Ardanaz, E., Sánchez, M.-J., Manjer, J., Lindkvist, B., Hallmans, G., Palmqvist, R., Allen, N., Key, T., Khaw, K.-T., Slimani, N., Rinaldi, S., Romieu, I., Boffetta, P., Romaguera, D., Norat, T., Riboli, E., Ferrari, P, Mckay, Jd, Jenab, M, Brennan, P, Canzian, F, Vogel, U, Tj?nneland, A, Overvad, K, Tolstrup, J, Boutron Ruault, Mc, Clavel Chapelon, F, Morois, S, Kaaks, R, Boeing, H, Bergmann, M, Trichopoulou, A, Katsoulis, M, Trichopoulos, D, Krogh, V, Panico, Salvatore, Sacerdote, C, Palli, D, Tumino, R, Peeters, Ph, van Gils, Ch, Bueno de Mesquita, B, Vrieling, A, Lund, E, Hjart?ker, A, Agudo, A, Suarez, Lr, Arriola, L, Chirlaque, Md, Ardanaz, E, S?nchez, Mj, Manjer, J, Lindkvist, B, Hallmans, G, Palmqvist, R, Allen, N, Key, T, Khaw, Kt, Slimani, N, Rinaldi, S, Romieu, I, Boffetta, P, Romaguera, D, and Norat, T

Subjects
Male, Oncology, Medicine (miscellaneous), polymorphism, 0302 clinical medicine, Risk Factors, Odds Ratio, Prospective Studies, Prospective cohort study, Genetics, 0303 health sciences, Nutrition and Dietetics, ADH1B, Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, ADH7, 030220 oncology & carcinogenesis, Female, Colorectal Neoplasms, Risk assessment, Genetic Prospective Studies Risk Assessment Risk Factors, Aged Alcohol Dehydrogenase/*genetics Alcohol Drinking/*genetics/metabolism Aldehyde Dehydrogenase/*genetics Alleles Case-Control Studies Colorectal Neoplasms/*genetics Ethanol/*metabolism Europe European Continental Ancestry Group/*genetics Female Humans Logistic Models Male Middle Aged Odds Ratio *Polymorphism, medicine.medical_specialty, Alcohol Drinking, colorectal cancer, Biology, Risk Assessment, White People, 03 medical and health sciences, aldehyde dehydrogenase, Internal medicine, medicine, Humans, Alleles, Molecular epidemiology Aetiology, screening and detection [NCEBP 1], Aged, 030304 developmental biology, ALDH2, Polymorphism, Genetic, Ethanol, Alcohol Dehydrogenase, Case-control study, Odds ratio, digestive system diseases, Logistic Models, Case-Control Studies, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, acetaldehyde, alcohol intake
Abstract

Ferrari, P McKay, J D Jenab, M Brennan, P Canzian, F Vogel, U Tjonneland, A Overvad, K Tolstrup, J S Boutron-Ruault, M-C Clavel-Chapelon, F Morois, S Kaaks, R Boeing, H Bergmann, M Trichopoulou, A Katsoulis, M Trichopoulos, D Krogh, V Panico, S Sacerdote, C Palli, D Tumino, R Peeters, P H van Gils, C H Bueno-de-Mesquita, B Vrieling, A Lund, E Hjartaker, A Agudo, A Suarez, L R Arriola, L Chirlaque, M-D Ardanaz, E Sanchez, M-J Manjer, J Lindkvist, B Hallmans, G Palmqvist, R Allen, N Key, T Khaw, K-T Slimani, N Rinaldi, S Romieu, I Boffetta, P Romaguera, D Norat, T Riboli, E eng 11692/Cancer Research UK/United Kingdom G1000143/Medical Research Council/United Kingdom British Heart Foundation/United Kingdom Cancer Research UK/United Kingdom Department of Health/United Kingdom Medical Research Council/United Kingdom Wellcome Trust/United Kingdom Research Support, Non-U.S. Gov't England 2012/11/15 06:00 Eur J Clin Nutr. 2012 Dec;66(12):1303-8. doi: 10.1038/ejcn.2012.173. Epub 2012 Nov 14.; International audience; BACKGROUND/OBJECTIVES: Heavy alcohol drinking is a risk factor of colorectal cancer (CRC), but little is known on the effect of polymorphisms in the alcohol-metabolizing enzymes, alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) on the alcohol-related risk of CRC in Caucasian populations. SUBJECTS/METHODS: A nested case-control study (1269 cases matched to 2107 controls by sex, age, study centre and date of blood collection) was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) to evaluate the impact of rs1229984 (ADH1B), rs1573496 (ADH7) and rs441 (ALDH2) polymorphisms on CRC risk. Using the wild-type variant of each polymorphism as reference category, CRC risk estimates were calculated using conditional logistic regression, with adjustment for matching factors. RESULTS: Individuals carrying one copy of the rs1229984(A) (ADH1B) allele (fast metabolizers) showed an average daily alcohol intake of 4.3 g per day lower than subjects with two copies of the rs1229984(G) allele (slow metabolizers) (P(diff)

Published
2012

5. Blood lipid and lipoprotein concentrations and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition

Author

Amir F. Ayyobi, Mazda Jenab, Heiner Boeing, Richard Palmqvist, Kostas Tsilidis, Giovanna Tagliabue, Veronika Fedirko, Françoise Clavel-Chapelon, Elio Riboli, Vardis Dilis, Laudina Rodríguez, Kim Overvad, Anne Pernille Toft-Petersen, Peter D. Siersema, Kay-Tee Khaw, H. Bas Bueno-de-Mesquita, María José Tormo, Vanessa Cottet, Paolo Vineis, Teresa Norat, Göran Hallmans, Jiri Frohlich, Petra H.M. Peeters, Miren Dorronsoro, Birgit Teucher, Esther Molina-Montes, Dagmar Drogan, Aurelio Barricarte, Fränzel J.B. Van Duijnhoven, Francesca L. Crowe, Sabina Rinaldi, Pagona Lagiou, Marie-Christine Boutron-Ruault, Carlos A. González, Rosario Tumino, Salvatore Panico, Anne Tjønneland, Domenico Palli, Veronique Chajes, Antonia Trichopoulou, Louise Hansen, Eugene Jansen, Tobias Pischon, Rudolf Kaaks, Miriam Calligaro, [van Duijnhoven,FJB, Bueno-De-Mesquita,HB, Calligaro,M, Jansen,EHJM] Natl Inst Publ Hlth & Environm RIVM, Bilthoven, Netherlands. [van Duijnhoven,FJB] Univ Med Ctr, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. [Bueno-De-Mesquita,HB, Siersema,PD] Univ Med Ctr, Dept Gastroenterol & Hepatol, Utrecht, Netherlands. [Jenab,M, Chajes,V, Fedirko,V, Rinaldi,S] Int Agcy Res Canc IARC WHO, Lyon, France. [Pischon,T, Boeing,H, Drogan,D] German Inst Human Nutr Potsdam Rehbrucke, Dept Epidemiol, Nuthetal, Germany. [Frohlich,J, Ayyobi,A] Univ British Columbia, St Pauls Hosp, Vancouver, Canada. [Overvad,K] Aarhus Univ, Sch Publ Hlth, Dept Epidemiol, Aarhus, Denmark. [Overvad,K, Toft-Petersen,AP] Aarhus Univ Hosp, Aalborg Hosp, Dept Cardiol, Aalborg, Denmark. [Tjonneland,A, Hansen,L] Danish Canc Soc, Inst Canc Epidemiol, Copenhagen, Denmark. [Boutron-Ruault,MC, Clavel-Chapelon,F, Cottet,V] INSERM, UMRS 1018, Team 9, Centre for Research in Epidemiology and Population Health, Paris S Univ, Inst Gustave Roussy, Ctr Res Epidemiol & Populat Hlth, Villejuif, France. [Palli,D] ISPO Canc Res & Prevent Inst, Mol & Nutr Epidemiol Unit, Florence, Italy. [Tagliabue, G] Fdn IRCCS Inst Nazl Tumori, Environm Epidemiol Unit, Milan, Italy. [Tagliabue, G] Fdn IRCCS Inst Nazl Tumori, Canc Registry, Milan, Italy. [Panico, S] Univ Naples Federico 2, Dept Clin & Expt Med, Naples, Italy. [Tumino,R] Civile MP Arezzo Hosp, Dept Oncol, Histopathol Unit, Ragusa, Italy. [Tumino, R] Civile MP Arezzo Hosp, Canc Registry, Ragusa, Italy. [Vineis, P] HuGeF Fdn Torino, Turin, Italy. [Vineis, P] Univ London Imperial Coll Sci Technol & Med, Sch Publ Hlth, MRC HPA Ctr Environm & Hlth, London, England. [Kaaks, R, Teucher, B] German Canc Res Ctr, Div Canc Epidemiol, D-6900 Heidelberg, Germany. [Trichopoulou, A, Lagiou, P] Univ Athens, Sch Med, Dept Hyg Epidemiol & Med Stat, WHO Collaborating Ctr Food & Nutr Policies, GR-11527 Athens, Greece. [Trichopoulou,A, Dilis,V] Hellen Hlth Fdn, Athens, Greece. [Peeters,PHM, Norat,T, Riboli,E] Univ London Imperial Coll Sci Technol & Med, Div Epidemiol Publ Hlth & Primary Care, London, England. [Rodriguez,L] Hlth & Hlth Care Serv Council, Publ Hlth & Participat Directorate, Asturias, Spain. [Gonzalez,CA] Catalan Inst Oncol, Unit Nutr Environm & Canc, Barcelona, Spain. [Molina-Montes,E] Andalusia Sch Publ Hlth, Granada, Spain. [Dorronsoro,M] Dept Publ Hlth Guipuzkoa, San Sebastian, Spain. [Tormo,MJ] Murcia Reg Hlth Council, Dept Epidemiol, Murcia, Spain. [Barricarte,A] Publ Hlth Inst Navarra, Pamplona, Spain. [Palmqvist,R] Umea Univ, Dept Med Biosci, Umea, Sweden. [Hallmans,G] Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden. [Khaw,KT] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge CB2 1TN, England. [Tsilidis,KK, Crowe,FL] Univ Oxford, Nuffield Dept Clin Med, Canc Epidemiol Unit, Oxford, England., This work was supported by the European Commission: Public Health and Consumer Protection Directorate 1993-2004, Research Directorate-General 2005-., Ligue contre le Cancer, Societé 3M, 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, Federal Ministry of Education and Research (Germany), Danish Cancer Society (Denmark), Health Research Fund (FIS) of the Spanish Ministry of Health, The participating regional governments and institutions (Spain), Cancer Research UK, Medical Research Council (UK), Hellenic Ministry of Health, the Stavros Niarchos Foundation and the Hellenic Health Foundation (Greece), Italian Association for Research on Cancer, 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), Swedish Cancer Society, Swedish Scientific Council, Regional government of Västerbotten (Sweden), Norwegian Cancer Society (Norway)., van Duijnhoven, Fj, Bueno De Mesquita, Hb, Calligaro, M, Jenab, M, Pischon, T, Jansen, Eh, Frohlich, J, Ayyobi, A, Overvad, K, Toft Petersen, Ap, Tjønneland, A, Hansen, L, Boutron Ruault, Mc, Clavel Chapelon, F, Cottet, V, Palli, D, Tagliabue, G, Panico, Salvatore, Tumino, R, Vineis, P, Kaaks, R, Teucher, B, Boeing, H, Drogan, D, Trichopoulou, A, Lagiou, P, Dilis, V, Peeters, Ph, Siersema, Pd, Rodríguez, L, González, Ca, Molina Montes, E, Dorronsoro, M, Tormo, Mj, Barricarte, A, Palmqvist, R, Hallmans, G, Khaw, Kt, Tsilidis, Kk, Crowe, Fl, Chajes, V, Fedirko, V, Rinaldi, S, Norat, T, and Riboli, E.

Subjects
Male, medicine.medical_specialty, Colorectal cancer, Lipoproteins, Blood lipids, Chemicals and Drugs::Lipids::Lipoproteins [Medical Subject Headings], Gastroenterology, Colorectal neoplasms, Body Mass Index, chemistry.chemical_compound, Patient Education as Topic, Nephelometry and Turbidimetry, Risk Factors, Internal medicine, Surveys and Questionnaires, medicine, Biomarkers, Tumor, Humans, Cáncer colorrectal, Prospective Studies, Risk factor, Encuestas nutricionales, Prospective cohort study, Aged, Cholesterol, business.industry, Incidence, Cancer, Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [Medical Subject Headings], Middle Aged, medicine.disease, Prognosis, Nutrition Surveys, Lipids, European Prospective Investigation into Cancer and Nutrition, Europe, Endocrinology, chemistry, Lípidos, lipids (amino acids, peptides, and proteins), Colorimetry, Female, Geographical Locations::Geographic Locations::Europe [Medical Subject Headings], Metabolic syndrome, business, Colorectal Neoplasms, Follow-Up Studies, Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Data Collection::Nutrition Assessment::Nutrition Surveys [Medical Subject Headings]
Abstract

Objective To examine the association between serum concentrations of total cholesterol, high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol, triglycerides, apolipoprotein A-I (apoA), apolipoprotein B and the incidence of colorectal cancer (CRC). Design Nested case–control study. Setting The study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort of more than 520 000 participants from 10 western European countries. Participants 1238 cases of incident CRC, which developed after enrolment into the cohort, were matched with 1238 controls for age, sex, centre, follow-up time, time of blood collection and fasting status. Main outcome measures Serum concentrations were quantitatively determined by colorimetric and turbidimetric methods. Dietary and lifestyle data were obtained from questionnaires. Conditional logistic regression models were used to estimate incidence rate ratios (RRs) and 95% CIs which were adjusted for height, weight, smoking habits, physical activity, education, consumption of fruit, vegetables, meat, fish, alcohol, fibre and energy. Results After adjustments, the concentrations of HDL and apoA were inversely associated with the risk of colon cancer (RR for 1 SD increase of 16.6 mg/dl in HDL and 32.0 mg/dl in apoA of 0.78 (95% CI 0.68 to 0.89) and 0.82 (95% CI 0.72 to 0.94), respectively). No association was observed with the risk of rectal cancer. Additional adjustment for biomarkers of systemic inflammation, insulin resistance and oxidative stress or exclusion of the first 2 years of follow-up did not influence the association between HDL and risk of colon cancer. Conclusions These findings show that high concentrations of serum HDL are associated with a decreased risk of colon cancer. The mechanism behind this association needs further elucidation. Yes

Published
2011

6. Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study

Author

Jakob Linseisen, Pierre Hainaut, Antonia Trichopoulou, Eiliv Lund, Pietro Ferrari, Sophie Morois, Kay-Tee Khaw, Kim Overvad, Philippe Autier, Gesthimani Misirli, Dimitrios Trichopoulos, Timothy J. Key, Andrew W. Roddam, Carla H. van Gils, Salvatore Panico, María J. Tormo, Paolo Vineis, Graham Byrnes, Eugene Jansen, Fränzel J.B. Van Duijnhoven, María José Sánchez, Martine M. Ros, Teresa Norat, Anja Olsen, Anne Tjønneland, Rudolf Kaaks, H. Bas Bueno-de-Mesquita, Tobias Pischon, Göran Hallmans, R. Palmqvist, Domenico Palli, Rosario Tumino, Sabina Rinaldi, Manuela M. Bergmann, Franco Berrino, Magritt Brustad, Eva Ardanaz, Heiner Boeing, Miren Dorronsoro, Nadia Slimani, Françoise Clavel-Chapelon, Petra H.M. Peeters, Elio Riboli, Mazda Jenab, Laudina Rodríguez, Marie-Christine Boutron-Ruault, Carlos A. González, [Jenab M, Ferrari P, Slimani N, Byrnes G, Rinaldi S, Autier P, Hainaut P] International Agency for Research on Cancer (IARC-WHO), Lyon, France. [Bueno-de-Mesquita HB, van Duijnhoven FJB, Jansen EHJM, Ros MM] National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands. [Ferrari P] Data Collection and Exposure Unit, European Food Safety Authority (EFSA), Parma, Italy. [van Duijnhoven FJB, van Gils CH, Peeters PH] Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, Netherlands. [Norat T, Vineis P, Riboli E] School of Public Health, Imperial College, London, UK. [Pischon T, Boeing H, Bergmann MM] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. [Tjonneland A, Olsen A] Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark. [Overvad K] Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark. [Boutron-Ruault M-C, Clavel-Chapelon F, Morois S] Inserm (Institut National de la Santé et de la Recherche Médicale) ERI 20, EA. [Kaaks R, Linseisen J] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Trichopoulou A, Misirli G] Department of Hygiene and Epidemiology, University of Athens Medical School, Greece. [Trichopoulou A] Hellenic Health Foundation, Greece. [Trichopoulos D] Department of Epidemiology, Harvard School of Public Health, USA and Bureau of Epidemiologic Research, Academy of Athens, Greece. [Berrino F] Department of Preventive and Predictive Medicine, Etiologic Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori (National Cancer Institute), Milan, Italy. [Vineis P] ISI Foundation, Turin, Italy. [Panico S] Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. [Palli D] Molecular and Nutritional Epidemiology Unit, ISPO (Cancer Research and Prevention Institute), Florence, Italy. [Tumino R] Ragusa Cancer Registry and Histopathology Unit, 'Civile M.P.Arezzo' Hospital, ASP 7 Ragusa, Italy. [Ros MM] Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands. [Brustad M, Lund E] Centre for Sami Health Research, Institute of Community Medicine, University of Tromsø, Tromsø, Norway. [Tormo MJ] Epidemiology Service, Murcia Regional Health Authority, Spain. [Ardanaz E] Public Health Institute of Navarra, Pamplona, Spain. [Ardanaz E, Sánchez MJ] CIBER Epidemiología y Salud Pública (CIBERESP), Spain. [Rodríguez L] Health Information Section, Public Health and Participation Directorate, Health and Health Care Services Council, Asturias, Spain. [Sánchez MJ] Andalusian School of Public Health-Granada (Spain). [Dorronsoro M] Epidemiology Unit, Public Health Division of Guipuzkoa, San Sebastian, Spain. [Gonzalez CA] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. [Hallmans G] Department of Public Health and Clinical Medicine, Nutritional Research, Umeå, Sweden. [Palmqvist R] Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden. [Roddam A, Key TJ] Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. [Khaw KT] Clinical Gerontology Unit, University of Cambridge, Cambridge, UK. [Bueno-de-Mesquita HB] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, Netherlands. [Linseisen J] Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany, We thank the World Cancer Research Fund (WCRF, London, UK, grant number 2005/12) for grant funding for the present study. The EPIC study was supported by the Europe Against Cancer Programme of the European Commission (SANCO), Ligue contre le Cancer (France), Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM), German Cancer Aid, German Cancer Research Center, German Federal Ministry of Education and Research, Danish Cancer Society, Health Research Fund (FIS) of the Spanish Ministry of Health (RETIC-RD06/0020), the participating regional governments and institutions of Spain, The ISCIII Red de Centro RCESP (C03/09), Cancer Research UK, Medical Research Council, UK, the Stroke Association, UK, British Heart Foundation, Department of Health, UK, Food Standards Agency, UK, the Wellcome Trust, UK, Greek Ministry of Health and Social Solidarity, Hellenic Health Foundation and Stavros Niarchos Foundation, Greek Ministry of Education, Italian Association for Research on Cancer, Italian National Research Council, Compagnia di San Paolo, Dutch Ministry of Public Health, Welfare and Sports, Dutch Ministry of Health, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), Swedish Cancer Society, Swedish Scientific Council, Regional Governments of Skane and Vasterbotten, Sweden, and Norwegian Cancer Society., Jenab, M, Bueno de Mesquita, Hb, Ferrari, P, van Duijnhoven, Fj, Norat, T, Pischon, T, Jansen, Eh, Slimani, N, Byrnes, G, Rinaldi, S, Tjønneland, A, Olsen, A, Overvad, K, Boutron Ruault, Mc, Clavel Chapelon, F, Morois, S, Kaaks, R, Linseisen, J, Boeing, H, Bergmann, Mm, Trichopoulou, A, Misirli, G, Trichopoulos, D, Berrino, F, Vineis, P, Panico, Salvatore, Palli, D, Tumino, R, Ros, Mm, van Gils, Ch, Peeters, Ph, Brustad, M, Lund, E, Tormo, Mj, Ardanaz, E, Rodríguez, L, Sánchez, Mj, Dorronsoro, M, Gonzalez, Ca, Hallmans, G, Palmqvist, R, Roddam, A, Key, Tj, Khaw, Kt, Autier, P, Hainaut, P, Riboli, E., and University of Groningen

Subjects
Oncology, Male, Colorectal cancer, 0302 clinical medicine, Risk Factors, Neoplasias colorrectales, SERUM 25-HYDROXYVITAMIN-D, DIETARY-INTAKE, Epidemiology, 030212 general & internal medicine, Vitamin D, General Environmental Science, 2. Zero hunger, Colon Cancer, COLON-CANCER, Confounding, General Engineering, Estudios de Casos y Controles, Geographicals::Geographic Locations::Europe [Medical Subject Headings], General Medicine, Middle Aged, META-ANALYSIS, 3. Good health, Europe, 030220 oncology & carcinogenesis, Cohort, Female, Risk assessment, Colorectal Neoplasms, Europa, Life Sciences & Biomedicine, D SUPPLEMENTATION, medicine.medical_specialty, CALCIUM INTAKE, Vitamina D, Chemicals and Drugs::Polycyclic Compounds::Steroids::Secosteroids::Vitamin D [Medical Subject Headings], Enzyme-Linked Immunosorbent Assay, Molecular epidemiology [NCEBP 1], 03 medical and health sciences, Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies [Medical Subject Headings], Medicine, General & Internal, D-RECEPTOR, General & Internal Medicine, Internal medicine, Vitamin D and neurology, medicine, Humans, ddc:610, Life Style, Immunology (Including Allergy), Science & Technology, Dose-Response Relationship, Drug, 25-HYDROXYVITAMIN-D LEVELS, business.industry, Research, Case-control study, Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [Medical Subject Headings], medicine.disease, RANDOMIZED-CONTROLLED-TRIALS, Diet, Epidemiologic Studies, Endocrinology, Cardiovascular and Metabolic Diseases, Case-Control Studies, Nested case-control study, General Earth and Planetary Sciences, Calcium, D METABOLITES, business
Abstract

Contains fulltext : 88351.pdf (Publisher’s version ) (Open Access) OBJECTIVE: To examine the association between pre-diagnostic circulating vitamin D concentration, dietary intake of vitamin D and calcium, and the risk of colorectal cancer in European populations. DESIGN: Nested case-control study. Setting The study was conducted within the EPIC study, a cohort of more than 520 000 participants from 10 western European countries. PARTICIPANTS: 1248 cases of incident colorectal cancer, which developed after enrolment into the cohort, were matched to 1248 controls MAIN OUTCOME MEASURES: Circulating vitamin D concentration (25-hydroxy-vitamin-D, 25-(OH)D) was measured by enzyme immunoassay. Dietary and lifestyle data were obtained from questionnaires. Incidence rate ratios and 95% confidence intervals for the risk of colorectal cancer by 25-(OH)D concentration and levels of dietary calcium and vitamin D intake were estimated from multivariate conditional logistic regression models, with adjustment for potential dietary and other confounders. RESULTS: 25-(OH)D concentration showed a strong inverse linear dose-response association with risk of colorectal cancer (P for trend or=100.0 nmol/l: 0.77 (0.56 to 1.06)). In analyses by quintile of 25-(OH)D concentration, patients in the highest quintile had a 40% lower risk of colorectal cancer than did those in the lowest quintile (P

Published
2010

7. Plasma vitamins B2, B6, B12, and related genetic variants as predictors of colorectal cancer risk

Author

Simone J. P. M. Eussen, Øivind Midttun, Kim Overvad, Elio Riboli, Tobias Pischon, Ole Thorlacius-Ussing, Paolo Vineis, Rudolf Kaaks, Laudina Rodríguez, Domenico Palli, Bethany VanGuelpen, Mazda Jenab, Per Magne Ueland, Ulrika Ericson, Cornelia Weikert, Åse Fredriksen, Anne Tjønneland, Carmen Enid Martínez, Petra H.M. Peeters, Paolo Boffetta, Klaus Meyer, Carmen Navarro, H. Bas Bueno-de-Mesquita, Jonas Manjer, Valeria Pala, Françoise Clavel-Chapelon, Teresa Norat, Sophie Morois, Fränzel J.B. Van Duijnhoven, Anja Olsen, Rosario Tumino, Kay-Tee Khaw, Steinar Hustad, Jakob Linseisen, Michael Katsoulis, Richard Palmqvist, Stein Emil Vollset, Sheila Bingham, Antonia Trichopoulou, Guri Skeie, Miren Dorronsoro, Demosthenes Zilis, Nadia Slimani, Eva Ardanaz, Salvatore Panico, Xavier Muñoz, Marie-Christine Boutron-Ruault, Eussen, Sj, Vollset, Se, Hustad, S, Midttun, Ø, Meyer, K, Fredriksen, A, Ueland, Pm, Jenab, M, Slimani, N, Boffetta, P, Overvad, K, Thorlacius Ussing, O, Tjønneland, A, Olsen, A, Clavel Chapelon, F, Boutron Ruault, Mc, Morois, S, Weikert, C, Pischon, T, Linseisen, J, Kaaks, R, Trichopoulou, A, Zilis, D, Katsoulis, M, Palli, D, Pala, V, Vineis, P, Tumino, R, Panico, Salvatore, Peeters, Ph, Bueno de Mesquita, Hb, van Duijnhoven, Fj, Skeie, G, Muñoz, X, Martínez, C, Dorronsoro, M, Ardanaz, E, Navarro, C, Rodríguez, L, Vanguelpen, B, Palmqvist, R, Manjer, J, Ericson, U, Bingham, S, Khaw, Kt, Norat, T, Riboli, E., Eussen, S.J.P.M., Vollset, S.E., Hustad, S., Midttun, Ø., Meyer, K., Fredriksen, Å., Ueland, P.M., Jenab, M., Slimani, N., Boffetta, P., Overvad, K., Thorlacius-Ussing, O., Tjønneland, A., Olsen, A., Clavel-Chapelon, F., Boutron-Ruault, M.-C., Morois, S., Weikert, C., Pischon, T., Linseisen, J., Kaaks, R., Trichopoulou, A., Zilis, D., Katsoulis, M., Palli, D., Pala, V., Vineis, P., Tumino, R., Panico, S., Peeters, P.H.M., Bueno-de-Mesquita, H.B., Van Duijnhoven, F.J.B., Skeie, G., Muñoz, X., Martínez, C., Dorronsoro, M., Ardanaz, E., Navarro, C., Rodríguez, L., VanGuelpen, B., Palmqvist, R., Manjer, J., Ericson, U., Bingham, S., Khaw, K.-T., and Norat, T.

Subjects
Oncology, Male, medicine.medical_specialty, Epidemiology, Colorectal cancer, Riboflavin, Polymorphism, Single Nucleotide, Article, Cohort Studies, Folic Acid, Risk Factors, Internal medicine, Genotype, medicine, Humans, Vitamin B12, ONE-CARBON METABOLISM, METHIONINE SYNTHASE GENE, METHYLENETETRAHYDROFOLATE REDUCTASE, FOLATE METABOLISM, MASS-SPECTROMETRY, HOMOCYSTEINE METABOLISM, DNA METHYLATION, DIETARY-INTAKE, RAT-LIVER, POLYMORPHISMS, B12, biology, colorectal cancer risk, business.industry, Case-control study, Cancer, Middle Aged, medicine.disease, Vitamin B 6, B vitamins, Vitamin B 12, Endocrinology, Methylenetetrahydrofolate reductase, Case-Control Studies, biology.protein, B6, Female, B2, business, Colorectal Neoplasms, Cohort study
Abstract

Background: B-vitamins are essential for one-carbon metabolism and have been linked to colorectal cancer. Although associations with folate have frequently been studied, studies on other plasma vitamins B2, B6, and B12 and colorectal cancer are scarce or inconclusive. Methods: We carried out a nested case-control study within the European Prospective Investigation into Cancer and Nutrition, including 1,365 incident colorectal cancer cases and 2,319 controls matched for study center, age, and sex. We measured the sum of B2 species riboflavin and flavin mononucleotide, and the sum of B6 species pyridoxal 5′-phosphate, pyridoxal, and 4-pyridoxic acid as indicators for vitamin B2 and B6 status, as well as vitamin B12 in plasma samples collected at baseline. In addition, we determined eight polymorphisms related to one-carbon metabolism. Relative risks for colorectal cancer were estimated using conditional logistic regression, adjusted for smoking, education, physical activity, body mass index, alcohol consumption, and intakes of fiber and red and processed meat. Results: The relative risks comparing highest to lowest quintile were 0.71 [95% confidence interval (95% CI), 0.56-0.91; Ptrend = 0.02] for vitamin B2, 0.68 (95% CI, 0.53-0.87; Ptrend Conclusions: Higher plasma concentrations of vitamins B2 and B6 are associated with a lower colorectal cancer risk. Impact: This European population-based study is the first to indicate that vitamin B2 is inversely associated with colorectal cancer, and is in agreement with previously suggested inverse associations of vitamin B6 with colorectal cancer. Cancer Epidemiol Biomarkers Prev; 19(10); 2549–61. ©2010 AACR.

Published
2010

8. Plasma folate, related genetic variants, and colorectal cancer risk in EPIC

Author

Elio Riboli, Klaus Meyer, Rudolf Kaaks, Eiliv Lund, Salvatore Panico, Françoise Clavel-Chapelon, Åse Fredriksen, Laudina Rodríguez, H. Bas Bueno-de-Mesquita, Sophie Morois, Richard Palmqvist, Guri Skeie, Teresa Norat, Carmen Navarro, Inger T. Gram, Kim Overvad, Jakob Linseisen, Stein Emil Vollset, Jannicke Igland, Miren Dorronsoro, Demosthenes Zilis, Nadia Slimani, Mazda Jenab, Bethany Van Guelpen, Paolo Vineis, Paolo Boffetta, Ulrika Ericson, Carlos A. González, Petra H.M. Peeters, Marie-Christine Boutron-Ruault, Franco Berrino, Eva Ardanaz, Fränzel J.B. Van Duijnhoven, Sheila Bingham, Anja Olsen, Antonia Trichopoulou, Rosario Tumino, Jonas Manjer, Kay-Tee Khaw, Cornelia Weikert, Carmen Enid Martínez, Simone J. P. M. Eussen, Tobias Pischon, Domenico Palli, Per Magne Ueland, Michael Katsoulis, Anne Tjønneland, Eussen, Sj, Vollset, Se, Igland, J, Meyer, K, Fredriksen, A, Ueland, Pm, Jenab, M, Slimani, N, Boffetta, P, Overvad, K, Tjønneland, A, Olsen, A, Clavel Chapelon, F, Boutron Ruault, Mc, Morois, S, Weikert, C, Pischon, T, Linseisen, J, Kaaks, R, Trichopoulou, A, Zilis, D, Katsoulis, M, Palli, D, Berrino, F, Vineis, P, Tumino, R, Panico, Salvatore, Peeters, Ph, Bueno de Mesquita, Hb, van Duijnhoven, Fj, Gram, It, Skeie, G, Lund, E, González, Ca, Martínez, C, Dorronsoro, M, Ardanaz, E, Navarro, C, Rodríguez, L, Van Guelpen, B, Palmqvist, R, Manjer, J, Ericson, U, Bingham, S, Khaw, Kt, Norat, T, Riboli, E., Eussen, S.J.P.M., Vollset, S.E., Igland, J., Meyer, K., Fredriksen, Å., Ueland, P.M., Jenab, M., Slimani, N., Boffetta, P., Overvad, K., Tjønneland, A., Olsen, A., Clavel-Chapelon, F., Boutron-Ruault, M.-C., Morois, S., Weikert, C., Pischon, T., Linseisen, J., Kaaks, R., Trichopoulou, A., Zilis, D., Katsoulis, M., Palli, D., Berrino, F., Vineis, P., Tumino, R., Panico, S., Peeters, P.H.M., Bueno-de-Mesquita, H.B., Van Duijnhoven, F.J.B., Gram, I.T., Skeie, G., Lund, E., González, C.A., Martínez, C., Dorronsoro, M., Ardanaz, E., Navarro, C., Rodríguez, L., Van Guelpen, B., Palmqvist, R., Manjer, J., Ericson, U., Bingham, S., Khaw, K.-T., and Norat, T.

Subjects
Adult, Male, Oncology, medicine.medical_specialty, Epidemiology, Colorectal cancer, colorectal cancer, Biology, medicine.disease_cause, Polymorphism, Single Nucleotide, Article, Methylenetetrahydrofolate reductase polymorphism, Nested case-control, Human methionine synthase, Carbon metabolic pathway, C677T MTHFR polymorphism, Colon-cancer, Folic-acid, Mass-spectrometry, Dietary patterns, Common mutation, Folic Acid, Risk Factors, Molecular genetics, Internal medicine, Genetic variation, medicine, Humans, Genetic Predisposition to Disease, Prospective Studies, Prospective cohort study, Methylenetetrahydrofolate Reductase (NADPH2), Aged, Aged, 80 and over, Genetics, Plasma folate, Case-control study, Middle Aged, Prognosis, medicine.disease, digestive system diseases, Survival Rate, Case-Control Studies, Methylenetetrahydrofolate reductase, Nested case-control study, biology.protein, Female, EPIC, Colorectal Neoplasms, Carcinogenesis
Abstract

Background: A potential dual role of folate in colorectal cancer (CRC) is currently subject to debate. We investigate the associations between plasma folate, several relevant folate-related polymorphisms, and CRC risk within the large European Prospective Investigation into Cancer and Nutrition cohort.Methods: In this nested case-control study, 1,367 incident CRC cases were matched to 2,325 controls for study center, age, and sex. Risk ratios (RR) were estimated with conditional logistic regression and adjusted for smoking, education, physical activity, and intake of alcohol and fiber.Results: Overall analyses did not reveal associations of plasma folate with CRC. The RR (95% confidence interval; Ptrend) for the fifth versus the first quintile of folate status was 0.94 (0.74-1.20; 0.44). The polymorphisms MTHFR677C→T, MTHFR1298A→C, MTR2756A→G, MTRR66A→G, and MTHFD11958G→A were not associated with CRC risk. However, in individuals with the lowest plasma folate concentrations, the MTHFR 677TT genotype showed a statistically nonsignificant increased CRC risk [RR (95% CI; Ptrend) TT versus CC = 1.39 (0.87-2.21); 0.12], whereas those with the highest folate concentrations showed a nonsignificant decreased CRC risk [RR TT versus CC = 0.74 (0.39-1.37); 0.34]. The SLC19A180G→A showed a positive association with CRC risk [RR AA versus GG 1.30 (1.06-1.59); Conclusions: This large European prospective multicenter study did not show an association of CRC risk with plasma folate status nor with MTHFR polymorphisms.Impact: Findings of the present study tend to weaken the evidence that folate plays an important role in CRC carcinogenesis. However, larger sample sizes are needed to adequately address potential gene-environment interactions. Cancer Epidemiol Biomarkers Prev; 19(5); 1328–40. ©2010 AACR.

Published
2010

9. Fruit, vegetables, and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition

Author

Petra H.M. Peeters, Domenico Palli, Carmen Navarro, Carla H. van Gils, Jonas Manjer, Corinne Casagrande, Mazda Jenab, Jakob Linseisen, Ute Nöthlings, Paolo Vineis, Martine M. Ros, Sheila Bingham, Anja Olsen, Miren Dorronsoro, Elio Riboli, Göran Berglund, Pietro Ferrari, Aurelio Barricarte, Nadia Slimani, Antonia Trichopoulou, Marie-Christine Boutron-Ruault, Dagrun Engeset, Salvatore Panico, Marga C. Ocké, Françoise Clavel-Chapelon, Sabina Sieri, Ole Thorlacius-Ussing, Dimitrios Trichopoulos, Sophie Morois, Timothy J. Key, Kim Overvad, Valentina Gallo, Carlos A. González, Rosario Tumino, Paolo Boffetta, Heiner Boeing, H. Bas Bueno-de-Mesquita, Kay-Tee Khaw, Anne Tjønneland, Teresa Norat, Laudina Rodríguez Suárez, Fränzel J. B. van Duijnhoven, Guri Skeie, Naomi E. Allen, Eiliv Lund, Rudolf Kaaks, Richard Palmqvist, Gesthimani Misirli, María José Sánchez, Göran Hallmans, Hendriek C. Boshuizen, Sabina Rinaldi, Van Duijnhoven, F.J.B., Bueno-De-Mesquita, H.B., Ferrari, P., Jenab, M., Boshuizen, H.C., Ros, M.M., Casagrande, C., Tjønneland, A., Olsen, A., Overvad, K., Thorlacius-Ussing, O., Clavel-Chapelon, F., Boutron-Ruault, M.-C., Morois, S., Kaaks, R., Linseisen, J., Boeing, H., Nöthlings, U., Trichopoulou, A., Trichopoulos, D., Misirli, G., Palli, D., Sieri, S., Panico, S., Tumino, R., Vineis, P., Peeters, P.H.M., Van Gils, C.H., Ocké, M.C., Lund, E., Engeset, D., Skeie, G., Suárez, L.R., González, C.A., Sánchez, M.-J., Dorronsoro, M., Navarro, C., Barricarte, A., Berglund, G., Manjer, J., Hallmans, G., Palmqvist, R., Bingham, S.A., Khaw, K.-T., Key, T.J., Allen, N.E., Boffetta, P., Slimani, N., Rinaldi, S., Gallo, V., Norat, T., Riboli, E., van Duijnhoven, Fj, Bueno De Mesquita, Hb, Ferrari, P, Jenab, M, Boshuizen, Hc, Ros, Mm, Casagrande, C, Tjønneland, A, Olsen, A, Overvad, K, Thorlacius Ussing, O, Clavel Chapelon, F, Boutron Ruault, Mc, Morois, S, Kaaks, R, Linseisen, J, Boeing, H, Nöthlings, U, Trichopoulou, A, Trichopoulos, D, Misirli, G, Palli, D, Sieri, S, Panico, Salvatore, Tumino, R, Vineis, P, Peeters, Ph, van Gils, Ch, Ocké, Mc, Lund, E, Engeset, D, Skeie, G, Suárez, Lr, González, Ca, Sánchez, Mj, Dorronsoro, M, Navarro, C, Barricarte, A, Berglund, G, Manjer, J, Hallmans, G, Palmqvist, R, Bingham, Sa, Khaw, Kt, Key, Tj, Allen, Ne, Boffetta, P, Slimani, N, Rinaldi, S, Gallo, V, and Norat, T

Subjects
Questionnaires, Oncology, Male, medicine.medical_specialty, Time Factors, Colorectal cancer, Medicine (miscellaneous), Environment, Gastroenterology, 03 medical and health sciences, Fruit vegetables colorectal cancer risk The European Prospective Investigation Cancer Nutrition, 0302 clinical medicine, Risk Factors, Internal medicine, Surveys and Questionnaires, Vegetables, medicine, Humans, ddc:610, Prospective Studies, Risk factor, Life Style, 030304 developmental biology, 2. Zero hunger, 0303 health sciences, Nutrition and Dietetics, Proportional hazards model, business.industry, Incidence (epidemiology), Incidence, Patient Selection, Hazard ratio, Smoking, Cancer, Reproducibility of Results, Colonoscopy, medicine.disease, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Diet, Europe, 030220 oncology & carcinogenesis, Fruit, Cohort, Female, business, Colorectal Neoplasms, Demography, Follow-Up Studies
Abstract

Background: A high consumption of fruit and vegetables is possibly associated with a decreased risk of colorectal cancer (CRC). However, the findings to date are inconsistent. Objective: We examined the relation between self-reported usual consumption of fruit and vegetables and the incidence of CRC. Design: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 452,755 subjects (131,985 men and 320,770 women) completed a dietary questionnaire in 1992-2000 and were followed up for cancer incidence and mortality until 2006. A multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HRs) and 95% CIs. Results: After an average follow-up of 8.8 y, 2,819 incident CRC cases were reported. Consumption of fruit and vegetables was inversely associated with CRC in a comparison of the highest with the lowest EPIC-wide quintile of consumption (HR: 0.86; 95% CI: 0.75, 1.00; P for trend = 0.04), particularly with colon cancer risk (HR: 0.76; 95% CI: 0.63, 0.91; P for trend < 0.01). Only after exclusion of the first 2 y of follow-up were these findings corroborated by calibrated continuous analyses for a 100-g increase in consumption: HRs of 0.95 (95% CI: 0.91, 1.00; P = 0.04) and 0.94 (95% CI: 0.89, 0.99; P = 0.02), respectively. The association between fruit and vegetable consumption and CRC risk was inverse in never and former smokers, but positive in current smokers. This modifying effect was found for fruit and vegetables combined and for vegetables alone (P for interaction < 0.01 for both). Conclusions: These findings suggest that a high consumption of fruit and vegetables is associated with a reduced risk of CRC, especially of colon cancer. This effect may depend on smoking status. © 2009 American Society for Nutrition.

Published
2009

10. Lifetime and baseline alcohol intake and risk of colon and rectal cancers in the European prospective investigation into cancer and nutrition (EPIC)

Author

Salvatore Panico, Marga C. Ocké, H. Bas Bueno-de-Mesquita, Carla H. van Gils, Teresa Norat, Antonio Agudo, Pilar Amiano, Göran Berglund, Mazda Jenab, Eva Ardanaz, Rudolf Kaaks, Jonas Manjer, Pietro Ferrari, Dolores C. López, Jakob Linseisen, Elio Riboli, Françoise Clavel-Chapelon, Sophie Morois, María José Sánchez, Mathieu Mazuir, Heiner Boeing, Rosario Tumino, Majken K. Jensen, Christina Kassapa, Marie-Christine Boutron-Ruault, Petra H.M. Peeters, Eiliv Lund, Paolo Vineis, Kim Overvad, Anja Olsen, Timothy J. Key, Paolo Boffetta, Giovanna Masala, Manuela M. Bergmann, Sabine Rohrmann, Vittorio Krogh, Nadia Slimani, Guri Skeie, Naomi E. Allen, Aurelie Moskal, José Ramón Quirós, Bethany Van Guelpen, Richard Palmqvist, Dimitra Kontopoulou, Anne Tjønneland, Sheila Bingham, Antonia Trichopoulou, Ferrari, P, Jenab, M, Norat, T, Moskal, A, Slimani, N, Olsen, A, Tjonneland, A, Overvad, K, Jensen, Mk, BOUTRON RUAULT, Mc, CLAVEL CHAPELON, F, Morois, S, Rohrmann, S, Linseisen, J, Boeing, H, Bergmann, M, Kontopoulou, D, Trichopoulou, A, Kassapa, C, Masala, G, Krogh, V, Vineis, P, Panico, Salvatore, Tumino, R, Gils, Ch, Peeters, P, BUENO DE MESQUITA, Hb, Ocke, Mc, Skeie, G, Lund, E, Agudo, A, Ardanaz, E, Lopez, Dc, Sanchez, Mj, Quiros, Jr, Amiano, P, Berglund, G, Manjer, J, Palmqvist, R, Guelpen, Bv, Allen, N, Key, T, Bingham, S, Mazuir, M, Boffetta, P, Kaaks, R, Riboli, E., Ferrari, P., Jenab, M., Norat, T., Moskal, A., Slimani, N., Olsen, A., Tjønneland, A., Overvad, K., Jensen, M.K., Boutron-Ruault, M.-C., Clavel-Chapelon, F., Morois, S., Rohrmann, S., Linseisen, J., Boeing, H., Bergmann, M., Kontopoulou, D., Trichopoulou, A., Kassapa, C., Masala, G., Krogh, V., Vineis, P., Panico, S., Tumino, R., Van Gils, C.H., Peeters, P., Bueno-de-Mesquita, H.B., Ocké, M.C., Skeie, G., Lund, E., Agudo, A., Ardanaz, E., López, D.C., Sanchez, M.-J., Quirós, J.R., Amiano, P., Berglund, G., Manjer, J., Palmqvist, R., Van Guelpen, B., Allen, N., Key, T., Bingham, S., Mazuir, M., Boffetta, P., and Kaaks, R.

Subjects
Oncology, Male, Cancer Research, medicine.medical_specialty, Time Factors, Alcohol intake and risk of colon and rectal cancers, Alcohol Drinking, Colorectal cancer, alcohol, lifetime exposure, colorectal cancer, prospective study, EPIC, Gastroenterology, Risk Factors, Internal medicine, Epidemiology, medicine, Humans, ddc:610, Risk factor, Prospective cohort study, Colonic disease, Sex Characteristics, business.industry, Rectal Neoplasms, Middle Aged, medicine.disease, European Prospective Investigation into Cancer and Nutrition, Europe, Nutrition Assessment, Colonic Neoplasms, Alcohol intake, Female, business
Abstract

Alcohol consumption may be associated with risk of colorectal cancer (CRC), but the epidemiological evidence for an association with specific anatomical subsites, types of alcoholic beverages and current vs. lifetime alcohol intake is inconsistent. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), 478,732 study subjects free of cancer at enrolment between 1992 and 2000 were followed up for an average of 6.2 years, during which 1,833 CRC cases were observed. Detailed information on consumption of alcoholic beverages at baseline (all cases) and during lifetime (1,447 CRC cases, 69% of the cohort) was collected from questionnaires. Cox proportional hazard models were used to examine the alcohol-CRC association. After adjustment for potential confounding factors, lifetime alcohol intake was significantly positively associated to CRC risk (hazard ratio, HR = 1.08, 95%CI = 1.04-1.12 for 15 g/day increase), with higher cancer risks observed in the rectum (HR = 1.12, 95%CI = 1.06-1.18) than distal colon (HR = 1.08, 95%CI = 1.01-1.16), and proximal colon (HR = 1.02, 95%CI = 0.92-1.12). Similar results were observed for baseline alcohol intake. When assessed by alcoholic beverages at baseline, the CRC risk for beer (HR = 1.38, 95%CI = 1.08-1.77 for 20-39.9 vs. 0.1-2.9 g/day) was higher than wine (HR = 1.21, 95%CI = 1.02-1.44), although the two risk estimates were not significantly different from each other. Higher HRs for baseline alcohol were observed for low levels of folate intake (1.13, 95%CI = 1.06-1.20 for 15 g/day increase) compared to high folate intake (1.03, 95%CI = 0.98-1.09). In this large European cohort, both lifetime and baseline alcohol consumption increase colon and rectum cancer risk, with more apparent risk increases for alcohol intakes greater than 30 g/day. © 2007 Wiley-Liss, Inc.

Published
2007

11. Smokeless tobacco (snus) use and colorectal cancer incidence and survival: Results from nine pooled cohorts

Author

Ylva Trolle Lagerros, Björn Gylling, Anders Knutsson, Weimin Ye, Marzieh Araghi, Maria Rosaria Galanti, Lars Alfredsson, Richard Palmqvist, Nancy L. Pedersen, Michael Lundberg, Zhiwei Liu, Per-Olof Östergren, Cecilia Magnusson, Patrik Wennberg, Jonas Manjer, Rino Bellocco, Gunnar Engström, Anton Lager, Margareta Norberg, Araghi, M, Galanti, M, Lundberg, M, Liu, Z, Ye, W, Lager, A, Engstrom, G, Manjer, J, Alfredsson, L, Knutsson, A, Norberg, M, Palmqvist, R, Gylling, B, Wennberg, P, Lagerros, Y, Bellocco, R, Pedersen, N, Ostergren, P, and Magnusson, C

Subjects
Oncology, Adult, Male, medicine.medical_specialty, Tobacco, Smokeless, Colorectal cancer, Colorectal Neoplasm, survival, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, 030212 general & internal medicine, Risk factor, Sweden, business.industry, Risk Factor, Incidence (epidemiology), Incidence, Public Health, Environmental and Occupational Health, General Medicine, Middle Aged, medicine.disease, Survival Analysis, Smokeless tobacco, snu, 030220 oncology & carcinogenesis, Snus, Survival Analysi, Cohort Studie, business, Colorectal Neoplasms, Human, Biomedical sciences
Abstract

Aims: Although smoking is considered to be an established risk factor for colorectal cancer, the current evidence on the association between smokeless tobacco and colorectal cancer is scant and inconclusive. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess this association. Methods: A total of 417,872 male participants from nine cohort studies across Sweden were followed up for incidence of colorectal cancer and death. Outcomes were ascertained through linkage to health registers. We used shared frailty models with random effects at the study level to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During 7,135,504 person-years of observation, 4170 men developed colorectal cancer. There was no clear association between snus use and colorectal cancer overall. Exclusive current snus users, however, had an increased risk of rectal cancer (HR 1.40: 95% CI 1.09, 1.79). There were no statistically significant associations between snus use and either all-cause or colorectal cancer-specific mortality after colorectal cancer diagnosis. Conclusions: Our findings, from a large sample, do not support any strong relationships between snus use and colorectal cancer risk and survival among men. However, the observed increased risk of rectal cancer is noteworthy, and in merit of further attention.

Published
2017

12. Meat, fish, and colorectal cancer risk: the European Prospective Investigation into cancer and nutrition

Author

Salvatore Panico, Emmanuelle Kesse, Pietro Ferrari, Bertrand Hémon, Anne Tjønneland, Eiliv Lund, Guri Skeie, Timothy J. Key, Kim Overvad, Göran Berglund, H. Bas Bueno-de-Mesquita, Carmen Navarro, Mazda Jenab, Teresa Norat, Iréne Mattisson, Nicholas E. Day, Carlos González, Dagrun Engeset, María José Sánchez, Marie-Christine Boutron-Ruault, Rudolf Kaaks, Françoise Clavel, Mathieu Mazuir, Elio Riboli, Petra H.M. Peeters, Yannis Tountas, Göran Hallmans, Manuela M. Bergmann, Anja Olsen, Sheila Bingham, Nadia Slimani, Antonia Trichopoulou, Richard Palmqvist, Dimitrios Trichopoulos, Heiner Boeing, Rosario Tumino, Jakob Linseisen, Franco Berrino, Paolo Vineis, Rodolfo Saracci, J. Ramón Quirós, Eva Ardanaz, Kay-Tee Khaw, Domenico Palli, Alexandra Nieters, Unit of Nutrition, Environment, and Cancer, Catalan Institute of Oncology, Nutrition Unit, MRC Dunn Human, Department of Clinical Epidemiology, Aarhus University Hospital, Department of Cardiology and Department of Clinical Epidemiology, Institute of Cancer Epidemiology, Danish Cancer Society, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke (DifE), Leibniz Association, Division of Clinical Epidemiology, Deutches Krebsforschungszentrum, Department of Hygiene and Epidemiology, University of Athens Medical School [Athens], Epidemiology Unit, Istituto Tumori, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Center, Department of Clinical and Experimental Medicine, Università degli studi di Napoli Federico II, Ragusa Cancer Registry, Azienda Ospedaliera Civile MP, University of Torino and CPO-Piemonte, Università degli studi di Torino (UNITO), Center for Nutrition and Health, National Institute of Public Health and Environment, Julius Center for Health Sciences and Primary Care, VU University Medical Center [Amsterdam], Institute of Community Medicine, University of Tromsø (UiT), Public Health Institute of Navarra, Department of Epidemiology, Epidemiology Department, Health Council of Murcia, Public Health and Health Planning Directorate, Andalusian School of Public Health [Granada], Malmö Diet and Cancer Study, Lund University [Lund], Department of Nutritional Research, Umeå University, Department of Medical Biosciences, Pathology, Strangeways Research Laboratory, Clinical Gerontology Unit, University of Cambridge [UK] (CAM), Cancer Research UK Epidemiology Unit, University of Oxford [Oxford], The work described in this article was carried out with financial support of the 'Europe Against Cancer Program' of the European Commission (SANCO), the Danish Cancer Society, German Cancer Aid, Ligue Nationale contre le Cancer, the 3M Company, INSERM, the German Cancer Research Center, the GermanFederal Ministry of Education and Research, the Dutch Ministry of Public Health, Welfare and Sports, the National Cancer Registry and the Regional Cancer Registries Amsterdam, East and Maastricht of The Netherlands, the Norwegian Cancer Society, the Norwegian Research Council, the Health Research Fund (FIS) of the Spanish Ministry of Health, the Greek Ministry of Health, the Greek Ministry of Education, the Italian Association for Research on Cancer, Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, and ISCIII, Red de Centros RCESP, C03/09, the Swedish Cancer Society, the Swedish Scientific Council, the Regional Government of Skane, Sweden, Cancer Research UK, the Medical Research Council, U.K., the Stroke Association, U.K., the British Heart Foundation, the Department of Health, U.K., the Food Standards Agency, U.K., and the Wellcome Trust, U.K., University of Naples Federico II = Università degli studi di Napoli Federico II, Università degli studi di Torino = University of Turin (UNITO), University of Oxford, Clavel-Chapelon, F., Norat, T, Bingham, S, Ferrari, P, Slimani, N, Jenab, M, Mazuir, M, Overvad, K, Olsen, A, Tjonneland, A, Clavel, F, BOUTRON RUAULT, Mc, Kesse, E, Boeing, H, Bergmann, Mm, Nieters, A, Linseisen, J, Trichopoulou, A, Trichopoulos, D, Tountas, Y, Berrino, F, Palli, D, Panico, Salvatore, Tumino, R, Vineis, P, BUENO DE MESQUITA, Hb, Peeters, Ph, Engeset, D, Lund, E, Skeie, G, Ardanaz, E, Gonzalez, C, Navarro, C, Quiros, Jr, Sanchez, Mj, Berglund, G, Mattisson, I, Hallmans, G, Palmqvist, R, Day, Ne, Khaw, Kt, Key, Tj, SAN JOAQUIN, M, Hemon, B, Saracci, R, Kaaks, R, and Riboli, E.

Subjects
Dietary Fiber, Male, Cancer Research, 030309 nutrition & dietetics, Colorectal cancer, MESH: Food Habits, Gastroenterology, Poultry, MESH: Proportional Hazards Models, 0302 clinical medicine, Risk Factors, MESH: Poultry, Surveys and Questionnaires, Odds Ratio, MESH: Animals, Prospective Studies, Prospective cohort study, 2. Zero hunger, MESH: Aged, MESH: Meat, 0303 health sciences, MESH: Middle Aged, MESH: Risk, Fishes, Absolute risk reduction, MESH: Life Style, Confounding Factors, Epidemiologic, Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Oncology, Research Design, 030220 oncology & carcinogenesis, Income, Red meat, Educational Status, Population study, Female, Colorectal Neoplasms, Adult, medicine.medical_specialty, Meat, [SDV.CAN]Life Sciences [q-bio]/Cancer, Risk Assessment, Article, MESH: Multivariate Analysis, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Animals, Humans, ddc:610, European Union, Risk factor, Life Style, Aged, Proportional Hazards Models, MESH: Humans, business.industry, MESH: Questionnaires, Cancer, MESH: Adult, Feeding Behavior, medicine.disease, MESH: Male, MESH: Odds Ratio, MESH: Prospective Studies, Surgery, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, MESH: Fishes, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Multivariate Analysis, MESH: Dietary Fiber, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Europe, business, MESH: Female, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, MESH: Colorectal Neoplasms
Abstract

Background: Current evidence suggests that high red meat intake is associated with increased colorectal cancer risk. High fish intake may be associated with a decreased risk, but the existing evidence is less convincing. Methods: We prospectively followed 478 040 men and women from 10 European countries who were free of cancer at enrollment between 1992 and 1998. Information on diet and lifestyle was collected at baseline. After a mean follow-up of 4.8 years, 1329 incident colorectal cancers were documented. We examined the relationship between intakes of red and processed meat, poultry, and fish and colorectal cancer risk using a proportional hazards model adjusted for age, sex, energy (nonfat and fat sources), height, weight, work-related physical activity, smoking status, dietary fiber and folate, and alcohol consumption, stratified by center. A calibration substudy based on 36 994 subjects was used to correct hazard ratios (HRs) and 95% confidence intervals (CIs) for diet measurement errors. All statistical tests were two-sided. Results: Colorectal cancer risk was positively associated with intake of red and processed meat (highest [>160 g/day] versus lowest [80 g/day versus

Published
2016

13. Educational level and risk of colorectal cancer in EPIC with specific reference to tumor location

Author

Aurelio Barricarte, Konstantinos K. Tsilidis, Domenico Palli, Philippos Orfanos, Carmen Navarro, Petra H.M. Peeters, Göran Hallmans, Salvatore Panico, Maria Jose Sanchez-Perez, Martin Almquist, Fränzel J.B. Van Duijnhoven, Nicholas J. Wareham, Ioulia Goufa, Birgit Teucher, Tonje Braaten, Anja Olsen, Tobias Pischon, H. Bas Bueno-de-Mesquita, Leila Lujan-Barroso, Traci Mouw, Anke M. Leufkens, Silvia Polidoro, Françoise Clavel-Chapelon, Valentina Gallo, Kim Overvad, Anne Tjønneland, Laudina Rodríguez, Guri Skeie, Rudolf Kaaks, Hendriek C. Boshuizen, Anton E. Kunst, Peter D. Siersema, Sophie Morois, Kay-Tee Khaw, Vittorio Krogh, Antonia Trichopoulou, Rosario Tumino, Marie-Christine Boutron-Ruault, Richard Palmqvist, Mazda Jenab, Sophia Zackrisson, Elio Riboli, APH - Amsterdam Public Health, Public and occupational health, Leufkens, Am, Van Duijnhoven, Fj, Boshuizen, Hc, Siersema, Pd, Kunst, Ae, Mouw, T, Tj?nneland, A, Olsen, A, Overvad, K, Boutron Ruault, Mc, Clavel Chapelon, F, Morois, S, Krogh, V, Tumino, R, Panico, Salvatore, Polidoro, S, Palli, D, Kaaks, R, Teucher, B, Pischon, T, Trichopoulou, A, Orfanos, P, Goufa, I, Peeters, Ph, Skeie, G, Braaten, T, Rodr?guez, L, Lujan Barroso, L, S?nchez P?rez, Mj, Navarro, C, Barricarte, A, Zackrisson, S, Almquist, M, Hallmans, G, Palmqvist, R, Tsilidis, Kk, Khaw, Kt, Wareham, N, Gallo, V, Jenab, M, Riboli, E, and Bueno de Mesquita, Hb

Subjects
Gerontology, Male, Cancer Research, Nutrition and Disease, Colorectal cancer, Wiskundige en Statistische Methoden - Biometris, deprivation, Cohort Studies, 0302 clinical medicine, Risk Factors, Voeding en Ziekte, Medicine, rectum, 030212 general & internal medicine, Prospective Studies, socioeconomic-status, Hazard ratio, Confounding, health, Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, nutrition, Oncology, 030220 oncology & carcinogenesis, Educational Status, Female, women, Colorectal Neoplasms, Adult, united-states, Lower risk, survival, 03 medical and health sciences, inequalities, Humans, Socioeconomic status, Mathematical and Statistical Methods - Biometris, VLAG, Aged, colon, business.industry, Proportional hazards model, medicine.disease, Confidence interval, digestive system diseases, Social Class, business, Demography, Follow-Up Studies
Abstract

Existing evidence is inconclusive on whether socioeconomic status (SES) and educational inequalities influence colorectal cancer (CRC) risk, and whether low or high SES/educational level is associated with developing CRC. The aim of our study was to investigate the relationship between educational level and CRC. We studied data from 400,510 participants in the EPIC (European Prospective Investigation into Cancer and Nutrition) study, of whom 2,447 developed CRC (colon: 1,551, rectum: 896, mean follow-up 8.3 years). Cox proportional hazard regression analysis stratified by age, gender and center, and adjusted for potential confounders were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). Relative indices of inequality (RII) for education were estimated using Cox regression models. We conducted separate analyses for tumor location, gender and geographical region. Compared with participants with college/university education, participants with vocational secondary education or less had a nonsignificantly lower risk of developing CRC. When further stratified for tumor location, adjusted risk estimates for the proximal colon were statistically significant for primary education or less (HR 0.73, 95% CI 0.57-0.94) and for vocational secondary education (HR 0.76, 95% CI 0.58-0.98). The inverse association between low education and CRC risk was particularly found in women and Southern Europe. These associations were statistically significant for CRC, for colon cancer and for proximal colon cancer. In conclusion, CRC risk, especially in the proximal colon, is lower in subjects with a lower educational level compared to those with a higher educational level. This association is most pronounced in women and Southern Europe

Published
2012

14. Pre-diagnostic anthropometry and survival after colorectal cancer diagnosis in Western European populations

Author

Fedirko, Veronika, Romieu, Isabelle, Aleksandrova, Krasimira, Pischon, Tobias, Trichopoulos, Dimitrios, Peeters, Petra H, Romaguera-Bosch, Dora, Bueno-de-Mesquita, H Bas, Dahm, Christina C, Overvad, Kim, Chirlaque, Maria-Dolores, Johansen, Christoffer, Bidstrup, Pernille Envold Hansen, Dalton, Susanne Oksbjerg, Gunter, Marc J, Wark, Petra A, Norat, Teresa, Halkjaer, Jytte, Tjønneland, Anne, Dik, Vincent K, Siersema, Peter D, Boutron-Ruault, Marie-Christine, Dossus, Laure, Bastide, Nadia, Kühn, Tilman, Kaaks, Rudolf, Boeing, Heiner, Trichopoulou, Antonia, Klinaki, Eleni, Katsoulis, Michalis, Pala, Valeria, Panico, Salvatore, Tumino, Rosario, Palli, Domenico, Vineis, Paolo, Weiderpass, Elisabete, Skeie, Guri, González, Carlos A, Sánchez, María-José, Barricarte, Aurelio, Amiano, Pilar, Quiros, J Ramon, Manjer, Jonas, Jirström, Karin, Ljuslinder, Ingrid, Palmqvist, Richard, Khaw, Kay-Tee, Wareham, Nick, Bradbury, Kathryn E, Stepien, Magdalena, Duarte-Salles, Talita, Riboli, Elio, Jenab, Mazda, Fedirko, V, Romieu, I, Aleksandrova, K, Pischon, T, Trichopoulos, D, Peeters, Ph, Romaguera Bosch, D, Bueno de Mesquita, Hb, Dahm, Cc, Overvad, K, Chirlaque, Md, Johansen, C, Bidstrup, Pe, Dalton, So, Gunter, Mj, Wark, Pa, Norat, T, Halkjaer, J, Tj?nneland, A, Dik, Vk, Siersema, Pd, Boutron Ruault, Mc, Dossus, L, Bastide, N, K?hn, T, Kaaks, R, Boeing, H, Trichopoulou, A, Klinaki, E, Katsoulis, M, Pala, V, Panico, Salvatore, Tumino, R, Palli, D, Vineis, P, Weiderpass, E, Skeie, G, Gonz?lez, Ca, S?nchez, Mj, Barricarte, A, Amiano, P, Quiros, Jr, Manjer, J, Jirstr?m, K, Ljuslinder, I, Palmqvist, R, Khaw, Kt, Wareham, N, Bradbury, Ke, Stepien, M, Duarte Salles, T, Riboli, E, and Jenab, M.

Subjects
Male, Anthropometry, Waist-Hip Ratio, Incidence, Adenocarcinoma, Middle Aged, Body Mass Index, Europe, Multivariate Analysis, Humans, Female, Obesity, Prospective Studies, Sex Distribution, Waist Circumference, Colorectal Neoplasms, Aged, Proportional Hazards Models
Abstract

General and abdominal adiposity are associated with a high risk of developing colorectal cancer (CRC), but the role of these exposures on cancer survival has been less studied. The association between pre-diagnostic anthropometric characteristics and CRC-specific and all-cause death was examined among 3,924 men and women diagnosed with CRC between 1992 and 2009 in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Multivariable Cox proportional hazards models were used to calculate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Over a mean follow-up period of 49 months, 1,309 deaths occurred of which 1,043 (79.7%) were due to CRC. In multivariable analysis, pre-diagnostic BMI ≥30 kg/m(2) was associated with a high risk for CRC-specific (HR = 1.26, 95% CI = 1.04-1.52) and all-cause (HR = 1.32, 95% CI = 1.12-1.56) death relative to BMI

Published
2014

15. Biomarker patterns of inflammatory and metabolic pathways are associated with risk of colorectal cancer: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author

Anne Tjønneland, Christina Bamia, Aurelio Barricarte, Laure Dossus, Petra H.M. Peeters, Marc J. Gunter, Sabine Westhpal, Antonia Trichopoulou, Sabina Rinaldi, Ruth C. Travis, Veronika Fedirko, Fränzel J.B. Van Duijnhoven, J. Ramón Quirós, Kay-Tee Khaw, Philippos Orfanos, Rudolf Kaaks, Krasimira Aleksandrova, Richard Palmqvist, Neil Murphy, Esther Molina-Montes, Eric J. Duell, Eugene Jansen, Jytte Halkjær, Nicholas J. Wareham, Tobias Pischon, Mazda Jenab, Antoine Racine, María Dolores Chirlaque, Domenico Palli, Claudia Agnoli, Miren Dorronsoro, Pietro Ferrari, Heiner Boeing, Kim Overvad, Rosario Tumino, Elio Riboli, Ingrid Ljuslinder, Marie-Christine Boutron-Ruault, Salvatore Panico, Annekatrin Lukanova, H. Bas Bueno-de-Mesquita, Isabelle Romieu, Paolo Vineis, Aleksandrova, K, Jenab, M, Bueno de Mesquita, Hb, Fedirko, V, Kaaks, R, Lukanova, A, van Duijnhoven, Fj, Jansen, E, Rinaldi, S, Romieu, I, Ferrari, P, Murphy, N, Gunter, Mj, Riboli, E, Westhpal, S, Overvad, K, Tj?nneland, A, Halkj?r, J, Boutron Ruault, Mc, Dossus, L, Racine, A, Trichopoulou, A, Bamia, C, Orfanos, P, Agnoli, C, Palli, D, Panico, Salvatore, Tumino, R, Vineis, P, Peeters, Ph, Duell, Ej, Molina Montes, E, Quir?s, Jr, Dorronsoro, M, Chirlaque, Md, Barricarte, A, Ljuslinder, I, Palmqvist, R, Travis, Rc, Khaw, Kt, Wareham, N, Pischon, T, and Boeing, H.

Subjects
Oncology, Male, Nutrition and Disease, multiple imputation, Epidemiology, hdl-cholesterol, Rate ratio, adipose-tissue, Body Mass Index, chemistry.chemical_compound, c-reactive protein, Risk Factors, Voeding en Ziekte, plasma adiponectin, oxidative stress, Prospective Studies, Prospective cohort study, Incidence, density-lipoprotein cholesterol, Middle Aged, Prognosis, European Prospective Investigation into Cancer and Nutrition, Europe, C-Reactive Protein, Biomarker (medicine), Female, Colorectal Neoplasms, Metabolic Networks and Pathways, medicine.medical_specialty, binding-proteins, insulin-resistance, soluble leptin receptor, Adipokines, Internal medicine, medicine, Biomarkers, Tumor, Humans, Triglycerides, VLAG, Aged, Glycated Hemoglobin, Inflammation, Leptin receptor, Adiponectin, business.industry, Case-control study, Endocrinology, Logistic Models, chemistry, Socioeconomic Factors, Case-Control Studies, Glycated hemoglobin, business
Abstract

A number of biomarkers of inflammatory and metabolic pathways are individually related to higher risk of colorectal cancer (CRC); however, the association between biomarker patterns and CRC incidence has not been previously evaluated. Our study investigates the association of biomarker patterns with CRC in a prospective nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC). During median follow-up time of 7.0 (3.7-9.4) years, 1,260 incident CRC cases occurred and were matched to 1,260 controls using risk-set sampling. Pre-diagnostic measurements of C-peptide, glycated hemoglobin, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP), reactive oxygen metabolites (ROM), insulin-like growth factor 1, adiponectin, leptin and soluble leptin receptor (sOB-R) were used to derive biomarker patterns from principal component analysis (PCA). The relation with CRC incidence was assessed using conditional logistic regression models. We identified four biomarker patterns 'HDL-C/Adiponectin fractions', 'ROM/CRP', 'TG/C-peptide' and 'leptin/sOB-R' to explain 60% of the overall biomarker variance. In multi-variable-adjusted logistic regression, the 'HDL-C/Adiponectin fractions', 'ROM/CRP' and 'leptin/sOB-R' patterns were associated with CRC risk [for the highest quartile vs the lowest, incidence rate ratio (IRR) = 0.69, 95% CI 0.51-0.93, P-trend = 0.01; IRR = 1.70, 95% CI 1.30-2.23, P-trend = 0.002; and IRR = 0.79, 95% CI 0.58-1.07; P-trend = 0.05, respectively]. In contrast, the 'TG/C-peptide' pattern was not associated with CRC risk (IRR = 0.75, 95% CI 0.56-1.00, P-trend = 0.24). After cases within the first 2 follow-up years were excluded, the 'ROM/CRP' pattern was no longer associated with CRC risk, suggesting potential influence of preclinical disease on these associations. By application of PCA, the study identified 'HDL-C/Adiponectin fractions', 'ROM/CRP' and 'leptin/sOB-R' as biomarker patterns representing potentially important pathways for CRC development. © Springer Science+Business Media 2014.

Published
2013

16. Plasma alkylresorcinols, biomarkers of whole-grain wheat and rye intake, and incidence of colorectal cancer

Author

Kyrø, Cecilie, Olsen, Anja, Landberg, Rikard, Skeie, Guri, Loft, Steffen, Åman, Per, Leenders, Max, Dik, Vincent K., Siersema, Peter D., Pischon, Tobias, Christensen, Jane, Overvad, Kim, Boutron-Ruault, Marie Christine, Fagherazzi, Guy, Cottet, Vanessa, Kühn, Tilman, Chang-Claude, Jenny, Boeing, Heiner, Trichopoulou, Antonia, Bamia, Christina, Trichopoulos, Dimitrios, Palli, Domenico, Krogh, Vittorio, Tumino, Rosario, Vineis, Paolo, Panico, Salvatore, Peeters, Petra H., Weiderpass, Elisabete, Bakken, Toril, Åsli, Lene Angell, Argüelles, Marcial, Jakszyn, Paula, Sánchez, María José, Amiano, Pilar, Huerta, José María, Barricarte, Aurelio, Ljuslinder, Ingrid, Palmqvist, Richard, Khaw, Kay Tee, Wareham, Nick, Key, Timothy J., Travis, Ruth C., Ferrari, Pietro, Freisling, Heinz, Jenab, Mazda, Gunter, Marc J., Murphy, Neil, Riboli, Eilo, Tjønneland, Anne, Bueno-De-Mesquita, H. B., LS IRAS EEPI GRA (Gezh.risico-analyse), IRAS RATIA-SIB, Risk Assessment of Toxic and Immunomodulatory Agents, Kyr?, C, Olsen, A, Landberg, R, Skeie, G, Loft, S, Aman, P, Leenders, M, Dik, Vk, Siersema, Pd, Pischon, T, Christensen, J, Overvad, K, Boutron Ruault, Mc, Fagherazzi, G, Cottet, V, K?hn, T, Chang Claude, J, Boeing, H, Trichopoulou, A, Bamia, C, Trichopoulos, D, Palli, D, Krogh, V, Tumino, R, Vineis, P, Panico, Salvatore, Peeters, Ph, Weiderpass, E, Bakken, T, Asli, La, Arg?elles, M, Jakszyn, P, S?nchez, Mj, Amiano, P, Huerta, Jm, Barricarte, A, Ljuslinder, I, Palmqvist, R, Khaw, Kt, Wareham, N, Key, Tj, Travis, Rc, Ferrari, P, Freisling, H, Jenab, M, Gunter, Mj, Murphy, N, Riboli, E, Tj?nneland, A, Bueno de Mesquita, Hb, LS IRAS EEPI GRA (Gezh.risico-analyse), IRAS RATIA-SIB, and Risk Assessment of Toxic and Immunomodulatory Agents

Subjects
Male, medicine.medical_specialty, Pathology, Cancer Research, Colorectal cancer, Scandinavian and Nordic Countries, Rate ratio, Gastroenterology, Body Mass Index, Alkylresorcinol, Risk Factors, Internal medicine, Odds Ratio, Medicine, Humans, Triticum, Aged, Cancer och onkologi, business.industry, Mediterranean Region, Incidence (epidemiology), Incidence, Secale, Case-control study, food and beverages, Cancer, Odds ratio, Feeding Behavior, Resorcinols, Middle Aged, medicine.disease, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Logistic Models, Oncology, Cardiovascular and Metabolic Diseases, Cancer and Oncology, Case-Control Studies, Female, business, Colorectal Neoplasms, Biomarkers
Abstract

Background Few studies have investigated the association between whole-grain intake and colorectal cancer. Because whole-grain intake estimation might be prone to measurement errors, more objective measures (eg, biomarkers) could assist in investigating such associations. Methods The association between alkylresorcinols, biomarkers of whole-grain rye and wheat intake, and colorectal cancer incidence were investigated using prediagnostic plasma samples from colorectal cancer case patients and matched control subjects nested within the European Prospective Investigation into Cancer and Nutrition. We included 1372 incident colorectal cancer case patients and 1372 individual matched control subjects and calculated the incidence rate ratios (IRRs) for overall and anatomical subsites of colorectal cancer using conditional logistic regression adjusted for potential confounders. Regional differences (Scandinavia, the Mediterranean, Central Europe) were also explored. Results High plasma total alkylresorcinol concentration was associated with lower incidence of distal colon cancer; the adjusted incidence rate ratio of distal colon cancer for the highest vs lowest quartile of plasma total alkylresorcinols was 0.48 (95% confidence interval [CI] = 0.28 to 0.83). An inverse association between plasma total alkylresorcinol concentrations and colon cancer was found for Scandinavian participants (IRR per doubling = 0.83; 95% CI = 0.70 to 0.98). However, plasma total alkylresorcinol concentrations were not associated with overall colorectal cancer, proximal colon cancer, or rectal cancer. Plasma alkylresorcinols concentrations were associated with colon and distal colon cancer only in Central Europe and Scandinavia (ie, areas where alkylresorcinol levels were higher). Conclusions High concentrations of plasma alkylresorcinols were associated with a lower incidence of distal colon cancer but not with overall colorectal cancer, proximal colon cancer, and rectal cancer.

Published
2013

17. Mediterranean diet and colorectal cancer risk: results from a European cohort

Author

Timothy J. Key, Domenico Palli, Isabelle Romieu, Brian Buijsse, Alessio Naccarati, Veronika Fedirko, Pagona Lagiou, Miren Dorronsoro, Kay-Tee Khaw, Richard Palmqvist, Petra H.M. Peeters, Fränzel J.B. Van Duijnhoven, Anja Olsen, Eiliv Lund, Guri Skeie, Christina C. Dahm, Christina Bamia, Anne Tjønneland, Sara Grioni, Sophie Morois, Claudia Agnoli, Kim Overvad, Dimitrios Trichopoulos, George Adarakis, Dagrun Engeset, Nicholas J. Wareham, Verena A. Grote, Antonia Trichopoulou, Dora Romaguera, Rosario Tumino, María José Sánchez, Heiner Boeing, Genevieve Buckland, Salvatore Panico, Vanessa Cottet, Birgit Teucher, Aurelio Barricarte, Mazda Jenab, J. Ramón Quirós, Isabel Drake, José María Huerta, H. Bas Bueno-de-Mesquita, Teresa Norat, Marie-Christine Boutron-Ruault, Aliki J. Taylor, Ingrid Ljuslinder, Bamia, C, Lagiou, P, Buckland, G, Grioni, S, Agnoli, C, Taylor, Aj, Dahm, Cc, Overvad, K, Olsen, A, Tj?nneland, A, Cottet, V, Boutron Ruault, Mc, Morois, S, Grote, V, Teucher, B, Boeing, H, Buijsse, B, Trichopoulos, D, Adarakis, G, Tumino, R, Naccarati, A, Panico, Salvatore, Palli, D, Bueno de Mesquita, Hb, van Duijnhoven, Fj, Peeters, Ph, Engeset, D, Skeie, G, Lund, E, S?nchez, Mj, Barricarte, A, Huerta, Jm, Quir?s, Jr, Dorronsoro, M, Ljuslinder, I, Palmqvist, R, Drake, I, Key, Tj, Khaw, Kt, Wareham, N, Romieu, I, Fedirko, V, Jenab, M, Romaguera, D, Norat, T, and Trichopoulou, A.

Subjects
Gerontology, Mediterranean diet, Nutrition and Disease, Epidemiology, population, Diet, Mediterranean, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Voeding en Ziekte, Medicine, Prospective Studies, 030212 general & internal medicine, adherence, Prospective cohort study, physical-activity, education.field_of_study, Incidence, Hazard ratio, health, Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, nutrition, 030220 oncology & carcinogenesis, Cohort, Female, epic cohort, Colorectal Neoplasms, Cohort study, metaanalysis, Adult, Population, survival, White People, 03 medical and health sciences, rectal cancers, Confidence Intervals, Humans, patterns, Sex Distribution, education, Aged, Proportional Hazards Models, VLAG, business.industry, Proportional hazards model, Socioeconomic Factors, business, Follow-Up Studies, Demography
Abstract

The authors investigated the association of adherence to Mediterranean diet with colorectal cancer (CRC) risk in the European Prospective Investigation into Cancer and nutrition study. Adherence to Mediterranean diet was expressed through two 10-unit scales, the Modified Mediterranean diet score (MMDS) and the Centre-Specific MMDS (CSMMDS). Both scales share the same dietary components but differ in the cut-off values that were used for these components in the construction of the scales. Adjusted hazard ratios (HR) for the associations of these scales with CRC incidence were estimated. After 5,296,617 person-years of follow-up, 4,355 incident CRC cases were identified. A decreased risk of CRC, of 8 and 11 % was estimated when comparing the highest (scores 6-9) with the lowest (scores 0-3) adherence to CSMMDS and MMDS respectively. For MMDS the HR was 0.89 (95 % confidence interval (CI): 0.80, 0.99). A 2-unit increment in either Mediterranean scale was associated with a borderline statistically significant 3 to 4 % reduction in CRC risk (HR for MMDS: 0.96; 95 % CI: 0.92, 1.00). These associations were somewhat more evident, among women, were mainly manifested for colon cancer risk and their magnitude was not altered when alcohol was excluded from MMDS. These findings suggest that following a Mediterranean diet may have a modest beneficial effect on CRC risk.

Published
2013

18. Consumption of Dairy Products and Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author

Salvatore Panico, Eiliv Lund, Petra H.M. Peeters, Marc J. Gunter, Pagona Lagiou, Paolo Vineis, Ingegerd Johansson, Martin Almquist, Veronika Fedirko, Bas Bueno-de-Mesquita, Kay-Tee Khaw, Francesca L. Crowe, Rudolf Kaaks, Pietro Ferrari, Teresa Norat, Carmen Navarro, Neil Murphy, Richard Palmqvist, Timothy J. Key, Rosario Tumino, Guri Skeie, Birgit Teucher, Jonas Manjer, Christina C. Dahm, Marie-Christine Boutron-Ruault, Raul Zamora-Ros, Françoise Clavel-Chapelon, María José Sánchez Pérez, Elio Riboli, Eva Ardanaz, Anja Olsen, Nicholas J. Wareham, Antonia Trichopoulou, Elisabete Weiderpass, Manuela M. Bergmann, Vincent K. Dik, Mazda Jenab, Anne Tjønneland, Dimitrios Trichopoulos, Jose Ramon Quiros Garcia, Kim Overvad, Valeria Pala, Domenico Palli, Laura Nailler, Miren Dorronsoro, Heiner Boeing, Murphy, N, Norat, T, Ferrari, P, Jenab, M, Bueno de Mesquita, B, Skeie, G, Olsen, A, Tj?nneland, A, Dahm, Cc, Overvad, K, Boutron Ruault, Mc, Clavel Chapelon, F, Nailler, L, Kaaks, R, Teucher, B, Boeing, H, Bergmann, Mm, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Palli, D, Pala, V, Tumino, R, Vineis, P, Panico, Salvatore, Peeters, Ph, Dik, Vk, Weiderpass, E, Lund, E, Garcia, Jr, Zamora Ros, R, P?rez, Mj, Dorronsoro, M, Navarro, C, Ardanaz, E, Manjer, J, Almquist, M, Johansson, I, Palmqvist, R, Khaw, Kt, Wareham, N, Key, Tj, Crowe, Fl, Fedirko, V, Gunter, Mj, and Riboli, E.

Subjects
Male, Non-Clinical Medicine, Colorectal cancer, Epidemiology, lcsh:Medicine, 0302 clinical medicine, Cheese, Epidemiology of cancer, Gastrointestinal Cancers, Medicine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, lcsh:Science, 2. Zero hunger, Multidisciplinary, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Cancer Risk Factors, Hazard ratio, Middle Aged, Metaanalysis, Yogurt, European Prospective Investigation into Cancer and Nutrition, Multidisciplinary Sciences, Milk, Health Education and Awareness, Oncology, Nutritional Correlates of Cancer, 030220 oncology & carcinogenesis, Observational Studies, Science & Technology - Other Topics, Female, Public Health, Colorectal Neoplasms, Cancer Prevention, Dietary calcium, Cancer Epidemiology, Research Article, medicine.medical_specialty, Colon-cancer, food.ingredient, Clinical Research Design, Health Informatics, Gastroenterology and Hepatology, 03 medical and health sciences, food, Internal medicine, Skimmed milk, Animals, Humans, Aged, Nutrition, Gynecology, Cancer och onkologi, Cancer prevention, Health Care Policy, Science & Technology, business.industry, Proportional hazards model, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Oncology: 762, lcsh:R, Health Risk Analysis, Milk-products, medicine.disease, Calcium, Dietary, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Onkologi: 762, Cancer and Oncology, Vitamin-D, lcsh:Q, Surgery, Dairy Products, Preventive Medicine, Health Statistics, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, Clinical Medicine, business
Abstract

Background: Prospective studies have consistently reported lower colorectal cancer risks associated with higher intakes of total dairy products, total milk and dietary calcium. However, less is known about whether the inverse associations vary for individual dairy products with differing fat contents. Materials and Methods: In the European Prospective Investigation into Cancer and Nutrition (EPIC), we investigated the associations between intakes of total milk and milk subtypes (whole-fat, semi-skimmed and skimmed), yoghurt, cheese, and dietary calcium with colorectal cancer risk amongst 477,122 men and women. Dietary questionnaires were administered at baseline. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusted for relevant confounding variables. Results: During the mean 11 years of follow-up, 4,513 incident cases of colorectal cancer occurred. After multivariable adjustments, total milk consumption was inversely associated with colorectal cancer risk (HR per 200 g/day 0.93, 95% CI: 0.89-0.98). Similar inverse associations were observed for whole-fat (HR per 200 g/day 0.90, 95% CI: 0.82-0.99) and skimmed milk (HR per 200 g/day 0.90, 95% CI: 0.79-1.02) in the multivariable models. Inverse associations were observed for cheese and yoghurt in the categorical models; although in the linear models, these associations were non-significant. Dietary calcium was inversely associated with colorectal cancer risk (HR per 200 mg/day 0.95, 95% CI: 0.91-0.99); this association was limited to dairy sources of calcium only (HR per 200 mg/day 0.95, 95% CI: 0.91-0.99), with no association observed for non-dairy calcium sources (HR per 200 mg/day 1.00, 95% CI: 0.81-1.24). Conclusions: Our results strengthen the evidence for a possible protective role of dairy products on colorectal cancer risk. The inverse associations we observed did not differ by the fat content of the dairy products considered.

Published
2013

19. Biomarkers of Oxidative Stress and Risk of Developing Colorectal Cancer:A Cohort-nested Case-Control Study in the European Prospective Investigation Into Cancer and Nutrition

Author

Kim Overvad, Elio Riboli, Krasimira Aleksandrova, Nicholas J. Wareham, Domenico Palli, Rosario Tumino, Miren Dorronsoro, Rudolf Kaaks, Valeria Pala, Petra H.M. Peeters, Françoise Clavel-Chapelon, Kay-Tee Khaw, María José Sánchez, Fränzel J.B. Van Duijnhoven, Francesca L. Crowe, Eva Ardanaz, Tobias Pischon, Anja Olsen, Veronika Fedirko, Peter D. Siersema, Heiner Boeing, Mazda Jenab, Paolo Vineis, Anne Tjønneland, José María Huerta, Annekatrin Lukanova, Sophie Morois, H. Bas Bueno-de-Mesquita, Dimitrios Trichopoulos, Teresa Norat, Carlos González, Göran Hallmans, Richard Palmqvist, Vardis Dilis, Eugene Jansen, Antonia Trichopoulou, Salvatore Panico, Sjoukje H.S. Woudt, Anke M. Leufkens, Guri Skeie, Naomi E. Allen, Marie-Christine Boutron-Ruault, Marcial Argüelles, Leufkens, Am, van Duijnhoven, Fj, Woudt, Sh, Siersema, Pd, Jenab, M, Jansen, Eh, Pischon, T, Tj?nneland, A, Olsen, A, Overvad, K, Boutron Ruault, Mc, Clavel Chapelon, F, Morois, S, Palli, D, Pala, V, Tumino, R, Vineis, P, Panico, Salvatore, Kaaks, R, Lukanova, A, Boeing, H, Aleksandrova, K, Trichopoulou, A, Trichopoulos, D, Dilis, V, Peeters, Ph, Skeie, G, Gonz?lez, Ca, Arg?elles, M, S?nchez, Mj, Dorronsoro, M, Huerta, Jm, Ardanaz, E, Hallmans, G, Palmqvist, R, Khaw, Kt, Wareham, N, Allen, Ne, Crowe, Fl, Fedirko, V, Norat, T, Riboli, E, and Bueno de Mesquita, Hb

Subjects
Oncology, Adult, Male, medicine.medical_specialty, Epidemiology, Rate ratio, Risk Factors, Internal medicine, medicine, Humans, Risk factor, Aged, business.industry, Incidence, Case-control study, Cancer, Middle Aged, medicine.disease, Surgery, European Prospective Investigation into Cancer and Nutrition, Diet, Europe, Oxidative Stress, Logistic Models, Case-Control Studies, Cohort, Nested case-control study, population characteristics, Female, business, Colorectal Neoplasms, Reactive Oxygen Species, Biomarkers, Cohort study
Abstract

Oxidative stress has been shown to play an important role in carcinogenesis, but prospective evidence for an association between biomarkers of oxidative stress and colorectal cancer (CRC) risk is limited. The authors investigated the association between prediagnostic serum levels of oxidative stress indicators (i.e., reactive oxygen metabolites (ROM) and ferric reducing ability of plasma (FRAP)) and CRC risk. This was examined in a nested case-control study (1,064 CRC cases, 1,064 matched controls) in the European Prospective Investigation Into Cancer and Nutrition cohort (1992-2003). Incidence rate ratios and 95% confidence intervals were calculated using conditional logistic regression analyses. ROM were associated with overall CRC risk (highest tertile vs. lowest: adjusted incidence rate ratio (IRR(adj)) = 1.91, 95% confidence interval (CI): 1.47, 2.48), proximal (IRR(adj) = 1.89, 95% CI: 1.06, 3.36) and distal (IRR(adj) = 2.31, 95% CI: 1.37, 3.89) colon cancer, and rectal cancer (IRR(adj) = 1.69, 95% CI: 1.05, 2.72). When results were stratified by tertile of follow-up time, the association remained significant only in participants with less than 2.63 years of follow-up (IRR(adj) = 2.28, 95% CI: 1.78, 2.94; P-heterogeneity < 0.01). FRAP was not associated with CRC risk. In conclusion, prediagnostic serum ROM levels were associated with increased risk of CRC. However, this association was seen only in subjects with relatively short follow-up, suggesting that the association results from production of reactive oxygen species by preclinical tumors.

Published
2012

20. Prediagnostic 25-hydroxyvitamin D, VDR and CASR polymorphisms, and survival in patients with colorectal cancer in western European ppulations

Author

Christina C. Dahm, Göran Hallmans, Mazda Jenab, Birgit Teucher, Sara Grioni, Guri Skeie, Eugene Jansen, Elio Riboli, Françoise Clavel-Chapelon, Antoine Racine, Miren Dorronsoro, Salvatore Panico, Vassiliki Benetou, Fränzel J.B. Van Duijnhoven, Francesca L. Crowe, Anja Olsen, Richard Palmqvist, Kim Overvad, Catalina Bonet, Petra H.M. Peeters, José Ramón Quirós, Nicholas J. Wareham, Pietro Ferrari, Antonia Trichopoulou, Magritt Brustad, Heiner Boeing, Aurelio Barricarte, Petra A. Wark, Marie-Christine Boutron-Ruault, Maria Dolores Chirlaque, María José Sánchez, Dora Romaguera, Rosario Tumino, Peter D. Siersema, Paolo Vineis, Dimitrios Trichopoulos, Anne Tjønneland, Veronika Fedirko, Annekatrin Lukanova, H. Bas Bueno-de-Mesquita, Teresa Norat, James McKay, Isabelle Romieu, Kay-Tee Khaw, Krasimira Aleksandrova, Timothy J. Key, Domenico Palli, Fedirko, V, Riboli, E, Tj?nneland, A, Ferrari, P, Olsen, A, Bueno de Mesquita, Hb, van Duijnhoven, Fj, Norat, T, Jansen, Eh, Dahm, Cc, Overvad, K, Boutron Ruault, Mc, Clavel Chapelon, F, Racine, A, Lukanova, A, Teucher, B, Boeing, H, Aleksandrova, K, Trichopoulou, A, Benetou, V, Trichopoulos, D, Grioni, S, Vineis, P, Panico, Salvatore, Palli, D, Tumino, R, Siersema, Pd, Peeters, Ph, Skeie, G, Brustad, M, Chirlaque, Md, Barricarte, A, Ram?n Quir?s, J, S?nchez, Mj, Dorronsoro, M, Bonet, C, Palmqvist, R, Hallmans, G, Key, Tj, Crowe, F, Khaw, Kt, Wareham, N, Romieu, I, Mckay, J, Wark, Pa, Romaguera, D, and Jenab, M.

Subjects
Oncology, Male, Nutrition and Disease, Epidemiology, Colorectal cancer, Calcitriol receptor, 25-dihydroxyvitamin d-3, Polymerase Chain Reaction, prostate-cancer, Prostate cancer, Risk Factors, Voeding en Ziekte, Prospective Studies, Vitamin D, Prospective cohort study, physical-activity, risk, 1,25-dihydroxyvitamin d-3, Middle Aged, Prognosis, Survival Rate, Female, serum 25-hydroxyvitamin-d, Colorectal Neoplasms, colon-cancer, medicine.medical_specialty, Genotype, Lower risk, Article, Internal medicine, vitamin-d-receptor, medicine, Vitamin D and neurology, Humans, supplement use, neoplasms, Survival rate, VLAG, calcium, Polymorphism, Genetic, business.industry, Case-control study, DNA, medicine.disease, cell lung-cancer, digestive system diseases, Endocrinology, Case-Control Studies, Receptors, Calcitriol, business, Receptors, Calcium-Sensing, Follow-Up Studies
Abstract

Background: Individuals with higher blood 25-hydroxyvitamin D [25(OH)D] levels have a lower risk of developing colorectal cancer (CRC), but the influence of 25(OH)D on mortality after CRC diagnosis is unknown. Methods: The association between prediagnostic 25(OH)D levels and CRC-specific (N = 444) and overall mortality (N = 541) was prospectively examined among 1,202 participants diagnosed with CRC between 1992 and 2003 in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Multivariable Cox proportional hazards models were used to calculate HRs and corresponding 95% CIs according to 25(OH)D quintiles and genetic variation within the VDR and CASR genes. Potential dietary, lifestyle, and metabolic effect modifiers were also investigated. Results: There were 541 deaths, 444 (82%) due to CRC. Mean follow-up was 73 months. In multivariable analysis, higher 25(OH)D levels were associated with a statistically significant reduction in CRC-specific (Ptrend = 0.04) and overall mortality (Ptrend = 0.01). Participants with 25(OH)D levels in the highest quintile had an adjusted HR of 0.69 (95% CI: 0.50–0.93) for CRC-specific mortality and 0.67 (95% CI: 0.50–0.88) for overall mortality, compared with the lowest quintile. Except for a possible interaction by prediagnostic dietary calcium intake (Pinteraction = 0.01), no other potential modifying factors related to CRC survival were noted. The VDR (FokI and BsmI) and CASR (rs1801725) genotypes were not associated with survival. Conclusions: High prediagnostic 25(OH)D levels are associated with improved survival of patients with CRC. Impact: Our findings may stimulate further research directed at investigating the effects of blood vitamin D levels before, at, and after CRC diagnosis on outcomes in CRC patients. Cancer Epidemiol Biomarkers Prev; 21(4); 582–93. ©2012 AACR.

Published
2012

21. Circulating C-reactive protein concentrations and risks of colon and rectal cancer: a nested case-control study within the European Prospective Investigation into Cancer and Nutrition

Author

Kim Overvad, Dora Romaguera, Rosario Tumino, Domenico Palli, Sabine Rohrmann, Vittorio Krogh, Anne Tjønneland, Marie-Christine Boutron-Ruault, Göran Hallmans, F. Clavel-Chapelon, Paolo Vineis, Sabina Rinaldi, Pagona Lagiou, Sophie Morois, María José Sánchez, Anke M. Leufkens, H. Bas Bueno-de-Mesquita, Laudina Rodríguez, Christina C. Dahm, Antonia Trichopoulou, Teresa Norat, Carmen Navarro, Richard Palmqvist, Rudolf Kaaks, Mazda Jenab, Salvatore Panico, Elizabeth A Spencer, Tobias Pischon, Nicholas J. Wareham, Catalina Bonet, Aurelio Barricarte, Miren Dorronsoro, Dimitrios Trichopoulos, Naomi E. Allen, Elio Riboli, Eugene Jansen, Heiner Boeing, Petra H.M. Peeters, Fränzel J.B. Van Duijnhoven, Anja Olsen, Krasimira Aleksandrova, Kay-Tee Khaw, Aleksandrova, K, Jenab, M, Boeing, H, Jansen, E, Bueno de Mesquita, Hb, Rinaldi, S, Riboli, E, Overvad, K, Dahm, Cc, Olsen, A, Tjønneland, A, Boutron Ruault, Mc, Clavel Chapelon, F, Morois, S, Palli, D, Krogh, V, Tumino, R, Vineis, P, Panico, Salvatore, Kaaks, R, Rohrmann, S, Trichopoulou, A, Lagiou, P, Trichopoulos, D, van Duijnhoven, Fj, Leufkens, Am, Peeters, Ph, Rodríguez, L, Bonet, C, Sánchez, Mj, Dorronsoro, M, Navarro, C, Barricarte, A, Palmqvist, R, Hallmans, G, Khaw, Kt, Wareham, N, Allen, Ne, Spencer, E, Romaguera, D, Norat, T, and Pischon, T.

Subjects
Adult, Male, medicine.medical_specialty, Epidemiology, Colorectal cancer, Gastroenterology, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, Risk factor, 030304 developmental biology, Aged, 2. Zero hunger, Glycated Hemoglobin, 0303 health sciences, business.industry, Rectal Neoplasms, Incidence, Cholesterol, HDL, Cancer, Middle Aged, medicine.disease, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Menstrual cycle phase, Europe, Endocrinology, C-Reactive Protein, Logistic Models, 030220 oncology & carcinogenesis, Relative risk, Case-Control Studies, Nested case-control study, Colonic Neoplasms, Female, Metabolic syndrome, Waist Circumference, business, Biomarkers
Abstract

Udgivelsesdato: 2010-Jul-15 The authors investigated associations between serum C-reactive protein (CRP) concentrations and colon and rectal cancer risk in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (1992-2003) among 1,096 incident cases and 1,096 controls selected using risk-set sampling and matched on study center, age, sex, time of blood collection, fasting status, menopausal status, menstrual cycle phase, and hormone replacement therapy. In conditional logistic regression with adjustment for education, smoking, nutritional factors, body mass index, and waist circumference, CRP showed a significant nonlinear association with colon cancer risk but not rectal cancer risk. Multivariable-adjusted relative risks for CRP concentrations of >/=3.0 mg/L versus

Published
2010

22. Vitamin D receptor and calcium sensing receptor polymorphisms and the risk of colorectal cancer in European populations

Author

Petra H.M. Peeters, Anne Tjønneland, Philippe Autier, Heiner Boeing, Rudolf Kaaks, Pierre Engel, Françoise Clavel-Chapelon, Fränzel J.B. Van Duijnhoven, James McKay, Anja Olsen, Paolo Vineis, Jakob Linseisen, Aurelio Barricarte, Núria Sala, Elio Riboli, Alina Vrieling, Eva Fisher, Sheila Bingham, Antonia Trichopoulou, Tobias Pischon, Erifili Oustoglou, María Dolores Chirlaque, Graham Byrnes, Miren Dorronsoro, Esther Molina, Hendrik B. Bueno-de-Mesquita, Teresa Norat, Nadia Slimani, Marie-Christine Boutron-Ruault, Pietro Ferrari, Paolo Boffetta, Rosario Tumino, Kay-Tee Khaw, Kim Overvad, Giovanna Masala, Eiliv Lund, Timothy J. Key, Andrew W. Roddam, Mazda Jenab, Eugene Jansen, Göran Hallmans, Sabina Rinaldi, Richard Palmqvist, Vardis Dilis, Franco Berrino, Carla H. van Gils, Magritt Brustad, Laudina Rodríguez Suárez, Amalia Mattiello, Jenab, M., McKay, J., Bueno-De-Mesquita, H.B., Van Duijnhoven, F.J.B., Ferrari, P., Slimani, N., Jansen, E.H.J.M., Pischon, T., Rinaldi, S., Tjønneland, A., Olsen, A., Overvad, K., Boutron-Ruault, M.-C., Clavel-Chapelon, F., Engel, P., Kaaks, R., Linseisen, J., Boeing, H., Fisher, E., Trichopoulou, A., Dilis, V., Oustoglou, E., Berrino, F., Vineis, P., Mattiello, A., Masala, G., Tumino, R., Vrieling, A., Van Gils, C.H., Peeters, P.H., Brustad, M., Lund, E., Chirlaque, M.-D., Barricarte, A., Suárez, L.R., Molina, E., Dorronsoro, M., Sala, N., Hallmans, G., Palmqvist, R., Roddam, A., Key, T.J., Khaw, K.-T., Bingham, S., Boffetta, P., Autier, P., Byrnes, G., Norat, T., and Riboli, E.

Subjects
Male, Oncology, medicine.medical_specialty, Genotype, Epidemiology, Colorectal cancer, Population, Single-nucleotide polymorphism, Calcitriol receptor, White People, Internal medicine, medicine, Vitamin D and neurology, Humans, Genetic Predisposition to Disease, Vitamin D, education, Life Style, education.field_of_study, Polymorphism, Genetic, business.industry, Case-control study, Cancer, Middle Aged, medicine.disease, Vitamin D receptor calcium sensing receptor polymorphisms colorectal cancer European populations, European Prospective Investigation into Cancer and Nutrition, Calcium, Dietary, Europe, Endocrinology, Case-Control Studies, Receptors, Calcitriol, Female, Colorectal Neoplasms, business, Receptors, Calcium-Sensing
Abstract

Increased levels of vitamin D and calcium may play a protective role in colorectal cancer (CRC) risk. It has been suggested that these effects may be mediated by genetic variants of the vitamin D receptor (VDR) and the calcium sensing receptor (CASR). However, current epidemiologic evidence from European populations for a role of these genes in CRC risk is scarce. In addition, it is not clear whether these genes may modulate CRC risk independently or by interaction with blood vitamin D concentration and level of dietary calcium intake. A case-control study was conducted nested within the European Prospective Investigation into Cancer and Nutrition. CRC cases (1,248) were identified and matched to 1,248 control subjects. Genotyping for the VDR (BsmI: rs1544410; Fok1: rs2228570) and CASR (rs1801725) genes was done by Taqman, and serum vitamin D (25OHD) concentrations were measured. Conditional logistic regression was used to estimate the incidence rate ratio (RR). Compared with the wild-type bb, the BB genotype of the VDR BsmI polymorphism was associated with a reduced risk of CRC [RR, 0.76; 95% confidence interval (CI), 0.59-0.98). The association was observed for colon cancer (RR, 0.69; 95% CI, 0.45-0.95) but not rectal cancer (RR, 0.97; 95% CI, 0.62-1.49). The Fok1 and CASR genotypes were not associated with CRC risk in this study. No interactions were noted for any of the polymorphisms with serum 25OHD concentration or level of dietary calcium. These results confirm a role for the BsmI polymorphism of the VDR gene in CRC risk, independent of serum 25OHD concentration and dietary calcium intake. (Cancer Epidemiol Biomarkers Prev 2009;18(9):2485-91)

Published
2009

23. Serum C-peptide, IGFBP-1 and IGFBP-2 and risk of colon and rectal cancers in the European Prospective Investigation into Cancer and Nutrition

Author

Naomi E. Allen, Paolo Vineis, Salvatore Panico, Marga C. Ocké, H. Bas Bueno-de-Mesquita, Teresa Norat, Carine Biessy, Alexandra Nieters, José Ramón Quirós, Heiner Boeing, Henning Grønbæk, Eleni Oikonomou, Miren Dorronsoro, María José Tormo, Carla H. van Gils, Petra H. Peters, Kim Overvad, Carmen Martinez-Garcia, Göran Berglund, Kay-Tee Khaw, Giovanna Masala, Dimitrios Trichopoulos, Tobias Pischon, Michelle A. Mendez, Mazda Jenab, Rosario Tumino, Elio Riboli, Franco Berrino, Ann Tjønneland, Timothy J. Key, Jonas Manjer, Jakob Linseisen, Marie-Christine Boutron-Ruault, Rudolf Kaaks, Eiliv Lund, Françoise Clavel-Chapelon, Rebecca J. Cleveland, Anne E. Cust, Richard Palmqvist, Sheila Bingham, Antonia Trichopoulou, Anja Olsen, Göran Hallmans, Sabina Rinaldi, Aurelio Barricarte, Jenab, M, Riboli, E, Cleveland, Rj, Norat, T, Rinaldi, S, Nieters, A, Biessy, C, Tjonneland, A, Olsen, A, Overvad, K, Gronbaek, H, CLAVEL CHAPELON, F, BOUTRON RUAULT, Mc, Linseisen, J, Boeing, H, Pischon, T, Trichopoulos, D, Oikonomou, E, Trichopoulou, A, Panico, Salvatore, Vineis, P, Berrino, F, Tumino, R, Masala, G, Peters, Ph, VAN GILS, Ch, BUENO DE MESQUITA, Hb, Ocke, Mc, Lund, E, Mendez, Ma, Tormo, Mj, Barricarte, A, MARTINEZ GARCIA, C, Dorronsoro, M, Quiros, Jr, Hallmans, G, Palmqvist, R, Berglund, G, Manjer, J, Key, T, Allen, Ne, Bingham, S, Khaw, Kt, Cust, A, and Kaaks, R.

Subjects
Oncology, Adult, Male, insulin, Cancer Research, medicine.medical_specialty, Colorectal cancer, colorectal cancer, Body Mass Index, Insulin resistance, Risk Factors, Internal medicine, medicine, Hyperinsulinemia, Humans, ddc:610, Prospective Studies, IGF, Risk factor, Prospective cohort study, Aged, Aged, 80 and over, C-Peptide, business.industry, Rectal Neoplasms, Case-control study, Cancer, Middle Aged, medicine.disease, European Prospective Investigation into Cancer and Nutrition, Europe, Insulin-Like Growth Factor Binding Protein 1, Insulin-Like Growth Factor Binding Protein 2, C-peptide, EPIC, Endocrinology, Logistic Models, Case-Control Studies, Female, business, Follow-Up Studies
Abstract

Western style diets and lifestyles are associated with increasing rates of obesity, diabetes and insulin resistance. Higher circulating insulin levels may modulate cell proliferation and apoptosis either directly or indirectly by increasing the bioactivity of IGF-I and decreasing the bioactivity of some of its binding proteins. The objective of this study was to determine the association of increasing levels of serum C-peptide, a biomarker of pancreatic insulin secretion, and IGF binding proteins (IGFBP) -1 and -2 with colorectal cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 Western European countries. A total of 1,078 colorectal cancer cases were matched (age, date of blood donation, fasting status, gender, study center) to an equal number of control subjects. Relative cancer risks were estimated using conditional logistic regression models. Serum C-peptide concentration was positively associated with an increased colorectal cancer risk for the highest versus the lowest quintile (OR=1.56, 95% CI=1.16-2.09, p(trend)

Published
2007

24. Body size and risk of colon and rectal cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC)

Author

J. Ramón Quirós, Christine M. Friedenreich, Göran Berglund, Sheila Bingham, H. Bas Bueno-de-Mesquita, Antonia Trichopoulou, Teresa Norat, Rudolf Kaaks, Jakob Linseisen, Carmen Martinez, Françoise Clavel-Chapelon, Kim Overvad, Carmen Navarro, Petra H. Lahmann, Jytte Halkjær, Sabina Sieri, Miren Dorronsoro, Bethany Van Guelpen, Dimitrios Trichopoulos, Elio Riboli, Anne Tjønneland, Richard Palmqvist, Nadia Slimani, Hendriek C. Boshuizen, Petra H.M. Peeters, Manuela M. Bergmann, Tobias Pischon, Kay-Tee Khaw, Domenico Palli, Naomi E. Allen, Heiner Boeing, Rosario Tumino, Aurelio Barricarte, Paolo Vineis, Nikolaus Becker, Marie-Christine Boutron-Ruault, Salvatore Panico, Gregory Guernec, Carlos A. González, Pietro Ferrari, Andrew W. Roddam, Pischon, T, Lahmann, Ph, Boeing, H, Friedenreich, C, Norat, T, Tjonneland, A, Halkjaer, J, Overvad, K, CLAVEL CHAPELON, F, BOUTRON RUAULT, Mc, Guernec, G, Bergmann, Mm, Linseisen, J, Becker, N, Trichopoulou, A, Trichopoulos, D, Sieri, S, Palli, D, Tumino, R, Vineis, P, Panico, Salvatore, Peeters, Ph, BUENO DE MESQUITA, Hb, Boshuizen, Hc, VAN GUELPEN, B, Palmqvist, R, Berglund, G, Gonzalez, Ca, Dorronsoro, M, Barricarte, A, Navarro, C, Martinez, C, Quiros, Jr, Roddam, A, Allen, N, Bingham, S, Khaw, Kt, Ferrari, P, Kaaks, R, Slimani, N, and Riboli, E.

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Colorectal cancer, Population, Abdominal Fat, Risk Assessment, Body Mass Index, Waist–hip ratio, Sex Factors, Risk Factors, medicine, Body Fat Distribution, Body Size, Humans, Obesity, Prospective Studies, ddc:610, Risk factor, Sex Distribution, education, Life Style, Aged, Proportional Hazards Models, Gynecology, education.field_of_study, Obstetrics, business.industry, Rectal Neoplasms, Waist-Hip Ratio, Estrogen Replacement Therapy, Absolute risk reduction, Cancer, Confounding Factors, Epidemiologic, Feeding Behavior, Middle Aged, medicine.disease, European Prospective Investigation into Cancer and Nutrition, Europe, Postmenopause, Oncology, Colonic Neoplasms, Multivariate Analysis, Female, business, Body mass index, Follow-Up Studies
Abstract

BACKGROUND: Body weight and body mass index (BMI) are positively related to risk of colon cancer in men, whereas weak or no associations exist in women. This discrepancy may be related to differences in fat distribution between sexes or to the use of hormone replacement therapy (HRT) in women. METHODS: We used multivariable adjusted Cox proportional hazards models to examine the association between anthropometric measures and risks of colon and rectal cancer among 368 277 men and women who were free of cancer at baseline from nine countries of the European Prospective Investigation Into Cancer and Nutrition. All statistical tests were two-sided. RESULTS: During 6.1 years of follow-up, we identified 984 and 586 patients with colon and rectal cancer, respectively. Body weight and BMI were statistically significantly associated with colon cancer risk in men (highest versus lowest quintile of BMI, relative risk [RR] = 1.55, 95% confidence interval [CI] = 1.12 to 2.15; P(trend) = .006) but not in women. In contrast, comparisons of the highest to the lowest quintile showed that several anthropometric measures, including waist circumference (men, RR = 1.39, 95% CI = 1.01 to 1.93; P(trend) = .001; women, RR = 1.48, 95% CI = 1.08 to 2.03; P(trend) = .008), waist-to-hip ratio (WHR; men, RR = 1.51, 95% CI = 1.06 to 2.15; P(trend) = .006; women, RR = 1.52, 95% CI = 1.12 to 2.05; P(trend) = .002), and height (men, RR = 1.40, 95% CI = 0.99 to 1.98; P(trend) = .04; women, RR = 1.79, 95% CI = 1.30 to 2.46; P(trend)

Published
2006

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