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1. Meat consumption and mortality--results from the European Prospective Investigation into Cancer and Nutrition

Author: Pietro Ferrari, Dagrun Engeset, Timothy J. Key, Kuanrong Li, Anne Tjønneland, Kim Overvad, José María Huerta, H. Bas Bueno-de-Mesquita, Christine L. Parr, Guri Skeie, Pilar Amiano, Kay-Tee Khaw, Teresa Norat, Göran Hallmans, Anne C. Vergnaud, Isabelle Romieux, Fulvio Ricceri, M. Luisa Redondo, Dimitirios Trichopoulos, Rosario Tumino, Veronika Fedirko, Françoise Clavel-Chapelon, Elio Riboli, Androniki Naska, Rikke Egeberg, Nicholas J. Wareham, Marianne Uhre Jakobsen, Emily Sonestedt, Heiner Boeing, Aurelio Barricarte, Salvatore Panico, Max Leenders, Manuela M. Bergmann, Laura Nailler, Isabel Drake, Paula Jakszyn, Marie-Christine Boutron-Ruault, Domenico Palli, Sabine Rohrmann, Vittorio Krogh, Antonia Trichopoulou, María José Sánchez, Jakob Linseisen, Petra H.M. Peeters, Ingegerd Johansson, Francesca L. Crowe, Rudolf Kaaks, Khaw, Kay-Tee [0000-0002-8802-2903], Wareham, Nicholas [0000-0003-1422-2993], Apollo - University of Cambridge Repository, University of Zurich, Rohrmann, Sabine, [Rohrmann,S] Division of Cancer Epidemiology and Prevention, Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland. [Rohrmann,S., Li,K, Kaaks,R, Linseisen,J] Division of Cancer Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany. [Overvad,K, Jakobsen,MU] Section of Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. [Bueno-de-Mesquita,HB] National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.[Bueno-de-Mesquita, HB, Leenders,M] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. [Egeberg,R, Tjønneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Nailler,L, Boutron-Ruault,MC, Clavel-Chapelon,F] Inserm, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Villejuif, France. [Nailler,L, Clavel-Chapelon,F] Paris South University, UMRS, Villejuif, France. [Krogh,V] Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. [Panico,S] Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, 'Civile - M.P.Arezzo' Hospital, Ragusa, Italy. [Ricceri,F] HuGeF - Human Genetics Foundation - Torino, Torino, Italy. [Bergmann,MM, Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. [Khaw,KT] Department of Public Health and Primary Care, University of Cambridge, Cambridge UK. [Wareham,NJ] Medical Research Council (MRC) Epidemiology Unit, Cambridge UK. [Crowe,FL, Key,TJ] Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. [Naska,A, Trichopoulou,A] WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Trichopoulou,A, Trichopoulos,D] Hellenic Health Foundation, Athens, Greece. [Trichopoulos,D] Department of Epidemiology, Harvard School of Public Health, Boston MA, USA.Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. [Peeters,PHM] Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands. [Peeters,PHM, Norat,T, Vergnaud,AC, Riboli,E] School of Public Health, Imperial College, London, UK. [Engeset,D, Skeie,G] Department of Community Medicine, University of Tromsø, Tromsø, Norway. [Parr,CL] Department of Biostatistics, Faculty of Medicine, University of Oslo, Oslo, Norway. [Jakszyn,P] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Barcelona, Spain. [Sánchez,MJ, Huerta,JM] Andalusian School of Public Health, Granada, Spain. [Sánchez,MJ, Barricarte,A, Amiano,P] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. [Redondo,ML] Public Health Directorate Asturias, Oviedo, Spain. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Amiano,P] Public Health Division of Gipuzkoa, BIODonostia Research Institute, Department of Health of the Regional Government of the Basque Country, San Sebastian, Spain. [Drake,I, Sonestedt,E] Department of Clinical Sciences, Lund University, Malmö, Sweden. [Hallmans,G] Department of Public Health and Clinical Medicine, Nutrition Research, Umeå University, Umeå, Sweden. [Johansson,I] Department of Odontology, Cariology, Umeå University, Umeå, Sweden. [Fedirko,V, Romieux,I, Ferrari,P] International Agency for Research on Cancer (IARC), Lyon, France. [Linseisen,J] Institute of Epidemiology, Helmholtz Centre Munich, Neuherberg, Germany., Europe Against Cancer Program of the European Commission (SANCO), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, German Federal Ministry of Education and Research, Danish Cancer Society, Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, ISCIII RCESP exp. C03/09, Spain, Cancer Research UK, Medical Research Council, United Kingdom, Stroke Association, United Kingdom, British Heart Foundation, Department of Health, United Kingdom, Food Standards Agency, United Kingdom, Wellcome Trust, United Kingdom, the Hellenic Health Foundation and the Stavros Niarchos Foundation, Italian Association for Research on Cancer (AIRC), Italian National Research Council, Fondazione-Istituto Banco Napoli, 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 Skåne, Sweden, Nordforsk the Norwegian Cancer Society, French League against Cancer (LNCC), National Institute for Health and Medical Research (INSERM), France, Mutuelle Générale de l’Education Nationale (MGEN), France, 3M Co, France, Gustave Roussy Institute (IGR), France, and General Councils of France, BMC, Ed., Division of Cancer Epidemiology and Prevention, Universität Zürich [Zürich] = University of Zurich (UZH)-Institute of Social and Preventive Medicine, Division of Cancer Epidemiology, Deutsches Krebsforschungszentrum, Section of Epidemiology, Aarhus University [Aarhus], Department of Gastroenterology and Hepatology, University Medical Centre, National Institute for Public Health and the Environment [Bilthoven] (RIVM), Danish Cancer Society Research Center, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori - National Cancer Institute [Milan], Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Department of Clinical and Experimental Medicine, University of Naples Federico II = Università degli studi di Napoli Federico II, Cancer Registry and Histopathology Unit, Civile - M.P.Arezzo Hospital, HuGeF - Human Genetics Foundation - Torino, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Department of Public Health and Primary Care, University of Cambridge [UK] (CAM), Epidemiology Unit, Medical Research Council, Cancer Epidemiology Unit, University of Oxford, WHO Collaborating Center for Food and Nutrition Policies, University of Athens Medical School [Athens], Hellenic Health Foundation, Harvard School of Public Health, Bureau of Epidemiologic Research, Academy of Athens, Julius Center, University Medical Center [Utrecht], School of Public Health, Imperial College London, Department of Community Medicine, University of Tromsø (UiT), Department of Biostatistics [Oslo], Institute of Basic Medical Sciences [Oslo], Faculty of Medicine [Oslo], University of Oslo (UiO)-University of Oslo (UiO)-Faculty of Medicine [Oslo], University of Oslo (UiO)-University of Oslo (UiO), Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Andalusian School of Public Health [Granada], Consortium for Biomedical Research in Epidemiology and Public Health, CIBER de Epidemiología y Salud Pública (CIBERESP), Murcia Regional Health Council, Public Health Directorate Asturias, Navarre Public Health Institute, Public Health Division of Gipuzkoa, BIODonostia Research Institute, Department of Clinical Sciences, Lund University [Lund], Department of Public Health and Clinical Medicine, Umeå University, Department of Odontology, Cariology, International Agency for Cancer Research (IACR), Institute of Epidemiology, Helmholtz Centre Munich, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Università degli studi di Napoli Federico II, University of Oxford [Oxford], Rohrmann, S, Overvad, K, Bueno de Mesquita, Hb, Jakobsen, Mu, Egeberg, R, Tj?nneland, A, Nailler, L, Boutron Ruault, Mc, Clavel Chapelon, F, Krogh, V, Palli, D, Panico, Salvatore, Tumino, R, Ricceri, F, Bergmann, Mm, Boeing, H, Li, K, Kaaks, R, Khaw, Kt, Wareham, Nj, Crowe, Fl, Key, Tj, Naska, A, Trichopoulou, A, Trichopoulos, D, Leenders, M, Peeters, Ph, Engeset, D, Parr, Cl, Skeie, G, Jakszyn, P, S?nchez, Mj, Huerta, Jm, Redondo, Ml, Barricarte, A, Amiano, P, Drake, I, Sonestedt, E, Hallmans, G, Johansson, I, Fedirko, V, Romieux, I, Ferrari, P, Norat, T, Vergnaud, Ac, Riboli, E, and Linseisen, J.
Subjects: Male, 030309 nutrition & dietetics, Colorectal cancer, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Survival Analysis [Medical Subject Headings], Review, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], 2700 General Medicine, DISEASE, COLORECTAL-CANCER, VDP::Medical disciplines: 700::Health sciences: 800::Nutrition: 811, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Cohort Studies, Diet, Meat, Mortality, Cohort, Europe, Cardiovascular, Cancer, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Health Surveys::Nutrition Surveys [Medical Subject Headings], 0302 clinical medicine, Neoplasms, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Medicine(all), RISK, CALIBRATION, 2. Zero hunger, 0303 health sciences, Nutrition and Dietetics, cardiovascular, Diabetes, Hazard ratio, food and beverages, cohort, General Medicine, Diseases::Neoplasms [Medical Subject Headings], Middle Aged, Nutrition Surveys, Neoplasias, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Näringslära, Cardiovascular Diseases, Red meat, [SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Female, Enfermedades cardiovasculares, Life Sciences & Biomedicine, Geographicals::Geographic Locations::Americas::North America::United States [Medical Subject Headings], CERTIFICATES, Research Article, Cohort study, Technology, Industry, Agriculture::Food and Beverages::Food::Meat [Medical Subject Headings], Adult, medicine.medical_specialty, 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], Processed meat, Estudios de cohortes, Check Tags::Male [Medical Subject Headings], 610 Medicine & health, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Feeding Behavior [Medical Subject Headings], VDP::Medisinske Fag: 700::Helsefag: 800::Ernæring: 811, VEGETARIANS, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], medicine, cancer, Humans, ddc:610, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Diseases::Cardiovascular Diseases [Medical Subject Headings], Aged, Science & Technology, business.industry, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Oncology: 762, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), Feeding Behavior, medicine.disease, mortality, Survival Analysis, United States, Surgery, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Onkologi: 762, RED MEAT, Check Tags::Female [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Commentary, 21-YEAR FOLLOW-UP, business, Body mass index, Demography
Abstract: Background Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods Included in the analysis were 448,568 men and women without prevalent cancer, stroke, or myocardial infarction, and with complete information on diet, smoking, physical activity and body mass index, who were between 35 and 69 years old at baseline. Cox proportional hazards regression was used to examine the association of meat consumption with all-cause and cause-specific mortality. Results As of June 2009, 26,344 deaths were observed. After multivariate adjustment, a high consumption of red meat was related to higher all-cause mortality (hazard ratio (HR) = 1.14, 95% confidence interval (CI) 1.01 to 1.28, 160+ versus 10 to 19.9 g/day), and the association was stronger for processed meat (HR = 1.44, 95% CI 1.24 to 1.66, 160+ versus 10 to 19.9 g/day). After correction for measurement error, higher all-cause mortality remained significant only for processed meat (HR = 1.18, 95% CI 1.11 to 1.25, per 50 g/d). We estimated that 3.3% (95% CI 1.5% to 5.0%) of deaths could be prevented if all participants had a processed meat consumption of less than 20 g/day. Significant associations with processed meat intake were observed for cardiovascular diseases, cancer, and 'other causes of death'. The consumption of poultry was not related to all-cause mortality. Conclusions The results of our analysis support a moderate positive association between processed meat consumption and mortality, in particular due to cardiovascular diseases, but also to cancer.
Published: 2013
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2. Validation of a Parent-Reported Physical Activity Questionnaire by Accelerometry in European Children Aged from 6 to 12 Years Old

Author: Daniel Prieto-Botella, Desirée Valera-Gran, Loreto Santa-Marina, Izaro Babarro, Mikel Subiza-Pérez, Maribel Casas, Mónica Guxens, Gabriela Cárdenas-Fuentes, Barbara Heude, Jonathan Y. Bernard, Rosemary R. C. McEachan, Judith García-Aymerich, Martine Vrijheid, Eva-María Navarrete-Muñoz, Miguel Hernandez University (UMH), CIBER de Epidemiología y Salud Pública (CIBERESP), BIODonostia Research Institute, Ministry of Health of the Basque Government, University of the Basque Country/Euskal Herriko Unibertsitatea (UPV/EHU), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Bradford Institute for Health Research [Bradford, UK], Bradford Teaching Hospitals NHS Foundation Trust [Bradford, UK] (BTHFT), Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-FISABIO), Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana [Espagne] (FISABIO), Bernard, Jonathan, European Commission, and Child and Adolescent Psychiatry / Psychology
Subjects: Male, Health, Toxicology and Mutagenesis, moderate-to-vigorous physical activity, validity measures, measurement, childhood, Public Health, Environmental and Occupational Health, moderate to vigorous physical activity, World Health Organization, Leisure Activities, SDG 3 - Good Health and Well-being, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Surveys and Questionnaires, Accelerometry, Humans, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Child, Exercise
Abstract: Validated physical activity (PA) questionnaires are crucial for collecting information in large epidemiological studies during childhood. Thus, this study analyzed the validity of a parent-reported PA questionnaire based on the Children's Leisure Activities Study Survey by accelerometry in European children aged from 6 to 12 years old. We used data from 230 children of the Human Early-Life Exposome and Infancia y Medio Ambiente projects. Mean differences between moderate-to-vigorous PA (MVPA) reported by the questionnaire and the accelerometer were calculated (min/day), and its associated factors were explored by multiple robust linear regression. The agreement between methods was examined using a Bland-Altman plot. The concurrent validity of assessing MVPA was analyzed by cohort-adjusted Spearman's partial correlations. ROC curve analysis was also used to explore the questionnaire's capability to identify active children based on the World Health Organization guidelines. A moderate correlation was found between parent-reported and accelerometer MVPA (rho = 0.41, p < 0.001). The child's sex (girl) was statistically associated with the mean MVPA difference between methods. However, this questionnaire accurately identified physically active children (area under the curve = 83.8% and 82.7% for boys and girls, cut-points = 68.6 and 45.4 min/day in MVPA, respectively). Consequently, this questionnaire is suitable for classifying active children in order to monitor public health interventions regarding PA. This study was supported by funding from the European Community’s Seventh Framework Programme [FP7/2007–2013] under grant agreement no. 308333—the HELIX project. INMA data collections were supported by grants from the Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041; PI041436; PI081151 incl. FEDER funds; PI12/01890 incl. FEDER funds; CP13/00054 incl. FEDER funds; PI15/00118 incl. FEDER funds; CP16/00128 incl. FEDER funds; PI16/00118 incl. FEDER funds; PI16/00261 incl. FEDER funds; PI17/01340 incl. FEDER funds; PI18/00547 incl. FEDER funds, PI18/01237 incl. FEDER funds, PI18/00825 incl. FEDER funds); Generalitat Valenciana (GVA/2021/191); CIBERESP; and the Generalitat de Catalunya-CIRIT 1999SGR 00241; Generalitat de Catalunya-AGAUR (2009 SGR 501, 2014 SGR 822), Fundació La marató de TV3 (090430). ISGlobal acknowledges support from the Spanish Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program, Spanish Ministry of Economy and Competitiveness (SAF2012-32991 incl. FEDER funds), Agence Nationale de Securite Sanitaire de l’Alimentation de l’Environnement et du Travail (1262C0010; EST-2016 RF-21), EU Commission (261357, 308333, 603794 and 634453); and annual agreements with the municipalities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia y Beasain). M.C. and M.G. hold Miguel Servet fellowships (CP16/00128, CPII18/00018) funded by Instituto de Salud Carlos III and co-funded by European Social Fund “Investing in your future”. R.R.C.M. received funding from the National Institute for Health Research Applied Research Collaboration for Yorkshire and Humber.
Published: 2022
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3. Prenatal exposure to mixtures of phthalates and phenols and body mass index and blood pressure in Spanish preadolescents

Author: Nuria Güil-Oumrait, German Cano-Sancho, Parisa Montazeri, Nikos Stratakis, Charline Warembourg, Maria-Jose Lopez-Espinosa, Jesús Vioque, Loreto Santa-Marina, Alba Jimeno-Romero, Rosa Ventura, Nuria Monfort, Martine Vrijheid, Maribel Casas, European Commission, Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), Laboratoire d'étude des Résidus et Contaminants dans les Aliments (LABERCA), École nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), École des Hautes Études en Santé Publique [EHESP] (EHESP), Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana [Espagne] (FISABIO), Universitat de València (UV), Universidad Miguel Hernández [Elche] (UMH), University of the Basque Country/Euskal Herriko Unibertsitatea (UPV/EHU), BIODonostia Research Institute, IMIM-Hospital del Mar, Generalitat de Catalunya, This study was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176, CB06/02/0041, PI041436, PI081151 incl. FEDER funds), CIBERESP, Generalitat de Catalunya-CIRIT 1999SGR 00241, Generalitat de Catalunya-AGAUR 2009 SGR 501, Fundació La marató de TV3 (090430), EU Commission (261357, H2020 No 874583, the ATHLETE project, and No 825712, the OBERON project). Maribel Casas holds a Miguel Servet fellowship (MS16/00128) funded by Instituto de Salud Carlos III and co-funded by European Social Fund 'Investing in your future'. We acknowledge support from the Spanish Ministry of Science and Innovation and the State Research Agency through the 'Centro de Excelencia Severo Ochoa 2019-2023' Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. INMA-Gipuzkoa: This study was funded by grants from Instituto de Salud Carlos III (FIS-PI13/02187 and FIS-PI18/01142 incl. FEDER funds), CIBERESP, Department of Health of the Basque Government (2015111065), and the Provincial Government of Gipuzkoa (DFG15/221) and annual agreements with the municipalities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia y Beasain). INMA-Valencia: This study was funded by Grants from UE (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1), Spain: ISCIII (G03/176, FIS-FEDER: PI11/01007, PI11/02591, PI11/02038, PI12/00610, PI13/1944, PI13/2032, PI14/00891, PI14/01687, PI16/1288, and PI17/00663, and Miguel Servet-FEDER MS11/00178, MS15/00025, and MSII16/00051), Generalitat Valenciana (AICO/2021/182, and FISABIO: UGP 15-230, UGP-15-244, and UGP-15-249), and Alicia Koplowitz Foundation 2017.
Subjects: Pediatric Obesity, phthalates, blood pressure (BP), Phenol, [SDV]Life Sciences [q-bio], Phthalic Acids, Bayes Theorem, Blood Pressure, phenols, benzophenone-3, Body Mass Index, parabens, Cohort Studies, Pregnancy, Prenatal Exposure Delayed Effects, Humans, body mass index (BMI), Environmental Pollutants, Female, Child, General Environmental Science
Abstract: Background: Pregnant women are simultaneously exposed to several non-persistent endocrine-disrupting chem-icals, which may influence the risk of childhood obesity and cardiovascular diseases later in life. Previous prospective studies have mostly examined single-chemical effects, with inconsistent findings. We assessed the association between prenatal exposure to phthalates and phenols, individually and as a mixture, and body mass index (BMI) and blood pressure (BP) in preadolescents. Methods: We used data from the Spanish INMA birth cohort study (n = 1,015), where the 1st and 3rd-trimester maternal urinary concentrations of eight phthalate metabolites and six phenols were quantified. At 11 years of age, we calculated BMI z-scores and measured systolic and diastolic BP. We estimated individual chemical effects with linear mixed models and joint effects of the chemical mixture with hierarchical Bayesian kernel machine regression (BKMR). Analyses were stratified by sex and by puberty status. Results: In single-exposure models, benzophenone-3 (BP3) was nonmonotonically associated with higher BMI z -score (e.g. Quartile (Q) 3: beta = 0.23 [95% CI = 0.03, 0.44] vs Q1) and higher diastolic BP (Q2: beta = 1.27 [0.00, 2.53] mmHg vs Q1). Methyl paraben (MEPA) was associated with lower systolic BP (Q4: beta =-1.67 [-3.31,-0.04] mmHg vs Q1). No consistent associations were observed for the other compounds. Results from the BKMR confirmed the single-exposure results and showed similar patterns of associations, with BP3 having the highest importance in the mixture models, especially among preadolescents who reached puberty status. No overall mixture effect was found, except for a tendency of higher BMI z-score and lower systolic BP in girls. Conclusions: Prenatal exposure to UV-filter BP3 may be associated with higher BMI and diastolic BP during preadolescence, but there is little evidence for an overall phthalate and phenol mixture effect. We thank all study participants for their generous collaboration. INMA-Sabadell: This study was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041; PI041436; PI081151 incl. FEDER funds), CIBERESP, Generalitat de CatalunyaCIRIT 1999SGR 00241, Generalitat de Catalunya-AGAUR 2009 SGR 501, Fundacio La marato de TV3 (090430), EU Commission (261357, H2020 No 874583, the ATHLETE project, and No 825712, the OBERON project). Maribel Casas holds a Miguel Servet fellowship (MS16/00128) funded by Instituto de Salud Carlos III and co-funded by European Social Fund "Investing in your future". We acknowledge support from the Spanish Ministry of Science and Innovation and the State Research Agency through the "Centro de Excelencia Severo Ochoa 2019-2023" Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. INMA-Gipuzkoa: This study was funded by grants from Instituto de Salud Carlos III (FIS-PI13/02187 and FIS-PI18/01142 incl. FEDER funds), CIBERESP, Department of Health of the Basque Government (2015111065), and the Provincial Government of Gipuzkoa (DFG15/221) and annual agreements with the municipalities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia y Beasain). INMA-Valencia: This study was funded by Grants from UE (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1), Spain: ISCIII (G03/176; FIS-FEDER: PI11/01007, PI11/02591, PI11/02038, PI12/00610, PI13/1944, PI13/2032, PI14/00891, PI14/01687, PI16/1288, and PI17/00663; Miguel Servet-FEDER MS11/00178, MS15/00025, and MSII16/00051), Generalitat Valenciana (AICO/2021/182, and FISABIO: UGP 15-230, UGP-15-244, and UGP-15-249), and Alicia Koplowitz Foundation 2017.
Published: 2022
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4. Evidence Update on the Relationship between Diet and the Most Common Cancers from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study: A Systematic Review

Author: Ubago-Guisado, Esther, Rodríguez-Barranco, Miguel, Ching-López, Ana, Petrova, Dafina, Molina-Montes, Esther, Amiano, Pilar, Barricarte-Gurrea, Aurelio, Chirlaque, María-Dolores, Agudo, Antonio, Sánchez, María-José, [Ubago-Guisado,E, Rodríguez-Barranco,M, Ching-López,A, Petrova,D, Sánchez,MJ] Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain. [Ubago-Guisado,E, Molina-Montes,E, Amiano,P, Barricarte-Gurrea,A, Chirlaque,MD, Sánchez,MJ] Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. [Ubago-Guisado,E, Sánchez,MJ] Cancer Epidemiology Group, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain. [Petrova,D] Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain. [Molina-Montes,E] Department of Nutrition and Food Science, Campus of Cartuja, University of Granada, Granada, Spain. [Molina-Montes,E] Institute of Nutrition and Food Technology (INYTA) ‘José Mataix’, Biomedical Research Centre, University of Granada, Granada, Spain. [Amiano,P] Public Health Division of Gipuzkoa, BioDonostia Research Institute, Donostia-San Sebastian, Spain. [Barricarte-Gurrea,A] Navarra Public Health Institute, Pamplona, Spain. [Barricarte-Gurrea,A] Navarra Institute for Health Research (IdiSNA), Pamplona, Spain. [Chirlaque,MD] Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain. [Agudo,A] Unit of Nutrition and Cancer, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain. [Agudo,A] Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute—IDIBELL, L’Hospitalet de Llobregat, Spain. [Sánchez,MJ] Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain., and E.U.-G. is supported by the Programa Operativo Fondo Social Europeo (FSE) de Andalucía (2014–2020) and Junta de Andalucía (reference DOC_01618).
Subjects: Metaanalisis, Frutas, Meat, Neoplasias de la próstata, Neoplasias pulmonares, Etanol, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], Diseases::Neoplasms::Neoplasms by Site::Thoracic Neoplasms::Respiratory Tract Neoplasms::Lung Neoplasms [Medical Subject Headings], Carne, Fruits, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Ingestión de alimentos, Diseases::Neoplasms::Neoplasms by Site::Urogenital Neoplasms::Genital Neoplasms, Male::Prostatic Neoplasms [Medical Subject Headings], Breast cancer, Neoplasias colorrectales, Vegetables, Prospective Studies, Diseases::Neoplasms::Neoplasms by Site::Breast Neoplasms [Medical Subject Headings], Prostate cancer, Revisión sistemática, Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [Medical Subject Headings], Diseases::Neoplasms [Medical Subject Headings], Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena [Medical Subject Headings], Colorectal cancer, Fish, Verduras, Neoplasias de la mama, Intake, Geographical Locations::Geographic Locations::Europe [Medical Subject Headings], Lung cancer, Alcohol
Abstract: The European Prospective Investigation into Cancer and Nutrition (EPIC) is a multicentre prospective study conducted in 23 centres in 10 European countries. Here we review the findings from EPIC on the relationship between diet-related exposures and incidence or mortality from the four most frequent cancers in the European population: colorectal, breast, lung, and prostate cancer. We conducted a systematic review following PRISMA guidelines and identified 110 high-quality studies based on the EPIC cohort. Fruit and vegetable consumption had a protective effect against colorectal, breast, and lung cancer, whereas only fruit had a protective effect against prostate cancer. A higher consumption of fish and lower consumption of red and processed meat were related with a lower risk of colorectal cancer; and higher consumption of fatty fish with lower risk of breast cancer. Calcium and yogurt intake were found to protect against colorectal and prostate cancer. Alcohol consumption increased the risk for colorectal and breast cancer. Finally, adherence to the Mediterranean diet emerged as a protective factor for colorectal and breast cancer. The EPIC study results are in agreement with the latest evidence from leading authorities on cancer prevention and help to inform public prevention policies and strategies. Yes
Published: 2021

5. Bisphenol-A exposure and risk of breast and prostate cancer in the Spanish European Prospective Investigation into Cancer and Nutrition study

Author: Sandra Colorado, María José Sánchez, Ana Jimenez, Antonio Agudo, Pilar Amiano, Elena Salamanca-Fernández, Marcela Guevara, Nicolás Olea, Fernando Vela, Josu Delfrade, Juan P. Arrebola, Miguel Rodríguez-Barranco, Maria Dolores Chirlaque, [Salamanca-Fernández,E, Rodríguez-Barranco,M, Sánchez,MJ] Andalusian School of Public Health (EASP), Campus Universitario de Cartuja, Granada, Spain. [Salamanca-Fernández,E, Arrebola,JP, Vela,F, Olea,N, Sánchez,MJ] Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain. [Rodríguez-Barranco,M, Amiano,P, Delfrade,J, Chirlaque,MD, Colorado,S, Guevara,M, Sánchez,MJ] CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Amiano,P, Jimenez,A] Public Health Division of Gipuzkoa, BioDonostia Research Institute, Donostia-San Sebastian, Spain. [Delfrade,J, Guevara,M] Navarra Public Health Institute, Pamplona, Spain. [Delfrade,J, Guevara,M] Navarra Institute for Health Research (IdiSNA), Pamplona, Spain. [Chirlaque,MD, Colorado,S] Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. [Chirlaque,MD] Department of Health and Sciences, University of Murcia, Murcia, Spain. [Colorado,S] Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia. [Arrebola,JP, Sánchez,MJ] Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain. [Olea,N] Department of Radiology, University of Granada, Granada, Spain. [Agudo,A] Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute - IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain., and This work was supported by the Ministry of economy and competitiveness and the National Institute of Health: Instituto de Salud Carlos III (ISCIII). Exps: PI14/00067, PI14/01716, PI14/01880, PI14/00556. BA15/00093. FFIS-CC 2016–06 AECC 'Junta provincial de Murcia'. FEDER and AECC 2015. Dr. J.P. Arrebola is under contract within Ramon y Cajal program (RYC-2016-20155, Ministerio de Economía, Industria y Competitividad, Spain). The EPIC-Spain cohort was supported by the Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), the Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain).
Subjects: Oncology, Chemicals and Drugs::Chemical Actions and Uses::Toxic Actions::Environmental Pollutants [Medical Subject Headings], Male, Neoplasias de la próstata, Health, Toxicology and Mutagenesis, Endocrine Disruptors, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Cohort Studies, Prostate cancer, Breast cancer, Chemicals and Drugs::Organic Chemicals::Carboxylic Acids::Acids, Acyclic::Acrylates::Methacrylates::Bisphenol A-Glycidyl Methacrylate [Medical Subject Headings], Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings], education.field_of_study, Factors de risc en les malalties, Hazard ratio, Middle Aged, European Prospective Investigation into Cancer and Nutrition, Health Care::Environment and Public Health::Public Health::Environmental Pollution::Environmental Exposure [Medical Subject Headings], Environmental pollutants, Diseases::Male Urogenital Diseases::Urogenital Neoplasms::Genital Neoplasms, Male::Prostatic Neoplasms [Medical Subject Headings], Bisphenol a, Endocrine disruptor, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk [Medical Subject Headings], Neoplasias de la mama, Population study, Female, Public aspects of medicine, RA1-1270, Disruptores endocrinos, Adult, Risk, medicine.medical_specialty, endocrine system, 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], Risk factors in diseases, Population, Estudios de cohortes, Case-cohort, Check Tags::Male [Medical Subject Headings], Breast Neoplasms, Càncer de mama, Phenols, Bisfenol A glicidil metacrilato, Internal medicine, Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Benzene Derivatives::Phenols [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies [Medical Subject Headings], medicine, Humans, Benzhydryl Compounds, education, Persons::Persons::Age Groups::Adult [Medical Subject Headings], Diseases::Neoplasms::Neoplasms by Site::Breast Neoplasms [Medical Subject Headings], Aged, Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings], Càncer de pròstata, Proportional hazards model, business.industry, urogenital system, Research, Public Health, Environmental and Occupational Health, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Endocrine Disruptors [Medical Subject Headings], Prostatic Neoplasms, Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Benzene Derivatives::Benzhydryl Compounds [Medical Subject Headings], Environmental Exposure, medicine.disease, Industrial medicine. Industrial hygiene, RC963-969, Check Tags::Female [Medical Subject Headings], Spain, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Sensitivity and Specificity::Limit of Detection [Medical Subject Headings], business, Contaminantes ambientales
Abstract: This work was supported by the Ministry of economy and competitiveness and the National Institute of Health: Instituto de Salud Carlos III (ISCIII). Exps: PI14/00067, PI14/01716, PI14/01880, PI14/00556. BA15/00093. FFIS-CC 2016-06 AECC "Junta provincial de Murcia". FEDER and AECC 2015. Dr. J.P. Arrebola is under contract within Ramon y Cajal program (RYC-2016-20155, Ministerio de Economia, Industria y Competitividad, Spain). The EPIC-Spain cohort was supported by the Health Research Fund (FIS) -Instituto de Salud Carlos III (ISCIII), the Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology -ICO (Spain)., Background Bisphenol A (BPA) is an endocrine disruptor that it is present in numerous products of daily use. The aim of this study was to assess the potential association of serum BPA concentrations and the risk of incident breast and prostate cancer in a sub-cohort of the Spanish European Prospective Investigation into Cancer and Nutrition (EPIC). Methods We designed a case-cohort study within the EPIC-Spain cohort. Study population consisted on 4812 participants from 4 EPIC-Spain centers (547 breast cancer cases, 575 prostate cancer cases and 3690 sub-cohort participants). BPA exposure was assessed by means of chemical analyses of serum samples collected at recruitment. Borgan II weighted Cox regression was used to estimate hazard ratios. Results Median follow-up time in our study was 16.9 years. BPA geometric mean serum values of cases and sub-cohort were 1.12 ng/ml vs 1.10 ng/ml respectively for breast cancer and 1.33 ng/ml vs 1.29 ng/ml respectively for prostate cancer. When categorizing BPA into tertiles, a 40% increase in risk of prostate cancer for tertile 1 (p = 0.022), 37% increase for tertile 2 (p = 0.034) and 31% increase for tertile 3 (p = 0.072) was observed with respect to values bellow the limit of detection. No significant association was observed between BPA levels and breast cancer risk. Conclusions We found a similar percentage of detection of BPA among cases and sub-cohort from our population, and no association with breast cancer risk was observed. However, we found a higher risk of prostate cancer for the increase in serum BPA levels. Further investigation is needed to understand the influence of BPA in prostate cancer risk., Ministry of economy and competitiveness, National Institute of Health: Instituto de Salud Carlos III (ISCIII), AECC "Junta provincial de Murcia" PI14/00067- PI14/01716- PI14/01880- PI14/00556- BA15/00093- FFIS-CC 2016-06, Spanish Government RYC-2016-20155, Health Research Fund (FIS) -Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, Catalan Institute of Oncology -ICO (Spain)
Published: 2021

6. Project overview

Author: Vrijheid, Martine, Basagaña, Xavier, Gonzalez, Juan, Jaddoe, Vincent W. V., Jensen, Genon, Keun, Hector C., McEachan, Rosemary R. C., Porcel, Joana, Siroux, Valerie, Swertz, Morris A., Thomsen, Cathrine, Aasvang, Gunn Marit, Andrušaitytėm, Sandra, Angeli, Karine, Avraam, Demetris, Ballester, Ferran, Burton, Paul, Bustamante, Mariona, Casas, Maribel, Chatzi, Leda, Chevrier, Cécile, Cingotti, Natacha, Conti, David, Crépetn, Amélie, Dadvand, Payam, Duijts, Liesbeth, van Enckevort, Esther, Esplugues, Ana, Fossati, Serena, Garlantezec, Ronan, Gómez Roigu, María Dolores, Grazuleviciene, Regina, Gützkow, Kristine B., Guxens, Mònica, Haakma, Sido, Hessel, Ellen V. S., Hoyles, Lesley, Hyde, Eleanor, Klanova, Jana, van Klaveren, Jacob D., Kortenkamp, Andreas, Le Brusquet, Laurent, Leenen, Ivonne, Lertxundi, Aitana, Lertxundi, Nerea, Lionis, Christos, Llop, Sabrina, Lopez-Espinosa, Maria-Jose, Lyon-Caen, Sarah, Maitre, Lea, Mason, Dan, Mathy, Sandrine, Mazarico, Edurne, Nawrot, Tim, Nieuwenhuijsen, Mark, Ortiz, Rodney, Pedersen, Marie, Perelló, Josep, Pérez-Cruz, Míriam, Philippat, Claire, Piler, Pavel, Pizzi, Costanza, Quentin, Joane, Richiardi, Lorenzo, Rodriguez, Adrian, Roumeliotaki, Theano, Capote, José Manuel Sabin, Santiago, Leonardo, Santos, Susana, Siskos, Alexandros, Strandberg-Larsen, Katrine, Stratakis, Nikos, Sunyer, Jordi, Tenenhaus, Arthur, Vafeiadi, Marina, Wilson, Rebecca C., Wright, John, Yang, Tiffany, Slama, Remy, Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF), The Generation R Study Group, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Health & Environment Alliance, Imperial College London, Bradford Institute for Health Research Bradford, Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), University Medical Center Groningen [Groningen] (UMCG), Norwegian Institute of Public Health [Oslo] (NIPH), Vytautas Magnus University - Vytauto Didziojo Universitetas (VDU), Direction de l'Evaluation des Risques (DER), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), Newcastle University [Newcastle], Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana [Espagne] (FISABIO), CIBER de Epidemiología y Salud Pública (CIBERESP), University of Southern California (USC), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Universitat de València (UV), École des Hautes Études en Santé Publique [EHESP] (EHESP), CHU Pontchaillou [Rennes], Institut de Recerca Pediàtrica Hospital Sant Joan de Déu [Barcelona, Spain], National Institute for Public Health and the Environment [Bilthoven] (RIVM), Nottingham Trent University, Research Centre for Toxic Compounds in the Environment [Brno] (RECETOX / MUNI), Faculty of Science [Brno] (SCI / MUNI), Masaryk University [Brno] (MUNI)-Masaryk University [Brno] (MUNI), Brunel University London [Uxbridge], Institut des Neurosciences Paris-Saclay (NeuroPSI), Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), University of the Basque Country [Bizkaia] (UPV/EHU), Biodonostia Health Research Institute [Donostia-San Sebastian, Spain] (IIS Biodonostia), University of Crete [Heraklion] (UOC), Universitat Jaume I, Laboratoire d'Economie Appliquée de Grenoble (GAEL), Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Hasselt University (UHasselt), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), University of Copenhagen = Københavns Universitet (KU), Bettair Cities SL, Barcelona, Masaryk University [Brno] (MUNI), Department of Oncology [University of Turin], University of Turin, Erasmus University Rotterdam, IT University of Copenhagen, Laboratoire des signaux et systèmes (L2S), CentraleSupélec-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), University of Liverpool, This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement number 874583—the Advancing Tools for Human Early Lifecourse Exposome Research and Translation (ATHLETE) project. This publication reflects only the authors’ view and the European Commission is not responsible for any use that may be made of the information it contains., Dr. Dadvand is funded by a Ramón y Cajal fellowship (RYC-2012-10995) awarded by the Spanish Ministry of Economy and Finance. Drs. Casas and Guxens are funded by the Instituto de Salud Carlos III (MS16/00128, CPII18/00018). Drs. Chatzi and Conti were supported by the National Institute of Environmental Health Sciences (R21ES029681, R01ES029944, R01ES030364, R01ES030691, and P30ES007048). Additional funding from National Institutes of Health supported Dr. Conti (P01CA196569, R01CA140561) and Dr. Stratakis (P30DK048522). Investigators Drs. McEachan and Wright receive funding from the National Institute for Health Research under its Applied Research Collaboration Yorkshire and Humber. Dr. Jaddoe received funding from a Consolidator Grant from the European Research Council (ERC-2014-CoG-648916). Dr. Duijts received funding from the European Union’s Horizon 2020 co-funded programme European Research Area Net on Biomarkers for Nutrition and Health (European Research Area Healthy Diet for a Healthy Life) (Early life programming of childhood health project [number 696295, 2017], ZonMW, The Netherlands [number 529051014, 2017]). Dr. Guxens received funding from the Agence Nationale de Securite Sanitaire de l’Alimentation de l’Environnement et du Travail (EST-18 RF-25)., European Project: 874583,H2020,H2020-EU.3.1.2.,ATHLETE(2020), Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Health & Environment Alliance (HEAL), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK (BIHR), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), University of the Basque Country/Euskal Herriko Unibertsitatea (UPV/EHU), BIODonostia Research Institute, University of Copenhagen = Københavns Universitet (UCPH), Università degli studi di Torino = University of Turin (UNITO), IT University of Copenhagen (ITU), Pediatrics, Mathy, Sandrine, Advancing Tools for Human Early Lifecourse Exposome Research and Translation - ATHLETE - - H20202020-01-01 - 2024-12-31 - 874583 - VALID, Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Basagana, Xavier/0000-0002-8457-1489, Stratakis, Nikos/0000-0003-4613-0989, Yang, Tiffany/0000-0003-4549-7850, Andrusaityte, Sandra/0000-0002-4309-0208, McEachan, Rosemary/0000-0003-1302-6675, Hoyles, Lesley/0000-0002-6418-342X, LERTXUNDI MANTEROLA, AITANA/0000-0002-9421-6237, Lopez-Espinosa, Maria-Jose/0000-0003-1202-8740, Santos, Susana/0000-0003-0613-3181, Nawrot, Tim/0000-0002-3583-3593, and Wilson, Becca/0000-0003-2294-593X
Subjects: PARENTAL SMOKING, exposure assessment, [SDV]Life Sciences [q-bio], ENDOCRINE-DISRUPTING CHEMICALS, Adolescent health, Environmental Sciences & Ecology, exposome, Child health, Early life, Exposome, Exposure assessment, SDG 3 - Good Health and Well-being, early life, LIFE-COURSE APPROACH, [SHS.ECO] Humanities and Social Sciences/Economics and Finance, Public, Environmental & Occupational Health, Science & Technology, BIRTH COHORT, adolescent health, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, AMBIENT AIR-POLLUTION, [SDV] Life Sciences [q-bio], GREEN SPACES, COGNITIVE-DEVELOPMENT, COHORT PROFILE, child health, Life Sciences & Biomedicine, SOCIOECONOMIC POSITION, Environmental Sciences, PREGNANT-WOMEN
Abstract: Early life stages are vulnerable to environmental hazards and present important windows of opportunity for lifelong disease prevention. This makes early life a relevant starting point for exposome studies. The Advancing Tools for Human Early Lifecourse Exposome Research and Translation (ATHLETE) project aims to develop a toolbox of exposome tools and a Europe-wide exposome cohort that will be used to systematically quantify the effects of a wide range of community- and individual-level environmental risk factors on mental, cardiometabolic, and respiratory health outcomes and associated biological pathways, longitudinally from early pregnancy through to adolescence. Exposome tool and data development include as follows: (1) a findable, accessible, interoperable, reusable (FAIR) data infrastructure for early life exposome cohort data, including 16 prospective birth cohorts in 11 European countries; (2) targeted and nontargeted approaches to measure a wide range of environmental exposures (urban, chemical, physical, behavioral, social); (3) advanced statistical and toxicological strategies to analyze complex multidimensional exposome data; (4) estimation of associations between the exposome and early organ development, health trajectories, and biological (metagenomic, metabolomic, epigenetic, aging, and stress) pathways; (5) intervention strategies to improve early life urban and chemical exposomes, co-produced with local communities; and (6) child health impacts and associated costs related to the exposome. Data, tools, and results will be assembled in an openly accessible toolbox, which will provide great opportunities for researchers, policy-makers, and other stakeholders, beyond the duration of the project. ATHLETE'S results will help to better understand and prevent health damage from environmental exposures and their mixtures from the earliest parts of the life course onward. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement number 874583—the Advancing Tools for Human Early Lifecourse Exposome Research and Translation (ATHLETE) project. This publication reflects only the authors’ view and the European Commission is not responsible for any use that may be made of the information it contains. Dr. Dadvand is funded by a Ramón y Cajal fellowship (RYC2012-10995) awarded by the Spanish Ministry of Economy and Finance. Drs. Casas and Guxens are funded by the Instituto de Salud Carlos III (MS16/00128, CPII18/00018). Drs. Chatzi and Conti were supported by the National Institute of Environmental Health Sciences (R21ES029681, R01ES029944, R01ES030364, R01ES030691, and P30ES007048). Additional funding from National Institutes of Health supported Dr. Conti (P01CA196569, R01CA140561) and Dr. Stratakis (P30DK048522). Investigators Drs. McEachan and Wright receive funding from the National Institute for Health Research under its Applied Research Collaboration Yorkshire and Humber. Dr. Jaddoe received funding from a Consolidator Grant from the European Research Council (ERC-2014-CoG-648916). Dr. Duijts received funding from the European Union’s Horizon 2020 co-funded programme European Research Area Net on Biomarkers for Nutrition and Health (European Research Area Healthy Diet for a Healthy Life) (Early life programming of childhood health project [number 696295; 2017], ZonMW, The Netherlands [number 529051014; 2017]). Dr. Guxens received funding from the Agence Nationale de Securite Sanitaire de l’Alimentation de l’Environnement et du Travail (EST-18 RF-25). The views expressed are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.
Published: 2021
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7. The LifeCycle Project-EU Child Cohort Network: a federated analysis infrastructure and harmonized data of more than 250,000 children and parents

Author: Andersen, Anne-Marie Nybo, Elhakeem, Ahmed, Foong, Rachel, Grote, Veit, Haakma, Sido, Hanson, Mark, Harris, Jennifer, Heude, Barbara, Huang, Rae-Chi, Inskip, Hazel, Järvelin, Marjo-Riitta, Koletzko, Berthold, Lawlor, Deborah, Lindeboom, Maarten, Mceachan, Rosemary, Mikkola, Tuija, Nader, Johanna, de Moira, Angela Pinot, Pizzi, Costanza, Richiardi, Lorenzo, Sebert, Sylvain, Schwalber, Ameli, Sunyer, Jordi, Swertz, Morris, Vafeiadi, Marina, Vrijheid, Martine, Wright, John, Duijts, Liesbeth, Project Group, Lifecycle, de Lauzon-Guillain, Blandine, Dargent-Molina, Patricia, Cornet, Maxime, Harrar, Faryal, Lioret, Sandrine, Plancoulaine, Sabine, Jaddoe, Vincent, Felix, Janine, Andersen, Anne-Marie, Charles, Marie-Aline, Chatzi, Leda, Corpeleijn, Eva, Donner, Nina, Elhakeem, ·, Eriksson, Johan, de Lauzon-Guillain, Blandine, Early-life stressors and LifeCycle health - LIFECYCLE - - H20202017-01-01 - 2021-12-31 - 733206 - VALID, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Hospital Universitari de Sant Joan de Reus, Institut d’Investigació Sanitària Pere Virgili, Ciberdem, BIODonostia Research Institute, Università degli studi di Torino = University of Turin (UNITO), University of Southampton, University of Bristol [Bristol], IT University of Copenhagen (ITU), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Bradford Teaching Hospitals NHS Foundation Trust [Bradford, Royaume-Uni], University of Manchester [Manchester], University of Groningen [Groningen], University of Crete [Heraklion] (UOC), University of Southern California (USC), Norwegian Institute of Public Health [Oslo] (NIPH), Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana [Espagne] (FISABIO), IMIM-Hospital del Mar, Generalitat de Catalunya, Etude longitudinale française depuis l'enfance (UMS : Ined-Inserm-EFS) (ELFE), Institut national d'études démographiques (INED)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF), University of the Basque Country/Euskal Herriko Unibertsitatea (UPV/EHU), Universitat de València (UV), Conselleria de Sanitat, Laboratorio de Salud Pública de Valencia, and European Project: 733206,H2020,H2020-SC1-2016-RTD,LIFECYCLE(2017)
Subjects: Birth cohorts, Exposome, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Life course, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Non-communicable diseases, Consortium
Abstract: Early life is an important window of opportunity to improve health across the full lifecycle. An accumulating body of evidence suggests that exposure to adverse stressors during early life leads to developmental adaptations, which subsequently affect disease risk in later life. Also, geographical, socio-economic, and ethnic differences are related to health inequalities from early life onwards. To address these important public health challenges, many European pregnancy and childhood cohorts have been established over the last 30 years. The enormous wealth of data of these cohorts has led to important new biological insights and important impact for health from early life onwards. The impact of these cohorts and their data could be further increased by combining data from different cohorts. Combining data will lead to the possibility of identifying smaller effect estimates, and the opportunity to better identify risk groups and risk factors leading to disease across the lifecycle across countries. Also, it enables research on better causal understanding and modelling of life course health trajectories. The EU Child Cohort Network, established by the Horizon2020-funded LifeCycle Project, brings together nineteen pregnancy and childhood cohorts, together including more than 250,000 children and their parents. A large set of variables has been harmonised and standardized across these cohorts. The harmonized data are kept within each institution and can be accessed by external researchers through a shared federated data analysis platform using the R-based platform DataSHIELD, which takes relevant national and international data regulations into account. The EU Child Cohort Network has an open character. All protocols for data harmonization and setting up the data analysis platform are available online. The EU Child Cohort Network creates great opportunities for researchers to use data from different cohorts, during and beyond the LifeCycle Project duration. It also provides a novel model for collaborative research in large research infrastructures with individual-level data. The LifeCycle Project will translate results from research using the EU Child Cohort Network into recommendations for targeted prevention strategies to improve health trajectories for current and future generations by optimizing their earliest phases of life.
Published: 2020
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8. Prospective analysis of circulating metabolites and breast cancer in EPIC

Author: José María Huerta, Salvatore Panico, Antonia Trichopoulou, Joseph A. Rothwell, Sabina Sieri, Anja Olsen, Christina C. Dahm, Ruth C. Travis, Audrey Gicquiau, Pilar Amiano, Elisabete Weiderpass, N. Charlotte Onland-Moret, Antonio Agudo, Anna Karakatsani, Isabelle Romieu, Paolo Vineis, Mathilde His, Elio Riboli, Marc J. Gunter, Guri Skeie, Tilman Kühn, Augustin Scalbert, Carla H. van Gils, Georgia Martimianaki, Therese Haugdahl Nøst, Anne Tjønneland, Heiner Boeing, Laure Dossus, Pietro Ferrari, Julie A. Schmidt, Rosario Tumino, Konstantinos K. Tsilidis, David Achaintre, Torkjel M. Sandanger, Agnès Fournier, Sofia Christakoudi, María José Sánchez, Vivian Viallon, Renée T. Fortner, Kim Overvad, Giovanna Masala, Sabina Rinaldi, J. Ramón Quirós, Gianluca Severi, Eva Ardanaz, [His,M, Viallon,V, Dossus,L, Gicquiau,A, Achaintre,D, Scalbert,A, Ferrari,P, Weiderpass,E, Gunter,MJ, Rinaldi,S] International Agency for Research on Cancer, Lyon, France. [Romieu,I] Centre for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico. [Onland-Moret,NC, van Gils,CH] Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. [Dahm,CC, Overvad,K] Department of Public Health, Aarhus University, Aarhus, Denmark. [Overvad,K] Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. [Olsen,A, Tjønneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Tjønneland,A] University of Copenhagen, Copenhagen, Denmark. [Fournier,A, Rothwell,JA, Severi,G] CESP, Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France. [Fournier,A, Severi,G] Gustave Roussy, Villejuif, France. [Kühn,T, Fortner,R] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany. [Trichopoulou,A, Karakatsani,A, Martimianaki,G] Hellenic Health Foundation, Athens, Greece. [Karakatsani,A] Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, 'ATTIKON' University Hospital, Haidari, Greece. [Masala,G] Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network – ISPRO, Florence, Italy. [Sieri,S] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Department, 'M.P.Arezzo'Hospital, ASP Ragusa, Ragusa, Italy. [Vineis,P] Italian Institute for Genomic Medicine (IIGM), Turin, Italy. [Vineis,P] MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK. [Panico,S] Dipartimento di medicina clinica e chirurgia, Federico II University, Naples, Italy. [Nøst,TH, Sandanger,TM, Skeie,G] Department of Community Medicine, UiT the Arctic University of Norway, Tromso, Norway. [Skeie,G] Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK. [Quirós,JR] Public Health Directorate, Asturias, Spain. [Agudo,A] Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain. [Sánchez,MJ] Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Universidad de Granada, Granada, Spain. [Sánchez,MJ, Amiano,P, Huerta,JM, Ardanaz,E] CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain. [Amiano,P] Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. [Ardanaz,E] Navarra Public Health Institute, Pamplona, Spain. [Ardanaz,E] IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. [Schmidt,JA, Travis,RC] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. [Riboli,E, Tsilidis,KK, Christakoudi,S] Department of Epidemiology and Biostatistics, Imperial College London, St Mary’s Campus, Norfolk Place, London, UK. [Tsilidis,KK] Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. [Christakoudi,S] MRC Centre for Transplantation, King’s College London, Great Maze Pond, London, SE1 9RT, UK, This work was funded by the French National Cancer Institute (grant number 2015-166). The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany), the Hellenic Health Foundation (Greece), Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands), European Research Council (ERC-2009-AdG 232997), and Nordforsk, Nordic Centre of Excellence Programme on Food, Nutrition and Health (Norway), Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236), Navarra, and the CERCA Program (Generalitat de Catalunya) (Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden), and Cancer Research UK (14136 to EPIC-Norfolk, and C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (United Kingdom).
Subjects: 0301 basic medicine, Oncology, lcsh:Medicine, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings], Mass Spectrometry, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Cohort Studies, 0302 clinical medicine, Breast cancer, Information Science::Information Science::Data Collection::Vital Statistics::Morbidity::Incidence [Medical Subject Headings], Risk Factors, Estudios prospectivos, Prospective Studies, Prospective cohort study, 11 Medical and Health Sciences, Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings], education.field_of_study, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies [Medical Subject Headings], VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Incidence, Disciplines and Occupations::Natural Science Disciplines::Biological Science Disciplines::Biochemistry::Metabolomics [Medical Subject Headings], General Medicine, Metabolómica, Middle Aged, metabolomics, 3. Good health, Research Design, 030220 oncology & carcinogenesis, Cohort, Neoplasias de la mama, Female, Chemicals and Drugs::Biological Factors::Biological Markers::Biomarkers, Pharmacological [Medical Subject Headings], Cohort study, Research Article, prospective study, Adult, medicine.medical_specialty, 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], Population, Breast Neoplasms, Càncer de mama, 03 medical and health sciences, breast cancer, Internal medicine, Cell Line, Tumor, General & Internal Medicine, medicine, Journal Article, Metabolomics, Humans, Prospective study, education, Persons::Persons::Age Groups::Adult [Medical Subject Headings], Diseases::Neoplasms::Neoplasms by Site::Breast Neoplasms [Medical Subject Headings], Aged, business.industry, lcsh:R, Case-control study, Cancer, Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Odds ratio, medicine.disease, 030104 developmental biology, Check Tags::Female [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Case-Control Studies, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Chemistry Techniques, Analytical::Mass Spectrometry [Medical Subject Headings], Biomarkers
Abstract: BackgroundMetabolomics is a promising molecular tool to identify novel etiologic pathways leading to cancer. Using a targeted approach, we prospectively investigated the associations between metabolite concentrations in plasma and breast cancer risk.MethodsA nested case-control study was established within the European Prospective Investigation into Cancer cohort, which included 1624 first primary incident invasive breast cancer cases (with known estrogen and progesterone receptor and HER2 status) and 1624 matched controls. Metabolites (n = 127, acylcarnitines, amino acids, biogenic amines, glycerophospholipids, hexose, sphingolipids) were measured by mass spectrometry in pre-diagnostic plasma samples and tested for associations with breast cancer incidence using multivariable conditional logistic regression.ResultsAmong women not using hormones at baseline (n = 2248), and after control for multiple tests, concentrations of arginine (odds ratio [OR] per SD = 0.79, 95% confidence interval [CI] = 0.70–0.90), asparagine (OR = 0.83 (0.74–0.92)), and phosphatidylcholines (PCs) ae C36:3 (OR = 0.83 (0.76–0.90)), aa C36:3 (OR = 0.84 (0.77–0.93)), ae C34:2 (OR = 0.85 (0.78–0.94)), ae C36:2 (OR = 0.85 (0.78–0.88)), and ae C38:2 (OR = 0.84 (0.76–0.93)) were inversely associated with breast cancer risk, while the acylcarnitine C2 (OR = 1.23 (1.11–1.35)) was positively associated with disease risk. In the overall population, C2 (OR = 1.15 (1.06–1.24)) and PC ae C36:3 (OR = 0.88 (0.82–0.95)) were associated with risk of breast cancer, and these relationships did not differ by breast cancer subtype, age at diagnosis, fasting status, menopausal status, or adiposity.ConclusionsThese findings point to potentially novel pathways and biomarkers of breast cancer development. Results warrant replication in other epidemiological studies.
Published: 2019
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9. Development and validation of circulating CA125 prediction models in postmenopausal women

Author: J. Ramón Quirós, N. Charlotte Onland-Moret, Anna Karakatsani, Marina Kvaskoff, Raina N. Fichorova, Pilar Amiano, Eva Lundin, Louise Hansen, Kathryn L. Terry, Sara Grioni, Kay-Tee Khaw, Leila Lujan-Barroso, Amalia Mattiello, Renée T. Fortner, Agnès Fournier, Linda J. Titus, Rudolf Kaaks, Sandra Colorado-Yohar, Anne Tjønneland, Timothy J. Key, Marc J. Gunter, Aurelio Barricarte, Shelley S. Tworoger, Laure Dossus, Britton Trabert, Naoko Sasamoto, Inger T. Gram, David C. Muller, Hanna Sartor, Bernard Rosner, Allison F. Vitonis, Francesca Mancini, Eleni Peppa, Valentina Fiano, María José Sánchez, Heiner Boeing, Daniel W. Cramer, Ana Babic, Hidemi S. Yamamoto, Rosario Tumino, Nicolas Wentzensen, Domenico Palli, Annika Idahl, Elisabete Weiderpass, Antonia Trichopoulou, Elio Riboli, Sasamoto, Naoko [0000-0002-4526-2181], Tjønneland, Anne [0000-0003-4385-2097], Tumino, Rosario [0000-0003-2666-414X], Apollo - University of Cambridge Repository, [Sasamoto,N, Vitonis,AF, Cramer,DW, Terry,KL] Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital and Harvard Medical School, 221 Longwood Avenue, Boston, MA, USA. [Babic,A] Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. [Rosner,BA] Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA. [Fortner,RT, Kaaks,R] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Yamamoto,H, Fichorova,RN] Laboratory of Genital Tract Biology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Boston, MA, USA.[Titus,LJ] Departments of Epidemiology and Pediatrics, Geisel School of Medicine at Dartmouth and Norris Cotton Cancer Center, Hanover, NH, USA. [Tjønneland,A, Hansen,L] Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark. [Tjønneland,A] Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. [Kvaskoff,M, Fournier,A, Mancini,FR] CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France. [Kvaskoff,M, Mancini,FR] Gustave Roussy, Villejuif, France. [Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. [Trichopoulou,A, Peppa,E, Karakatsani,A] Hellenic Health Foundation, Athens, Greece. [Trichopoulou,A] WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. [Karakatsani,A] 2nd Pulmonary Medicine Department, School of Medicine, 'ATTIKON' University Hospital, National and Kapodistrian University of Athens, Haidari, Greece. [Palli,D] Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy. [Grioni,S] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy. [Mattiello,A] Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Naples, Italy. [Tumino,R] Cancer Registry and Histopathology Department, 'Civic - M.P. Arezzo'Hospital, ASP, Ragusa, Italy. [Fiano,V] Unit of Cancer Epidemiology– CeRMS, Department of Medical Sciences, University of Turin, Turin, Italy. [Onland-Moret,NC] Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands. [Weiderpass,E, Gunter,M, Dossus,L] International Agency for Research on Cancer, Lyon, France. [Gram,IT] Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. [Quirós,JR] Public Health Directorate, Asturias, Spain. [Lujan-Barroso,L] Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), L’ Hospitalet de Llobregat, Barcelona, Spain. [Sánchez,MJ] Andalusian School of Public Health (EASP), Granada, Spain. [Sánchez,MJ] Instituto de Investigación Biosanitaria de Granada (ibs. GRANADA). Universidad de Granada, Granada, Spain. [Sánchez,MJ, Colorado-Yohar,S, Barricarte,A, Amiano,P] CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. [Colorado-Yohar,S] Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. [Colorado-Yohar,S] Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia. [Barricarte,A] Navarra Public Health Institute, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain. [Amiano,P] Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain. [Idahl,A] Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden. [Lundin,E] Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden. [Sartor,H] Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden. [Sartor,H] Department of Translational Medicine, Lund University, Lund, Sweden. [Khaw,KT] Cancer Epidemiology Unit, University of Cambridge, Cambridge, UK. [Key,TJ] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. [Muller,D, Riboli,E] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. [Trabert,B, Wentzensen,N] Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Washington, D.C, USA. [Tworoger,SS] Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA. [Tworoger,SS, Terry,KL] Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Research reported in this publication was supported by U.S. National Institutes of Health under the following award numbers: R01 CA193965 (to K.L. Terry), R01 CA 158119 and R35 CA197605 (to D.W. Cramer), P01 CA087969 (to S.S. Tworoger), UM1 CA186107, R01 CA49449, UM1 CA176726, R01 CA67262, and supported in part by the intramural research program of the U.S. National Cancer Institute, National Institutes of Health, Department of Health and Human Services. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany), the Hellenic Health Foundation (Greece), Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands), ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway), Health Research Fund (FIS), PI13/00061 to Granada, PI13/01162 to EPIC-Murcia), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII RETIC (RD06/0020) (Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten, The Cancer Research Foundation of Northern Sweden (Sweden), Cancer Research UK (14136 to EPIC-Norfolk, and C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (United Kingdom).
Subjects: Antígeno Ca-125, Oncology, endocrine system diseases, medicine.medical_treatment, Càncer d'ovari, Ovarian neoplasms, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Models, Theoretical [Medical Subject Headings], 0302 clinical medicine, Neoplasms, PROSTATE, 030212 general & internal medicine, CA-125, Early Detection of Cancer, Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings], 2. Zero hunger, RISK, Reproductive Biology, Biochemical markers, Obstetrics and Gynecology, Early detection, Diseases::Neoplasms [Medical Subject Headings], Middle Aged, Early diagnosis, female genital diseases and pregnancy complications, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Menopause, Postmenopause, Posmenopausia, 030220 oncology & carcinogenesis, Marcadors bioquímics, Biomarker (medicine), Female, Postmenopausal, Life Sciences & Biomedicine, Menopausa, medicine.medical_specialty, Neoplasias ováricas, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Early Diagnosis::Early Detection of Cancer [Medical Subject Headings], BIOMARKERS, CA125, Ovarian cancer, Prediction model, Reproduktionsmedicin och gynekologi, lcsh:Gynecology and obstetrics, Chemicals and Drugs::Biological Factors::Antigens::Antigens, Neoplasm::Antigens, Tumor-Associated, Carbohydrate::CA-125 Antigen [Medical Subject Headings], OVARIAN-CANCER, 03 medical and health sciences, Diagnóstico precoz, Internal medicine, Obstetrics, Gynecology and Reproductive Medicine, medicine, Journal Article, Humans, VDP::Medisinske Fag: 700, Phenomena and Processes::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Reproductive Physiological Processes::Sexual Development::Climacteric::Menopause::Postmenopause [Medical Subject Headings], lcsh:RG1-991, Aged, Hysterectomy, Science & Technology, business.industry, Research, Case-control study, CANCER SCREENING TRIAL, Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Stepwise regression, Models, Theoretical, medicine.disease, VDP::Medical disciplines: 700, Detección precoz del cáncer, Check Tags::Female [Medical Subject Headings], CA-125 Antigen, Hormone therapy, business, Body mass index, LUNG
Abstract: Background Cancer Antigen 125 (CA125) is currently the best available ovarian cancer screening biomarker. However, CA125 has been limited by low sensitivity and specificity in part due to normal variation between individuals. Personal characteristics that influence CA125 could be used to improve its performance as screening biomarker. Methods We developed and validated linear and dichotomous (≥35 U/mL) circulating CA125 prediction models in postmenopausal women without ovarian cancer who participated in one of five large population-based studies: Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO, n = 26,981), European Prospective Investigation into Cancer and Nutrition (EPIC, n = 861), the Nurses’ Health Studies (NHS/NHSII, n = 81), and the New England Case Control Study (NEC, n = 923). The prediction models were developed using stepwise regression in PLCO and validated in EPIC, NHS/NHSII and NEC. Result The linear CA125 prediction model, which included age, race, body mass index (BMI), smoking status and duration, parity, hysterectomy, age at menopause, and duration of hormone therapy (HT), explained 5% of the total variance of CA125. The correlation between measured and predicted CA125 was comparable in PLCO testing dataset (r = 0.18) and external validation datasets (r = 0.14). The dichotomous CA125 prediction model included age, race, BMI, smoking status and duration, hysterectomy, time since menopause, and duration of HT with AUC of 0.64 in PLCO and 0.80 in validation dataset. Conclusions The linear prediction model explained a small portion of the total variability of CA125, suggesting the need to identify novel predictors of CA125. The dichotomous prediction model showed moderate discriminatory performance which validated well in independent dataset. Our dichotomous model could be valuable in identifying healthy women who may have elevated CA125 levels, which may contribute to reducing false positive tests using CA125 as screening biomarker.
Published: 2019
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10. Human Early Life Exposome (HELIX) study: a European population-based exposome cohort

Author: Maitre, Léa, De Bont, Jeroen, Casas, Maribel, Robinson, Oliver, Aasvang, Gunn Marit, Agier, Lydiane, Andrušaitytė, Sandra, Ballester, Ferrán, Basagaña, Xavier, Borrás, Eva, Brochot, Céline, Bustamante, Mariona, Carracedo, Angel, De Castro, Montserrat, Dedele, Audrius, Donaire González, David, Estivill, Xavier, Evandt, Jorunn, Fossati, Serena, Giorgis Allemand, Lise, Granum, Berit, Grazuleviciene, Regina, Gützkow, Kristine Bjerve, Småstuen Haug, Line, Hernández Ferrer, Carles, Heude, Barbara, Ibarluzea Maurolagoitia, Jesús María, Julvez, Jordi, Karachaliou, Marianna, Keun, Hector C, Hjertager Krog, Norun, Lau, Chung-Ho E., Leventakou, Vasiliki, Lyon Caen, Sarah, Manzano, Cyntia, Mason, Dan, McEachan, Rosemary, Meltzer, Helle Margrete, Petraviciene, Inga, Quentin, Joane, Roumeliotaki, Theano, Sabido, Eduard, Saulnier, Pierre-Jean, Siskos, Alexandros P, Siroux, Valérie, Sunyer, Jordi, Tamayo, Ibon, Urquiza, Jose, Vafeiadi, Marina, Van Gent, Diana, Vives Usano, Marta, Waiblinger, Dagmar, Warembourg, Charline, Chatzi, Leda, Coen, Muireann, Van den Hazel, Peter, Nieuwenhuijsen, Mark J., Slama, Rémy, Thomsen, Cathrine, Wright, John, Vrijheid, Martine, Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), Norwegian Institute of Public Health [Oslo] (NIPH), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Vytautas Magnus University - Vytauto Didziojo Universitetas (VDU), Universitat de València (UV), Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana [Espagne] (FISABIO), Centre for Genomic Regulation [Barcelona] (CRG), Universitat Pompeu Fabra [Barcelona] (UPF)-Centro Nacional de Analisis Genomico [Barcelona] (CNAG), Institut National de l'Environnement Industriel et des Risques (INERIS), Universidade de Santiago de Compostela [Spain] (USC ), CIBER de Enfermedades Raras (CIBERER), Sidra Medicine [Doha, Qatar], Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University of the Basque Country/Euskal Herriko Unibertsitatea (UPV/EHU), BIODonostia Research Institute, Public Health Division of Gipuzkoa, University of Crete [Heraklion] (UOC), Imperial College London, CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Harvard University [Cambridge], Keck School of Medicine [Los Angeles], University of Southern California (USC), Maastricht University [Maastricht], Veiligheids-en Gezondheidsregio Gelderland Midden [Arnhem, the Netherlands] (VGGM), Civs, Gestionnaire, Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Commission of the European Communities, Universidade de Santiago de Compostela. Departamento de Ciencias Forenses, Anatomía Patolóxica, Xinecoloxía e Obstetricia, e Pediatría, Universidade de Santiago de Compostela. Instituto de Ciencias Forenses 'Luis Concheiro'(INCIFOR), RS: NUTRIM - R3 - Respiratory & Age-related Health, and Complexe Genetica
Subjects: Male, Urban Population, Epidemiology, Blood Pressure, 01 natural sciences, 0302 clinical medicine, USE REGRESSION-MODELS, Prospective Studies, profile, education.field_of_study, Anthropometry, public health, birth cohort, General Medicine, 3. Good health, MOTHER, Child, Preschool, Prenatal Exposure Delayed Effects, [SDV.TOX]Life Sciences [q-bio]/Toxicology, Cohort, Body Composition, HEALTH, Food Hypersensitivity, Birth cohort, medicine.medical_specialty, Exposome, exposome, 03 medical and health sciences, land-use, [SDV.EE.SANT] Life Sciences [q-bio]/Ecology, environment/Health, Humans, education, Psychological Tests, child cohort, Public health, areas, Infant, Environmental Exposure, AIR-POLLUTION, DNA Methylation, Omics, medicine.disease, CHILD COHORT, exposure, Attention Deficit Disorder with Hyperactivity, Biomarkers, Proteome, Salut Pública, Neurodevelopment, use regression-models, 010501 environmental sciences, AREAS, 11. Sustainability, 030212 general & internal medicine, Prospective cohort study, mother, Smoking, Community child health, health, omics, Respiratory Function Tests, [SDV.TOX] Life Sciences [q-bio]/Toxicology, Europe, PREGNANCY, Exposoma, Blood pressure, Metabolome, epidemiology, Female, pregnancy, community child health, Adult, Population, Mothers, PROFILE, Childhood obesity, Hazardous Substances, Young Adult, Environmental health, medicine, air-pollution, Body Weights and Measures, EXPOSURE, 0105 earth and related environmental sciences, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, LAND-USE, business.industry, Respiratory health, Infant, Newborn, HELIX, Socioeconomic Factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Gene-Environment Interaction, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, European population, business, Transcriptome
Abstract: Purpose Essential to exposome research is the collection of data on many environmental exposures from different domains in the same subjects. The aim of the Human Early Life Exposome (HELIX) study was to measure and describe multiple environmental exposures during early life (pregnancy and childhood) in a prospective cohort and associate these exposures with molecular omics signatures and child health outcomes. Here, we describe recruitment, measurements available and baseline data of the HELIX study populations. Participants The HELIX study represents a collaborative project across six established and ongoing longitudinal population-based birth cohort studies in six European countries (France, Greece, Lithuania, Norway, Spain and the UK). HELIX used a multilevel study design with the entire study population totalling 31472 mother-child pairs, recruited during pregnancy, in the six existing cohorts (first level); a subcohort of 1301 mother-child pairs where biomarkers, omics signatures and child health outcomes were measured at age 6-11 years (second level) and repeat-sampling panel studies with around 150 children and 150 pregnant women aimed at collecting personal exposure data (third level). Findings to date Cohort data include urban environment, hazardous substances and lifestyle-related exposures for women during pregnancy and their offspring from birth until 6-11 years. Common, standardised protocols were used to collect biological samples, measure exposure biomarkers and omics signatures and assess child health across the six cohorts. Baseline data of the cohort show substantial variation in health outcomes and determinants between the six countries, for example, in family affluence levels, tobacco smoking, physical activity, dietary habits and prevalence of childhood obesity, asthma, allergies and attention deficit hyperactivity disorder. Future plans HELIX study results will inform on the early life exposome and its association with molecular omics signatures and child health outcomes. Cohort data are accessible for future research involving researchers external to the project. The research leading to these results has received funding from the European Community's Seventh Framework Programme (FP7/2007-206) under grant agreement no 308333-the HELIX project. Dr Maribel Casas and Dr Jordi Julvez received funding from Instituto de Salud Carlos III (Ministry of Economy and Competitiveness) (MS16/00128, MS14/00108). INMA data collections were supported by grants from the Instituto de Salud Carlos III, CIBERESP, the Conselleria de Sanitat, Generalitat Valenciana, Department of Health of the Basque Government; the Provincial Government of Gipuzkoa, and the Generalitat de Catalunya-CIRIT. KANC was funded by the grant of the Lithuanian Agency for Science Innovation and Technology (6-04-2014_31V-66). The Norwegian Mother and Child Cohort Study (MoBa) is supported by the Norwegian Ministry of Health and the Ministry of Education and Research, NIH/NIEHS (contract no. N01-ES-75558), and NIH/NINDS (grant no. 1 UO1 NS 047537-01 and grant no. 2 UO1 NS 047537-06A1). The Rhea project was financially supported by European projects, and the Greek Ministry of Health (Program of Prevention of Obesity and Neurodevelopmental Disorders in Preschool Children, in Heraklion district, Crete, Greece: 2011-2014; 'Rhea Plus': Primary Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012-2015). The work was also supported by MICINN (MTM2015-68140-R) and Centro Nacional de Genotipado-CEGEN-PRB2-ISCIII. CW received funding from the Fondation de France.
Published: 2018
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11. Osteoprotegerin and breast cancer risk by hormone receptor subtype: A nested case-control study in the EPIC cohort

Author: Miren Dorronsoro, Marc J. Gunter, Mathilde His, Helena Schock, Sabina Sieri, Maria Dolores Chirlaque, Aurélie Affret, Rudolf Kaaks, Elisabete Weiderpass, H. Bas Bueno-de-Mesquita, Philippos Orfanos, Melissa A. Merritt, Anne Tjønneland, Domenico Palli, J. Ramón Quirós, María José Sánchez, Theron Johnson, Danja Sarink, Eva Ardanaz, Antonio Agudo, Renée T. Fortner, Laure Dossus, Timothy J. Key, Kim Overvad, Rosario Tumino, Androniki Naska, Petra H.M. Peeters, Heiner Boeing, Amalia Mattiello, Anja Olsen, Sabina Rinaldi, Eiliv Lund, Antonia Trichopoulou, Carla H. van Gils, Marie-Christine Boutron-Ruault, Kay-Tee Khaw, Elio Riboli, Fulvio Ricceri, Khaw, Kay-Tee [0000-0002-8802-2903], Apollo - University of Cambridge Repository, University Medical Center Utrecht, Imperial College Trust, [Fortner,RT, Sarink,D, Schock,H, Johnson,T, Kaaks,R] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Tjønneland,A, Olsen,A] Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark. [Overvad,K] Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. [Affret,A, His,M, Boutron-Ruault,MC] Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France. [Affret,A, Boutron-Ruault,MC] Villejuif, France. [Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. [Trichopoulou,A, Naska,A, Orfanos,P] Hellenic Health Foundation, Athens, Greece. [Trichopoulou,A, Orfanos,P] WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Palli,D] Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy. [Sieri,S] Epidemiology and Prevention Unit, Department of Preventive & Predictive Medicine Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Mattiello,A] Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, 'Civic - M.p.Arezzo' Hospital, ASP Ragusa, Italy. [Ricceri,F] Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco (TO), Italy. [Ricceri,F] Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy. [Bueno-de-Mesquita,HB] Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. [Bueno-de-Mesquita,HB, Merritt,MA, Riboli,E] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. [Bueno-de-Mesquita,HB] Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. [Peeters,PH, Van Gils,CH] Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands. [Peeters,PH] MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK. [Weiderpass,E, Lund,E] Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. [Weiderpass,E] Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway. [Weiderpass,E] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. [Weiderpass,E] Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland. [Quirós,JR] Public Health Directorate, Asturias, Spain. [Agudo,A] Unit of Nutrition and Cancer. Cancer Epidemiology Research Program. Catalan Institute of Oncology-IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain. [Sánchez,MJ] Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs. GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. [Sánchez,MJ, Chirlaque,MD, Ardanaz,E] CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Chirlaque,MD] Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain. [Chirlaque,MD] Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. [Ardanaz,E] Navarra Public Health Institute, Pamplona, Spain. [Ardanaz,E] IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. [Dorronsoro,M] Public Health Direction and Biodonostia Research Institute CIBERESP, Basque Regional Health Department, San Sebastian, Spain. [Key,T] Nuffield Department of Population Health, University of Oxford, Oxford, UK. [Khaw,KT] Cancer Epidemiology Unit, University of Cambridge, Cambridge, UK. [Rinaldi,S, Dossus,L, Gunter,M] International Agency for Research on Cancer, Lyon, France., This project was funded by research grant 111454 from the Deutsche Kresbshilfe. RT Fortner was supported by a Marie Curie International Incoming Fellowship of the European Commission’s Seventh Framework Programme (MC-IIF-623984). The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by the Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, and Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, and Federal Ministry of Education and Research (Germany), the Hellenic Health Foundation (Greece), Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and the National Research Council (Italy), the 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), and Statistics Netherlands (The Netherlands), ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway), Health Research Fund (FIS), PI13/00061 to Granada, PI13/01162 to EPIC-Murcia, Regional Governments of Andalucía, Asturias, Basque Country, Murcia, and Navarra, and ISCIII RETIC (RD06/0020) (Spain), the Swedish Cancer Society, Swedish Research Council, and County Councils of Skåne and Västerbotten (Sweden), and Cancer Research UK (14136 to EPIC-Norfolk, and C570/A16491 and C8221/A19170 to EPIC-Oxford), and the Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (UK).
Subjects: 0301 basic medicine, Oncology, Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Transcription Factors::Receptors, Cytoplasmic and Nuclear::Receptors, Steroid::Receptors, Progesterone [Medical Subject Headings], Estrogen receptor, Progesterone receptor, Cohort Studies, 0302 clinical medicine, Breast cancer, Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Membrane Proteins::Receptors, Cell Surface::Receptors, Immunologic::Receptors, Cytokine::Receptors, Tumor Necrosis Factor::Receptor Activator of Nuclear Factor-kappa B [Medical Subject Headings], Risk Factors, Prospective Studies, Prospective cohort study, Medicine(all), Osteoprotegerina, biology, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, 11 Medical And Health Sciences, General Medicine, Middle Aged, Necrosi, 3. Good health, European Prospective Investigation into Cancer and Nutrition, RANK axis, RANKL, 030220 oncology & carcinogenesis, Neoplasias de la mama, Female, Research Article, musculoskeletal diseases, medicine.medical_specialty, Receptores estrogénicos, Health Care::Environment and Public Health::Public Health::Epidemiologic Factors::Causality::Risk Factors [Medical Subject Headings], Breast Neoplasms, Receptores de progesterona, Receptores de hormonas, Hormone receptor, Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::DNA-Binding Proteins::Receptors, Cytoplasmic and Nuclear::Receptors, Steroid::Receptors, Estrogen [Medical Subject Headings], Càncer de mama, Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies [Medical Subject Headings], Necrosis, 03 medical and health sciences, Osteoprotegerin, General & Internal Medicine, Internal medicine, Journal Article, medicine, Humans, Diseases::Neoplasms::Neoplasms by Site::Breast Neoplasms [Medical Subject Headings], business.industry, Case-control study, medicine.disease, Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Prospective Studies [Medical Subject Headings], 030104 developmental biology, Endocrinology, Case-Control Studies, Nested case-control study, Phenomena and Processes::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Climacteric::Menopause::Postmenopause [Medical Subject Headings], biology.protein, Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Membrane Proteins::Receptors, Cell Surface::Receptors, Immunologic::Receptors, Cytokine::Receptors, Tumor Necrosis Factor::Tumor Necrosis Factor Decoy Receptors::Osteoprotegerin [Medical Subject Headings], VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business
Abstract: All Author: Renée T. Fortner, Danja Sarink, Helena Schock, Theron Johnson, Anne Tjønneland, Anja Olsen, Kim Overvad, Aurélie Affret, Mathilde His, Marie-Christine Boutron-Ruault, Heiner Boeing, Antonia Trichopoulou, Androniki Naska, Philippos Orfanos, Domenico Palli, Sabina Sieri, Amalia Mattiello, Rosario Tumino, Fulvio Ricceri, H. Bas Bueno-de-Mesquita, Petra H. M. Peeters, Carla H. Van Gils, Elisabete Weiderpass, Eiliv Lund, J. Ramón Quirós, Antonio Agudo, Maria-José Sánchez, María-Dolores Chirlaque, Eva Ardanaz, Miren Dorronsoro, Tim Key, Kay-Tee Khaw, Sabina Rinaldi, Laure Dossus, Marc Gunter, Melissa A. Merritt, Elio Riboli and Rudolf Kaaks, Background: Circulating osteoprotegerin (OPG), a member of the receptor activator of nuclear factor kappa-B (RANK) axis, may influence breast cancer risk via its role as the decoy receptor for both the RANK ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Circulating OPG and breast cancer risk has been examined in only one prior study. Methods: A case-control study was nested in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 2008 incident invasive breast cancer cases (estrogen receptor (ER)+, n = 1622; ER–, n = 386), matched 1:1 to controls, were included in the analysis. Women were predominantly postmenopausal at blood collection (77%); postmenopausal women included users and non-users of postmenopausal hormone therapy (HT). Serum OPG was quantified with an electrochemiluminescence assay. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression. Results: The associations between OPG and ER+ and ER– breast cancer differed significantly. Higher concentrations of OPG were associated with increased risk of ER– breast cancer (top vs. bottom tertile RR = 1.93 [95% CI 1.24–3.02]; ptrend = 0.03). We observed a suggestive inverse association for ER+ disease overall and among women premenopausal at blood collection. Results for ER– disease did not differ by menopausal status at blood collection (phet = 0.97), and we observed no heterogeneity by HT use at blood collection (phet ≥ 0.43) or age at breast cancer diagnosis (phet ≥ 0.30). Conclusions: This study provides the first prospective data on OPG and breast cancer risk by hormone receptor subtype. High circulating OPG may represent a novel risk factor for ER– breast cancer., This project was funded by research grant 111454 from the Deutsche Kresbshilfe. RT Fortner was supported by a Marie Curie International Incoming Fellowship of the European Commission’s Seventh Framework Programme (MC-IIF-623984). The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by the Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, and Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and the National Research Council (Italy); the 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), and Statistics Netherlands (The Netherlands); ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway); Health Research Fund (FIS), PI13/00061 to Granada, PI13/01162 to EPIC-Murcia, Regional Governments of Andalucía, Asturias, Basque Country, Murcia, and Navarra, and ISCIII RETIC (RD06/0020) (Spain); the Swedish Cancer Society, Swedish Research Council, and County Councils of Skåne and Västerbotten (Sweden); and Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), and the Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (UK).
Published: 2017
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12. The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort

Author: María José Sánchez, Jennifer Ose, Antonia Trichopoulou, J. Ramón Quirós, Marc J. Gunter, Xavier Castellsagué, Carlotta Sacerdote, Inger T. Gram, H B As Bueno-de-Mesquita, Johanna Ekström, Ruth C. Travis, Joakim Dillner, Carmen Navarro, Silvia de Sanjosé, Annika Idahl, Renée T. Fortner, Domenico Palli, Noémie Travier, Amalia Mattiello, David Lindquist, Annika Steffen, Elisabete Weiderpass, Christian Munk, Kay-Tee Khaw, Aurelio Barricarte, Elio Riboli, Michael Pawlita, Petra H.M. Peeters, Valeria Pala, Eiliv Lund, Philippos Orfanos, Sabina Rinaldi, F. Xavier Bosch, Pagona Lagiou, Kim Overvad, Nerea Larrañaga, N. Margall, Sylvie Mesrine, Massimo Tommasino, Silvia Franceschi, Silvia Polidoro, Melissa A. Merritt, Tim Waterboer, Giovanna Masala, Agnès Fournier, Rosario Tumino, Esther Roura, Anne Tjønneland, Françoise Clavel-Chapelon, University Medical Center Utrecht, Imperial College Trust, [Roura,E, de Sanjosé,S, Bosch,FX, Castellsagué,X] Unit of Infections and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Catalonia, Spain. [Roura,E, Sánchez,MJ, Navarro,C, Barricarte,A, Larrañaga,N, Castellsagué,X] CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Travier,N] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Catalonia, Spain. [Waterboer,T, Pawlita,M] Division of Molecular Diagnostics of Oncogenic Infections (F020), Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.[Pala,V] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Weiderpass, Dillner,J] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. [Weiderpass,E, Gram,IT, Lund,E] Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway. [Weiderpass,E] Department of Research, Cancer Registry of Norway, Oslo, Norway. Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland. [Margall,N] Microbiology Department, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain. [Dillner,J] Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden. [Tjønneland,A] Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark. [Munk,C] Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark. [Palli,D, Masala,G] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute–ISPO, Florence, Italy. [Khaw,K] School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom. [Overvad,K] Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. [Clavel-Chapelon,F, Mesrine,S, Fournier,A] Inserm, Centre for research in Epidemiology and Population Health (CESP), Nutrition, Hormones and Women’s Health team, Villejuif, France. Université Paris Sud, Villejuif, France.Institut Gustave Roussy, Villejuif, France. [Fortne,RT, Ose,J] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Steffen,A] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. [Trichopoulou,A, Orfanos,P] Hellenic Health Foundation, Athens, Greece. [Lagiou,P, Orfanos,P] Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Lagiou,P] Department of Epidemiology, Harvard School of Public Health, Boston, United States of America. [Tumino,R] Cancer Registry and Histopathology Unit, 'Civic—M.P. Arezzo' Hospital, Ragusa, Italy. [Sacerdote,C] Unit of Cancer Epidemiology, University of Turin, Turin, Italy. Centre for Cancer Epidemiology and Prevention (CPO Piemonte), Turin, Italy. [Polidoro,S] Human Genetics Foundation (HuGeF), Turin, Italy. [Mattiello,A] Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Naples, Italy. [Peeters,PH] MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom. Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. [Bueno-de-Mesquita,HB] Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands.[Bueno-de-Mesquita,HB, Merritt,MA, Gunter,MJ, Riboli,E] Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom. [Bueno-de-Mesquita,HB] Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.[Quirós,JR] Public Health Directorate, Asturias, Spain. [Sánchez,MJ] Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. [Navarro,C] Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. [Barricarte,A] Navarra Public Health Institute, Pamplona, Spain. Navarra Institute for Health Research (IdiSNA), Pamplona, Spain. [Larrañaga,N] Public Health Division of Gipuzkoa, BIODonostia Research Institute, Basque Health Department, Bilbao, Spain. [Ekström,J] BBMRI.se Service Center for Southern Sweden, Lund University, Medicon Village, Lund, Sweden. [Lindquist,D] Department of Radiation Sciences, Umeå University, Umeå, Sweden. [Idahl,A] Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden. [Travis,RC] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. [Rinaldi,S, Tommasino,M, Franceschi,S] International Agency for Research on Cancer, Lyon, France., Funding: The work was partially supported by grants from the Instituto de Salud Carlos III (Spanish Government) (grants FIS PI08/1308, PI13/00053, RCESP C03/09, RTICESP C03/10, RTIC RD06/0020/0095, RD12/0036/0056, RD12/0036/0018, and CIBERESP) and from the Agència de Gestió d’Ajuts Universitaris i de Recerca – Generalitat de Catalunya (Catalonian Government) (grants AGAUR 2005SGR00695, 2009SGR939 and 2009SGR126, 2014SGR1077, 2014SGR2016). The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by the Health Research Fund (FIS) of the Spanish Ministry of Health (Exp P10710130), Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236), Navarra and the Catalan Institute of Oncology, La Caixa (BM 06-130), RTICC-RD06/10091 (Spain), Danish Cancer Society (Denmark), Ligue contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany), the Hellenic Health Foundation (Greece), Italian Association for Research on Cancer (AIRC) and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) and Statistics Netherlands (The Netherlands), Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skåne and Västerbotten (Sweden), Cancer Research UK, Medical Research Council (United Kingdom), and Norwegian Research Council, Norwegian Cancer Society, University of Tromso (Norway).
Subjects: Diseases::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Glandular and Epithelial::Carcinoma::Carcinoma in Situ::Cervical Intraepithelial Neoplasia [Medical Subject Headings], Oncology, Replacement therapy, Pathology and Laboratory Medicine, Antibodies, Viral, Biochemistry, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Pregnancy, Prospective Studies, lcsh:Science, Gonadal Steroid Hormones, education.field_of_study, Hormonal Therapy, Contraceptives, Humanos, Anticonceptivos, 030220 oncology & carcinogenesis, Cohort, Carcinoma, Squamous Cell, Cohort studies, Science & Technology - Other Topics, Intreaepithelial neoplasia, Human, Cohort study, Oral, Human Papillomavirus Infection, medicine.medical_specialty, Càncer de coll uterí, Sexually Transmitted Diseases, Estudios retrospectivos, 03 medical and health sciences, Drug Therapy, Diseases::Neoplasms::Neoplasms by Site::Urogenital Neoplasms::Genital Neoplasms, Female::Uterine Neoplasms::Uterine Cervical Neoplasms [Medical Subject Headings], Neoplasias del cuello uterino, Humans, education, Phenomena and Processes::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Parity [Medical Subject Headings], Aged, Pharmacology, Gynecology, Cancer och onkologi, Science & Technology, Herpes Genitalis, Genitourinary Infections, Herpesvirus 2, lcsh:R, Case-control study, Biology and Life Sciences, Estrogens, medicine.disease, Hormones, 030104 developmental biology, Check Tags::Female [Medical Subject Headings], Cancer and Oncology, Case-Control Studies, Cervical cancer, Medical Devices and Equipment, lcsh:Q, Intrauterine Devices, 0301 basic medicine, Glutathione-S-transferase, Viral Diseases, Human papillomavirus infection, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies [Medical Subject Headings], Herpesvirus 2, Human, lcsh:Medicine, Uterine Cervical Neoplasms, Chlamydia trachomatis, Cervical Cancer, Cohort Studies, Cervix cancer, Paridad, Medicine and Health Sciences, Viral, Non-U.S. Gov't, Prospective cohort study, Papillomaviridae, Reproductive History, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Reproductive Control Agents::Contraceptive Agents [Medical Subject Headings], Phenomena and Processes::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Reproductive Physiological Processes::Reproduction::Pregnancy [Medical Subject Headings], Multidisciplinary, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies [Medical Subject Headings], Pharmaceutics, Research Support, Non-U.S. Gov't, Femenino, Drugs, Estudios de Casos y Controles, Middle Aged, humanities, Multidisciplinary Sciences, Infectious Diseases, Serology, Research Design, Hormonal therapy, Female, Research Article, Biotechnology, Adult, Risk, Papillomaviruses, Embarazo, General Science & Technology, Hormone Replacement Therapy, Urology, Population, Individual data, Research Support, Research and Analysis Methods, Cervical intraepithelial neoplasia, Antibodies, Contraceptives, Oral, Hormonal, Young Adult, Collaborative reanalysis, Internal medicine, Oral-contraceptives, MD Multidisciplinary, Journal Article, medicine, Multicentric case-control, Cervical Intraepithelial Neoplasia, Neoplasia Intraepitelial Cervical, Papil·lomavirus, Reproductive factors, Hormonal, business.industry, Carcinoma, Papillomavirus Infections, Cancers and Neoplasms, Chlamydia Infections, Uterine Cervical Dysplasia, Squamous Cell, Organisms::Viruses::DNA Viruses::Papillomaviridae [Medical Subject Headings], business, Gynecological Tumors, Follow-Up Studies
Abstract: The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by the Health Research Fund (FIS) of the Spanish Ministry of Health (Exp P10710130) In addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC). However, most of the evidence comes from retrospective case-control studies. The aim of this study is to prospectively evaluate associations between hormonal factors and risk of developing cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ (CIS) and invasive cervical cancer (ICC). We followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. At enrollment, participants completed a questionnaire and provided serum. After a 9-year median follow-up, 261 ICC and 804 CIN3/CIS cases were reported. In a nested case-control study, the sera from 609 cases and 1,218 matched controls were tested for L1 antibodies against HPV types 11,16,18,31,33,35,45,52,58, and antibodies against Chlamydia trachomatis and Human herpesvirus 2. Multivariate analyses were performed to estimate hazard ratios (HR), odds ratios (OR) and corresponding 95% confidence intervals (CI). The cohort analysis showed that number of full-term pregnancies was positively associated with CIN3/CIS risk (p-trend = 0.03). Duration of oral contraceptives use was associated with a significantly increased risk of both CIN3/CIS and ICC (HR = 1.6 and HR = 1.8 respectively for ≥15 years versus never use). Ever use of menopausal hormone therapy was associated with a reduced risk of ICC (HR = 0.5, 95%CI: 0.4-0.8). A non-significant reduced risk of ICC with ever use of intrauterine devices (IUD) was found in the nested case-control analysis (OR = 0.6). Analyses restricted to all cases and HPV seropositive controls yielded similar results, revealing a significant inverse association with IUD for combined CIN3/CIS and ICC (OR = 0.7). Even though HPV is the necessary cause of CC, our results suggest that several hormonal factors are risk factors for cervical carcinogenesis. Adherence to current cervical cancer screening guidelines should minimize the increased risk of CC associated with these hormonal risk factors.
Published: 2016

13. Maternal occupation during pregnancy, birth weight, and length of gestation: combined analysis of 13 European birth cohorts

Author: Karl-Christian Nordby, Evridiki Patelarou, Mariana F. Fernández, Daniela Zugna, Claudia Snijder, Anne-Marie Nybo Andersen, Henrique Barros, Mark J. Nieuwenhuijsen, Eva Hallner, Merete Eggesbø, Asta Danileviciute, Vasiliki Melaki, Martine Vrijheid, Ana M. García, Pernille Stemann Larsen, Jens Peter Bonde, Regina Gražuleviciene, Ana Cristina Santos, Lorenzo Richiardi, Inger Kull, Manon van Eijsden, Manolis Kogevinas, Loreto Santa Marina, Sylvaine Cordier, Adonina Tardón, Christine Monfort, Alex Burdorf, David Martinez, Tanja G. M. Vrijkotte, Kinga Polańska, Wojciech Hanke, Joelle Fevotte, Maribel Casas, Nathalie Costet, Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, CIBER de Epidemiología y Salud Pública (CIBERESP), Universitat Pompeu Fabra [Barcelona] (UPF), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), University of Porto Medical School and Institute of Public Health, University of Porto Medical School, Bispebjerg Hospital, University of Copenhagen = Københavns Universitet (KU), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Vytautas Magnus University - Vytauto Didziojo Universitetas (VDU), Division of Epidemiology, Norwegian Institute of Public Health [Oslo] (NIPH), University of Granada [Granada], Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR T9405), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), University of Valencia, The Institute of Environmental Medicine [Stockholm] (IMM), Karolinska Institutet [Stockholm], Stockholm County Council, Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, National School of Public Health, Sachs' Children's Hospital, Department of Clinical Science and Education, Department of Public Health [Copenhagen], Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU), University Hospital of Heraklion, NIOH, Department of Social Medicine, University of Crete [Heraklion] (UOC)-Medical School, Florence Nightingale School of Nursing and Midwifery, King‘s College London, Cancer Epidemiology Unit, Université de Turin-CPO-Piemonte, BIODonostia Research Institute, Public Health Department, Basque Government, University of Oviedo, Department of Epidemiology, Documentation and Health Promotion, Public Health Service of Amsterdam, Academic Medical Centre, Department of Public Health, University of Amsterdam [Amsterdam] (UvA), Université de Rennes (UR), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Universidade do Porto = University of Porto, University of Copenhagen = Københavns Universitet (UCPH), Universidad de Granada = University of Granada (UGR), University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH), Jonchère, Laurent, Public Health, APH - Amsterdam Public Health, ARD - Amsterdam Reproduction and Development, and Public and occupational health
Subjects: [SDV]Life Sciences [q-bio], Health Behavior, small for gestational age, 0302 clinical medicine, cohort studies, Risk Factors, Surveys and Questionnaires, occupation, 030212 general & internal medicine, 2. Zero hunger, education.field_of_study, Obstetrics, Pregnancy Outcome, Gestational age, Cohort study, Europe, Low birth weight, Meta-analysis, Preterm delivery, Small for gestational age, Public Health, Environmental and Occupational Health, birth cohort, 030210 environmental & occupational health, [SDV] Life Sciences [q-bio], Maternal Exposure, Premature birth, Infant, Small for Gestational Age, 8. Economic growth, Premature Birth, Regression Analysis, Female, maternal occupation, Public Health, pregnancy, medicine.symptom, Public aspects of medicine, RA1-1270, preterm delivery, Employment, medicine.medical_specialty, Birth weight, Population, Gestational Age, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, 03 medical and health sciences, Meta-Analysis as Topic, medicine, cohort study, Humans, low birth weight, Occupations, education, length of gestation, Pregnancy, business.industry, Environmental and Occupational Health, Infant, Newborn, birth weight, Infant, Low Birth Weight, medicine.disease, meta-analysis, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, european birth cohort, business
Abstract: International audience; Objectives - We assessed whether maternal employment during pregnancy - overall and in selected occupational sectors - is associated with birth weight, small for gestational age (SGA), term low birth weight (LBW), length of gestation, and preterm delivery in a population-based birth cohort design. Methods - We used data from >200 000 mother-child pairs enrolled in 13 European birth cohorts and compared employed versus non-employed women. Among employees, we defined groups of occupations representing the main sectors of employment for women where potential reproductive hazards are considered to be present. The comparison group comprised all other employed women not included in the occupational sector being assessed. We performed meta-analyses of cohort-specific estimates and explored heterogeneity. Results - Employees had a lower risk of preterm delivery than non-employees [adjusted odds ratio (OR adj) 0.86, 95% confidence interval (95% CI) 0.81-0.91]. Working in most of the occupational sectors studied was not associated with adverse birth outcomes. Being employed as a nurse was associated with lower risk SGA infants (OR adj0.91, 95% CI 0.84-0.99) whereas food industry workers had an increased risk of preterm delivery (OR adj1.50, 95% CI 1.12-2.02). There was little evidence for heterogeneity between cohorts. Conclusions - This study suggests that, overall, employment during pregnancy is associated with a reduction in the risk of preterm birth and that work in certain occupations may affect pregnancy outcomes. This exploratory study provides an important platform on which to base further prospective studies focused on the potential consequences of maternal occupational exposures during pregnancy on child development.
Published: 2015
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14. Nutrient Patterns and Their Food Sources in an International Study Setting: Report from the EPIC Study

Author: Andrea Wendt, Joline W.J. Beulens, H. Bas Bueno-de-Mesquita, Pilar Amiano, Stephanie E. Chiuve, Elio Riboli, Anette Hjartåker, Domenico Palli, Isabel Drake, Pietro Ferrari, Anne Tjønneland, Maria Santucci de Magistris, Esther Molina-Montes, Heinz Freisling, Timothy J. Key, Aurelio Barricarte Gurrea, Aurelie Moskal, Jytte Halkjær, Brian Buijsse, Carlotta Sacerdote, Valeria Pala, Philippos Orfanos, Pedro T. Pisa, Tilman Kühn, Heiner Boeing, Antonia Trichopoulou, José María Huerta Castaño, José Ramón Quirós, Ulrika Ericson, Lena Maria Nilsson, Elisabete Weiderpass, Anna Winkvist, Genevieve Buckland, Nadia Slimani, Laura Nailler, Marleen A. H. Lentjes, Anne-Claire Vergnaud, Marie-Christine Boutron-Ruault, Graham Byrnes, Kay-Tee Khaw, Christina C. Dahm, Christina Bamia, Claire Cadeau, Marga C. Ocké, Dora Romaguera, Rosario Tumino, Epidemiology and Data Science, ACS - Diabetes & metabolism, ACS - Heart failure & arrhythmias, APH - Health Behaviors & Chronic Diseases, [Moskal,A, Pisa,PT, Freisling,H, Slimani,N] Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France. [Ferrari,P] Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France. [Byrnes,G] Biostatistics Group, International Agency for Research on Cancer, Lyon, France. [Boutron-Ruault,M, Cadeau,C, Nailler,L] Center for research in Epidemiology and Population Health, Nutrition, Hormones and Women’s Health, INSERM, Villejuif, France. Université Paris Sud, Villejuif, France. Institut Gustave-Roussy, Villejuif, France. [Wendt,A, Kühn,T] Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany. [Boeing,H, Buijsse,B] Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany. [Tjønneland,A, Halkjær,J] Danish Cancer Society Research Center, Diet, Genes and Environment, Copenhagen, Denmark. [Dahm,CC] Section for Epidemiology, Institute of Public Health, Aarhus University, Aarhus, Denmark. [Chiuve,SE] Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America. Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America. [Quirós,JR] Public Health and Health Planning Directorate, Asturias, Spain. [Buckland,G] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain. [Molina-Montes,E] Andalusian School of Public Health, Granada, Spain. [Amiano,P, Huerta,JM, Barricarte,A] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain. [Amiano,P] Public Health Division of Gipuzkoa, BIODonostia Research Institute, San Sebastian, Spain. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. [Khaw,K, Lentjes,MA] Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. [Key,TJ] Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom. [Romaguera,D, Vergnaud,A, Riboli,E] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. [Romaguera,D] CIBER Fisiopatología de la Obesidad y Nutrición, Madrid, Spain. [Trichopoulou,A, Bamia,C, Orfanos,P] WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of AthensMedical School, Athens, Greece. Hellenic Health Foundation, Athens, Greece. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute ISPO, Florence, Italy. [Pala,V] Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, ‘‘Civile - M.P. Arezzo’’ Hospital, Ragusa, Italy. [Sacerdote,C] HuGeF Foundation and Center for Cancer Prevention CPOPiemonte, Torino, Italy. [Magistris,MS] Department of Clinical and ExperimentalMedicine, Federico II University, Naples, Italy. [Bueno-de-Mesquita,HB, Ocké,MC] The National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. [Bueno-de-Mesquita,HB] Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, The Netherlands. [Beulens,JWJ] Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. [Ericson,U] Diabetes and cardiovascular Disease, Genetic Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden. [Drake,I] Department of Clinical Sciences in Malmö, Research Group in Nutritional Epidemiology, Lund University, Malmö, Sweden. [Nilsson,LM] Department of Public Health and Clinical Medicine, Nutrition Research, Umea University, Umea, Sweden. [Winkvist,A] Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden. [Weiderpass,E] Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway. Department of Research, Cancer Registry of Norway, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Samfundet Folkhälsan, Helsinki, Finland. [Hjartaker,A] Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway., Funding: The coordination of EPIC is supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Ge´ne´ rale de l’Education Nationale, Institut National de la Sante´ et de la Recherche Me´dicale (INSERM) (France), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany), Hellenic Health Foundation (Greece), Italian Association for Research on Cancer (AIRC) and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands), [ERC-2009-AdG 232997] and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway), Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucı´a, Asturias, Basque Country, Murcia [no. 6236] and Navarra and the Catalan Institute of Oncology, ISCIII RETIC [RD06/0020] (Spain), Swedish Cancer Society, Swedish Scientific Council and Regional Government of Ska°ne and Va¨sterbotten (Sweden), Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, and Wellcome Trust (United Kingdom)., and 16491, Cancer Research UK, United Kingdom
Subjects: Male, Epidemiology, EXPLORATORY FACTOR-ANALYSIS, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], VDP::Medical disciplines: 700::Health sciences: 800::Nutrition: 811, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Surveys and Questionnaires, estudios prospectivos, Estudios prospectivos, Public and Occupational Health, Food science, Prospective Studies, Cuestionarios, lcsh:Science, mediana edad, Evaluación nutricional, Disciplines and Occupations::Natural Science Disciplines::Science::Research [Medical Subject Headings], 0303 health sciences, anciano, dieta, Geographicals::Geographic Locations::Europe [Medical Subject Headings], Vitamins, adulto, Explained variation, Food Analysis, 3. Good health, DIETARY PATTERNS, Näringslära, Micronutrient Deficiencies, 030220 oncology & carcinogenesis, estilo de vida, Physical Sciences, Science & Technology - Other Topics, evaluación nutricional, Statistics (Mathematics), Check Tags::Male [Medical Subject Headings], factores socioeconómicos, Biostatistics, Endocrinology and Diabetes, Technology, Industry, Agriculture::Food and Beverages::Food [Medical Subject Headings], Estilo de vida, VDP::Medisinske Fag: 700::Helsefag: 800::Ernæring: 811, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], BREAST-CANCER, Humans, Statistical Methods, Life Style, Aged, conducta alimentaria, Science & Technology, MULTIDISCIPLINARY SCIENCES, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Oncology: 762, lcsh:R, OLDER EUROPEANS, Biology and Life Sciences, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], Food Patterns, LARYNGEAL-CANCER, Check Tags::Female [Medical Subject Headings], Food, lcsh:Q, EUROPEAN COUNTRIES, Mathematics, análisis de alimentos, 030309 nutrition & dietetics, Animal food, humanos, lcsh:Medicine, COLORECTAL-CANCER, Nutrient, Alimentos, Medicine and Health Sciences, Public Health Surveillance, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Food Analysis [Medical Subject Headings], RISK, 2. Zero hunger, Nutrition and Dietetics, Multidisciplinary, Nutritional Deficiencies, Factores socioeconómicos, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Habits::Food Habits [Medical Subject Headings], Middle Aged, European Prospective Investigation into Cancer and Nutrition, PRINCIPAL COMPONENTS, Europe, Hábitos alimenticios, Principal component analysis, Investigación, Epidemiological Methods and Statistics, Female, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Health Surveys::Nutrition Surveys::Diet Surveys [Medical Subject Headings], Europa, Cancer Epidemiology, Research Article, Adult, 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], Context (language use), Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], Biology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Nutrition Assessment [Medical Subject Headings], Environmental health, Confidence Intervals, Vigilancia en salud pública, vigilancia en salud pública, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Nutrition, Nutrients, Feeding Behavior, Diet, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Onkologi: 762, Nutrition Assessment, Socioeconomic Factors, GASTRIC-CANCER
Abstract: Background: Compared to food patterns, nutrient patterns have been rarely used particularly at international level. We studied, in the context of a multi-center study with heterogeneous data, the methodological challenges regarding pattern analyses. Methodology/Principal Findings: We identified nutrient patterns from food frequency questionnaires (FFQ) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study and used 24-hour dietary recall (24-HDR) data to validate and describe the nutrient patterns and their related food sources. Associations between lifestyle factors and the nutrient patterns were also examined. Principal component analysis (PCA) was applied on 23 nutrients derived from country-specific FFQ combining data from all EPIC centers (N = 477,312). Harmonized 24-HDRs available for a representative sample of the EPIC populations (N = 34,436) provided accurate mean group estimates of nutrients and foods by quintiles of pattern scores, presented graphically. An overall PCA combining all data captured a good proportion of the variance explained in each EPIC center. Four nutrient patterns were identified explaining 67% of the total variance: Principle component (PC) 1 was characterized by a high contribution of nutrients from plant food sources and a low contribution of nutrients from animal food sources; PC2 by a high contribution of micro-nutrients and proteins; PC3 was characterized by polyunsaturated fatty acids and vitamin D; PC4 was characterized by calcium, proteins, riboflavin, and phosphorus. The nutrients with high loadings on a particular pattern as derived from country-specific FFQ also showed high deviations in their mean EPIC intakes by quintiles of pattern scores when estimated from 24-HDR. Center and energy intake explained most of the variability in pattern scores. Conclusion/Significance: The use of 24-HDR enabled internal validation and facilitated the interpretation of the nutrient patterns derived from FFQs in term of food sources. These outcomes open research opportunities and perspectives of using nutrient patterns in future studies particularly at international level., The coordination of EPIC is supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (INSERM) (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); Hellenic Health Foundation (Greece); Italian Association for Research on Cancer (AIRC) and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); [ERC-2009-AdG 232997] and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway); Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia [no. 6236] and Navarra and the Catalan Institute of Oncology, ISCIII RETIC [RD06/0020] (Spain); Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skane and Vasterbotten (Sweden); Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, and Wellcome Trust (United Kingdom). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Published: 2014
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15. The LifeCycle Project-EU Child Cohort Network: a federated analysis infrastructure and harmonized data of more than 250,000 children and parents

Author: Jaddoe, Vincent W. V., Felix, Janine F., Andersen, Anne-Marie Nybo, Charles, Marie-Aline, Chatzi, Leda, Corpeleijn, Eva, Donner, Nina, Elhakeem, Ahmed, Eriksson, Johan G., Foong, Rachel, Grote, Veit, Haakma, Sido, Harris, Jennifer R., Heude, Barbara, Huang, Rae-Chi, Inskip, Hazel, Järvelin, Marjo-Riitta, Koletzko, Berthold, Lawlor, Deborah A., Lindeboom, Maarten, McEachan, Rosemary R. C., Mikkola, Tuija M., Nader, Johanna L. T., de Moira, Angela Pinot, Pizzi, Costanza, Richiardi, Lorenzo, Sebert, Sylvain, Schwalber, Ameli, Sunyer, Jordi, Swertz, Morris A., Vafeiadi, Marina, Vrijheid, Martine, Wright, John, Duijts, Liesbeth, El Marroun, Hanan, Gaillard, Romy, Santos, Susana, Geurtsen, Madelon L., Kooijman, Marjolein N., Mensink-Bout, Sara M., Vehmeijer, Florianne O. L., Voerman, Ellis, Nieuwenhuijsen, Mark, Basagaña, Xavier, Bustamante, Mariona, Casas, Maribel, de Castro, Montserrat, Cirugeda, Lourdes E., Fernández-Barrés, Sílvia, Fossati, Serena, Garcia, Raquel, Júlvez, Jordi, Lertxundi, Aitana C., Lertxundi, Nerea, Llop, Sabrina, López-Vicente, Mònica, Lopez-Espinosa, Maria-Jose B., Maitre, Lea, Murcia, Mario, Lea, Jose, Urquiza, H., Warembourg, Charline, Zugna, Daniela, Popovic, Maja, Isaevska, Elena, Maule, Milena, Moccia, Chiara, Moirano, Giovenale, Rasella, Davide, Hanson, Mark A., Inskip, Hazel M., Jacob, Chandni Maria, Salika, Theodosia, Cadman, Tim, Strandberg-Larsen, Katrine M., Pedersen, Marie, Vinther, Johan L., Wilson, Paul, Mason, Dan, Yang, Tiffany C., Cardol, Marloes, van Enckevoort, Esther, Hyde, Eleanor, Scholtens, Salome, Snieder, Harold, Thio, Chris H. L., Chatzi, Lida, Margetaki, Katerina C. A., Roumeliotaki, Theano, Nader, Johanna L., Knudsen, Gun Peggy, Magnus, Per, Panico, Lidia, Ichou, Mathieu, de Lauzon-Guillain, Blandine, Dargent-Molina, Patricia, Cornet, Maxime, Florian, Sandra M., Harrar, Faryal, Lepeule, Johanna, Lioret, Sandrine, Melchior, Maria, Plancoulaine, Sabine, Männikkö, Minna, Parmar, Priyanka, Rautio, Nina, Ronkainen, Justiina, Tolvanen, Mimmi, Mikkola, Tuija M, Aumüller, Nicole, Closa-Monasterolo, Ricardo, Escribano, Joaquin, Ferré, Natalia, Gruszfeld, Dariusz, Gürlich, Kathrin, Langhendries, Jean-Paul, Luque, Veronica, Riva, Enrica, Schwarzfischer, Phillipp, Totzauer, Martina, Verduci, Elvira, Xhonneux, Annick, Zaragoza-Jordana, Marta, Schwalber, Amelie, Foong, Rachel E., Hall, Graham L., Lin, Ashleigh, Carson, Jennie, Melton, Phillip, Rauschert, Sebastian, UNIVERSITY OF OULU, Economics, Tinbergen Institute, Clinicum, Research Programs Unit, Johan Eriksson / Principal Investigator, Department of General Practice and Primary Health Care, University of Helsinki, Helsinki University Hospital Area, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Hospital Universitari de Sant Joan de Reus, Institut d’Investigació Sanitària Pere Virgili, Ciberdem, BIODonostia Research Institute, University of Turin, University of Southampton, University of Bristol [Bristol], IT University of Copenhagen, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Bradford Teaching Hospitals NHS Foundation Trust [Bradford, Royaume-Uni], University of Manchester [Manchester], University of Groningen [Groningen], University of Crete [Heraklion] (UOC), University of Southern California (USC), Norwegian Institute of Public Health [Oslo] (NIPH), Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana [Espagne] (FISABIO), IMIM-Hospital del Mar, Generalitat de Catalunya, Etude longitudinale française depuis l'enfance (UMS : Ined-Inserm-EFS) (ELFE), Institut national d'études démographiques (INED)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF), University of the Basque Country [Bizkaia] (UPV/EHU), Universitat de València (UV), Conselleria de Sanitat, Laboratorio de Salud Pública de Valencia, European Project: 733206,H2020,H2020-SC1-2016-RTD,LIFECYCLE(2017), Università degli studi di Torino = University of Turin (UNITO), IT University of Copenhagen (ITU), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK (BIHR), University of the Basque Country/Euskal Herriko Unibertsitatea (UPV/EHU), Erasmus MC other, Pediatrics, Lifestyle Medicine (LM), Reproductive Origins of Adult Health and Disease (ROAHD), and Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI)
Subjects: Male, Parents, Databases, Factual, Epidemiology, Ethnic group, BLOOD-PRESSURE, consortium, 030204 cardiovascular system & hematology, Cohort Studies, 0302 clinical medicine, Pregnancy, Risk Factors, 030212 general & internal medicine, Marketing, Child, DNA METHYLATION, Public, Environmental & Occupational Health, life course, Birth cohorts, birth cohorts, SDG 10 - Reduced Inequalities, ASSOCIATION, non-communicable diseases, 3142 Public health care science, environmental and occupational health, 3. Good health, Exposome, PREGNANCY, Child, Preschool, Cohort, Life course approach, Generation R, Female, Life Sciences & Biomedicine, Environmental Health, EARLY NUTRITION, medicine.medical_specialty, Adolescent, LifeCycle Project Group, exposome, FOLIC-ACID SUPPLEMENTS, PROFILE, 1117 Public Health and Health Services, New Consortium, 03 medical and health sciences, SDG 3 - Good Health and Well-being, medicine, Humans, Consortium, Life course, Non-communicable diseases, European Union, Noncommunicable Diseases, Window of opportunity, Science & Technology, business.industry, Public health, Stressor, Infant, Environmental Exposure, COHORTS, LIFE_COURSE, BIRTH-WEIGHT, Socioeconomic Factors, GENERATION R, RISK-FACTORS, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, DATA_ANALYSIS, business
Abstract: Early life is an important window of opportunity to improve health across the full lifecycle. An accumulating body of evidence suggests that exposure to adverse stressors during early life leads to developmental adaptations, which subsequently affect disease risk in later life. Also, geographical, socio-economic, and ethnic differences are related to health inequalities from early life onwards. To address these important public health challenges, many European pregnancy and childhood cohorts have been established over the last 30 years. The enormous wealth of data of these cohorts has led to important new biological insights and important impact for health from early life onwards. The impact of these cohorts and their data could be further increased by combining data from different cohorts. Combining data will lead to the possibility of identifying smaller effect estimates, and the opportunity to better identify risk groups and risk factors leading to disease across the lifecycle across countries. Also, it enables research on better causal understanding and modelling of life course health trajectories. The EU Child Cohort Network, established by the Horizon2020-funded LifeCycle Project, brings together nineteen pregnancy and childhood cohorts, together including more than 250,000 children and their parents. A large set of variables has been harmonised and standardized across these cohorts. The harmonized data are kept within each institution and can be accessed by external researchers through a shared federated data analysis platform using the R-based platform DataSHIELD, which takes relevant national and international data regulations into account. The EU Child Cohort Network has an open character. All protocols for data harmonization and setting up the data analysis platform are available online. The EU Child Cohort Network creates great opportunities for researchers to use data from different cohorts, during and beyond the LifeCycle Project duration. It also provides a novel model for collaborative research in large research infrastructures with individual-level data. The LifeCycle Project will translate results from research using the EU Child Cohort Network into recommendations for targeted prevention strategies to improve health trajectories for current and future generations by optimizing their earliest phases of life. The LifeCycle project received funding from the European Union’s Horizon 2020 research and innovation programme (Grant Agreement No. 733206 LifeCycle). All study specific acknowledgements and funding are presented in the supplementary materials. This manuscript reflects only the author's view and the Commission is not responsible for any use that may be made of the information it contains
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16. Comparing Mohs micrographic surgery and wide local excision in the management of head and neck dermatofibrosarcoma protuberans: a scoping review.

Author: Sanabria A, Pinillos P, Chiesa-Estomba C, Guntinas-Lichius O, Kowalski LP, Mäkitie AA, Rao KN, and Ferlito A
Subjects: Adult, Humans, Mohs Surgery methods, Neoplasm Recurrence, Local surgery, Retrospective Studies, Dermatofibrosarcoma surgery, Skin Neoplasms surgery
Abstract: Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive cutaneous sarcoma with a propensity for recurrence. Its management, particularly in the head and neck (H&N) region, presents unique challenges. This study aimed to evaluate the effectiveness of Mohs micrographic surgery (MMS) compared to wide local excision (WLE) in treating H&N DFSP and its impact on recurrence rates and tissue preservation. A comprehensive search was conducted in PubMed/MEDLINE, yielding 29 relevant studies. We included studies comparing MMS and WLE in adult patients with H&N DFSP and reporting local recurrence outcomes. Data were analyzed using random effects analysis, with a meta-analysis performed for comparative studies. Analysis of studies demonstrated a lower recurrence for MMS. Comparative analysis of five studies involving 117 patients showed a significantly lower recurrence rate in the MMS group (2%) compared to the WLE group (19%). Margin status varied between studies, with some achieving negative margins at shorter distances. In the management of H&N DFSP, MMS has emerged as a superior surgical technique, consistently associated with reduced recurrence rates and the potential for tissue preservation. The adoption of MMS should be considered for its capacity to achieve negative margins with fewer processing steps, particularly in anatomically complex regions like the H&N.
Published: 2024
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17. Prophylactic antibiotics in sialendoscopy: a randomized clinical trial.

Author: Chiesa-Estomba CM, Sanchez-Barrueco A, Cammaroto G, Lechien JR, Mayo-Yanez M, Cenjor C, Capaccio P, and Saga-Gutierrez C
Subjects: Humans, Male, Female, Double-Blind Method, Middle Aged, Prospective Studies, Adult, Anti-Bacterial Agents therapeutic use, Anti-Bacterial Agents administration & dosage, Aged, Surgical Wound Infection prevention & control, Young Adult, Adolescent, Antibiotic Prophylaxis methods, Endoscopy methods
Abstract: Objective: Antibiotics have been prescribed routinely in sialendoscopy procedures to reduce the risk of postoperative infection, despite the limited evidence supporting this practice. Being necessary to assess the need for antibiotics in Sialendoscopy, aiming to provide evidence-based guidance to clinicians regarding antibiotic administration in this procedure., Materials & Method: A prospective, randomized, double-blind, controlled clinical trial to evaluate the of prophylactic antibiotics in Sialendoscopy was designed., Results: A total of 80 patients were included in this study, including 57 females (71.8%) and 23 males (28.8%). In terms of prophylaxis, 36 patients (45%) received prophylactic treatment, and 44 patients (55%) did not. The occurrence of infectious events was observed in 2 patients (5.6%) with prophylaxis and 4 patients (9.1%) without prophylaxis. However, this difference was not statistically significant (p = 0.556)., Conclusion: In conclusion, our prospective, randomized clinical trial aimed to address the debate regarding the use of prophylactic antibiotics in sialendoscopy. Our study's findings suggest that the routine use antibiotics may not be necessary to prevent postoperative infections in sialendoscopy procedures. These results have important implications for clinical practice, potentially reducing the unnecessary use of antibiotics and addressing concerns related to antibiotic resistance and adverse drug reactions., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Published: 2024
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18. Letter to the Editor: Serum identification of At-Risk MASH: The metabolomics-advanced steatohepatitis fibrosis score (MASEF).

Author: Noureddin M, Truong E, Mayo R, Martínez-Arranz I, Mincholé I, Banales JM, Arrese M, Cusi K, Arias-Loste MT, Bruha R, Romero-Gómez M, Iruzubieta P, Aller R, Ampuero J, Calleja JL, Ibañez-Samaniego L, Aspichueta P, Marín-Duce A, Kushner T, Ortiz P, Harrison SA, Anstee QM, Crespo J, Mato JM, and Sanyal AJ
Published: 2024
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19. Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors.

Author: Marcos-Delgado A, Martín-Sánchez V, Molina-Barceló A, Alonso-Molero J, Pérez-Gómez B, Pollán M, Aragonés N, Ederra-Sanza M, Fernández-Tardón G, Binefa G, Moreno V, Barrios-Rodríguez R, Amiano P, Huerta JM, Teso EP, Alguacil J, Castaño-Vinyals G, Kogevinas M, and Molina de la Torre AJ
Abstract: The aim of our study is to evaluate the relationship between sociodemographic and clinical characteristics of individuals with Colorectal Cancer (CRC), tumour-intrinsic characteristics and treatment received with health-related quality of life (HRQoL)., Methods: Cross-sectional analysis of data from 805 survivors from the MCC study was conducted. HRQoL was assessed through a general and specific questionnaire, SF-12 and FCSI (Colorectal Symptom Index). Statistical analyses were performed with linear regression with adjustment for sociodemographic variables, stage at diagnosis and histological grade., Results: Participants had survived a median of 7.9 years from diagnosis (IQR 7.1-8.5 years). Age at diagnosis, sex and area showed a clear association with HRQoL in both physical and mental dimensions of the SF-12 questionnaire. A direct association between CRC recurrence was also found in the PCS-12 and MCS-12 dimensions and radical surgery in the PCS-12. Regarding the scores in FCSI questionnaire, statistically significant differences were observed by sex, age and area, with older women being the most impaired ( p < 0.001)., Conclusions: Age, sex and area was associated with lower scores of HRQoL among CRC survivors. Knowing the determinants related to HRQoL would allow us to lay the groundwork to develop strategies that help reduce morbidity and mortality, relapses and increase HRQoL.
Published: 2024
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20. Visual snow syndrome in patients with migraine: widening the clinical spectrum of the syndrome with permanent and episodic manifestations.

Author: González-Ávila C, García-Azorín D, Mínguez-Olaondo A, Rubio-Flores L, Lamas R, Nieves-Castellanos C, López-Bravo A, Muñoz-Vendrell A, Campoy S, Sebastian-Valles F, and Quintas S
Subjects: Humans, Male, Female, Cross-Sectional Studies, Adult, Middle Aged, Vision Disorders epidemiology, Vision Disorders etiology, Vision Disorders physiopathology, Prevalence, Syndrome, Comorbidity, Perceptual Disorders, Migraine Disorders epidemiology, Migraine Disorders diagnosis, Migraine Disorders complications
Abstract: Purpose: Migraine is the comorbidity most frequently associated with visual snow syndrome (VSS), but the prevalence of VSS in patients with migraine (PWM) has not been studied. Our objective was to evaluate the frequency of VSS in PWM and to analyze if symptoms of VSS happened in a permanent or episodic manner (eVSS) in this population., Methods: We conducted a multicenter observational cross-sectional study. PWM was recruited from headache units, and a survey about the presence of visual snow symptoms was administered. The frequency and characteristics of patients that met current VSS criteria were analyzed. Demographic and clinical features of patients with VSS, eVSS, and PWM with no visual snow were compared., Results: A total of 217 PWM were included. Seventeen patients (7.8%) met the VSS criteria. VSS patients had visual aura more frequently (58.8% vs. 31%; p = 0.019) and a higher MIDAS score (96.6 vs. 47.7; p = 0.014). Fifty-eight PWM (26.7%) showed visual snow and associated features in an episodic way and were classified as eVSS. Patients with VSS showed a tendency towards a higher frequency of visual symptoms than patients with eVSS (p > 0.05). No statistically significant differences in sociodemographic characteristics and comorbid conditions were found between VSS and eVSS., Conclusion: The prevalence of VSS in PWM may be higher than that described for the general population. Some PWM may present similar visual symptoms to patients with VSS but in an episodic manner. Our study reinforces the observation that the clinical spectrum of visual snow is likely to be broader than previously described., (© 2024. Fondazione Società Italiana di Neurologia.)
Published: 2024
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21. Examining the Performance of ChatGPT 3.5 and Microsoft Copilot in Otolaryngology: A Comparative Study with Otolaryngologists' Evaluation.

Author: Mayo-Yáñez M, Lechien JR, Maria-Saibene A, Vaira LA, Maniaci A, and Chiesa-Estomba CM
Abstract: To evaluate the response capabilities, in a public healthcare system otolaryngology job competition examination, of ChatGPT 3.5 and an internet-connected GPT-4 engine (Microsoft Copilot) with the real scores of otolaryngology specialists as the control group. In September 2023, 135 questions divided into theoretical and practical parts were input into ChatGPT 3.5 and an internet-connected GPT-4. The accuracy of AI responses was compared with the official results from otolaryngologists who took the exam, and statistical analysis was conducted using Stata 14.2. Copilot (GPT-4) outperformed ChatGPT 3.5. Copilot achieved a score of 88.5 points, while ChatGPT scored 60 points. Both AIs had discrepancies in their incorrect answers. Despite ChatGPT's proficiency, Copilot displayed superior performance, ranking as the second-best score among the 108 otolaryngologists who took the exam, while ChatGPT was placed 83rd. A chat powered by GPT-4 with internet access (Copilot) demonstrates superior performance in responding to multiple-choice medical questions compared to ChatGPT 3.5., Competing Interests: Conflict of interestThe authors have no conflicts of interest to declare., (© Association of Otolaryngologists of India 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)
Published: 2024
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22. In Reference to Gastroesophageal Reflux and Chronic Rhinosinusitis: A Mendelian Randomization Study.

Author: Maniaci A, Iannella G, Chiesa-Estomba CM, Saibene AM, and Lechien JR
Subjects: Humans, Chronic Disease, Rhinosinusitis, Gastroesophageal Reflux diagnosis, Sinusitis genetics, Sinusitis complications, Rhinitis genetics, Mendelian Randomization Analysis
Published: 2024
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23. The biochemical pattern defines MASLD phenotypes linked to distinct histology and prognosis.

Author: Ampuero J, Aller R, Gallego-Durán R, Crespo J, Calleja JL, García-Monzón C, Gómez-Camarero J, Caballería J, Lo Iacono O, Ibañez L, García-Samaniego J, Albillos A, Francés R, Fernández-Rodríguez C, Maya-Miles D, Diago M, Poca M, Andrade RJ, Latorre R, Jorquera F, Morillas RM, Escudero D, Hernández-Guerra M, Pareja-Megia MJ, Banales JM, Aspichueta P, Benlloch S, Rosales JM, Turnes J, and Romero-Gómez M
Subjects: Humans, Female, Male, Middle Aged, Prognosis, Adult, Aged, Liver Cirrhosis pathology, Liver Cirrhosis diagnosis, Biopsy, Liver pathology, Elasticity Imaging Techniques methods, Alanine Transaminase blood, Cholestasis pathology, Cholestasis diagnosis, Phenotype
Abstract: Background: MASLD can manifest as hepatocellular damage, which can result in mild elevation of aminotransferases. However, in some patients, MASLD presents with cholestatic pattern., Objective: To assess the impact of the biochemical pattern on the natural course of MASLD, including liver damage in histology, the accuracy of non-invasive tests(NITs), and prognosis., Methods: Multicenter study enrolling 2156 patients with biopsy-proven MASLD, who were classified based on their[ALT/ULN)]/[(ALP/ULN)] levels at the time of biopsy: (a) hepatocellular pattern(H), > 5; (b) mixed pattern(M),2-5; (c) cholestatic pattern(C), < 2., Outcomes: (a) histological evaluation of the single components of NAS, MASH, and fibrosis; (b) NITs and transient elastography assessing advanced fibrosis; (c) prognosis determined by the appearance of decompensated cirrhosis and death., Results: Out of the 2156 patients, 22.9% exhibited the H-pattern, whilst 31.7% exhibited the C-pattern. Severe steatosis, ballooning, lobular inflammation, and MASH (56.4% H vs. 41.9% M vs. 31.9% C) were more common in H-pattern (p = 0.0001),whilst C-pattern was linked to cirrhosis (5.8% H vs. 5.6% M vs. 10.9% C; p = 0.0001). FIB-4(0.74(95% CI 0.69-0.79) vs. 0.83 (95% CI 0.80-0.85); p = 0.005) and Hepamet Fibrosis Score(0.77 (95% CI 0.69-0.85) vs. 0.84 (95% CI 0.80-0.87); p = 0.044)exhibited lower AUROCs in the H-pattern. The C-pattern[HR 2.37 (95% CI 1.12-5.02); p = 0.024], along with age, diabetes, and cirrhosis were independently associated with mortality. Most patients maintained their initial biochemical pattern during the second evaluation., Conclusions: The H-pattern exhibited greater necro-inflammation in the histology than the C-pattern, whereas the latter showed more cirrhosis. The accuracy of NITs in detecting fibrosis was decreased in H-pattern. The occurrence of decompensated events and mortality was predominant in C-pattern. Therefore, identifying MASLD phenotypes based on the biochemical presentation could be relevant for clinical practice., (© 2024. The Author(s).)
Published: 2024
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24. Comparison of TEVA vs. PRAAT in the Acoustic Characterization of the Tracheoesophageal Voice in Laryngectomized Patients.

Author: Klein-Rodríguez A, Cabo-Varela I, Vázquez-de la Iglesia F, Chiesa-Estomba CM, and Mayo-Yáñez M
Abstract: Background: Previous studies have assessed the capability of PRAAT for acoustic voice analysis in total laryngectomized (TL) patients, although this software was designed for acoustic analysis of laryngeal voice. Recently, we have witnessed the development of specialized acoustic analysis software, Tracheoesophageal Voice Analysis (TEVA). This study aims to compare the analysis with both programs in TL patients. Methods: Observational analytical study of 34 TL patients where a quantitative acoustic analysis was performed for stable phonation with vowels [a] and [i] as well as spectrographic characterization using the TEVA and PRAAT software. Results: The Voice Handicap Index (VHI-10) showed a mean score of 11.29 ± 11.16 points, categorized as a moderate handicap. TEVA analysis found lower values in the fundamental frequency vs. PRAAT ( p < 0.05). A significant increase in shimmer values was observed with TEVA (>20%). No significant differences were found between spectrographic analysis with TEVA and PRAAT. Conclusions: Tracheoesophageal speech is an alaryngeal voice, characterized by a higher degree of irregularity and noise compared to laryngeal speech. Consequently, it necessitates a more tailored approach using objective assessment tools adapted to these distinct features, like TEVA, that are designed specifically for TL patients. This study provides statistical evidence supporting its reliability and suitability for the evaluation and tracking of tracheoesophageal speakers.
Published: 2024
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25. Correction to: Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort.

Author: Stepien M, Duarte-Salles T, Fedirko V, Trichopoulou A, Lagiou P, Bamia C, Overvad K, Tjønneland A, Hansen L, Boutron-Ruault MC, Fagherazzi G, Severi G, Kühn T, Kaaks R, Aleksandrova K, Boeing H, Klinaki E, Palli D, Grioni S, Panico S, Tumino R, Naccarati A, Bueno-de-Mesquita HB, Peeters PH, Skeie G, Weiderpass E, Parr CL, Quirós JR, Buckland G, Molina-Montes E, Amiano P, Chirlaque MD, Ardanaz E, Sonestedt E, Ericson U, Wennberg M, Nilsson LM, Khaw KT, Wareham N, Bradbury KE, Ward HA, Romieu I, and Jenab M
Published: 2024
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26. Stereotactic Body Radiotherapy as a Curative Treatment for De Novo Mucosal Carcinoma of the Head and Neck: A Feasible Alternative Option for Fragile Patients with Small Lesion: A Systematic Review.

Author: Strojan P, Kokalj M, Plavc G, Ng SP, Nuyts S, Chiesa-Estomba CM, Eisbruch A, de Bree R, Chow JCH, Mäkitie AA, Lopez F, Saba NF, and Ferlito A
Abstract: Stereotactic body radiotherapy (SBRT) is characterized by a high dose per fraction, well-defined small targets, superior dose conformity, and a steep off-target dose gradient. A literature search was conducted to examine the experience with SBRT as a curative treatment for newly diagnosed mucosal carcinoma of the head and neck (MCHN). Four retrospective case series and one prospective phase I clinical trial published between 2012 and 2020 described 124 patients. SBRT was mainly performed in older patients with different tumor sites. The median size of the planning target volumes ranged from 5.3 to 41 cm 3 . Different approaches were used to create margins. In two studies, limited elective nodal irradiation was performed. The equivalent doses used were 60-83.33 Gy delivered in five fractions. Considerable heterogeneity was observed in the radiation dose specification. The incidence of grade ≥3 late toxicity was 0-8.3%, with local and regional control ranging from 73% to 100%. Improved or stable quality of life after SBRT was reported in two studies. Curative-intent SBRT for de novo MCHN appears to be an effective and relatively safe treatment for small tumor targets, preferably without concomitant elective tissue irradiation. Standardization of SBRT practice and well-designed prospective clinical trials are needed to better define the role of SBRT in this setting.
Published: 2024
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27. Correction: Exploring the potential of Chat-GPT as a supportive tool for sialendoscopy clinical decision making and patient information support.

Author: Chiesa-Estomba CM, Lechien JR, Vaira LA, Brunet A, Cammaroto G, Mayo-Yanez M, Sanchez-Barrueco A, and Saga-Gutierrez C
Published: 2024
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28. Validity and reliability of an instrument evaluating the performance of intelligent chatbot: the Artificial Intelligence Performance Instrument (AIPI).

Author: Lechien JR, Maniaci A, Gengler I, Hans S, Chiesa-Estomba CM, and Vaira LA
Subjects: Female, Humans, Reproducibility of Results, Psychometrics, Surveys and Questionnaires, Artificial Intelligence
Abstract: Objectives: To evaluate the reliability and validity of the Artificial Intelligence Performance Instrument (AIPI)., Methods: Medical records of patients consulting in otolaryngology were evaluated by physicians and ChatGPT for differential diagnosis, management, and treatment. The ChatGPT performance was rated twice using AIPI within a 7-day period to assess test-retest reliability. Internal consistency was evaluated using Cronbach's α. Internal validity was evaluated by comparing the AIPI scores of the clinical cases rated by ChatGPT and 2 blinded practitioners. Convergent validity was measured by comparing the AIPI score with a modified version of the Ottawa Clinical Assessment Tool (OCAT). Interrater reliability was assessed using Kendall's tau., Results: Forty-five patients completed the evaluations (28 females). The AIPI Cronbach's alpha analysis suggested an adequate internal consistency (α = 0.754). The test-retest reliability was moderate-to-strong for items and the total score of AIPI (r s = 0.486, p = 0.001). The mean AIPI score of the senior otolaryngologist was significantly higher compared to the score of ChatGPT, supporting adequate internal validity (p = 0.001). Convergent validity reported a moderate and significant correlation between AIPI and modified OCAT (r s = 0.319; p = 0.044). The interrater reliability reported significant positive concordance between both otolaryngologists for the patient feature, diagnostic, additional examination, and treatment subscores as well as for the AIPI total score., Conclusions: AIPI is a valid and reliable instrument in assessing the performance of ChatGPT in ear, nose and throat conditions. Future studies are needed to investigate the usefulness of AIPI in medicine and surgery, and to evaluate the psychometric properties in these fields., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Published: 2024
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29. Is the evolving role of artificial intelligence and chatbots in the field of otolaryngology embracing the future?

Author: Chiesa-Estomba CM, Speth MM, Mayo-Yanez M, Liu DT, Maniaci A, and Borsetto D
Subjects: Humans, Artificial Intelligence
Published: 2024
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30. Chat GPT for the management of obstructive sleep apnea: do we have a polar star?

Author: Mira FA, Favier V, Dos Santos Sobreira Nunes H, de Castro JV, Carsuzaa F, Meccariello G, Vicini C, De Vito A, Lechien JR, Chiesa-Estomba C, Maniaci A, Iannella G, Rojas EP, Cornejo JB, and Cammaroto G
Subjects: Humans, Cross-Sectional Studies, Prospective Studies, Alanine Transaminase, Clinical Decision-Making, Sleep Apnea, Obstructive diagnosis, Sleep Apnea, Obstructive therapy
Abstract: Purpose: This study explores the potential of the Chat-Generative Pre-Trained Transformer (Chat-GPT), a Large Language Model (LLM), in assisting healthcare professionals in the diagnosis of obstructive sleep apnea (OSA). It aims to assess the agreement between Chat-GPT's responses and those of expert otolaryngologists, shedding light on the role of AI-generated content in medical decision-making., Methods: A prospective, cross-sectional study was conducted, involving 350 otolaryngologists from 25 countries who responded to a specialized OSA survey. Chat-GPT was tasked with providing answers to the same survey questions. Responses were assessed by both super-experts and statistically analyzed for agreement., Results: The study revealed that Chat-GPT and expert responses shared a common answer in over 75% of cases for individual questions. However, the overall consensus was achieved in only four questions. Super-expert assessments showed a moderate agreement level, with Chat-GPT scoring slightly lower than experts. Statistically, Chat-GPT's responses differed significantly from experts' opinions (p = 0.0009). Sub-analysis revealed areas of improvement for Chat-GPT, particularly in questions where super-experts rated its responses lower than expert consensus., Conclusions: Chat-GPT demonstrates potential as a valuable resource for OSA diagnosis, especially where access to specialists is limited. The study emphasizes the importance of AI-human collaboration, with Chat-GPT serving as a complementary tool rather than a replacement for medical professionals. This research contributes to the discourse in otolaryngology and encourages further exploration of AI-driven healthcare applications. While Chat-GPT exhibits a commendable level of consensus with expert responses, ongoing refinements in AI-based healthcare tools hold significant promise for the future of medicine, addressing the underdiagnosis and undertreatment of OSA and improving patient outcomes., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Published: 2024
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31. Exploring the potential of Chat-GPT as a supportive tool for sialendoscopy clinical decision making and patient information support.

Author: Chiesa-Estomba CM, Lechien JR, Vaira LA, Brunet A, Cammaroto G, Mayo-Yanez M, Sanchez-Barrueco A, and Saga-Gutierrez C
Subjects: Humans, Prospective Studies, Cross-Sectional Studies, Reproducibility of Results, Endoscopy methods, Alanine Transaminase, Artificial Intelligence, Salivary Gland Diseases surgery
Abstract: Introduction: Sialendoscopy has emerged in the last decades as a groundbreaking technique, offering a minimally invasive approach for exploring and managing salivary gland disorders. More recently, the advent of chatbots, powered by advanced natural processing language and artificial intelligence algorithms, has revolutionized the way healthcare professionals and patients access and analyze medical information and potentially will support soon the clinical decision-making process., Materials and Methods: A prospective, cross-sectional study was designed to assess the level of agreement between Chat-GPT and 10 expert sialendoscopists aiming the capabilities of Chat-GPT to further improve the management of salivary gland disorders., Results: The mean level of agreement was 3.4 (SD: 0.69; Min: 2, Max: 4) for Chat-GPT's answers while it was 4.1 (SD: 0.56; Min: 3, Max: 5) for the group of EESS (p < 0.015). The overall Wilcoxon signed-rank test yielded a significance level of p < 0.026 when comparing the level of agreement between Chat-GPT and EESS. The mean number of therapeutic alternatives suggested by Chat-GPT was 3.33 (SD: 1.2; Min: 2, Max: 5), while it was 2.6 (SD: 0.51; Min: 2, Max: 3) for the group of EESS; p = 0.286 (95% CI - 0.385 to 1.320)., Conclusion: Chat-GPT represents a promising tool in the clinical decision-making process within the salivary gland clinic, particularly for patients who are candidates for sialendoscopy treatment. Additionally, it serves as a valuable source of information for patients. However, further development is necessary to enhance the reliability of these tools and ensure their safety and optimal use in the clinical setting., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Published: 2024
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32. Heterogeneity, crosstalk, and targeting of cancer-associated fibroblasts in cholangiocarcinoma.

Author: Cantallops Vilà P, Ravichandra A, Agirre Lizaso A, Perugorria MJ, and Affò S
Subjects: Humans, Bile Ducts, Intrahepatic, Tumor Microenvironment, Cancer-Associated Fibroblasts, Cholangiocarcinoma drug therapy, Cholangiocarcinoma genetics, Biliary Tract, Bile Duct Neoplasms drug therapy, Contracture, Arachnodactyly
Abstract: Cholangiocarcinoma (CCA) comprises diverse tumors of the biliary tree and is characterized by late diagnosis, short-term survival, and chemoresistance. CCAs are mainly classified according to their anatomical location and include diverse molecular subclasses harboring inter-tumoral and intratumoral heterogeneity. Besides the tumor cell component, CCA is also characterized by a complex and dynamic tumor microenvironment where tumor cells and stromal cells crosstalk in an intricate network of interactions. Cancer-associated fibroblasts, one of the most abundant cell types in the tumor stroma of CCA, are actively involved in cholangiocarcinogenesis by participating in multiple aspects of the disease including extracellular matrix remodeling, immunomodulation, neo-angiogenesis, and metastasis. Despite their overall tumor-promoting role, recent evidence indicates the presence of transcriptional and functional heterogeneous CAF subtypes with tumor-promoting and tumor-restricting properties. To elucidate the complexity and potentials of cancer-associated fibroblasts as therapeutic targets in CCA, this review will discuss the origin of cancer-associated fibroblasts, their heterogeneity, crosstalk, and role during tumorigenesis, providing an overall picture of the present and future perspectives toward cancer-associated fibroblasts targeting CCA., (Copyright © 2023 American Association for the Study of Liver Diseases.)
Published: 2024
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33. Advancing tracheoesophageal fistula repair techniques: Suggestions for future research.

Author: Mayo-Yanez M, Cocuzza S, Chiesa Estomba C, Lechien JR, and Maniaci A
Subjects: Humans, Forecasting, Retrospective Studies, Tracheoesophageal Fistula surgery
Published: 2024
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34. Osteopontin characterizes bile duct-associated macrophages and correlates with liver fibrosis severity in primary sclerosing cholangitis.

Author: De Muynck K, Heyerick L, De Ponti FF, Vanderborght B, Meese T, Van Campenhout S, Baudonck L, Gijbels E, Rodrigues PM, Banales JM, Vesterhuus M, Folseraas T, Scott CL, Vinken M, Van der Linden M, Hoorens A, Van Dorpe J, Lefere S, Geerts A, Van Nieuwerburgh F, Verhelst X, Van Vlierberghe H, and Devisscher L
Subjects: Humans, Osteopontin, Liver Cirrhosis pathology, Bile Ducts pathology, Macrophages pathology, Cholangitis, Sclerosing pathology, Cholestasis pathology, Colitis
Abstract: Background and Aims: Primary sclerosing cholangitis (PSC) is an immune-mediated cholestatic liver disease for which pharmacological treatment options are currently unavailable. PSC is strongly associated with colitis and a disruption of the gut-liver axis, and macrophages are involved in the pathogenesis of PSC. However, how gut-liver interactions and specific macrophage populations contribute to PSC is incompletely understood., Approach and Results: We investigated the impact of cholestasis and colitis on the hepatic and colonic microenvironment, and performed an in-depth characterization of hepatic macrophage dynamics and function in models of concomitant cholangitis and colitis. Cholestasis-induced fibrosis was characterized by depletion of resident KCs, and enrichment of monocytes and monocyte-derived macrophages (MoMFs) in the liver. These MoMFs highly express triggering-receptor-expressed-on-myeloid-cells-2 ( Trem2 ) and osteopontin ( Spp1 ), markers assigned to hepatic bile duct-associated macrophages, and were enriched around the portal triad, which was confirmed in human PSC. Colitis induced monocyte/macrophage infiltration in the gut and liver, and enhanced cholestasis-induced MoMF- Trem2 and Spp1 upregulation, yet did not exacerbate liver fibrosis. Bone marrow chimeras showed that knockout of Spp1 in infiltrated MoMFs exacerbates inflammation in vivo and in vitro , while monoclonal antibody-mediated neutralization of SPP1 conferred protection in experimental PSC. In human PSC patients, serum osteopontin levels are elevated compared to control, and significantly increased in advanced stage PSC and might serve as a prognostic biomarker for liver transplant-free survival., Conclusions: Our data shed light on gut-liver axis perturbations and macrophage dynamics and function in PSC and highlight SPP1/OPN as a prognostic marker and future therapeutic target in PSC., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Published: 2024
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35. ChatGPT performance in laryngology and head and neck surgery: a clinical case-series.

Author: Lechien JR, Georgescu BM, Hans S, and Chiesa-Estomba CM
Subjects: Humans, Otolaryngologists, Biopsy, Diagnosis, Differential, Positron Emission Tomography Computed Tomography, Otolaryngology
Abstract: Objectives: To study the performance of ChatGPT in the management of laryngology and head and neck (LHN) cases., Methods: History and clinical examination of patients consulting at the Otolaryngology-Head and Neck Surgery department were presented to ChatGPT, which was interrogated for differential diagnosis, management, and treatment. The ChatGPT performance was assessed by two blinded board-certified otolaryngologists using the following items of a composite score and the Ottawa Clinic Assessment Tool: differential diagnosis; additional examination; and treatment options. The complexity of clinical cases was evaluated with the Amsterdam Clinical Challenge Scale test., Results: Forty clinical cases were submitted to ChatGPT, accounting for 14 (35%), 12 (30%), and 14 (35%) easy, moderate and difficult cases, respectively. ChatGPT indicated a significant higher number of additional examinations compared to practitioners (p = 0.001). There was a significant agreement between practitioners and ChatGPT for the indication of some common examinations (audiometry, ultrasonography, biopsy, gastrointestinal endoscopy or videofluoroscopy). ChatGPT never indicated some important additional examinations (PET-CT, voice quality assessment, or impedance-pH monitoring). ChatGPT reported highest performance in the proposition of the primary (90%) or the most plausible differential diagnoses (65%), and the therapeutic options (60-68%). The ChatGPT performance in the indication of additional examinations was lowest., Conclusions: ChatGPT is a promising adjunctive tool in LHN practice, providing extensive documentation about disease-related additional examinations, differential diagnoses, and treatments. The ChatGPT is more efficient in diagnosis and treatment, rather than in the selection of the most adequate additional examination., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Published: 2024
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36. Plasma Concentration of 36 (Poly)phenols and Prospective Body Weight Change in Participants from the EPIC Cohort.

Author: Gil-Lespinard M, Almanza-Aguilera E, Castañeda J, Guiñón-Fort D, Eriksen AK, Tjønneland A, Rothwell JA, Shah S, Cadeau C, Katzke V, Johnson T, Schulze MB, Oliverio A, Pasanisi F, Tumino R, Manfredi L, Masala G, Skeie G, Lundblad MW, Brustad M, Lasheras C, Crous-Bou M, Molina-Montes E, Colorado-Yohar S, Guevara M, Amiano P, Johansson I, Hultdin J, Forouhi NG, Freisling H, Merdas M, Debras C, Heath AK, Aglago EK, Aune D, and Zamora-Ros R
Subjects: Humans, Prospective Studies, Phenol, Body Weight, Biomarkers, Phenols, Neoplasms
Abstract: Introduction: Dietary intake of (poly)phenols has been linked to reduced adiposity and body weight (BW) in several epidemiological studies. However, epidemiological evidence on (poly)phenol biomarkers, particularly plasma concentrations, is scarce. We aimed to investigate the associations between plasma (poly)phenols and prospective BW change in participants from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort., Methods: This study included 761 participants with data on BW at baseline and after 5 years of follow-up. Plasma concentrations of 36 (poly)phenols were measured at baseline using liquid chromatography-tandem mass spectrometry. Associations were assessed through general linear mixed models and multinomial logistic regression models, using change in BW as a continuous or as a categorical variable (BW loss, maintenance, gain), respectively. Plasma (poly)phenols were assessed as log2-transformed continuous variables. The false discovery rate (FDR) was used to control for multiple comparisons., Results: Doubling plasma (poly)phenol concentrations showed a borderline trend towards a positive association with BW loss. Plasma vanillic acid showed the strongest association (-0.53 kg/5 years; 95% confidence interval [CI]: -0.99, -0.07). Similar results were observed for plasma naringenin comparing BW loss versus BW maintenance (odds ratio: 1.1; 95% CI: 1.0, 1.2). These results did not remain significant after FDR correction., Conclusion: Higher concentrations of plasma (poly)phenols suggested a tendency towards 5-year BW maintenance or loss. While certain associations seemed promising, they did not withstand FDR correction, indicating the need for caution in interpreting these results. Further studies using (poly)phenol biomarkers are needed to confirm these suggestive protective trends., (© 2024 The Author(s). Published by S. Karger AG, Basel.)
Published: 2024
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37. Serum identification of at-risk MASH: The metabolomics-advanced steatohepatitis fibrosis score (MASEF).

Author: Noureddin M, Truong E, Mayo R, Martínez-Arranz I, Mincholé I, Banales JM, Arrese M, Cusi K, Arias-Loste MT, Bruha R, Romero-Gómez M, Iruzubieta P, Aller R, Ampuero J, Calleja JL, Ibañez-Samaniego L, Aspichueta P, Martín-Duce A, Kushner T, Ortiz P, Harrison SA, Anstee QM, Crespo J, Mato JM, and Sanyal AJ
Subjects: Humans, Liver diagnostic imaging, Liver pathology, Liver Cirrhosis pathology, Fibrosis, Predictive Value of Tests, Biopsy adverse effects, Non-alcoholic Fatty Liver Disease pathology, Elasticity Imaging Techniques
Abstract: Background: Early identification of those with NAFLD activity score ≥ 4 and significant fibrosis (≥F2) or at-risk metabolic dysfunction-associated steatohepatitis (MASH) is a priority as these patients are at increased risk for disease progression and may benefit from therapies. We developed and validated a highly specific metabolomics-driven score to identify at-risk MASH., Methods: We included derivation (n = 790) and validation (n = 565) cohorts from international tertiary centers. Patients underwent laboratory assessment and liver biopsy for metabolic dysfunction-associated steatotic liver disease. Based on 12 lipids, body mass index, aspartate aminotransferase, and alanine aminotransferase, the MASEF score was developed to identify at-risk MASH and compared to the FibroScan-AST (FAST) score. We further compared the performance of a FIB-4 + MASEF algorithm to that of FIB-4 + liver stiffness measurements (LSM) by vibration-controlled transient elastography (VCTE)., Results: The diagnostic performance of the MASEF score showed an area under the receiver-operating characteristic curve, sensitivity, specificity, and positive and negative predictive values of 0.76 (95% CI 0.72-0.79), 0.69, 0.74, 0.53, and 0.85 in the derivation cohort, and 0.79 (95% CI 0.75-0.83), 0.78, 0.65, 0.48, and 0.88 in the validation cohort, while FibroScan-AST performance in the validation cohort was 0.74 (95% CI 0.68-0.79; p = 0.064), 0.58, 0.79, 0.67, and 0.73, respectively. FIB-4+MASEF showed similar overall performance compared with FIB-4 + LSM by VCTE ( p = 0.69) to identify at-risk MASH., Conclusion: MASEF is a promising diagnostic tool for the assessment of at-risk MASH. It could be used alternatively to LSM by VCTE in the algorithm that is currently recommended by several guidance publications., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Published: 2024
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38. Predictors of Success of Pharyngeal Surgery in the Treatment of Obstructive Sleep Apnea: A Narrative Review.

Author: Nunes HDSS, Vaz de Castro J, Favier V, Carsuzaa F, Kim MHR, Mira FA, Meccariello G, Vicini C, De Vito A, Lechien JR, Chiesa Estomba C, Maniaci A, Iannella G, and Cammaroto G
Abstract: (1) Background: This narrative review aims to explore the predictors of success for pharyngeal surgery in the treatment of obstructive sleep apnea (OSA). An extensive literature search was conducted, identifying relevant studies published up to June 2023, utilizing various databases and key search terms related to OSA, surgical interventions, and predictors of success. The review encompasses both retrospective and prospective studies, case series, and cohort studies to provide a broad understanding of the topic; (2) Methods: Review of English scientific literature on phenotypes of OSA related to predictors of success of pharyngeal surgery; (3) Results: Of 75 articles, 21 were included, in these the following were determined to be factors for surgical success: body mass index (BMI) (8 articles), apnea/hypopnea index (AHI) (8 articles), cephalometry (8 articles), palatine tonsil size (7 articles), Modified Mallampati score (2 articles), genioglossus electromyography (2 articles), Friedman score or upper airway anatomy (3 articles), nasopharyngolaryngoscopy (2 articles), drug-induced sleep endoscopy (DISE) (1 article), oral cavity anatomy (1 article) and oxygen desaturation index (ODI) (1 article); (4) Conclusions: The lack of standardized protocols for the indication of pharyngeal surgery is a reality, however identifying known predictors of surgical success may facilitate homogenizing indications.
Published: 2023
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39. Biomarkers in Laryngeal Squamous Cell Carcinoma: The Literature Review.

Author: Verro B, Saraniti C, Carlisi D, Chiesa-Estomba C, Maniaci A, Lechien JR, Mayo M, Fakhry N, and Lauricella M
Abstract: Laryngeal squamous cell carcinoma (LSCC) is the second most common cancer among head and neck cancers. Despite a lower incidence of laryngeal carcinoma, new diagnostic techniques, and more targeted therapies, the overall survival has not changed significantly in the last decades, leading to a negative prognosis in advanced stages. Recently, several studies have focused on the identification of biomarkers that may play a critical role in the pathogenesis of LSCC. Reviewing the literature on the main databases, this study aims to investigate the role of some biomarkers in LSCC that are correlated with oxidative stress and inflammation: heat shock proteins; metallothioneins; nuclear factor erythroid 2-related factor 2; heme oxygenase; cyclooxygenase-2; and micro ribonucleic acids. This review shows that biomarker expression depends on the type, grade of differentiation, stage, and site of carcinoma. In addition, the role of these biomarkers in LSCC is still little-known and little-studied. However, the study of biomarker expression and the detection of a possible correlation with patients' epidemiological, clinicopathological, and therapeutics data may lead to better awareness and knowledge of the tumor, to the identification of the best therapeutic strategy, and the most proper follow-up protocol tailored for each patient. In conclusion, the achievement of these goals may improve the prognosis of LSCC patients.
Published: 2023
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40. Targeting the Heterogeneous Tumour-Associated Macrophages in Hepatocellular Carcinoma.

Author: Agirre-Lizaso A, Huici-Izagirre M, Urretabizkaia-Garmendia J, Rodrigues PM, Banales JM, and Perugorria MJ
Abstract: Hepatocellular carcinoma (HCC) is a prevalent and aggressive cancer that comprises a complex tumour microenvironment (TME). Tumour-associated macrophages (TAMs) are one of the most abundant immune cells present in the TME, and play a key role both in the development and in the progression of HCC. Thus, TAM-based immunotherapy has been presented as a promising strategy to complement the currently available therapies for HCC treatment. Among the novel approaches focusing on TAMs, reprogramming their functional state has emerged as a promising option for targeting TAMs as an immunotherapy in combination with the currently available treatment options. Nevertheless, a further understanding of the immunobiology of TAMs is still required. This review synthesizes current insights into the heterogeneous nature of TAMs in HCC and describes the mechanisms behind their pro-tumoural polarization focusing the attention on their interaction with HCC cells. Furthermore, this review underscores the potential involvement of TAMs' reprogramming in HCC therapy and highlights the urgency of advancing our understanding of these cells within the dynamic landscape of HCC.
Published: 2023
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41. Velopharyngeal Incompetence in Musicians: A State-of-the-Art Review.

Author: Mata-Pose L, Mayo-Yáñez M, Chiesa-Estomba CM, Lechien JR, Vaira LA, Maniaci A, Saibene AM, Calvo-Henríquez C, and Cabo-Varela I
Abstract: The velopalatine sphincter is a muscular valve that creates a hermetic seal between the nasopharynx and the oropharynx. It guarantees phonation, swallowing, and breathing (forces expirations). In wind musicians, sphincter closure must be precise during sound generation. Its failure will cause velopharyngeal incompetence (VPI) and the end of professional success. The objective of this article was to conduct a state-of-art review of VPI in wind musicians with a systematic approach based on the PRISMA Statement. The etiology, epidemiology, clinic, diagnosis, and treatment of VPI in wind musicians were evaluated. The research was carried out in different databases (PubMed/MEDLINE, the Cochrane Library, Scielo) and through the Mergullador metasearch engine. A total of 20 publications were selected. VPI is a pathology that affects around one-third of wind musicians according to studies. It causes pharyngeal noises and nasal air emissions during performance. The main etiology seems to be the fatigue of the velopalatine sphincter muscles. The most used diagnostic techniques consist of clinical history, physical examination, and nasofibroscopy. There is no consensus among authors about therapeutic management. Future investigations are necessary to confirm that fatigue of velopalatine sphincter muscles and other factors that increase it are the main causes of VPI in wind musicians.
Published: 2023
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42. Predictive value of tumor budding in head and neck squamous cell carcinoma: an update.

Author: Chiesa-Estomba CM, Thompson L, Agaimy A, Zidar N, Simpson RHW, Franchi A, Rodrigo JP, Mäkitie AA, Almangush A, Leivo I, and Ferlito A
Subjects: Humans, Squamous Cell Carcinoma of Head and Neck, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Biomarkers, Tumor, Carcinoma, Squamous Cell pathology, Head and Neck Neoplasms
Abstract: Head and neck squamous cell carcinoma forms an anatomically and functionally complex group of malignancies. The significant local aggressiveness and frequent regional relapses motivate ongoing research to identify more reliable and sensitive prognostic and predictive biomarkers. One emerging area of cancer biology is the evaluation of tumor budding at the advancing invasive front of various types of epithelial cancers. Recent studies suggest that tumor budding is a relatively common phenomenon in cancer progression and that it may have important prognostic implications for patients due to its potential to provide valuable insights into the biology and clinical behavior of head and neck cancer. In this review, we aim to provide information about tumor budding in head and neck squamous cell carcinoma. Thus, we hope to shed light on the complex biology of these malignancies, as well as aiding diagnostic, classification, and better characterization and thereby, looking for new avenues for improving patient outcomes., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Published: 2023
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43. Indications, Efficacy, Safety, and Clinical Outcomes of 585 nm Pulsed Dye Laser in Non-Malignant Laryngeal Lesions: A Systematic Review.

Author: González-Rodríguez H, Mayo-Yáñez M, Maria-Saibene A, Allevi F, Chiesa-Estomba CM, Vaira LA, and Lechien JR
Abstract: The objective of this manuscript was to review the indications, efficacy, and safety of a 585 nm pulsed dye laser (PDL) in non-malignant laryngeal lesions. Following the PRISMA statement recommendations, three independent authors searched for articles published in PubMed/MEDLINE, the Cochrane Library, Google Scholar, Scielo, and Web of Science. A bias analysis was performed following NICE guidance tools. From the 506 identified publications, 19 observational studies met the inclusion criteria. The PDL improves vocal quality objectively and subjectively in vascular lesions ( p < 0.005) and improves vocal quality in patients with dysplasia/leukoplasia without changing the natural history of the disease compared to other treatments. Reinke's edema and granulomas require an average of 1.5 PDL sessions for resolution. Treatment of recurrent respiratory papillomatosis requires multiple sessions, with complete remission achieved in 50-70% of patients. Regardless of the lesion, the tolerance of the procedure under local anesthesia is exceptional (84-97%), and the results in terms of regression and vocal quality are promising. The complication rate is minimal, and the procedure does not interfere with other treatment alternatives. There is no consensus on laser settings. The lack of consistent use in evaluating vocal outcomes, whether objective or subjective, prevents the comparability between studies. The 585 nm pulsed dye laser appears to be an effective and safe therapeutic option in patients with non-malignant laryngeal pathology. Future controlled studies are needed to compare the 585 nm pulsed dye laser with other lasers or cold instrument procedures.
Published: 2023
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44. Impact of lymph node ratio and number of lymph node metastases on survival and recurrence in laryngeal squamous cell carcinoma.

Author: Molteni G, Nocini R, Mattioli F, Nakayama M, Dedivitis RA, Mannelli G, Crosetti E, Chiesa-Estomba CM, Sistiaga-Suarez JA, Giordano L, Galli A, Lionello M, Mercante G, Ralli M, Fermi M, Klein-Rodríguez A, Mayo-Yáñez M, Serafini E, Pirola F, Paderno A, Cambria F, Oridate N, Sano D, Boscolo-Rizzo P, Marcuzzo AV, Parrinello G, Marchi F, Saibene AM, Tucciarone M, Viscasillas G, Zeleník K, Ramos DM, Palacios-Garcia J, Tirelli G, Pellini R, Paludetti G, Galli J, Rossi G, De Vincentiis M, Cernea CR, Spriano G, Bussi M, Peretti G, Succo G, Piazza C, Bertolin A, Kowalski LP, Presutti L, and Sacchetto A
Subjects: Humans, Squamous Cell Carcinoma of Head and Neck pathology, Neoplasm Staging, Lymphatic Metastasis pathology, Lymph Node Ratio, Prognosis, Retrospective Studies, Lymph Node Excision, Lymph Nodes pathology, Head and Neck Neoplasms pathology
Abstract: Introduction: The aim of this study is to assess the impact of lymph node ratio (LNR) and number of positive lymph nodes (NPLN) on mortality and recurrence rates in patients with laryngeal squamous cell carcinoma., Materials and Methods: We conducted a retrospective multicenter international study involving 24 Otorhinolaryngology-Head and Neck Surgery divisions. Disease-specific survival (DSS) and disease-free survival (DFS) were evaluated as the main outcomes. The curves for DSS and DFS according to NPLN and LNR were analyzed to identify significant variations and establish specific cut-off values., Results: 2507 patients met the inclusion criteria. DSS and DFS were significantly different in the groups of patients stratified according to LNR and NPLN. The 5-year DSS and DFS based on LNR and NPLN demonstrated an improved ability to stratify patients when compared to pN staging., Conclusion: Our data demonstrate the potential prognostic value of NPLN and LNR in laryngeal squamous cell carcinoma., (© 2023 Wiley Periodicals LLC.)
Published: 2023
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45. Sociodemographic profile and description of the presenting symptom in women with breast cancer in a population-based study: Implications and role for nurses.

Author: Diaz-Santos MA, Marcos-Delgado A, Amiano P, Ardanaz E, Pollán M, and Alguacil J
Subjects: Humans, Female, Educational Status, Research Design, Spain epidemiology, Breast Neoplasms diagnosis, Breast Neoplasms epidemiology
Abstract: Objective: To describe the frequency and typology of the presenting symptom of women diagnosed of breast cancer in Spain and their socio-demographic profile., Methods: Descriptive study nested in a population epidemiological study (MCC-SPAIN) in 10 Spanish provinces. Between 2008 and 2012, 836 histologically confirmed incident cases of breast cancer were recruited who reported some symptom prior to diagnosis in a direct computerized interview. For the comparison of 2 discrete variables, the Pearson Chi square test was used., Results: The most frequent presenting symptom among women who reported at least one symptom was noticing a "lump in the breast" (73%), followed far behind by noticing "changes in the breast" (11%). Geographic heterogeneity was observed in the frequency of the presenting symptom, as well as with menopausal status. No association was observed between the type of presenting symptom and the rest of the sociodemographic variables explored, except for the educational level in which women with a higher educational level tended to proportionally report other symptoms different from the "lump in the breast" more frequently than less educated. Postmenopausal women reported noticing changes in the breast (13%) more frequently than premenopausal women (8%), although without reaching statistical significance (P = .056)., Conclusions: The most frequent presenting symptom is "breast lump", followed by "breast changes". There could be sociodemographic heterogeneity in the type of presenting symptom to be taken into account by nurses in their socio-sanitary interventions., (Copyright © 2023. Published by Elsevier España, S.L.U.)
Published: 2023
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46. Dysphagia after supraglottic laryngeal cancer surgery.

Author: Lechien JR, Chiesa-Estomba CM, Maniaci A, Vaira LA, and Gengler IM
Subjects: Humans, Squamous Cell Carcinoma of Head and Neck surgery, Laryngectomy adverse effects, Retrospective Studies, Neoplasm Staging, Laryngeal Neoplasms surgery, Laryngeal Neoplasms pathology, Deglutition Disorders diagnosis, Deglutition Disorders etiology, Deglutition Disorders surgery, Carcinoma, Squamous Cell surgery, Carcinoma, Squamous Cell pathology, Head and Neck Neoplasms surgery
Published: 2023
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47. Current management of xerostomia in head and neck cancer patients.

Author: Nathan CO, Asarkar AA, Entezami P, Corry J, Strojan P, Poorten VV, Makitie A, Eisbruch A, Robbins KT, Smee R, St John M, Chiesa-Estomba C, Winter SC, Beitler JJ, and Ferlito A
Subjects: Humans, Quality of Life, Salivary Glands, Submandibular Gland, Xerostomia etiology, Xerostomia prevention & control, Head and Neck Neoplasms complications, Head and Neck Neoplasms radiotherapy
Abstract: Radiotherapy (RT) continues to play a key role in the management of head and neck cancer (HNC). Xerostomia remains a principal detriment to the quality of life (QoL) for 80 % of surviving patients receiving head and neck radiation. Radiation-induced injury to the salivary glands is dose-dependent, and thus efforts have been focused on decreasing radiation to the salivary glands. Decreased saliva production reduces both short-term and long-term quality of life in head and neck survivors by impacting on taste and contributing to dysphagia. Several radioprotective agents to the salivary gland have been investigated. Although not widely practiced, surgical transfer of the submandibular gland prior to RT is the mainstay of surgical options in preventing xerostomia. This review focuses on the strategies to improve xerostomia following radiation therapy in head and neck cancers., (Copyright © 2023 Elsevier Inc. All rights reserved.)
Published: 2023
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48. Tissue augmentation treatment for periprosthetic leakage in patients who have undergone a total laryngectomy: A systematic review.

Author: Mayo-Yáñez M, Ramos-Neble MD, Cabo-Varela I, Chiesa-Estomba CM, Lechien JR, Fakhry N, Maniaci A, and Hutcheson KA
Subjects: Humans, Laryngectomy methods, Punctures adverse effects, Retrospective Studies, Laryngeal Neoplasms surgery, Larynx, Artificial adverse effects, Tracheoesophageal Fistula surgery
Abstract: Objectives: Tracheoesophageal puncture (TEP) is considered the gold standard for voice rehabilitation after total laryngectomy. One of the main causes of treatment failure, and a potentially serious complication, is the TEP enlargement and/or leakage around the voice prosthesis. The injection of biocompatible material to increase the volume of the puncture surrounding tissue has been studied as a popular option for conservative treatment of enlarged tracheoesophageal fistula. The aim of this paper was to perform a systematic review of the efficacy and safety of such treatment., Desingn: Search conducted in PubMed/MEDLINE, the Cochrane Library, Google Scholar, Scielo and Web of Science and through the meta-searcher Trip Database based on Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) statement., Settings: Human experiments published in peer-reviewed journals, where investigators assessed the use of peri-fistular tissue augmentation for periprosthetic leakage were evaluated., Participants: Laryngectomized patients with voice prosthesis, presenting periprosthetik leak due to enlarged fistula., Main Outcomes Measures: mean-duration without new leak., Results: A total of 196 peri-fistular tissue augmentation procedures in 97 patients were found in the 15 selected articles. The 58.8% of patients had a time without periprosthetic leak after treatment of >6 months. The 88.7% of tissue augmentation treatments resulted in periprosthetic leakage cessation. The general level of evidence of the studies included in this review was low., Conclusions: Tissue augmentation treatment is a minimally invasive, biocompatible and safe solution that temporarily resolves periprosthetic leaks in many cases. There is no standard technique or material, and treatment needs to be individualised according to the experience of the practitioner and the characteristics of the patient. Future randomised studies are needed to confirm these results., (© 2023 John Wiley & Sons Ltd.)
Published: 2023
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49. Locoregional strategies to decrease postoperative pain and neck discomfort after open thyroidectomy: A scoping review.

Author: Sanabria A, Betancourt C, Chiesa-Estomba C, Coca-Pelaz A, Florek E, Guntinas-Lichius O, Lopez F, Mäkitie AA, Nixon IJ, Randolph G, Rinaldo A, Rodrigo JP, Shaha AR, Tufano RP, Zafereo M, and Ferlito A
Subjects: Humans, Quality of Life, Pain, Postoperative prevention & control, Analgesics, Thyroidectomy adverse effects, Nerve Block
Abstract: Adequate pain control enhances patients' quality of life and allows a quick return to normal activities. Current pain management practices may contribute to the crisis of opioid addiction. We summarize the evidence that evaluates locoregional interventions to decrease pain and neck discomfort after thyroidectomy. We designed a scoping review. The search strategy was made in the Pubmed/MEDLINE and EMBASE database. We included only systematic reviews and RCTs that compared two or more strategies. Forty-nine publications including 5045 patients fulfilled criteria. Sore throat frequency is higher for endotracheal intubation and topical administration of anesthetic before intubation decreases this. Pre-incisional infiltration of the surgical wound decreases postoperative pain. Bilateral superficial plexus nerve block decreases analgesic requirements during and after thyroidectomy. Wound massage and neck exercises decrease postoperative discomfort. Locoregional interventions significantly impact postoperative pain and may reduce opioid use and improve patient outcomes., (© 2023 Wiley Periodicals LLC.)
Published: 2023
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50. Cost-Effectiveness Study of Double-Flange Voice Prostheses in the Treatment of Periprosthetic Leakage in Laryngectomized Patients.

Author: Rodríguez-Lorenzana P, Mayo-Yáñez M, Chiesa-Estomba CM, Vaira LA, Lechien JR, Maniaci A, and Cabo-Varela I
Abstract: Background: Tracheoesophageal speech with a voice prosthesis is considered the rehabilitation treatment of choice in laryngectomized patients. The main reasons for prosthesis failure are endoprosthetic leakage and periprosthetic leakage. The Provox XtraSeal ® stent incorporates an additional double flange on the esophageal side to prevent periprosthetic leakage. The objective of this study is to compare the duration and costs of the Provox Vega ® and Provox XtraSeal ® prostheses used in these patients in a tertiary university hospital., Materials and Methods: A prospective crossover case study of laryngectomees with Provox Vega ® who underwent Provox XtraSeal ® placement due to recurrent periprosthetic leaks and decreased theoretical prosthesis life. The duration and possible factors affecting voice prostheses were studied using Kaplan-Meier curves and Cox regression. A cost-effectiveness analysis was carried out from the perspective of the Spanish National Health System with an incremental cost-effectiveness calculation., Results: A total of 38 patients were recruited, 35 men and 3 women, with a mean age of 66.26 ± 9.36 years old. Information was collected from 551 voice prostheses, 484 Provox Vega ® and 68 Provox XtraSeal ® . The mean duration of Provox Vega ® was 119.75 ± 148.8 days and that of Provox XtraSeal ® was 181.99 ± 166.07 days ( p = 0.002). The most frequent reason for replacement was endoprosthetic leakage in both groups: 283 (60.86%) in the case of Provox Vega ® and 29 (48.33%) in that of XtraSeal ® ( p < 0.000). To obtain no cost differences (ICE ~ 0) between Provox Vega and Provox XtraSeal, the latter should cost EUR 551.63., Conclusions: The Provox XtraSeal ® is a cost-effective option in patients with increased prosthesis replacements due to periprosthetic leakage, reducing the number of replacements, increasing the duration of the prosthesis, and providing savings compared to Provox Vega ® .
Published: 2023
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