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1. Decline in Instrumental Activities of Daily Living over 4-Year: The Association with Hearing, Visual and Dual Sensory Impairments among Non-Institutionalized Women

Author: Bouscaren, N., Yildiz, H., Dartois, L., Vercambre, M. N., and Boutron-Ruault, Marie Christine
Published: 2019
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2. Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

Author: Buckland, G., Travier, N., Huerta, J. M., Bueno-de-Mesquita, H. B(as), Siersema, P. D., Skeie, G., Weiderpass, E., Engeset, D., Ericson, U., Ohlsson, B., Agudo, A., Romieu, I., Ferrari, P., Freisling, H., Colorado-Yohar, S., Li, K., Kaaks, R., Pala, V., Cross, A. J., Riboli, E., Trichopoulou, A., Lagiou, P., Bamia, C., Boutron-Ruault, M. C., Fagherazzi, G., Dartois, L., May, A. M., Peeters, P. H., Panico, S., Johansson, M., Wallner, B., Palli, D., Key, T. J., Khaw, K. T., Ardanaz, E., Overvad, K., Tjnneland, A., Dorronsoro, M., Sánchez, M. J., Quirós, J. R., Naccarati, A., Tumino, R., Boeing, H., and Gonzalez, C. A.
Published: 2015
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3. Oral contraceptive use and cutaneous melanoma risk: a French prospective cohort study

Author: Cervenka, I., primary, Mahamat‐Saleh, Y., additional, Savoye, I., additional, Dartois, L., additional, Boutron‐Ruault, M.C., additional, Fournier, A., additional, and Kvaskoff, M., additional
Published: 2018
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4. Exogenous hormone use and cutaneous melanoma risk in women: The European prospective investigation into cancer and nutrition

Author: Cervenka, I., primary, Mahamat-Saleh, Y., additional, Dartois, L., additional, Boutron-Ruault, M.-C., additional, Fournier, A., additional, and Kvaskoff, M., additional
Published: 2018
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5. Coffee Drinking and Mortality in 10 European Countries: A Multinational Cohort Study

Author: Gunter, M.J., Murphy, N., Cross, A.J., Dossus, L., Dartois, L., Fagherazzi, G., Kaaks, R., Kuhn, T., Boeing, H., Aleksandrova, K., Tjonneland, A., Olsen, A., Overvad, K., Larsen, S.C., Cornejo, M.L. Redondo, Agudo, A., Perez, M.J., Altzibar, J.M., Navarro, C, Ardanaz, E., Khaw, K.T., Butterworth, A., Bradbury, K.E., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Palli, D., Grioni, S., Vineis, P., Panico, S., Tumino, R., Bueno-de-Mesquita, B., Siersema, P.D., Leenders, M., Beulens, J.W., Uiterwaal, C.U., Wallstrom, P., Nilsson, L.M., Landberg, R., Weiderpass, E., Skeie, G., Braaten, T., Brennan, P., Licaj, I., Muller, D.C., Sinha, R., Wareham, N., Riboli, E., Gunter, M.J., Murphy, N., Cross, A.J., Dossus, L., Dartois, L., Fagherazzi, G., Kaaks, R., Kuhn, T., Boeing, H., Aleksandrova, K., Tjonneland, A., Olsen, A., Overvad, K., Larsen, S.C., Cornejo, M.L. Redondo, Agudo, A., Perez, M.J., Altzibar, J.M., Navarro, C, Ardanaz, E., Khaw, K.T., Butterworth, A., Bradbury, K.E., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Palli, D., Grioni, S., Vineis, P., Panico, S., Tumino, R., Bueno-de-Mesquita, B., Siersema, P.D., Leenders, M., Beulens, J.W., Uiterwaal, C.U., Wallstrom, P., Nilsson, L.M., Landberg, R., Weiderpass, E., Skeie, G., Braaten, T., Brennan, P., Licaj, I., Muller, D.C., Sinha, R., Wareham, N., and Riboli, E.
Abstract: Item does not contain fulltext, Background: The relationship between coffee consumption and mortality in diverse European populations with variable coffee preparation methods is unclear. Objective: To examine whether coffee consumption is associated with all-cause and cause-specific mortality. Design: Prospective cohort study. Setting: 10 European countries. Participants: 521 330 persons enrolled in EPIC (European Prospective Investigation into Cancer and Nutrition). Measurements: Hazard ratios (HRs) and 95% CIs estimated using multivariable Cox proportional hazards models. The association of coffee consumption with serum biomarkers of liver function, inflammation, and metabolic health was evaluated in the EPIC Biomarkers subcohort (n = 14 800). Results: During a mean follow-up of 16.4 years, 41 693 deaths occurred. Compared with nonconsumers, participants in the highest quartile of coffee consumption had statistically significantly lower all-cause mortality (men: HR, 0.88 [95% CI, 0.82 to 0.95]; P for trend < 0.001; women: HR, 0.93 [CI, 0.87 to 0.98]; P for trend = 0.009). Inverse associations were also observed for digestive disease mortality for men (HR, 0.41 [CI, 0.32 to 0.54]; P for trend < 0.001) and women (HR, 0.60 [CI, 0.46 to 0.78]; P for trend < 0.001). Among women, there was a statistically significant inverse association of coffee drinking with circulatory disease mortality (HR, 0.78 [CI, 0.68 to 0.90]; P for trend < 0.001) and cerebrovascular disease mortality (HR, 0.70 [CI, 0.55 to 0.90]; P for trend = 0.002) and a positive association with ovarian cancer mortality (HR, 1.31 [CI, 1.07 to 1.61]; P for trend = 0.015). In the EPIC Biomarkers subcohort, higher coffee consumption was associated with lower serum alkaline phosphatase; alanine aminotransferase; aspartate aminotransferase; gamma-glutamyltransferase; and, in women, C-reactive protein, lipoprotein(a), and glycated hemoglobin levels. Limitations: Reverse causality may have biased the findings; however, results did not differ aft
Published: 2017

6. Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study1,4

Author: Vergnaud, A, Romaguera, D, Peeters, P, Gils, v, Chan, D, Romieu, I, Freisling, H, Ferrari, P, Clavel-Chapelon, F, Fagherazzi, G, Dartois, L, Li, K, Tikk, K, Bergmann, M, Boeing, H, Tjønneland, A, Olsen, A, Overvad, K, Dahm, C, Redondo, M, Agudo, A, Sánchez, M, Amiano, P, Chirlaque, MD, and Ardanaz, E
Abstract: BACKGROUND: In 2007, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued recommendations on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence. OBJECTIVE: We investigated whether concordance with WCRF/AICR recommendations is related to risk of death. DESIGN: The current study included 378,864 participants from 9 European countries enrolled in the European Prospective Investigation into Cancer and Nutrition study. At recruitment (1992-1998), dietary, anthropometric, and lifestyle information was collected. A WCRF/AICR score, which incorporated 6 of the WCRF/AICR recommendations for men [regarding body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, and alcoholic drinks (score range: 0-6)] and 7 WCRF/AICR recommendations for women [plus breastfeeding (score range: 0-7)], was constructed. Higher scores indicated greater concordance with WCRF/AICR recommendations. Associations between the WCRF/AICR score and risks of total and cause-specific death were estimated by using Cox regression analysis. RESULTS: After a median follow-up time of 12.8 y, 23,828 deaths were identified. Participants within the highest category of the WCRF/AICR score (5-6 points in men; 6-7 points in women) had a 34% lower hazard of death (95% CI: 0.59, 0.75) compared with participants within the lowest category of the WCRF/AICR score (0-2 points in men; 0-3 points in women). Significant inverse associations were observed in all countries. The WCRF/AICR score was also significantly associated with a lower hazard of dying from cancer, circulatory disease, and respiratory disease. CONCLUSION: Results of this study suggest that following WCRF/AICR recommendations could significantly increase longevity.
Published: 2016

7. Healthy Lifestyle and Risk of Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort Study

Author: McKenzie, F, Biessy, C, Ferrari, P, Freisling, H, Rinaldi, S, Chajès, V, Dahm, C, Overvad, K, Dossus, L, Lagiou, P, Trichopoulos, D, Trichopoulou, A, Bueno-de-Mesquita, H, May, A, Peeters, P, Weiderpass, E, Sanchez, M, Navarro, C, Ardanaz, E, Ericson, U, Wirfält, E, Travis, R, Romieu, I, de Batlle, J, Dartois, L, Krogh, V, Panico, S, Tumino, R, Rosso, S, Buckland, G, Andersson, A, Sund, M, Key, T, Gunter, M, Riboli, E, Vergnaud, A, and Medical Research Council (MRC)
Subjects: Gerontology, Male, Health Status, GUIDELINES, 0302 clinical medicine, Behavior Therapy, Neoplasms, Medicine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Non-U.S. Gov't, INDEX, Cancer, Medicine(all), education.field_of_study, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Nutritional Support, Research Support, Non-U.S. Gov't, Hazard ratio, Age Factors, WOMEN, General Medicine, Middle Aged, Nutrition Surveys, Prognosis, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Multicenter Study, 030220 oncology & carcinogenesis, Cohort, Female, CONCORDANCE, Life Sciences & Biomedicine, RESEARCH FUND/AMERICAN INSTITUTE, Cohort study, Research Article, Adult, Population, Observational Study, Lower risk, Research Support, Risk Assessment, DIET, 03 medical and health sciences, Medicine, General & Internal, Sex Factors, General & Internal Medicine, Journal Article, Humans, CORONARY-HEART-DISEASE, education, Life Style, METAANALYSIS, Science & Technology, Cancer prevention, business.industry, Prevention, 1103 Clinical Sciences, PREVENTION, Arthritis & Rheumatology, Life style, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business, Demography, Follow-Up Studies, Forecasting
Abstract: It has been estimated that at least a third of the most common cancers are related to lifestyle and as such are preventable. Key modifiable lifestyle factors have been individually associated with cancer risk; however, less is known about the combined effects of these factors. This study generated a healthy lifestyle index score (HLIS) to investigate the joint effect of modifiable factors on the risk of overall cancers, alcohol-related cancers, tobacco-related cancers, obesity-related cancers, and reproductive-related cancers. The study included 391,608 men and women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The HLIS was constructed from 5 factors assessed at baseline (diet, physical activity, smoking, alcohol consumption, and anthropometry) by assigning scores of 0 to 4 to categories of each factor, for which higher values indicate healthier behaviors. Hazard ratios (HR) were estimated by Cox proportional regression and population attributable fractions (PAFs) estimated from the adjusted models. There was a 5% lower risk (adjusted HR 0.952, 95% confidence interval (CI): 0.946, 0.958) of all cancers per point score of the index for men and 4% (adjusted HR 0.961, 95% CI: 0.956, 0.966) for women. The fourth versus the second category of the HLIS was associated with a 28% and 24% lower risk for men and women respectively across all cancers, 41%and 33%for alcohol-related, 49%and 46%for tobacco-related, 41% and 26% for obesity-related, and 21% for female reproductive cancers. Findings suggest simple behavior modifications could have a sizeable impact on cancer prevention, especially for men.
Published: 2016

8. Abstract P2-06-05: Development and validation of a new non-parametric breast cancer risk assessment model on US and European screening populations

Author: Ragusa, S, primary, Gauthier, E, additional, Dartois, L, additional, Tice, J, additional, Dancourt, V, additional, Arveux, P, additional, Brixi, Z, additional, Bernoux, A, additional, Soyer, P, additional, Delattre, H, additional, Brechenade, S, additional, Catajar, N, additional, Kaufmanis, A, additional, Hélin, VM, additional, Clavel, F, additional, Kerlikowske, K, additional, Miglioretti, D, additional, and Delaloge, S, additional
Published: 2017
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9. Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

Author: Buckland, G. Travier, N. Huerta, J. M. Bueno-de-Mesquita, H. B(As) Siersema, P. D. Skeie, G. Weiderpass, E. Engeset, D. Ericson, U. Ohlsson, B. Agudo, A. Romieu, I. and Ferrari, P. Freisling, H. Colorado-Yohar, S. Li, K. and Kaaks, R. Pala, V. Cross, A. J. Riboli, E. Trichopoulou, A. Lagiou, P. Bamia, C. Boutron-Ruault, M. C. and Fagherazzi, G. Dartois, L. May, A. M. Peeters, P. H. and Panico, S. Johansson, M. Wallner, B. Palli, D. Key, T. J. Khaw, K. T. Ardanaz, E. Overvad, K. Tjonneland, A. and Dorronsoro, M. Sanchez, M. J. Quiros, J. R. Naccarati, A. Tumino, R. Boeing, H. Gonzalez, C. A.
Abstract: Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trends
Published: 2015

10. Fish consumption and mortality in the European Prospective Investigation into Cancer and Nutrition cohort

Author: Engeset, D. Braaten, T. Teucher, B. Kühn, T. Bueno-de-Mesquita, H.B. Leenders, M. Agudo, A. Bergmann, M.M. Valanou, E. Naska, A. Trichopoulou, A. Key, T.J. Crowe, F.L. Overvad, K. Sonestedt, E. Mattiello, A. Peeters, P.H. Wennberg, M. Jansson, J.H. Boutron-Ruault, M.-C. Dossus, L. Dartois, L. Li, K. Barricarte, A. Ward, H. Riboli, E. Agnoli, C. Huerta, J.M. Sánchez, M.-J. Tumino, R. Altzibar, J.M. Vineis, P. Masala, G. Ferrari, P. Muller, D.C. Johansson, M. Luisa Redondo, M. Tjønneland, A. Olsen, A. Olsen, K.S. Brustad, M. Skeie, G. Lund, E.
Abstract: Fish is a source of important nutrients and may play a role in preventing heart diseases and other health outcomes. However, studies of overall mortality and cause-specific mortality related to fish consumption are inconclusive. We examined the rate of overall mortality, as well as mortality from ischaemic heart disease and cancer in relation to the intake of total fish, lean fish, and fatty fish in a large prospective cohort including ten European countries. More than 500,000 men and women completed a dietary questionnaire in 1992–1999 and were followed up for mortality until the end of 2010. 32,587 persons were reported dead since enrolment. Hazard ratios and their 99 % confidence interval were estimated using Cox proportional hazard regression models. Fish consumption was examined using quintiles based on reported consumption, using moderate fish consumption (third quintile) as reference, and as continuous variables, using increments of 10 g/day. All analyses were adjusted for possible confounders. No association was seen for fish consumption and overall or cause-specific mortality for both the categorical and the continuous analyses, but there seemed to be a U-shaped trend (p
Published: 2015

11. Proportion of premenopausal and postmenopausal breast cancers attributable to known risk factors: Estimates from the E3N-EPIC cohort

Author: Dartois, L, Fagherazzi, G, Baglietto, L, Boutron-Ruault, M-C, Delaloge, S, Mesrine, S, Clavel-Chapelon, F, Dartois, L, Fagherazzi, G, Baglietto, L, Boutron-Ruault, M-C, Delaloge, S, Mesrine, S, and Clavel-Chapelon, F
Abstract: Breast cancer is the most frequently diagnosed cancer among women worldwide. Breast cancer risk factors have been widely explored individually; however, little is known about their combined impact. We included 67,634 women from the French E3N prospective cohort, aged 42-72 at baseline. During a 15-year follow-up period, 497 premenopausal and 3,138 postmenopausal invasive breast cancer cases were diagnosed. Population-attributable fractions (PAFs) were used to estimate cases proportions attributable to risk factors under hypothetical scenarios of lowest exposure. We examined overall premenopausal and postmenopausal invasive breast cancers and tumour subtypes (ER status and HER2 expression). Premenopausal breast cancer was not significantly attributable to non-behavioral (61.2%, -15.5 to 91.88%) nor to behavioral (39.9%, -71.0 to 93.9%) factors, contrary to postmenopausal breast cancer (41.9%, 4.5 to 68.7% and 53.5%, 12.8 to 78.7%, respectively). Individually, the highest statistically significant PAFs were obtained in premenopause for birth weight (33.6%, 5.7 to 56.6%) and age at menarche (19.8%, 5.2 to 33.6%) for non-behavioral factors and in postmenopause for history of benign breast diseases (14.9%, 11.6 to 18.0%) and age at menarche (9.7%, 3.9 to 15.5%) for non-behavioral factors and for body shape at menarche (17.1%, 9.7 to 24.3%), use of hormone replacement therapy (14.5%, 9.2 to 19.6%), dietary pattern (10.1%, 2.6 to 17.4%) and alcohol consumption (5.6%, 1.9 to 9.3%) for behavioral factors. These proportions were higher for ER+, HER2- and ER+/HER2- postmenopausal breast cancers. Our data support the hypothesis that in postmenopause, never starting unhealthy behaviors can reduce the number of diagnosed breast cancers.
Published: 2016

12. Healthy lifestyle and risk of breast cancer among postmenopausal women in the European Prospective Investigation into Cancer and Nutrition cohort study

Author: Mckenzie, F, Ferrari, P, Freisling, H, Chajès, V, Rinaldi, S, de Batlle, J, Dahm, CC, Overvad, K, Baglietto, L, Dartois, L, Dossus, L, Lagiou, P, Trichopoulos, D, Trichopoulou, A, Krogh, V, Panico, S, Tumino, R, Rosso, S, Bueno-de-Mesquita, HB, May, A, Peeters, PH, Weiderpass, E, Buckland, G, Sanchez, M-J, Navarro, C, Ardanaz, E, Andersson, A, Sund, M, Ericson, U, Wirfält, E, Key, TJ, Travis, RC, Gunter, M, Riboli, E, Vergnaud, A-C, Romieu, I, Mckenzie, Fiona, Ferrari, Pietro, Freisling, Heinz, Chajès, Veronique, Rinaldi, Sabina, de Batlle, Jordi, Dahm, Christina C, Overvad, Kim, Baglietto, Laura, Dartois, Laureen, Dossus, Laure, Lagiou, Pagona, Trichopoulos, Dimitrio, Trichopoulou, Antonia, Krogh, Vittorio, Panico, Salvatore, Tumino, Rosario, Rosso, Stefano, Bueno de Mesquita, H. B. A, May, Anne, Peeters, Petra H, Weiderpass, Elisabete, Buckland, Genevieve, Sanchez, Maria Jose, Navarro, Carmen, Ardanaz, Eva, Andersson, Anne, Sund, Malin, Ericson, Ulrika, Wirfält, Elisabet, Key, Tim J, Travis, Ruth C, Gunter, Marc, Riboli, Elio, Vergnaud, Anne Claire, and Romieu, Isabelle
Subjects: b reast cancer, Europe, healthy index, lifestyle, prospective studies, Medicine (all), Oncology, Cancer Research, MEXICAN WOMEN, DIETARY FIBER, Alcohol Drinking, Health Status, prospective studie, European Continental Ancestry Group, Breast Neoplasms, White People, Health Statu, breast cancer, ADHERENCE, Risk Factors, Journal Article, Humans, CORONARY-HEART-DISEASE, Prospective Studies, Oncology & Carcinogenesis, Exercise, Life Style, METAANALYSIS, Science & Technology, Anthropometry, Risk Factor, Research Support, Non-U.S. Gov't, ASSOCIATION, Middle Aged, PREVENTION, Diet, Postmenopause, GLYCEMIC INDEX, Women's Health, Female, CIGARETTE-SMOKING, FATTY-ACIDS, Life Sciences & Biomedicine, Risk Reduction Behavior, 1112 Oncology And Carcinogenesis, Breast Neoplasm, Human
Abstract: Breast cancer is the most common cancer among women and prevention strategies are needed to reduce incidence worldwide. A healthy lifestyle index score (HLIS) was generated to investigate the joint effect of modifiable lifestyle factors on postmenopausal breast cancer risk. The study included 242,918 postmenopausal women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, with detailed information on diet and lifestyle assessed at baseline. The HLIS was constructed from five factors (diet, physical activity, smoking, alcohol consumption and anthropometry) by assigning scores of 0-4 to categories of each component, for which higher values indicate healthier behaviours. Hazard ratios (HR) were estimated by Cox proportional regression models. During 10.9 years of median follow-up, 7,756 incident breast cancer cases were identified. There was a 3% lower risk of breast cancer per point increase of the HLIS. Breast cancer risk was inversely associated with a high HLIS when fourth versus second (reference) categories were compared [adjusted HR=0.74; 95% confidence interval (CI): 0.66-0.83]. The fourth versus the second category of the HLIS was associated with a lower risk for hormone receptor double positive (adjusted HR=0.81, 95% CI: 0.67-0.98) and hormone receptor double negative breast cancer (adjusted HR=0.60, 95% CI: 0.40-0.90). Findings suggest having a high score on an index of combined healthy behaviours reduces the risk of developing breast cancer among postmenopausal women. Programmes which engage women in long term health behaviours should be supported. What's new? How much does behavior really affect cancer risk? These authors set out to measure just that. First, they created a Healthy Lifestyle Index, which quantified five modifiable behaviors, such as smoking and physical activity. Then, using data from the European Prospective Investigation into Cancer and Nutrition (EPIC), they assigned each participant a score between 0 and 4 on each of the behaviors. It turned out that with each point added to a person's Healthy Lifestyle Index score, breast cancer risk fell by 3%, suggesting that public programs to help women maintain these behaviors could be worthwhile for cancer prevention.
Published: 2014

13. Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

Author: Buckland, Genevieve, Travier, N., Huerta, J. M., Bueno-De-Mesquita, H. B., Siersema, P. D., Skeie, G., Weiderpass, E., Engeset, D., Ericson, U., Ohlsson, B., Agudo, A., Romieu, I., Ferrari, P., Freisling, H., Colorado-Yohar, S., Li, K., Kaaks, R., Pala, V., Cross, A. J., Riboli, E., Trichopoulou, A., Lagiou, P., Bamia, C., Boutron-Ruault, M. C., Fagherazzi, G., Dartois, L., May, A. M., Peeters, P. H., Panico, S., Johansson, M., Wallner, B., Palli, D., Key, T. J., Khaw, K. T., Ardanaz, E., Overvad, K., Tjønneland, A., Dorronsoro, M., Sánchez, M. J., Quirós, J. R., Naccarati, A., Tumino, R., Boeing, H., Gonzalez, C. A., Buckland, Genevieve, Travier, N., Huerta, J. M., Bueno-De-Mesquita, H. B., Siersema, P. D., Skeie, G., Weiderpass, E., Engeset, D., Ericson, U., Ohlsson, B., Agudo, A., Romieu, I., Ferrari, P., Freisling, H., Colorado-Yohar, S., Li, K., Kaaks, R., Pala, V., Cross, A. J., Riboli, E., Trichopoulou, A., Lagiou, P., Bamia, C., Boutron-Ruault, M. C., Fagherazzi, G., Dartois, L., May, A. M., Peeters, P. H., Panico, S., Johansson, M., Wallner, B., Palli, D., Key, T. J., Khaw, K. T., Ardanaz, E., Overvad, K., Tjønneland, A., Dorronsoro, M., Sánchez, M. J., Quirós, J. R., Naccarati, A., Tumino, R., Boeing, H., and Gonzalez, C. A.
Published: 2015

14. Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study

Author: Romaguera, D., Ward, H., Wark, P.A., Vergnaud, A.C., Peeters, P.H.M., Gils, C.H. van, Ferrari, P., Fedirko, V., Jenab, M., Boutron-Ruault, M.C., Dossus, L., Dartois, L., Hansen, C.P., Dahm, C.C., Buckland, G., Sanchez, M.J., Dorronsoro, M., Navarro, C, Barricarte, A., Key, T.J., Trichopoulou, A., Tsironis, C., Lagiou, P., Masala, G., Pala, V., Tumino, R., Vineis, P., Panico, S., Bueno-de-Mesquita, H.B., Siersema, P.D., Ohlsson, B., Jirstrom, K., Wennberg, M., Nilsson, L.M., Weiderpass, E., Kuhn, T., Katzke, V., Khaw, K.T., Wareham, N.J., Tjonneland, A., Boeing, H., Quiros, J.R., Gunter, M.J., Riboli, E., Norat, T., Romaguera, D., Ward, H., Wark, P.A., Vergnaud, A.C., Peeters, P.H.M., Gils, C.H. van, Ferrari, P., Fedirko, V., Jenab, M., Boutron-Ruault, M.C., Dossus, L., Dartois, L., Hansen, C.P., Dahm, C.C., Buckland, G., Sanchez, M.J., Dorronsoro, M., Navarro, C, Barricarte, A., Key, T.J., Trichopoulou, A., Tsironis, C., Lagiou, P., Masala, G., Pala, V., Tumino, R., Vineis, P., Panico, S., Bueno-de-Mesquita, H.B., Siersema, P.D., Ohlsson, B., Jirstrom, K., Wennberg, M., Nilsson, L.M., Weiderpass, E., Kuhn, T., Katzke, V., Khaw, K.T., Wareham, N.J., Tjonneland, A., Boeing, H., Quiros, J.R., Gunter, M.J., Riboli, E., and Norat, T.
Abstract: Contains fulltext : 152598.pdf (publisher's version ) (Open Access), BACKGROUND: Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients. METHODS: The association between the WCRF/AICR score (score range 0-6 in men and 0-7 in women; higher scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872) and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. RESULTS: The HRs (95% CIs) for CRC-specific mortality among participants in the second (score range in men/women: 2.25-2.75/3.25-3.75), third (3-3.75/4-4.75), and fourth (4-6/5-7) categories of the score were 0.87 (0.72-1.06), 0.74 (0.61-0.90), and 0.70 (0.56-0.89), respectively (P for trend <0.0001), compared to participants with the lowest concordance with the recommendations (category 1 of the score: 0-2/0-3). Similar HRs for overall mortality were observed (P for trend 0.004). Meeting the recommendations on body fatness and plant food consumption were associated with improved survival among CRC cases in mutually adjusted models. CONCLUSIONS: Greater concordance with the WCRF/AICR recommendations on diet, physical activity, and body fatness prior to CRC diagnosis is associated with improved surv
Published: 2015

15. Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

Author: Cancer, MS MDL 1, Epi Kanker Team 1, JC onderzoeksprogramma Kanker, Buckland, Genevieve, Travier, N., Huerta, J. M., Bueno-De-Mesquita, H. B., Siersema, P. D., Skeie, G., Weiderpass, E., Engeset, D., Ericson, U., Ohlsson, B., Agudo, A., Romieu, I., Ferrari, P., Freisling, H., Colorado-Yohar, S., Li, K., Kaaks, R., Pala, V., Cross, A. J., Riboli, E., Trichopoulou, A., Lagiou, P., Bamia, C., Boutron-Ruault, M. C., Fagherazzi, G., Dartois, L., May, A. M., Peeters, P. H., Panico, S., Johansson, M., Wallner, B., Palli, D., Key, T. J., Khaw, K. T., Ardanaz, E., Overvad, K., Tjønneland, A., Dorronsoro, M., Sánchez, M. J., Quirós, J. R., Naccarati, A., Tumino, R., Boeing, H., Gonzalez, C. A., Cancer, MS MDL 1, Epi Kanker Team 1, JC onderzoeksprogramma Kanker, Buckland, Genevieve, Travier, N., Huerta, J. M., Bueno-De-Mesquita, H. B., Siersema, P. D., Skeie, G., Weiderpass, E., Engeset, D., Ericson, U., Ohlsson, B., Agudo, A., Romieu, I., Ferrari, P., Freisling, H., Colorado-Yohar, S., Li, K., Kaaks, R., Pala, V., Cross, A. J., Riboli, E., Trichopoulou, A., Lagiou, P., Bamia, C., Boutron-Ruault, M. C., Fagherazzi, G., Dartois, L., May, A. M., Peeters, P. H., Panico, S., Johansson, M., Wallner, B., Palli, D., Key, T. J., Khaw, K. T., Ardanaz, E., Overvad, K., Tjønneland, A., Dorronsoro, M., Sánchez, M. J., Quirós, J. R., Naccarati, A., Tumino, R., Boeing, H., and Gonzalez, C. A.
Published: 2015

16. P240: Capacité antioxydante totale et mortalité toutes causes et cause-spécifique dans la cohorte E3N

Author: Bastide, N., primary, Dyevre, V., additional, Dartois, L., additional, Kangas, S., additional, Serafini, M., additional, Clavel-Chapelon, F., additional, and Boutron-Ruault, M.-C., additional
Published: 2014
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17. Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study

Author: Ferrari, P., primary, Licaj, I., additional, Muller, D. C., additional, Kragh Andersen, P., additional, Johansson, M., additional, Boeing, H., additional, Weiderpass, E., additional, Dossus, L., additional, Dartois, L., additional, Fagherazzi, G., additional, Bradbury, K. E., additional, Khaw, K.-T., additional, Wareham, N., additional, Duell, E. J., additional, Barricarte, A., additional, Molina-Montes, E., additional, Sanchez, C. N., additional, Arriola, L., additional, Wallstrom, P., additional, Tjonneland, A., additional, Olsen, A., additional, Trichopoulou, A., additional, Benetou, V., additional, Trichopoulos, D., additional, Tumino, R., additional, Agnoli, C., additional, Sacerdote, C., additional, Palli, D., additional, Li, K., additional, Kaaks, R., additional, Peeters, P., additional, Beulens, J. W., additional, Nunes, L., additional, Gunter, M., additional, Norat, T., additional, Overvad, K., additional, Brennan, P., additional, Riboli, E., additional, and Romieu, I., additional
Published: 2014
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18. Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study1,4

Author: Vergnaud, A.C., Romaguera, D., Peeters, P.H.M., Gils, C.H. van, Chan, D.S., Romieu, I., Freisling, H., Ferrari, P., Clavel-Chapelon, F., Fagherazzi, G., Dartois, L., Li, K., Tikk, K., Bergmann, M.M., Boeing, H., Tjonneland, A., Olsen, A., Overvad, K., Dahm, C.C., Redondo, M.L., Agudo, A., Sanchez, M.J., Amiano, P., Chirlaque, M.D., Ardanaz, E., Khaw, K.T., Wareham, N.J., Crowe, F., Trichopoulou, A., Orfanos, P., Trichopoulos, D., Masala, G., Sieri, S., Tumino, R., Vineis, P., Panico, S., Bueno-De-Mesquita, H.B., Ros, M.M., May, A., Wirfalt, E., Sonestedt, E., Johansson, I., Hallmans, G., Lund, E., Weiderpass, E., Parr, C.L., Riboli, E., Norat, T., Vergnaud, A.C., Romaguera, D., Peeters, P.H.M., Gils, C.H. van, Chan, D.S., Romieu, I., Freisling, H., Ferrari, P., Clavel-Chapelon, F., Fagherazzi, G., Dartois, L., Li, K., Tikk, K., Bergmann, M.M., Boeing, H., Tjonneland, A., Olsen, A., Overvad, K., Dahm, C.C., Redondo, M.L., Agudo, A., Sanchez, M.J., Amiano, P., Chirlaque, M.D., Ardanaz, E., Khaw, K.T., Wareham, N.J., Crowe, F., Trichopoulou, A., Orfanos, P., Trichopoulos, D., Masala, G., Sieri, S., Tumino, R., Vineis, P., Panico, S., Bueno-De-Mesquita, H.B., Ros, M.M., May, A., Wirfalt, E., Sonestedt, E., Johansson, I., Hallmans, G., Lund, E., Weiderpass, E., Parr, C.L., Riboli, E., and Norat, T.
Abstract: Item does not contain fulltext, BACKGROUND: In 2007, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued recommendations on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence. OBJECTIVE: We investigated whether concordance with WCRF/AICR recommendations is related to risk of death. DESIGN: The current study included 378,864 participants from 9 European countries enrolled in the European Prospective Investigation into Cancer and Nutrition study. At recruitment (1992-1998), dietary, anthropometric, and lifestyle information was collected. A WCRF/AICR score, which incorporated 6 of the WCRF/AICR recommendations for men [regarding body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, and alcoholic drinks (score range: 0-6)] and 7 WCRF/AICR recommendations for women [plus breastfeeding (score range: 0-7)], was constructed. Higher scores indicated greater concordance with WCRF/AICR recommendations. Associations between the WCRF/AICR score and risks of total and cause-specific death were estimated by using Cox regression analysis. RESULTS: After a median follow-up time of 12.8 y, 23,828 deaths were identified. Participants within the highest category of the WCRF/AICR score (5-6 points in men; 6-7 points in women) had a 34% lower hazard of death (95% CI: 0.59, 0.75) compared with participants within the lowest category of the WCRF/AICR score (0-2 points in men; 0-3 points in women). Significant inverse associations were observed in all countries. The WCRF/AICR score was also significantly associated with a lower hazard of dying from cancer, circulatory disease, and respiratory disease. CONCLUSION: Results of this study suggest that following WCRF/AICR recommendations could significantly increase longevity.
Published: 2013

19. Fiber intake and total and cause-specific mortality in the European Prospective Investigation into Cancer and Nutrition cohort.

Author: Chuang, S.C., Norat, T., Murphy, N., Olsen, A., Tjonneland, A., Overvad, K., Boutron-Ruault, M.C., Perquier, F., Dartois, L., Kaaks, R., Teucher, B., Bergmann, M.M., Boeing, H., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Grioni, S., Sacerdote, C., Panico, S., Palli, D., Tumino, R., Peeters, P.H.M., Bueno-de-Mesquita, B., Ros, M.M., Brustad, M., Asli, L.A., Skeie, G., Quiros, J.R., Gonzalez, C.A., Sanchez, M.J., Navarro, C, Ardanaz Aicua, E., Dorronsoro, M., Drake, I., Sonestedt, E., Johansson, I., Hallmans, G., Key, T., Crowe, F., Khaw, K.T., Wareham, N., Ferrari, P., Slimani, N., Romieu, I., Gallo, V., Riboli, E., Vineis, P., Chuang, S.C., Norat, T., Murphy, N., Olsen, A., Tjonneland, A., Overvad, K., Boutron-Ruault, M.C., Perquier, F., Dartois, L., Kaaks, R., Teucher, B., Bergmann, M.M., Boeing, H., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Grioni, S., Sacerdote, C., Panico, S., Palli, D., Tumino, R., Peeters, P.H.M., Bueno-de-Mesquita, B., Ros, M.M., Brustad, M., Asli, L.A., Skeie, G., Quiros, J.R., Gonzalez, C.A., Sanchez, M.J., Navarro, C, Ardanaz Aicua, E., Dorronsoro, M., Drake, I., Sonestedt, E., Johansson, I., Hallmans, G., Key, T., Crowe, F., Khaw, K.T., Wareham, N., Ferrari, P., Slimani, N., Romieu, I., Gallo, V., Riboli, E., and Vineis, P.
Abstract: 1 juli 2012, Item does not contain fulltext, BACKGROUND: Previous studies have shown that high fiber intake is associated with lower mortality. However, little is known about the association of dietary fiber with specific causes of death other than cardiovascular disease (CVD). OBJECTIVE: The aim of this study was to assess the relation between fiber intake, mortality, and cause-specific mortality in a large European prospective study of 452,717 men and women. DESIGN: HRs and 95% CIs were estimated by using Cox proportional hazards models, stratified by age, sex, and center and adjusted for education, smoking, alcohol consumption, BMI, physical activity, total energy intake, and, in women, ever use of menopausal hormone therapy. RESULTS: During a mean follow-up of 12.7 y, a total of 23,582 deaths were recorded. Fiber intake was inversely associated with total mortality (HR(per 10-g/d increase): 0.90; 95% CI: 0.88, 0.92); with mortality from circulatory (HR(per 10-g/d increase): 0.90 and 0.88 for men and women, respectively), digestive (HR: 0.61 and 0.64), respiratory (HR: 0.77 and 0.62), and non-CVD noncancer inflammatory (HR: 0.85 and 0.80) diseases; and with smoking-related cancers (HR: 0.86 and 0.89) but not with non-smoking-related cancers (HR: 1.05 and 0.97). The associations were more evident for fiber from cereals and vegetables than from fruit. The associations were similar across BMI and physical activity categories but were stronger in smokers and participants who consumed >18 g alcohol/d. CONCLUSIONS: Higher fiber intake is associated with lower mortality, particularly from circulatory, digestive, and non-CVD noncancer inflammatory diseases. Our results support current recommendations of high dietary fiber intake for health maintenance.
Published: 2012

20. PIN2 ESTIMATED IMPACT OF SUSTAINED VIROLOGICAL RESPONSE (SVR) ON LIFE EXPECTANCY, QUALITY-ADJUSTED LIFE-YEARS (QALYS) AND LIFETIME COSTS IN CHRONIC HEPATITIS C (CHC) PATIENTS

Author: Cure, S, primary, Bianic, F, additional, Cawston, H, additional, Dartois, L, additional, and Zhang, H, additional
Published: 2010
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21. PIN4 IMPACT OF SUSTAINED VIROLOGICAL RESPONSE (SVR) ON LIFE EXPECTANCY AND QUALITY-ADJUSTED LIFE-YEARS (QALYS) IN CHRONIC HEPATITIS C (CHC) PATIENTS

Author: Cure, S, primary, Bianic, F, additional, Dartois, L, additional, Cawston, H, additional, and Zhang, H, additional
Published: 2010
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22. A power-efficient channel coder/decoder chip for GSM terminals

Author: Busschaert, H.J., primary, Reusens, P.P., additional, Van Wauwe, G., additional, De Langhe, M., additional, Van Camp, R.M.A., additional, Gouwy, C.M.W., additional, and Dartois, L., additional
Published: 1992
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23. A Single-chip GSM Vocoder

Author: Vanzieleghem, E., primary, Dartois, L., additional, Wenin, J., additional, Vanwelsenaers, A., additional, and Rabaey, D.H., additional
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24. A power efficient channel coder/decoder chip for GSM terminals.

Author: Busschaert, H.J., Reusens, P.P., Dartois, L., and Desperben, L.
Published: 1991
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25. A compact and power efficient GSM vocoder.

Author: Vanzieleghem, E., Schelfhout, K., Dartois, L., Wenin, J., Vanwelsenaers, A., and Rabaey, D.H.
Published: 1993
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26. A Single-chip GSM Vocoder.

Author: Vanzieleghem, E., Dartois, L., Wenin, J., Vanwelsenaers, A., and Rabaey, D.H.
Published: 1992
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27. Modifiable causes of premature death in middle-age in Western Europe : Results from the EPIC cohort study

Author: Marc J. Gunter, Ellen A. Struijk, Paul Brennan, Paolo Vineis, Christina Bamia, Guri Skeie, David C. Muller, M. Luisa Redondo, Cornelia Weikert, Salvatore Panico, Elena Molina-Portillo, Antonio Agudo, Rosario Tumino, Françoise Clavel, W M Monique Verschuren, Petra H.M. Peeters, Olle Melander, Jone M. Altzibar, Heiner Boeing, H. Bas Bueno-de-Mesquita, Ruth C. Travis, Elisabete Weiderpass, Gunnar Engström, Malin Sund, Teresa Norat, Anne Tjønneland, Manuela M. Bergmann, Philippos Orfanos, Laureen Dartois, Nicholas J. Wareham, Mattias Johansson, Elio Riboli, Kuanrong Li, Kay-Tee Khaw, Neil Murphy, Eiliv Lund, Antonia Trichopoulou, Marie-Christine Boutron-Ruault, Domenico Palli, Rudolf Kaaks, Konstantinos K. Tsilidis, Lluís Cirera, Pietro Ferrari, Valeria Pala, Timothy J. Key, Kim Overvad, Eva Ardanaz, Muller, David C, Murphy, Neil, Johansson, Mattia, Ferrari, Pietro, Tsilidis, Konstantinos K, Boutron Ruault, Marie Christine, Clavel, Francoise, Dartois, Laureen, Li, Kuanrong, Kaaks, Rudolf, Weikert, Cornelia, Bergmann, Manuela, Boeing, Heiner, Tjønneland, Anne, Overvad, Kim, Redondo, M. Luisa, Agudo, Antonio, Molina Portillo, Elena, Altzibar, Jone M, Cirera, Lluí, Ardanaz, Eva, Khaw, Kay Tee, Wareham, Nicholas J, Key, Timothy J, Travis, Ruth C, Bamia, Christina, Orfanos, Philippo, Trichopoulou, Antonia, Palli, Domenico, Pala, Valeria, Tumino, Rosario, Vineis, Paolo, Panico, Salvatore, Bueno de Mesquita, H. Ba, Verschuren, W. M. Monique, Struijk, Ellen A, Peeters, Petra H, Engström, Gunnar, Melander, Olle, Sund, Malin, Weiderpass, Elisabete, Skeie, Guri, Lund, Eiliv, Norat, Teresa, Gunter, Marc, Riboli, Elio, Brennan, Paul, [Muller,DC, Johansson,M, Ferrari,P, Brennan,P] International Agency for Research on Cancer, Lyon, France. [Murphy,N, Vineis,P, Bueno-de-Mesquita,HB, Peeters,PH, Norat,T, Gunter,M, Riboli,E] School of Public Health, Imperial College London, London, UK] [Tsilidis,KK] Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. [Boutron-Ruault,M] Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France. [Boutron-Ruault,M, Clavel,F, Dartois,L] Université Paris Sud, Villejuif, France. [Boutron-Ruault,M, Dartois,L, Dartois,L] Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France. [Li,K, Kaaks,R] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Weikert,C, Bergmann,M, Boeing,H] German Institute of Human Nutrition Potsdam-Rehbrücke (DifE), Nuthetal, Germany. [Tjønneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Overvad,K] Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark. [Redondo,ML] Public Health Directorate, Asturias, Spain. [Agudo,A] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain. [Molina-Portillo,E] Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. [Molina-Portillo,E, Altzibar,JM, Cirera,M, Ardanaz,E] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain. [Altzibar,JM] Public Health Division of Gipuzkoa-BIODONOSTIA, Basque Regional Health Department, Donostia - San Sebastián, Spain. [Cirera, L] Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. [Ardanaz,E] Navarra Public Health Institute, Pamplona, Spain. Navarra Institute for Health Research (IdiSNA) Pamplona, Pamplona, Spain. [Khaw,K] School of Clinical Medicine, University of Cambridge, Cambridge, UK. [Wareham,NJ] MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. [Key,TJ, Travis,RC] Cancer Epidemiology Unit, University of Oxford, Oxford, UK. [Bamia,C, Orfanos,P, Trichopoulou,A] Hellenic Health Foundation, Athens, Greece. Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. [Pala,V] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, 'Civic - M. P. Arezzo' Hospital, ASP Ragusa, Ragusa, Italy. [Vineis,P] Human Genetics Foundation (HuGeF), Torino, Italy. [Panico,S] Dipartimento di Medicina Clinica e Sperimentale, Federico II University, Naples, Italy. [Bueno-de-Mesquita,HB, Verschuren,WMM] Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. [Bueno-de-Mesquita,HB] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. [Verschuren,WMM, Struijk,EA, Peeters,PH] Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. [Engström,G] Department of Clinical Science, Malmö Lund University, Lund, Sweden. [Melander,O] Department of Clinical Sciences, Hypertension & Cardiovascular Disease, Clinical Research Centre, Malmö University Hospital, Malmö, Sweden. [Sund,M] Department of Surgical and Perioperative Sciences, Umea University, Umea, Sweden. [Weiderpass,E, Skeie,G, 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, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Samfundet Folkhälsan, Helsinki, Finland. [Skeie,G, Lund,E] The Arctic University of Norway, Tromsø, Norway., This work was supported by the French Social Affairs & Health Ministry, Department of Health (Direction Générale de la Santé). The work undertaken by David C Muller for this project was performed during the tenure of an IARC-Australia fellowship supported by Cancer Council Australia. Elio Riboli was supported by the Imperial College Biomedical Research Centre funded by the National Institute of Health Research of UK. 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), 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), Nordic Centre of xcellence programme on Food, Nutrition and Health. (Norway), Health Research Fund (FIS), PI13/00061 to Granada, Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain), Swedish Cancer Society, Swedish Scientific Council and County Councils of Skåne and Västerbotten (Sweden), Cancer Research UK (14136 to EPIC-Norfolk, C570/A16491 to EPIC-Oxford),Medical Research Council (1000143 to EPIC-Norfolk) (United Kingdom). The sponsors did not have any input into study design, study conduct, data collection, analysis, or interpretation nor did they influence the preparation, review, or approval of the manuscript., Khaw, Kay-Tee [0000-0002-8802-2903], Wareham, Nicholas [0000-0003-1422-2993], and Apollo - University of Cambridge Repository
Subjects: Gerontology, Male, 030204 cardiovascular system & hematology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings], Cohort Studies, Institut Gustave Roussy, 0302 clinical medicine, Risk Factors, Medicine, 030212 general & internal medicine, Prospective Studies, Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::Overweight [Medical Subject Headings], Non-U.S. Gov't, media_common, Medicine(all), VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Mortality, Premature [Medical Subject Headings], Research Support, Non-U.S. Gov't, Smoking, Public Health, Global Health, Social Medicine and Epidemiology, 11 Medical And Health Sciences, General Medicine, Middle Aged, Europe, Hypertension, Absolute risk, Modifiable risk factors, Mortality, Premature death, Attributable fraction, language, Female, Cohort study, Research Article, Adult, medicine.medical_specialty, Alcohol Drinking, media_common.quotation_subject, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Habits::Smoking [Medical Subject Headings], Library science, Motor Activity, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], Research Support, Danish, 03 medical and health sciences, Diseases::Cardiovascular Diseases::Vascular Diseases::Hypertension [Medical Subject Headings], Life Expectancy, Excellence, General & Internal Medicine, Journal Article, Humans, Obesity, Aged, business.industry, Mortality, Premature, Public health, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Life Expectancy [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Waist-Hip Ratio [Medical Subject Headings], language.human_language, Cancer registry, Diseases::Nutritional and Metabolic Diseases::Nutrition Disorders::Overnutrition::Obesity [Medical Subject Headings], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Mortalidad, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Drinking Behavior::Alcohol Drinking [Medical Subject Headings], Life expectancy, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business, Welfare, Modifiable risk factor, Mortalidad prematura
Abstract: Background: Life expectancy is increasing in Europe, yet a substantial proportion of adults still die prematurely before the age of 70 years. We sought to estimate the joint and relative contributions of tobacco smoking, hypertension, obesity, physical inactivity, alcohol and poor diet towards risk of premature death. Methods: We analysed data from 264,906 European adults from the EPIC prospective cohort study, aged between 40 and 70 years at the time of recruitment. Flexible parametric survival models were used to model risk of death conditional on risk factors, and survival functions and attributable fractions (AF) for deaths prior to age 70 years were calculated based on the fitted models. Results: We identified 11,930 deaths which occurred before the age of 70. The AF for premature mortality for smoking was 31 % (95 % confidence interval (CI), 31–32 %) and 14 % (95 % CI, 12–16 %) for poor diet. Important contributions were also observed for overweight and obesity measured by waist-hip ratio (10 %; 95 % CI, 8–12 %) and high blood pressure (9 %; 95 % CI, 7–11 %). AFs for physical inactivity and excessive alcohol intake were 7 % and 4 %, respectively. Collectively, the AF for all six risk factors was 57 % (95 % CI, 55–59 %), being 35 % (95 % CI, 32–37 %) among never smokers and 74 % (95 % CI, 73–75 %) among current smokers. Conclusions: While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially. Any attempt to minimise premature deaths will ultimately require all six factors to be addressed., This work was supported by the French Social Affairs & Health Ministry, Department of Health (Direction Générale de la Santé). The work undertaken by David C Muller for this project was performed during the tenure of an IARC-Australia fellowship supported by Cancer Council Australia. Elio Riboli was supported by the Imperial College Biomedical Research Centre funded by the National Institute of Health Research of UK. 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); 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); Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway); Health Research Fund (FIS), PI13/00061 to Granada, Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk) (United Kingdom). The sponsors did not have any input into study design, study conduct, data collection, analysis, or interpretation nor did they influence the preparation, review, or approval of the manuscript.
Published: 2016

28. Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study

Author: Carla H. van Gils, E. Riboli, Christos Tsironis, Anne-Claire Vergnaud, H. Bas Bueno-de-Mesquita, Laureen Dartois, José Ramón Quirós, Veronika Fedirko, Pietro Ferrari, Teresa Norat, Pagona Lagiou, Christina C. Dahm, Giovanna Masala, Timothy J. Key, Mark J. Gunter, Maria Wennberg, Kay-Tee Khaw, Verena Katzke, Petra H.M. Peeters, Aurelio Barricarte, Heather Ward, Nicholas J. Wareham, Anne Tjønneland, Lena Maria Nilsson, Bodil Ohlsson, Valeria Pala, Laure Dossus, Antonia Trichopoulou, Tilman Kühn, Heiner Boeing, Elisabete Weiderpass, Petra A. Wark, M. Dorronsoro, Carmen Navarro, Camilla Plambeck Hansen, Genevieve Buckland, Salvatore Panico, Marie-Christine Boutron-Ruault, María José Sánchez, Paolo Vineis, Peter D. Siersema, Karin Jirström, Dora Romaguera, Rosario Tumino, Mazda Jenab, Romaguera, Dora, Ward, Heather, Wark, Petra A, Vergnaud, Anne Claire, Peeters, Petra H, van Gils, Carla H, Ferrari, Pietro, Fedirko, Veronika, Jenab, Mazda, Boutron Ruault, Marie Christine, Dossus, Laure, Dartois, Laureen, Hansen, Camilla Plambeck, Dahm, Christina Catherine, Buckland, Genevieve, Sánchez, María José, Dorronsoro, Miren, Navarro, Carmen, Barricarte, Aurelio, Key, Timothy J, Trichopoulou, Antonia, Tsironis, Christo, Lagiou, Pagona, Masala, Giovanna, Pala, Valeria, Tumino, Rosario, Vineis, Paolo, Panico, Salvatore, Bueno de Mesquita, H. Ba, Siersema, Peter D, Ohlsson, Bodil, Jirström, Karin, Wennberg, Maria, Nilsson, Lena M, Weiderpass, Elisabete, Kühn, Tilman, Katzke, Verena, Khaw, Kay Tee, Wareham, Nick J, Tjønneland, Anne, Boeing, Heiner, Quirós, José R, Gunter, Marc J, Riboli, Elio, Norat, Teresa, Department of Medical and Clinical Genetics, Medicum, BMC, BMC, Department of Epidemiology and Public Health, Imperial College London, Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, CIBER Fisiopatología de la Obesidad y Nutrición ( (CIBEROBN)), Instituto de Salud Carlos III [Madrid] (ISC), Department of Primary Care and Public Health, Department of Epidemiology, University Medical Center [Utrecht]-Julius Center for Health Sciences and Primary Care, Nutrition and Metabolism Section, International Agency for Cancer Research (IACR), Emory University [Atlanta, GA]-Rollins School of Public Health-Winship Cancer Institute, 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), Section for Epidemiology, Aarhus University [Aarhus], Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL)-Cancer Epidemiology Research Programme, Granada Cancer Registry, Andalusian School of Public Health [Granada], Consorcio de Investigación Biomédica en Red especializado en Epidemiología y Salud Pública (CIBERESP), Los Centros de Investigación Biomédica en Red (CIBER), Murcia Regional Health Council [Murcia], Department of Health and Social Sciences, Universidad de Murcia, Navarre Public Health Institute, Cancer Epidemiology Unit, University of Oxford, Hellenic Health Foundation, Bureau of Epidemiologic Research, Academy of Athens, Department of Hygiene, Epidemiology and Medical Statistics, Harvard School of Public Health, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Tumori - National Cancer Institute [Milan], Cancer Registry and Histopathology Unit, Department of Oncology-Civile - M.P.Arezzo Hospital, Human Genetics Foundation (HuGeF), Università degli studi di Torino = University of Turin (UNITO), Dipartimento di Medicina Clinica e Chirurgia, University of Naples Federico II = Università degli studi di Napoli Federico II, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya = Universiti Malaya [Kuala Lumpur, Malaisie] (UM), Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment [Bilthoven] (RIVM), Department of Gastroenterology and Hepatology, University Medical Center [Utrecht], Division of Internal Medicine, Skane University Hospital [Malmo], Lund University [Lund]-Lund University [Lund], Division of Oncology and Pathology, Lund University [Lund], Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Arctic Research Centre, Department of Community Medicine, The Arctic University of Norway [Tromsø, Norway] (UiT), Department of Research, Cancer Registry of Norway, Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet [Stockholm], Genetic Epidemiology Group [Helsinki], Folkhälsan Research Center, Faculty of Medecine [Helsinki], Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Faculty of Medecine [Helsinki], Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Division of Cancer Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Clinical Gerontology Unit, University of Cambridge [UK] (CAM), MRC Epidemiology Unit, University of Cambridge [UK] (CAM)-Institute of Metabolic Science, Danish Cancer Society Research Center, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, Public Health Directorate, Khaw, Kay-Tee [0000-0002-8802-2903], Wareham, Nicholas [0000-0003-1422-2993], Apollo - University of Cambridge Repository, 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), University of Oxford [Oxford], Università degli studi di Torino (UNITO), University of Naples Federico II, University of Malaya, The Arctic University of Norway, University of Helsinki-University of Helsinki-Faculty of Medecine [Helsinki], University of Helsinki-University of Helsinki, [Romaguera,D, Ward,H, Vergnaud,A, Peeters,PH, Vineis,P, Bueno-de-Mesquita,HB, Gunter, MJ, Riboli,E, Norat,T] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. [Romaguera,D] Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, Palma de Mallorca, Spain. [Romaguera,D] CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. [Wark,PA] Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK. [Peeters,PH, Gils, CH] Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. [Ferrari,P, Jenab,M] International Agency for Cancer Research (IARC), Lyon CEDEX, France. [Fedirko,V] Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA. [Fedirko,V] Winship Cancer Institute, Emory University, Atlanta, USA. [Boutron-Ruault,M, Dossus,L, Dartois,L] Inserm (Institut National de la Santé et de la Recherche Médicale), Centre for Research in Epidemiology and Population Health (CESP), Vaillant, Villejuif, Cedex, France. [Boutron-Ruault,M, Dartois,L] Univ Paris Sud, Villejuif, France. [Boutron-Ruault,M, Dartois,L] Gustave Roussy, Villejuif, France. [Hansen,CP, Dahm,CC] Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark. [Buckland,G] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), 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, Dorronsoro,M, Navarro,C, Barricarte,A] CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. [Dorronsoro,M] Public Health Direction and Biodonostia Basque Regional Health Department, San Sebastian, Spain. [Navarro,C] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Campus Universitario de Espinardo, Murcia, Spain. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Key,TJ] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford UK. [Trichopoulou,A, Tsironis,C] Hellenic Health Foundation, Athens, Greece . [Trichopoulou,A, Lagiou,P] Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. [Lagiou,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, USA. [Masala,G] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy. [Pala,V] Epidemiology and Prevention Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, 'Civic – M.P. Arezzo' Hospital, Ragusa, Italy. [Vineis,P] HuGeF Foundation, Turin, Italy. [Panico,S] Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, 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, Siersema,PD] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. [Bueno-de-Mesquita,HB] Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. [Ohlsson,B] Division of Internal Medicine, Department of Clinical Sciences, Skane University Hospital, Malmo, Lund University, Lund, Sweden. [Jirström,K] Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden. [Wennberg,M] Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden. [Nilsson,LM] Arctic Research Centre, Umeå University, Umeå, Sweden. [Weiderpass,E] Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, ISM - Universitetet i Tromsø, Tromsø, Norway. Department of Research, Cancer Registry of Norway, Majorstuen Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Department of Genetic Epidemiology, Folkhälsan Research Center, Folkhälsan Research Center, Biomedicum 1, University of Helsinki, Helsinki, Finland. [Kühn,T, Katzke,V] German Cancer Research Center (DKFZ), Division of Cancer Epidemiology Im Neuenheimer Feld 581, Heidelberg, Germany. [Khaw,K] University of Cambridge School of Clinical Medicine, Clinical Gerontology Unit Box 251, Addenbrooke’s Hospital, Cambridge, UK. [Wareham,NJ] MRC Epidemiology Unit, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK. [Tjønneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. [Quirós,JR] Public Health Directorate, Oviedo Asturias, Spain., This study was funded by the World Cancer Research Fund (WCRF) International Regular Grant Programme (Grant number 2009/44). Dora Romaguera holds a Ramon y Cajal contract (Ministerio de Economía y Competitividad, Spain and European Regional Development Fund, RYC-2011-08796). In addition, EPIC investigators acknowledge funding from the following agencies: Europe Against Cancer Program of the European Commission (SANCO), German Cancer Aid, German Cancer Research Center (DKFZ), German Federal Ministry of Education and Research (BMBF), Danish Cancer Society, Catalan Institute of Oncology, Spain, Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RCESP exp. C03/09 and ISCIII RETICC RD06/0020/0091, Spain, Cancer Research UK, Medical Research Council, United Kingdom, The Hellenic Health Foundation, Greece, Italian Association for Research on Cancer (AIRC), Italian National Research Council, Fondazione-Istituto Banco Napoli, Italy, Dutch Ministry of Public Health, Welfare and Sports, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), The Netherlands, Swedish Cancer Society, Swedish Scientific Council, Regional Government of Skåne, Sweden, Helga—Nordic Center of Excellence Programme in Nutrition and Health, French League against Cancer (LNCC), National Institute for Health and Medical Research (INSERM), France, Mutuelle Générale de l'Education Romaguera et al. BMC Medicine (2015) 13:107 Page 10 of 12 Nationale (MGEN), France, 3 M Co., France, Gustave Roussy Institute (IGR), France, and and General Councils of France. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Subjects: Male, physical activity, 0302 clinical medicine, estudios prospectivos, Prospective Studies, estudios de cohortes, mediana edad, Aged, 80 and over, anciano, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Motor Activity [Medical Subject Headings], dieta, Incidence, Hazard ratio, COLON-CANCER, General Medicine, adulto, 3. Good health, Näringslära, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, estilo de vida, Cohort, Dieta, Estilo de Vida, RESEARCH FUND/AMERICAN INSTITUTE, Cohort study, Human, medicine.medical_specialty, Concordance, European Continental Ancestry Group, DIAGNOSIS, incidencia, White People, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Càncer colorectal, Neoplasias Colorrectales, BREAST-CANCER, Humans, Life Style, Aged, Cancer prevention, Proportional hazards model, Physical activity, Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [Medical Subject Headings], Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], weight, LIFE-STYLE FACTORS, Colorectal cancer, REPRODUCTIVE HISTORY, Prospective Studie, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Cancer and Oncology, Proportional Hazards Model, grupo de ascendencia continental europea, Estudios de Cohortes, Gerontology, cumplimiento del paciente, Survival, modelos de riesgos proporcionales, VDP::Medisinske Fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803, [SDV]Life Sciences [q-bio], humanos, Colorectal Neoplasm, Alcohol consumption, Breast cancer, Prospective study, Named Groups::Persons::Survivors [Medical Subject Headings], Cohort Studies, 030212 general & internal medicine, Prospective cohort study, Non-U.S. Gov't, 2. Zero hunger, Medicine(all), RISK, Nutrition and Dietetics, Healthy lifestyle, Diet, Weight, Research Support, Non-U.S. Gov't, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, European Prospective Investigation into Cancer and Nutrition, VDP::Medical disciplines: 700::Health sciences: 800::Epidemiology medical and dental statistics: 803, NUTRITION, Female, Colorectal Neoplasms, Research Article, Adult, neoplasias colorrectales, 3122 Cancers, RECREATIONAL PHYSICAL-ACTIVITY, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], colorectal cancer, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], Research Support, survival, Sobrevivientes, healthy lifestyle, Internal medicine, medicine, Journal Article, Proportional Hazards Models, Actividad Motora, business.industry, Physical fitness, BODY-MASS INDEX, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Other Clinical Medicine, 3121 General medicine, internal medicine and other clinical medicine, Patient Compliance, Cohort Studie, business, diet, Condició física
Abstract: Background: Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients. Methods: The association between the WCRF/AICR score (score range 0-6 in men and 0-7 in women; higher scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872) and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. Results: The HRs (95% CIs) for CRC-specific mortality among participants in the second (score range in men/women: 2.25-2.75/3.25-3.75), third (3-3.75/4-4.75), and fourth (4-6/5-7) categories of the score were 0.87 (0.72-1.06), 0.74 (0.61-0.90), and 0.70 (0.56-0.89), respectively (P for trend, We would like to acknowledge the contribution of all participants in the study. This study was funded by the World Cancer Research Fund (WCRF) International Regular Grant Programme (Grant number 2009/44). Dora Romaguera holds a Ramon y Cajal contract (Ministerio de Economia y Competitividad, Spain and European Regional Development Fund; RYC-2011-08796). In addition, EPIC investigators acknowledge funding from the following agencies: Europe Against Cancer Program of the European Commission (SANCO); German Cancer Aid; German Cancer Research Center (DKFZ); German Federal Ministry of Education and Research (BMBF); Danish Cancer Society; Catalan Institute of Oncology, Spain; Health Research Fund (FIS) of the Spanish Ministry of Health; Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia (no. 6236) and Navarra; ISCIII RCESP exp. C03/09 and ISCIII RETICC RD06/0020/0091, Spain; Cancer Research UK; Medical Research Council, United Kingdom; The Hellenic Health Foundation, Greece; Italian Association for Research on Cancer (AIRC); Italian National Research Council; Fondazione-Istituto Banco Napoli, Italy; Dutch Ministry of Public Health, Welfare and Sports, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), The Netherlands; Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, Sweden; Helga-Nordic Center of Excellence Programme in Nutrition and Health; French League against Cancer (LNCC); National Institute for Health and Medical Research (INSERM), France; Mutuelle Generale de l'Education Nationale (MGEN), France; 3 M Co., France; Gustave Roussy Institute (IGR), France; and General Councils of France.
Published: 2014

29. Fruit and vegetable intake and cause-specific mortality in the EPIC study

Author: Nicholas J. Wareham, Kathryn E. Bradbury, Mattias Johansson, Petra H.M. Peeters, Isabel Drake, Emily Sonestedt, José María Huerta, Idlir Licaj, H. Bas Bueno-de-Mesquita, Rudolf Kaaks, Dagrun Engeset, Pagona Lagiou, Anja Olsen, Tonje Braaten, Kim Overvad, Ingegerd Johansson, Antonio Agudo, Kuanrong Li, Anne Tjønneland, Neil Murphy, Laure Dossus, Antonia Trichopoulou, Maria Luisa Redondo, Elio Riboli, Peter D. Siersema, Elisabete Weiderpass, Heiner Boeing, Anna Winkvist, Dimitrios Trichopoulos, Eva Ardanaz, Laureen Dartois, Salvatore Panico, Max Leenders, Rosario Tumino, Pilar Amiano, Paolo Vineis, Kay-Tee Khaw, Domenico Palli, Marie-Christine Boutron-Ruault, Pietro Ferrari, Timothy J. Key, Marc J. Gunter, Vittorio Krogh, María José Sánchez, Hendriek C. Boshuizen, Manuela M. Bergmann, IRAS RATIA-SIB, LS IRAS EEPI GRA (Gezh.risico-analyse), Risk Assessment of Toxic and Immunomodulatory Agents, Leenders, M, Boshuizen, Hc, Ferrari, P, Siersema, Pd, Overvad, K, Tj?nneland, A, Olsen, A, Boutron Ruault, Mc, Dossus, L, Dartois, L, Kaaks, R, Li, K, Boeing, H, Bergmann, Mm, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Palli, D, Krogh, V, Panico, Salvatore, Tumino, R, Vineis, P, Peeters, Ph, Weiderpass, E, Engeset, D, Braaten, T, Redondo, Ml, Agudo, A, S?nchez, Mj, Amiano, P, Huerta, Jm, Ardanaz, E, Drake, I, Sonestedt, E, Johansson, I, Winkvist, A, Khaw, Kt, Wareham, Nj, Key, Tj, Bradbury, Ke, Johansson, M, Licaj, I, Gunter, Mj, Murphy, N, Riboli, E, and Bueno de Mesquita, Hb
Subjects: Male, Nutrition and Disease, Epidemiology, Disease, Wiskundige en Statistische Methoden - Biometris, project, Risk Factors, Voeding en Ziekte, Cause of Death, Neoplasms, Surveys and Questionnaires, Vegetables, Prospective Studies, cardiovascular-disease mortality, Cause of death, risk, education.field_of_study, Incidence (epidemiology), Incidence, Hazard ratio, Middle Aged, PE&RC, European Prospective Investigation into Cancer and Nutrition, Europe, nutrition, Cardiovascular Diseases, all-cause, Female, dietary-intake measurements, Adult, medicine.medical_specialty, cancer-mortality, Population, Lower risk, Diet Surveys, Environmental health, medicine, Humans, education, Mathematical and Statistical Methods - Biometris, Life Style, Aged, Proportional Hazards Models, hiroshima/nagasaki life-span, business.industry, Proportional hazards model, Feeding Behavior, heart-disease, Surgery, Diet, european countries, Fruit, business
Abstract: Consumption of fruits and vegetables is associated with a lower overall mortality. The aim of this study was to identify causes of death through which this association is established. More than 450,000 participants from the European Prospective Investigation into Cancer and Nutrition study were included, of which 25,682 were reported deceased after 13 years of follow-up. Information on lifestyle, diet and vital status was collected through questionnaires and population registries. Hazard ratios (HR) with 95 % confidence intervals (95 % CI) for death from specific causes were calculated from Cox regression models, adjusted for potential confounders. Participants reporting consumption of more than 569 g/day of fruits and vegetables had lower risks of death from diseases of the circulatory (HR for upper fourth 0.85, 95 % CI 0.77-0.93), respiratory (HR for upper fourth 0.73, 95 % CI 0.59-0.91) and digestive system (HR for upper fourth 0.60, 95 % CI 0.46-0.79) when compared with participants consuming less than 249 g/day. In contrast, a positive association with death from diseases of the nervous system was observed. Inverse associations were generally observed for vegetable, but not for fruit consumption. Associations were more pronounced for raw vegetable consumption, when compared with cooked vegetable consumption. Raw vegetable consumption was additionally inversely associated with death from neoplasms and mental and behavioral disorders. The lower risk of death associated with a higher consumption of fruits and vegetables may be derived from inverse associations with diseases of the circulatory, respiratory and digestive system, and may depend on the preparation of vegetables and lifestyle factors.
Published: 2014

30. Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study

Author: Vasiliki Benetou, Isabelle Romieu, Antonia Trichopoulou, Teresa Norat, Joline W.J. Beulens, Kim Overvad, Larraitz Arriola, Elisabete Weiderpass, Eric J. Duell, Aurelio Barricarte, Paul Brennan, Anne Tjønneland, Peter Wallström, Rosario Tumino, Mattias Johansson, Guy Fagherazzi, Laure Dossus, Petra H.M. Peeters, Marc J. Gunter, Dimitrios Trichopoulos, David C. Muller, Carlotta Sacerdote, Laureen Dartois, Elio Riboli, Nicholas J. Wareham, Pietro Ferrari, Claudia Agnoli, Idlir Licaj, Anja Olsen, Esther Molina-Montes, Domenico Palli, Per Kragh Andersen, Kathryn E. Bradbury, Kuanrong Li, Heiner Boeing, Luciana Neves Nunes, Rudolf Kaaks, Carmen Navarro Sánchez, Kay-Tee Khaw, [Ferrari,P, Licaj,I, Muller,DC, Johansson,M, Nunes,L, Brennan,P, Romieu,I] International Agency for Research on Cancer, Lyon, France. [Andersen,PK] Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark. [Boeing,H] Potsdam-Rehbrücke Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. [Weiderpass,E] Department of Community Medicine, Faculty of Health Sciences, University of Tromso, The Arctic University of Norway, 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. [Dossus,L, Dartois,L, Fagherazzi,G] Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women’s Health team, Villejuif, France. Université Paris Sud, UMRS 1018, Villejuif, France. IGR, Villejuif, France. [Bradbury,KE] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. [Khaw,K] Department of Public Health and Primary Care, University of Cambridge Addenbrooke’s Hospital, Cambridge, UK. [Wareham,N] Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK. [Duell,EJ] Unit of Nutrition, Cancer Epidemiology Research Program, Environment and Cancer, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology (ICO), Barcelona, Spain. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Barricarte,A, Arriola,L] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Murcia, Spain. [Molina-Montes,E] Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria de Granada, Granada, Spain. [Molina-Montes,E, Navarro,C] CIBER Epidemiología y Salud Pública (CIBERESP), Spain. [Navarro,C] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. [Arriola,L] Public Health Division of Gipuzkoa, Instituto BIO-Donostia, Basque Government, Spain. [Wallström,P] Nutrition Epidemiology Research Group, Department of Clinical Sciences, Lund University, Malmö, Sweden. [Tjønneland,A, Olsen,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Trichopoulou,A, Benetou,V] Department of Hygiene, Epidemiology and Medical Statistics, WHO Collaborating Center for Food and Nutrition Policies, 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, Massachusetts, USA. Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. [Tumino,R] Cancer Registry and Histopathology Unit, 'Civic-MP Arezzo' Hospital, ASP Ragusa, Italy. [Agnoli,C] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Sacerdote,C] Unit of Cancer Epidemiology, AO Citta’ della Salute e della Scienza-University of Turin and Center for Cancer Prevention (CPO-Piemonte), Turin, Italy. Human Genetics Foundation (HuGeF), Turin, Italy. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute—ISPO, Florence, Italy. [Li,K, Kaaks,R] Department of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany. [Peeters,P, Beulens,JW] Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands. [Nunes,L] Department of Statistics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. [Gunter,M, Norat,T, Norat,E] Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK. [Overvad,K] Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark. Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark., Funding This work was supported by the Direction Générale de la Santé (French Ministry of Health) (Grant GR-IARC-2003-09-12-01), by the European Commission (Directorate General for Health and Consumer Affairs) and the International Agency for Research on Cancer. The national cohorts are supported by the Danish Cancer Society (Denmark), the Ligue Contre le Cancer, the Institut Gustave Roussy, the Mutuelle Générale de l’Education Nationale and the Institut National de la Santé et de la Recherche Médicale (France), the Deutsche Krebshilfe, the Deutsches Krebsforschungszentrum, and the Federal Ministry of Education and Research (Germany), the Hellenic Health Foundation, the Stavros Niarchos Foundation and the Hellenic Ministry of Health and Social Solidarity (Greece), the Italian Association for Research on Cancer and the National Research Council (Italy), the Dutch Ministry of Public Health, Welfare and Sports, the Netherlands Cancer Registry, LK, Epidemiology and Data Science, ACS - Diabetes & metabolism, ACS - Heart failure & arrhythmias, and APH - Health Behaviors & Chronic Diseases
Subjects: Gerontology, Male, Time Factors, Etanol, Disease, DISEASE, Cause of Death, Neoplasms, Epidemiology, VDP::Medical disciplines: 700::Health sciences: 800::Health service and health administration research: 806, EPIDEMIOLOGY, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Nutritional Status [Medical Subject Headings], Prospective Studies, Estado Nutricional, Stroke, Nutrition and Dietetics, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Absolute risk reduction, Geographicals::Geographic Locations::Europe [Medical Subject Headings], Estudios Prospectivos, General Medicine, Diseases::Neoplasms [Medical Subject Headings], Middle Aged, Consumo de bebidas alcohólicas, COMPETING RISKS, Neoplasias, FRACTIONAL POLYNOMIALS, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, RATE ADVANCEMENT PERIODS, Cardiovascular Diseases, Cohort, Female, Europa, Life Sciences & Biomedicine, Adult, medicine.medical_specialty, Alcohol Drinking, MODELS, Cardiology, Risk Assessment, Medicine, General & Internal, Diabetes mellitus, General & Internal Medicine, medicine, Humans, METAANALYSIS, Aged, VDP::Medisinske Fag: 700::Helsefag: 800::Helsetjeneste- og helseadministrasjonsforskning: 806, Science & Technology, Nutrition & Dietetics, business.industry, Research, CONSUMPTION, ADULTS, GLOBAL BURDEN, medicine.disease, Chemicals and Drugs::Organic Chemicals::Alcohols::Ethanol [Medical Subject Headings], Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Drinking Behavior::Alcohol Drinking [Medical Subject Headings], VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business, Demography
Abstract: OBJECTIVES: To investigate the role of factors that modulate the association between alcohol and mortality, and to provide estimates of absolute risk of death.DESIGN: The European Prospective Investigation into Cancer and nutrition (EPIC).SETTING: 23 centres in 10 countries.PARTICIPANTS: 380 395 men and women, free of cancer, diabetes, heart attack or stroke at enrolment, followed up for 12.6 years on average.MAIN OUTCOME MEASURES: 20 453 fatal events, of which 2053 alcohol-related cancers (ARC, including cancers of upper aerodigestive tract, liver, colorectal and female breast), 4187 cardiovascular diseases/coronary heart disease (CVD/CHD), 856 violent deaths and injuries. Lifetime alcohol use was assessed at recruitment.RESULTS: HRs comparing extreme drinkers (≥30 g/day in women and ≥60 g/day in men) to moderate drinkers (0.1-4.9 g/day) were 1.27 (95% CI 1.13 to 1.43) in women and 1.53 (1.39 to 1.68) in men. Strong associations were observed for ARC mortality, in men particularly, and for violent deaths and injuries, in men only. No associations were observed for CVD/CHD mortality among drinkers, whereby HRs were higher in never compared to moderate drinkers. Overall mortality seemed to be more strongly related to beer than wine use, particularly in men. The 10-year risks of overall death for women aged 60 years, drinking more than 30 g/day was 5% and 7%, for never and current smokers, respectively. Corresponding figures in men consuming more than 60 g/day were 11% and 18%, in never and current smokers, respectively. In competing risks analyses, mortality due to CVD/CHD was more pronounced than ARC in men, while CVD/CHD and ARC mortality were of similar magnitude in women.CONCLUSIONS: In this large European cohort, alcohol use was positively associated with overall mortality, ARC and violent death and injuries, but marginally to CVD/CHD. Absolute risks of death observed in EPIC suggest that alcohol is an important determinant of total mortality.
Published: 2014

31. Different in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study

Author: Matthias B. Schulze, Nita G. Forouhi, Carlos González, Kim Overvad, María José Tormo, Fumiaki Imamura, Domenico Palli, J. Ramón Quirós, Yvonne T. van der Schouw, José María Huerta, Francesca L. Crowe, Joline W.J. Beulens, Geertruida J. van Woudenbergh, Valeria Pala, Françoise Clavel-Chapelon, Stephen J. Sharp, Daphne L. van der A, Claudia Langenberg, Edith J. M. Feskens, Marcela Guevara, Keith Summerhill, Pilar Amiano, Tilman Kühn, Kay-Tee Khaw, Guy Fagherazzi, Elio Riboli, Rosario Tumino, María José Sánchez, Nicholas J. Wareham, Nina Roswall, Rudolf Kaaks, Amalia Mattiello, Marianne Uhre Jakobsen, Timothy J. Key, Julian L. Griffin, L. Wang, Janine Kröger, Olov Rolandsson, Laureen Dartois, Annemieke M.W. Spijkerman, Carlotta Sacerdote, Heiner Boeing, Anne Tjønneland, Albert Koulman, Nadia Slimani, Paul W. Franks, Peter M. Nilsson, Epidemiology and Data Science, ACS - Diabetes & metabolism, ACS - Heart failure & arrhythmias, APH - Health Behaviors & Chronic Diseases, [Forouhi,NG] MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. [Koulman,A, Wang,L, Summerhill,K, Griffin,JL] MRC Human Nutrition Research, Cambridge, UK. [Sharp,SJ, Imamura,F, Langenberg,C, Wareham,NJ] MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. [Kröger,J, Schulze,MB, Boeing,H] German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany. [Crowe,FL, Key,TJ] Nuffield Department of Medicine, University of Oxford, Oxford, UK. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain. [Guevara,M] CIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain, Navarre Public Health Institute (ISPN), Pamplona, Spain. [Beulens,JW, van der Schouw,YT] University Medical Center Utrecht, Utrecht, Netherlands. [van Woudenbergh,GJ, Feskens,EJ] Wageningen University, Wageningen, Netherlands. [Amiano,P] CIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain, Public Health Division of Gipuzkoa, San Sebastian, Spain, Instituto BIO-Donostia, Basque Government, San Sebastian, Spain. [Clavel-Chapelon,F, Dartois L, Fagherazzi,G] Inserm, CESP, Villejuif, France, Univ Paris-Sud, Villejuif, France, Gustave Roussy Institute, Villejuif, France. [Franks,PW] Lund University, Malmö, Sweden, Umeå University, Umeå, Sweden. [Gonzalez,C] Catalan Institute of Oncology (ICO), Barcelona, Spain. [Jakobsen,MU] Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark. [Kaaks,R, Kühn,T] German Cancer Research Centre (DKFZ), Heidelberg, Germany. [Khaw,KT] Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. [Mattiello,A] Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy. [Nilsson,PM] Lund University, Malmö, Sweden. [Overvad,K] Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark, Aalborg University Hospital, Aalborg, Denmark. [Pala,V] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Palli,D] Cancer Research and Prevention Institute (ISPO), Florence, Italy. [Quirós,JR] Public Health Directorate, Asturias, Spain. [Rolandsson,O] Umeå University, Umeå, Sweden. [Roswall,N] Danish Cancer Society, Copenhagen, Denmark. [Sacerdote,C] Unit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital-University of Turin and Centre for Cancer Prevention (CPO), Turin, Italy, Human Genetics Foundation (HuGeF), Turin, Italy. [Sánchez,MJ] CIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain, Andalusian School of Public Health, Granada, Spain, Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada, Spain. [Slimani,N] International Agency for Research on Cancer, Lyon, France. [Spijkerman,AM, van der A,DL] National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands. [Tjonneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Tormo,MJ] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain, Department of Health and Social Sciences, Universidad de Murcia, Spain. [Tumino,R] Associazione Italiana Registri Tumori, Dipartimento di Prevenzione Medica, Azienda Sanitaria Provinciale, Ragusa, Italy, Aire Onlus, Ragusa, Italy. [Riboli,E] School of Public Health, Imperial College London, London, UK., and EU FP6 programme, Medical Research Council Epidemiology Unit, Medical Research Council Human Nutrition Research, and Cambridge Lipidomics Biomarker Research Initiative.
Subjects: Male, Nutrition and Disease, 030309 nutrition & dietetics, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Pentadecanoic acid, Palmitic acid, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], chemistry.chemical_compound, 0302 clinical medicine, Endocrinology, project, Voeding en Ziekte, Estudios prospectivos, Fosfolípidos, Prospective Studies, humans, risk-factors, Ácidos grasos, Phospholipids, 2. Zero hunger, 0303 health sciences, Estudios de casos y controles, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies [Medical Subject Headings], Fatty Acids, de-novo lipogenesis, Articles, Chemicals and Drugs::Lipids::Fatty Acids [Medical Subject Headings], Middle Aged, 3. Good health, Endokrinologi och diabetes, Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Diabetes Mellitus::Diabetes Mellitus, Type 2 [Medical Subject Headings], biomarker, dietary, Heptadecanoic acid, Female, Stearic acid, 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], Diabetes Mellitus tipo 2, Lignoceric acid, Check Tags::Male [Medical Subject Headings], 030209 endocrinology & metabolism, Endocrinology and Diabetes, 03 medical and health sciences, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, cancer, Chemicals and Drugs::Lipids::Phospholipids [Medical Subject Headings], VLAG, Mediana edad, disease, business.industry, medicine.disease, dairy product intake, chemistry, Check Tags::Female [Medical Subject Headings], Diabetes Mellitus, Type 2, Case-Control Studies, Odd-chain fatty acid, business, mellitus
Abstract: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; BACKGROUND Conflicting evidence exists regarding the association between saturated fatty acids (SFAs) and type 2 diabetes. In this longitudinal case-cohort study, we aimed to investigate the prospective associations between objectively measured individual plasma phospholipid SFAs and incident type 2 diabetes in EPIC-InterAct participants. METHODS The EPIC-InterAct case-cohort study includes 12,403 people with incident type 2 diabetes and a representative subcohort of 16,154 individuals who were selected from a cohort of 340.234 European participants with 3·99 million person-years of follow-up (the EPIC study). Incident type 2 diabetes was ascertained until Dec 31, 2007, by a review of several sources of evidence. Gas chromatography was used to measure the distribution of fatty acids in plasma phospholipids (mol%); samples from people with type 2 diabetes and subcohort participants were processed in a random order by centre, and laboratory staff were masked to participant characteristics. We estimated country-specific hazard ratios (HRs) for associations per SD of each SFA with incident type 2 diabetes using Prentice-weighted Cox regression, which is weighted for case-cohort sampling, and pooled our findings using random-effects meta-analysis. FINDINGS SFAs accounted for 46% of total plasma phospholipid fatty acids. In adjusted analyses, different individual SFAs were associated with incident type 2 diabetes in opposing directions. Even-chain SFAs that were measured (14:0 [myristic acid], 16:0 [palmitic acid], and 18:0 [stearic acid]) were positively associated with incident type 2 diabetes (HR [95% CI] per SD difference: myristic acid 1·15 [95% CI 1·09-1·22], palmitic acid 1·26 [1·15-1·37], and stearic acid 1·06 [1·00-1·13]). By contrast, measured odd-chain SFAs (15:0 [pentadecanoic acid] and 17:0 [heptadecanoic acid]) were inversely associated with incident type 2 diabetes (HR [95% CI] per 1 SD difference: 0·79 [0·73-0·85] for pentadecanoic acid and 0·67 [0·63-0·71] for heptadecanoic acid), as were measured longer-chain SFAs (20:0 [arachidic acid], 22:0 [behenic acid], 23:0 [tricosanoic acid], and 24:0 [lignoceric acid]), with HRs ranging from 0·72 to 0·81 (95% CIs ranging between 0·61 and 0·92). Our findings were robust to a range of sensitivity analyses. INTERPRETATION Different individual plasma phospholipid SFAs were associated with incident type 2 diabetes in opposite directions, which suggests that SFAs are not homogeneous in their effects. Our findings emphasise the importance of the recognition of subtypes of these fatty acids. An improved understanding of differences in sources of individual SFAs from dietary intake versus endogenous metabolism is needed. FUNDING EU FP6 programme, Medical Research Council Epidemiology Unit, Medical Research Council Human Nutrition Research, and Cambridge Lipidomics Biomarker Research Initiative. Yes
Published: 2014

32. Combined impact of healthy lifestyle factors on colorectal cancer : a large European cohort study

Author: Domenico Palli, Aurelio Barricarte, José Ramón Quirós, Laureen Dartois, Heather Ward, Salvatore Panico, Isabelle Romieu, Veronika Fedirko, Ulrika Ericson, Kim Overvad, Miren Dorronsoro, Pagona Lagiou, Krasimira Aleksandrova, Rudolf Kaaks, Kay-Tee Khaw, Anne Tjønneland, Elio Riboli, Laure Dossus, Sabina Rinaldi, Ingrid Ljuslinder, Genevieve Buckland, Marc J. Gunter, Petra H.M. Peeters, Vittorio Krogh, Alessio Naccarati, Ingegerd Johansson, Bodil Ohlsson, Peter D. Siersema, Kathryn E. Bradbury, Heiner Boeing, María José Sánchez, Mazda Jenab, Antonia Trichopoulou, H. Bas Bueno-de-Mesquita, Elisabete Weiderpass, Guri Skeie, Kristin Benjaminsen Borch, Tobias Pischon, Sven Knüppel, Teresa Norat, Nicholas J. Wareham, Joyce Kong, Dora Romaguera, Kuanrong Li, Dimitrios Trichopoulos, Rosario Tumino, Marie-Christine Boutron-Ruault, María Dolores Chirlaque, [Aleksandrova,K, Knüppe,S, Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. [Pischon,T] Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine (MDC), Berlin-Buch, Germany. [Jenab,M, Fedirko,V, Rinald,S, Romieu,I, Kong,J] International Agency for Research on Cancer (IARC-WHO), Lyon, France. [Bueno-de-Mesquita,HB] National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands. [Bueno-de-Mesquita,HB, Siersema,PD] Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, the Netherlands. [Bueno-de-Mesquita,HB, Norat,T, Romaguera,D, Peeters,PHM, Gunter,MJ, Ward,HA, Riboli,E] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. [Fedirko,V] Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, USA. [Romaguera,D] Instituto de Investigacion Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, Palma de Mallorca, Spain. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Santiago de Compostela, Spain. [Boutron-Ruault,M, Dossus,L, Dartois,L] Inserm, Centre for research in Epidemiology and Population Health (CESP), Nutrition, Hormones and Women’s Health team, Villejuif, France. Univ Paris Sud, Villejuif, France. IGR, Villejuif, France. [Kaaks,R, Li,K] Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany. [Tjønneland,K] Diet, Genes and Environment Danish Cancer Society Research Center, Copenhagen, Denmark. [Overvad,K] Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark. [Quirós,JR] Public Health Directorate, Asturias, Spain. [Buckland,G] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. [Sánchez,MJ] Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada, Spain. [Sánchez,MJ, Chirlaque,M] CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Dorronsoro,M] Epidemiology and Health Information, Public Health Division of Gipuzkoa, Basque Regional Health Department, San Sebastian, Spain. [Chirlaque,M] Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Khaw,K] Clinical Gerontology Unit, Addenbrooke’s Hospital, University of Cambridge School of Clinical Medicine, Cambridge, UK. [Wareham,NJ] MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK. [Bradbury,KE] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. [Trichopoulou,A] Hellenic Health Foundation, Athens, Greece. [Trichopoulou,A, Lagiou,P, Trichopoulos,D] Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. [Lagiou,P, Trichopoulos,D] Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Trichopoulos,D] Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy. [Krogh,V] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, 'M.P.Arezzo' Hospital, Ragusa, Italy. [Naccarati,A] HuGeF - Human Genetics Foundation – Torino, Molecular and Genetic Epidemiology Unit, Turin, Italy. [Panico,S] Department of clinical and experimental medicine-Federico II University, Naples, Italy. [Peeters,PHM] Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherland. [Ljuslinder,I] Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden. [Johansson,I] Department of Odontology, Umeå University, Umeå, Sweden. [Ericson,U] Diabetes and Cardiovascular Disease, Genetic Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden. [Ohlsson,B] Department of Clinical Sciences, Division of Internal Medicine, Skåne University Hospital Malmö, Lund University, Malmö, Sweden. [Weiderpass,E, Skeie,G, Borch,KB] Department of Community Medicine, Faculty of Health Sciences, University of Tromso, The Arctic University of Norway, Tromsø, Norway. [Weiderpass,E] Department of Research, Cancer Registry of Norway, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Samfundet Folkhälsan, Helsinki, Finland., The coordination of the EPIC study 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), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany), Hellenic Health Foundation (Greece), Italian Association for Research on Cancer (AIRC), National Research Council, HuGeF Foundation, Compagnia di San Paolo, Sicily Regional Government, AIRE ONLUS Ragusa and AVIS Ragusa (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), ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health, Norwegian Research Council, Norwegian Cancer Society, University of Tromso (Norway), Health Research Fund (FIS), Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain), Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skåne and Västerbotten (Sweden), Cancer Research UK, Medical Research Council (United Kingdom)., Aleksandrova, Krasimira, Pischon, Tobia, Jenab, Mazda, Bueno de Mesquita, H. Ba, Fedirko, Veronika, Norat, Teresa, Romaguera, Dora, Knüppel, Sven, Boutron Ruault, Marie Christine, Dossus, Laure, Dartois, Laureen, Kaaks, Rudolf, Li, Kuanrong, Tjønneland, Anne, Overvad, Kim, Quirós, José Ramón, Buckland, Genevieve, Sánchez, María José, Dorronsoro, Miren, Chirlaque, Maria Dolore, Barricarte, Aurelio, Khaw, Kay Tee, Wareham, Nicholas J, Bradbury, Kathryn E, Trichopoulou, Antonia, Lagiou, Pagona, Trichopoulos, Dimitrio, Palli, Domenico, Krogh, Vittorio, Tumino, Rosario, Naccarati, Alessio, Panico, Salvatore, Siersema, Peter D, Peeters, Petra H. M, Ljuslinder, Ingrid, Johansson, Ingegerd, Ericson, Ulrika, Ohlsson, Bodil, Weiderpass, Elisabete, Skeie, Guri, Borch, Kristin Benjaminsen, Rinaldi, Sabina, Romieu, Isabelle, Kong, Joyce, Gunter, Marc J, Ward, Heather A, Riboli, Elio, and Boeing, Heiner
Subjects: Male, consumo de alcohol, Health Behavior, 0302 clinical medicine, estudios prospectivos, European Prospective Investigation into Cancer and, Prospective Studies, estudios de cohortes, mediana edad, PROPORTION, anciano, education.field_of_study, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Motor Activity [Medical Subject Headings], dieta, Incidence, COLON-CANCER, Hazard ratio, lifestyle factors, General Medicine, adulto, 3. Good health, estilo de vida, 030220 oncology & carcinogenesis, Cohort, acrylamide, Dieta, Cohort study, Human, medicine.medical_specialty, Alcohol Drinking, European Continental Ancestry Group, Lifestyles, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Habits::Smoking [Medical Subject Headings], European Prospective Investigation into Cancer and Nutrition (EPIC), Endocrinology and Diabetes, dietary questionnaires, haemoglobin adducts, incidencia, White People, 03 medical and health sciences, Càncer colorectal, population attributable risks, Humans, education, Life Style, METAANALYSIS, Aged, Cancer och onkologi, Science & Technology, Proportional hazards model, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Oncology: 762, biomarkers, Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [Medical Subject Headings], Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], PREVENTION, Prospective Studie, MYOCARDIAL-INFARCTION, ATTRIBUTABLE RISK, Cardiovascular and Metabolic Diseases, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Cancer and Oncology, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Drinking Behavior::Alcohol Drinking [Medical Subject Headings], RISK-FACTORS, Proportional Hazards Model, grupo de ascendencia continental europea, measurement errors, Gerontology, colorectal cancer, combined impact, modelos de riesgos proporcionales, humanos, Colorectal Neoplasm, Cohort Studies, Risk Factors, Neoplasias colorrectales, Hábito de fumar, 030212 general & internal medicine, Prospective cohort study, conducta sanitaria, Medicine(all), Consumo de alcohol, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, European Prospective Investigation into Cancer and Nutrition, Europe, NUTRITION, Female, Colorectal Neoplasms, Life Sciences & Biomedicine, Research Article, Adult, Estils de vida, neoplasias colorrectales, 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, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], smoking, Medicine, General & Internal, General & Internal Medicine, Internal medicine, medicine, factores de riesgo, Proportional Hazards Models, Nutrition (EPIC), RECTAL CANCERS, business.industry, Risk Factor, Diet, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Onkologi: 762, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, PHYSICAL-ACTIVITY, Attributable risk, Cohort Studie, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business
Abstract: Background: Excess body weight, physical activity, smoking, alcohol consumption and certain dietary factors are individually related to colorectal cancer (CRC) risk; however, little is known about their joint effects. The aim of this study was to develop a healthy lifestyle index (HLI) composed of five potentially modifiable lifestyle factors healthy weight, physical activity, non-smoking, limited alcohol consumption and a healthy diet, and to explore the association of this index with CRC incidence using data collected within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods: In the EPIC cohort, a total of 347,237 men and women, 25- to 70-years old, provided dietary and lifestyle information at study baseline (1992 to 2000). Over a median follow-up time of 12 years, 3,759 incident CRC cases were identified. The association between a HLI and CRC risk was evaluated using Cox proportional hazards regression models and population attributable risks (PARs) have been calculated. Results: After accounting for study centre, age, sex and education, compared with 0 or 1 healthy lifestyle factors, the hazard ratio (HR) for CRC was 0.87 (95% confidence interval (CI): 0.44 to 0.77) for two factors, 0.79 (95% CI: 0.70 to 0.89) for three factors, 0.66 (95% CI: 0.58 to 0.75) for four factors and 0.63 (95% CI: 0.54 to 0.74) for five factors; P-trend, The coordination of the EPIC study 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 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), National Research Council, HuGeF Foundation, Compagnia di San Paolo, Sicily Regional Government, AIRE ONLUS Ragusa and AVIS Ragusa (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); ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health, Norwegian Research Council, Norwegian Cancer Society, University of Tromso (Norway); Health Research Fund (FIS), Regional Governments of Andalucia, Asturias, Basque Country, Murcia (no. 6236) and Navarra, 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 (United Kingdom).
Published: 2014

33. Non-invasive risk scores for prediction of type 2 diabetes (EPIC-InterAct):A validation of existing models

Author: Aurelio Barricarte, Olov Rolandsson, Laureen Dartois, Matthias B. Schulze, J. Ramón Quirós, Yvonne T. van der Schouw, Timothy J. Key, Diederick E. Grobbee, Larraitz Arriola, Kay-Tee Khaw, Elio Riboli, Kristin Mühlenbruch, María José Tormo, Carlotta Sacerdote, Andre Pascal Kengne, Annemieke M.W. Spijkerman, Luigi Palla, Thure Filskov Overvad, Peter M. Nilsson, Anne Tjønneland, José María Huerta, Giovanna Tagliabue, Rosario Tumino, Rudolf Kaaks, Nadia Slimani, Paul W. Franks, Daphne L. van der A, Domenico Palli, Simon J. Griffin, Nicholas J. Wareham, Françoise Clavel-Chapelon, Heiner Boeing, Karel G.M. Moons, Nina Roswall, María José Sánchez, Claudia Langenberg, Nita G. Forouhi, Joline W.J. Beulens, Kim Overvad, Noël C. Barengo, Catalina Bonet, Kuanrong Li, Guy Fagherazzi, Linda M. Peelen, Stephen J. Sharp, Salvatore Panico, Kengne, Ap, Beulens, Jw, Peelen, Lm, Moons, Kg, van der Schouw, Yt, Schulze, Mb, Spijkerman, Am, Griffin, Sj, Grobbee, De, Palla, L, Tormo, Mj, Arriola, L, Barengo, Nc, Barricarte, A, Boeing, H, Bonet, C, Clavel Chapelon, F, Dartois, L, Fagherazzi, G, Franks, Pw, Huerta, Jm, Kaaks, R, Key, Tj, Khaw, Kt, Li, K, M?hlenbruch, K, Nilsson, Pm, Overvad, K, Overvad, Tf, Palli, D, Panico, Salvatore, Quir?s, Jr, Rolandsson, O, Roswall, N, Sacerdote, C, S?nchez, Mj, Slimani, N, Tagliabue, G, Tj?nneland, A, Tumino, R, van der A., Dl, Forouhi, Ng, Sharp, Sj, Langenberg, C, Riboli, E, Wareham, Nj, Epidemiology and Data Science, ACS - Diabetes & metabolism, ACS - Heart failure & arrhythmias, APH - Health Behaviors & Chronic Diseases, Department of Public Health, and Hjelt Institute (-2014)
Subjects: Male, Gerontology, EXTERNAL VALIDATION, LIFE-STYLE INTERVENTIONS, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Body Mass Index, Cohort Studies, MELLITUS, 0302 clinical medicine, Endocrinology, TOOL, Medicine, 030212 general & internal medicine, 10. No inequality, media_common, education.field_of_study, Age Factors, Middle Aged, 3. Good health, Cohort, Female, IDENTIFYING INDIVIDUALS, Waist Circumference, Risk assessment, Cohort study, Waist, education, Population, 030209 endocrinology & metabolism, Models, Biological, Risk Assessment, White People, 03 medical and health sciences, Sex Factors, Internal Medicine, Humans, media_common.cataloged_instance, COHORT, VALIDITY, European union, METAANALYSIS, business.industry, medicine.disease, PREVENTION, Diabetes Mellitus, Type 2, 3121 General medicine, internal medicine and other clinical medicine, FOLLOW-UP, business, Body mass index, Demography
Abstract: Background: The comparative performance of existing models for prediction of type 2 diabetes across populations has not been investigated. We validated existing non-laboratory-based models and assessed variability in predictive performance in European populations. Methods: We selected non-invasive prediction models for incident diabetes developed in populations of European ancestry and validated them using data from the EPIC-InterAct case-cohort sample (27 779 individuals from eight European countries, of whom 12 403 had incident diabetes). We assessed model discrimination and calibration for the first 10 years of follow-up. The models were first adjusted to the country-specific diabetes incidence. We did the main analyses for each country and for subgroups defined by sex, age (2 vs ≥25 kg/m2), and waist circumference (men heterogeneityheterogeneity>0·05) except for three models. However, two models overestimated risk, DPoRT by 34% (95% CI 29-39%) and Cambridge by 40% (28-52%). Discrimination was always better in individuals younger than 60 years or with a low waist circumference than in those aged at least 60 years or with a large waist circumference. Patterns were inconsistent for BMI. All models overestimated risks for individuals with a BMI of 2. Calibration patterns were inconsistent for age and waist-circumference subgroups. Interpretation: Existing diabetes prediction models can be used to identify individuals at high risk of type 2 diabetes in the general population. However, the performance of each model varies with country, age, sex, and adiposity. Funding: The European Union.
Published: 2014

34. Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study1,4

Author: Vergnaud, Anne-Claire, Romaguera, Dora, Peeters, Petra H, van Gils, Carla H, Chan, Doris S M, Romieu, Isabelle, Freisling, Heinz, Ferrari, Pietro, Clavel-Chapelon, Françoise, Fagherazzi, Guy, Dartois, Laureen, Li, Kuanrong, Tikk, Kaja, Bergmann, Manuela M, Boeing, Heiner, Tjønneland, Anne, Olsen, Anja, Overvad, Kim, Dahm, Christina Catherine, Redondo, Maria Luisa, Agudo, Antonio, Sánchez, María-José, Amiano, Pilar, Chirlaque, María-Dolores, Ardanaz, Eva, Khaw, Kay-Tee, Wareham, Nick J, Crowe, Francesca, Trichopoulou, Antonia, Orfanos, Philippos, Trichopoulos, Dimitrios, Masala, Giovanna, Sieri, Sabina, Tumino, Rosario, Vineis, Paolo, Panico, Salvatore, Bueno-de-Mesquita, H Bas, Ros, Martine M, May, Anne, Wirfält, Elisabet, Sonestedt, Emily, Johansson, Ingegerd, Hallmans, Göran, Lund, Eiliv, Weiderpass, Elisabete, Parr, Christine L, Riboli, Elio, Norat, Teresa, Vergnaud, Ac, Romaguera, D, Peeters, Ph, van Gils, Ch, Chan, D, Romieu, I, Freisling, H, Ferrari, P, Clavel Chapelon, F, Fagherazzi, G, Dartois, L, Li, K, Tikk, K, Bergmann, Mm, Boeing, H, Tj?nneland, A, Olsen, A, Overvad, K, Dahm, Cc, Redondo, Ml, Agudo, A, S?nchez, Mj, Amiano, P, Chirlaque, Md, Ardanaz, E, Khaw, Kt, Wareham, Nj, Crowe, F, Trichopoulou, A, Orfanos, P, Trichopoulos, D, Masala, G, Sieri, S, Tumino, R, Vineis, P, Panico, Salvatore, Bueno de Mesquita, Hb, Ros, Mm, May, A, Wirf?lt, E, Sonestedt, E, Johansson, I, Hallmans, G, Lund, E, Weiderpass, E, Parr, Cl, Riboli, E, and Norat, T.
Subjects: Adult, Male, Questionnaires, European Continental Ancestry Group, Guidelines as Topic, Middle Aged, Motor Activity, Nutrition Surveys, Diet, Cohort Studies, Europe, Risk Factors, Neoplasms, Humans, Patient Compliance, Female, Prospective Studies, Energy Intake, Life Style, Aged, Follow-Up Studies, Proportional Hazards Models, Molecular epidemiology Aetiology, screening and detection [NCEBP 1]
Abstract: Item does not contain fulltext BACKGROUND: In 2007, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued recommendations on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence. OBJECTIVE: We investigated whether concordance with WCRF/AICR recommendations is related to risk of death. DESIGN: The current study included 378,864 participants from 9 European countries enrolled in the European Prospective Investigation into Cancer and Nutrition study. At recruitment (1992-1998), dietary, anthropometric, and lifestyle information was collected. A WCRF/AICR score, which incorporated 6 of the WCRF/AICR recommendations for men [regarding body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, and alcoholic drinks (score range: 0-6)] and 7 WCRF/AICR recommendations for women [plus breastfeeding (score range: 0-7)], was constructed. Higher scores indicated greater concordance with WCRF/AICR recommendations. Associations between the WCRF/AICR score and risks of total and cause-specific death were estimated by using Cox regression analysis. RESULTS: After a median follow-up time of 12.8 y, 23,828 deaths were identified. Participants within the highest category of the WCRF/AICR score (5-6 points in men; 6-7 points in women) had a 34% lower hazard of death (95% CI: 0.59, 0.75) compared with participants within the lowest category of the WCRF/AICR score (0-2 points in men; 0-3 points in women). Significant inverse associations were observed in all countries. The WCRF/AICR score was also significantly associated with a lower hazard of dying from cancer, circulatory disease, and respiratory disease. CONCLUSION: Results of this study suggest that following WCRF/AICR recommendations could significantly increase longevity.
Published: 2013

35. Development and Validation of a Risk Score Predicting Substantial Weight Gain over 5 Years in Middle-Aged European Men and Women

Author: Philippos Orfanos, Lefkos T. Middleton, Vittorio Krogh, Kuanrong Li, J. Ramón Quirós, Sven Knüppel, Birgit Teucher, Eva Ardanaz, Heiner Boeing, Anne M. May, Laureen Dartois, Guy Fagherazzi, Domenico Palli, Peter Wallström, Bo Hedblad, Jytte Halkjær, Rosario Tumino, Annika Steffen, José María Huerta, María José Sánchez, Amalia Mattiello, Nicholas J. Wareham, Kim Overvad, H. Bas Bueno-de-Mesquita, Kay-Tee Khaw, Daphne L. van der A, Antonia Trichopoulou, Miren Dorronsoro, Anne Tjønneland, Paolo Vineis, Thorkild I. A. Sørensen, Dimitrios Trichopoulos, Noémie Travier, Petra H.M. Peeters, Francesca L. Crowe, [Steffen,A, Knüppel,S, Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. [Sørensen,TIA] Instiute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals – Part of Copenhagen University Hospital, The Capital Region, Denmark. [Travier,N] Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, Barcelona, Spain. [Sánchez,MJ] Andalusian School of Public Health, Granada, Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. [Sánchez,MJ, Huerta,JM, Ardanaz,E] CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. [Quirós,JR] Public Health Directorate, Asturias, Spain. [Ardanaz,E] Navarre Public Health Institute, Pamplona, Spain. [Dorronsoro,M] Basque Regional Health Department and Ciberesp – Biodonostia, San Sebastian, Spain. [Teucher,B, Li,K] Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany. [Bueno-de-Mesquita,HB, A,D] National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. [Bueno-de-Mesquita,HB] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. [Mattiello,A] Dipartimento di Medicina Clinica e Chirurgia, Frederico II University, Naples, Italy. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute, Florence, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, ‘‘Civile – M.P.Arezzo’’ Hospital, Ragusa, Italy. [Krogh,V] Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Vineis,P] HuGeF Foundation Torino, Italy. [Trichopoulou,A, Orfanos,P, Trichopoulos,D] Hellenic Health Foundation, Athens, Greece. [Trichopoulou,A, Orfanos,P] WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Trichopoulos,D] Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America. [Trichopoulos,D] Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. [Hedblad,B] Department of Clinical Sciences in Malmö, Clinical Research Centre, Skane University Hospital, Malmö, Sweden. [Wallström,P] Nutrition Epidemiology Research Group, Department of Clinical Sciences, Lund University, Malmö, Sweden. [Overvad,K] Section of Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. [Halkjær,J, Tjønneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Fagherazzi,G, Dartois,L] Inserm, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Villejuif, France. Paris South University, Villejuif, France. [Crowe,F] Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom. [Khaw,K] Clinical Gerontology Unit, University of Cambridge, Cambridge, United Kingdom. [Wareham,N] Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. [Vineis,P, Middleton,L] School of Public Health, Imperial College, London, United Kingdom. [May,AM, Peeters,PHM] Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands. [Peeters,PHM] Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom., This publication arises from a collaboration of two EU projects, the Diet, Obesity and Genes (DiOGenes) project and the Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating out of Home and Obesity (PANACEA) project. DiOGenes is a pan-European study within the EU Sixth Framework Programme for Research and Technological Development (2005-2009) (FOOD-CT-2005-513946, http://www.diogenes.eu.org). PANACEA received funding from the EU in the framework of the Public Health Programme (project 2005328). This work was further supported by the European Commission: Public Health and Consumer Protection Directorate 1993–2004, the Research Directorate-General 2005, the Ligue contre le Cancer, the Societe´ 3M, the Mutuelle Ge´ne´ rale de l’Education Nationale, and the Institut National de la Sante´ et de la Recherche Me´ dicale, German Cancer Aid, the German Cancer Research Center, and the Federal Ministry of Education and Research (Germany), the Danish Cancer Society (Denmark), Health Research Fund (FIS) of the Spanish Ministry of Health RTICC ’Red Tema´tica de Investigacio´n Cooperativa en Ca´ncer (grant number C03/10, R06/0020), the participating regional governments and institutions of Spain, Cancer Research United Kingdom, the Medical Research Council, the Stroke Association, the British Heart Foundation, the Department of Health, the Food Standards Agency, and the Wellcome Trust (United Kingdom), the Italian Association for Research on Cancer and the National Research Council (Italy), the Dutch Ministry of Public Health, Welfare and Sports, the Dutch Ministry of Health, Dutch Prevention Funds, LK Research Funds, the Dutch Zorg Onderzoek Nederland, and the World Cancer Research Fund (Netherlands), and the Swedish Cancer Society, the Swedish Scientific Council, and the Regional Government of Skane. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Subjects: Male, Gerontology, Research Validity, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], Non-Clinical Medicine, Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::Body Weight Changes::Weight Gain [Medical Subject Headings], Epidemiology, lcsh:Medicine, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Weight Gain, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Cohort Studies, Mediana Edad, 0302 clinical medicine, Risk Factors, Positive predicative value, Aumento de Peso, Cardiac and Cardiovascular Systems, Prospective Studies, 030212 general & internal medicine, Masculino, lcsh:Science, Factores de Riesgo, education.field_of_study, Multidisciplinary, Framingham Risk Score, Nutrition and Dietetics, Adulto, Femenino, Geographicals::Geographic Locations::Europe [Medical Subject Headings], Epidemiology of Aging, Estudios Prospectivos, Middle Aged, Research Assessment, Humanos, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Medicine, Female, Public Health, medicine.symptom, Europa, 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], Clinical Research Design, Science Policy, Anciano, Population, Check Tags::Male [Medical Subject Headings], 030209 endocrinology & metabolism, External validity, 03 medical and health sciences, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], medicine, Humans, Obesity, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Statistical Methods, education, Aged, Proportional Hazards Models, Nutrition, Health Care Policy, Receiver operating characteristic, business.industry, Proportional hazards model, lcsh:R, Health Risk Analysis, Check Tags::Female [Medical Subject Headings], lcsh:Q, Modelos de Riesgos Proporcionales, business, Weight gain, Demography
Abstract: Journal Article; Research Support, Non-U.S. Gov't; BACKGROUND Identifying individuals at high risk of excess weight gain may help targeting prevention efforts at those at risk of various metabolic diseases associated with weight gain. Our aim was to develop a risk score to identify these individuals and validate it in an external population. METHODS We used lifestyle and nutritional data from 53°758 individuals followed for a median of 5.4 years from six centers of the European Prospective Investigation into Cancer and Nutrition (EPIC) to develop a risk score to predict substantial weight gain (SWG) for the next 5 years (derivation sample). Assuming linear weight gain, SWG was defined as gaining ≥ 10% of baseline weight during follow-up. Proportional hazards models were used to identify significant predictors of SWG separately by EPIC center. Regression coefficients of predictors were pooled using random-effects meta-analysis. Pooled coefficients were used to assign weights to each predictor. The risk score was calculated as a linear combination of the predictors. External validity of the score was evaluated in nine other centers of the EPIC study (validation sample). RESULTS Our final model included age, sex, baseline weight, level of education, baseline smoking, sports activity, alcohol use, and intake of six food groups. The model's discriminatory ability measured by the area under a receiver operating characteristic curve was 0.64 (95% CI = 0.63-0.65) in the derivation sample and 0.57 (95% CI = 0.56-0.58) in the validation sample, with variation between centers. Positive and negative predictive values for the optimal cut-off value of ≥ 200 points were 9% and 96%, respectively. CONCLUSION The present risk score confidently excluded a large proportion of individuals from being at any appreciable risk to develop SWG within the next 5 years. Future studies, however, may attempt to further refine the positive prediction of the score. Yes
Published: 2013

36. Fiber intake and total and cause-specific mortality in the European Prospective Investigation into Cancer and Nutrition cohort

Author: Guri Skeie, Emily Sonestedt, Petra H.M. Peeters, Paolo Vineis, Heiner Boeing, Martine M. Ros, Anne Tjønneland, Ingegerd Johansson, Francesca L. Crowe, Domenico Palli, Elio Riboli, Anja Olsen, Pietro Ferrari, Timothy J. Key, Neil Murphy, Miren Dorronsoro, Lene Angell Åsli, Shu Chun Chuang, Pagona Lagiou, Rosario Tumino, Nadia Slimani, Sara Grioni, Florence Perquier, Valentina Gallo, Kim Overvad, Marie-Christine Boutron-Ruault, Antonia Trichopoulou, Salvatore Panico, Kay-Tee Khaw, Carlotta Sacerdote, Nicholas J. Wareham, Dimitrios Trichopoulos, Magritt Brustad, Laureen Dartois, Teresa Norat, Carlos A. González, Isabelle Romieu, Bas Bueno-de-Mesquita, Isabel Drake, Göran Hallmans, J. Ramón Quirós, Birgit Teucher, Rudolf Kaaks, Eva Ardanaz Aicua, Carmen Navarro, María José Sánchez, Manuela M. Bergmann, Chuang, Sc, Norat, T, Murphy, N, Olsen, A, Tj?nneland, A, Overvad, K, Boutron Ruault, Mc, Perquier, F, Dartois, L, Kaaks, R, Teucher, B, Bergmann, Mm, Boeing, H, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Grioni, S, Sacerdote, C, Panico, Salvatore, Palli, D, Tumino, R, Peeters, Ph, Bueno de Mesquita, B, Ros, Mm, Brustad, M, sli, La, Skeie, G, Quir?s, Jr, Gonz?lez, Ca, S?nchez, Mj, Navarro, C, Ardanaz Aicua, E, Dorronsoro, M, Drake, I, Sonestedt, E, Johansson, I, Hallmans, G, Key, T, Crowe, F, Khaw, Kt, Wareham, N, Ferrari, P, Slimani, N, Romieu, I, Gallo, V, Riboli, E, and Vineis, P.
Subjects: Adult, Dietary Fiber, Male, Risk, medicine.medical_specialty, Digestive System Diseases, Medicine (miscellaneous), Cereals, Disease, Health Promotion, Nutrition Policy, Cohort Studies, Internal medicine, Vegetables, medicine, Humans, Prospective Studies, Mortality, Prospective cohort study, Molecular epidemiology Aetiology, screening and detection [NCEBP 1], Cause of death, Aged, Nutrition and Dietetics, Proportional hazards model, business.industry, Middle Aged, medicine.disease, Surgery, European Prospective Investigation into Cancer and Nutrition, Menopause, Europe, Immune System Diseases, Fruit, Cohort, Female, business, Edible Grain, Cohort study, Follow-Up Studies
Abstract: Item does not contain fulltext BACKGROUND: Previous studies have shown that high fiber intake is associated with lower mortality. However, little is known about the association of dietary fiber with specific causes of death other than cardiovascular disease (CVD). OBJECTIVE: The aim of this study was to assess the relation between fiber intake, mortality, and cause-specific mortality in a large European prospective study of 452,717 men and women. DESIGN: HRs and 95% CIs were estimated by using Cox proportional hazards models, stratified by age, sex, and center and adjusted for education, smoking, alcohol consumption, BMI, physical activity, total energy intake, and, in women, ever use of menopausal hormone therapy. RESULTS: During a mean follow-up of 12.7 y, a total of 23,582 deaths were recorded. Fiber intake was inversely associated with total mortality (HR(per 10-g/d increase): 0.90; 95% CI: 0.88, 0.92); with mortality from circulatory (HR(per 10-g/d increase): 0.90 and 0.88 for men and women, respectively), digestive (HR: 0.61 and 0.64), respiratory (HR: 0.77 and 0.62), and non-CVD noncancer inflammatory (HR: 0.85 and 0.80) diseases; and with smoking-related cancers (HR: 0.86 and 0.89) but not with non-smoking-related cancers (HR: 1.05 and 0.97). The associations were more evident for fiber from cereals and vegetables than from fruit. The associations were similar across BMI and physical activity categories but were stronger in smokers and participants who consumed >18 g alcohol/d. CONCLUSIONS: Higher fiber intake is associated with lower mortality, particularly from circulatory, digestive, and non-CVD noncancer inflammatory diseases. Our results support current recommendations of high dietary fiber intake for health maintenance. 01 juli 2012
Published: 2012

37. Combined Impact of Lifestyle Factors on Prospective Change in Body Weight and Waist Circumference in Participants of the EPIC-PANACEA Study

Author: Salvatore Panico, Marianne Uhre Jakobsen, Carlos González, Noémie Travier, Emily Sonestedt, Dora Romaguera, Rosario Tumino, Kim Overvad, Rudolf Kaaks, Isabel Drake, Petra H.M. Peeters, Sabina Rinaldi, Domenico Palli, María José Sánchez, Jytte Halkjær, Marie-Christine Boutron-Ruault, Antonio Agudo, Isabelle Romieu, Francesca L. Crowe, Anne M. May, Paolo Vineis, J. Ramón Quirós, Nadia Slimani, Claudia Agnoli, Eva Ardanaz, Philippos Orfanos, José María Huerta, Pilar Amiano, H. Bas Bueno-de-Mesquita, Antonia Trichopoulou, Elio Riboli, Heiner Boeing, Teresa Norat, Manuela M. Bergmann, Tonje Braaten, Monique Verschuren, Androniki Naska, Birgit Teucher, Ulf Ekelund, Guy Fagherazzi, Annika Steffen, Anne Tjønneland, Laureen Dartois, Nicholas J. Wareham, May, Am, Romaguera, D, Travier, N, Ekelund, U, Bergmann, Mm, Kaaks, R, Teucher, B, Steffen, A, Boeing, H, Halkjaer, J, Tjonneland, A, Jakobsen, Mu, Overvad, K, Dartois, L, Fagherazzi, G, Boutron Ruault, Mc, Quir?s, Jr, Agudo, A, Gonzalez, C, S?nchez, Mj, Amiano, P, Huerta, Jm, Ardanaz, E, Wareham, Nj, Crowe, Fl, Naska, A, Orfanos, P, Trichopoulou, A, Palli, D, Agnoli, C, Tumino, R, Vineis, P, Panico, Salvatore, Bueno de Mesquita, Hb, Verschuren, M, Drake, I, Sonestedt, E, Braaten, T, Rinaldi, S, Romieu, I, Slimani, N, Norat, T, Riboli, E, and Peeters, Ph
Subjects: Gerontology, Male, Mediterranean diet, Non-Clinical Medicine, Epidemiology, Health Behavior, lcsh:Medicine, 0302 clinical medicine, Modiried Mediterranean diet, Mass index, 030212 general & internal medicine, Prospective Studies, lcsh:Science, Cancer, 2. Zero hunger, Multidisciplinary, Nutrition and Dietetics, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Smoking, Abdominal adiposity, Middle Aged, Circumference, Socioeconomic Aspects of Health, Europe, Multidisciplinary Sciences, Health Education and Awareness, Medicine, Science & Technology - Other Topics, Female, Public Health, medicine.symptom, Waist Circumference, Behavioral and Social Aspects of Health, Research Article, Adult, Waist, 030209 endocrinology & metabolism, Motor Activity, Alcohol-consumption, 03 medical and health sciences, Health behaviours, medicine, Humans, Obesity, Life Style, Aged, Nutrition, Randomized controlled-trail, Health Care Policy, Science & Technology, business.industry, Body Weight, lcsh:R, Health Risk Analysis, Anthropometry, Prospective cohort, medicine.disease, Diet, lcsh:Q, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business, Weight gain, Body mass index, Demography
Abstract: Background: The evidence that individual dietary and lifestyle factors influence a person's weight and waist circumference is well established; however their combined impact is less well documented. Therefore, we investigated the combined effect of physical activity, nutrition and smoking status on prospective gain in body weight and waist circumference. Methods: We used data of the prospective EPIC-PANACEA study. Between 1992 and 2000, 325,537 participants (94,445 men and 231,092 women, aged between 25-70) were recruited from nine European countries. Participants were categorised into two groups (positive or negative health behaviours) for each of the following being physically active, adherent to a healthy (Mediterranean not including alcohol) diet, and never-smoking for a total score ranging from zero to three. Anthropometric measures were taken at baseline and were mainly self-reported after a medium follow-up time of 5 years. Results: Mixed-effects linear regression models adjusted for age, educational level, alcohol consumption, baseline body mass index and follow-up time showed that men and women who reported to be physically active, never-smoking and adherent to the Mediterranean diet gained over a 5-year period 537 (95% CI -706, -368) and 200 (-478, -87) gram less weight and 0.95 (-1.27, -0.639) and 0.99 (-1.29, -0.69) cm less waist circumference, respectively, compared to participants with zero healthy behaviours. Conclusion: The combination of positive health behaviours was associated with significantly lower weight and waist circumference gain.
Published: 2012

38. Population attributable fractions of the main type 2 diabetes mellitus risk factors in women: Findings from the French E3N cohort.

Author: Rajaobelina K, Dow C, Romana Mancini F, Dartois L, Boutron-Ruault MC, Balkau B, Bonnet F, and Fagherazzi G
Subjects: Adult, Exercise, Female, France epidemiology, Humans, Middle Aged, Prospective Studies, Risk Factors, Smoking, Women's Health, Diabetes Mellitus, Type 2 epidemiology, Diet, Life Style, Risk Assessment methods
Abstract: Background: Although many type 2 diabetes mellitus (T2DM) risk factors have been identified, little is known regarding their contributions to the diabetes burden at the population level., Methods: The study included 72 655 French women from the Etude Epidemiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) prospective cohort followed between 1993 and 2011. Cox multivariable models including the main T2DM risk factors (metabolic, dietary, clinical, socioeconomic and hormonal) and a healthy lifestyle index combining five characteristics (smoking, body mass index [BMI], alcohol consumption, fruit and vegetable consumption, and physical activity) were used to estimate hazard ratios and population attributable fractions (PAFs) for T2DM., Results: In multivariate models, factors with the strongest effect on T2DM risk were, in decreasing order, BMI ≥ 30 kg/m 2 (PAF = 43%; 95% confidence interval [CI] 37-47), high adherence to a Western dietary pattern (PAF = 30%; 95% CI 20-40), hypertension (PAF = 26%; 95% CI 20-32), an acidogenic diet (PAF = 24%; 95% CI 16-32), a family history of diabetes (PAF = 20%; 95% CI 17-22), and, with a negative correlation, moderate alcohol consumption (PAF-19%; 95% CI -34, -4). The PAF for an unhealthy lifestyle was 57% (95% CI 50-63)., Conclusions: We have been able to sort out and quantify the effect of various dietary and biological T2DM risk factors simultaneously in a single population, and to highlight the importance of a healthy lifestyle for primary prevention: more than half the T2DM cases could have been prevented through a healthier lifestyle., (© 2018 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)
Published: 2019
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39. Relation between hysterectomy, oophorectomy and the risk of incident differentiated thyroid cancer: The E3N cohort.

Author: Guenego A, Mesrine S, Dartois L, Leenhardt L, Clavel-Chapelon F, Kvaskoff M, Boutron-Ruault MC, and Bonnet F
Subjects: Adult, Female, Follow-Up Studies, France, Genital Diseases, Female, Humans, Incidence, Middle Aged, Risk Factors, Hysterectomy adverse effects, Leiomyoma complications, Ovariectomy, Thyroid Neoplasms etiology
Abstract: Background: Thyroid cancers are threefold more frequent in women than in men. A role of reproductive or hormonal factors has been suggested but with contradictory results. We investigated potential associations between history of hysterectomy, with or without oophorectomy, and history of benign gynaecological disease (uterine fibroids, endometriosis) and the incidence of differentiated thyroid cancer, in a large French prospective cohort., Methods: A total of 89 340 women from the E3N cohort were followed up between 1990 and 2012. Gynaecological diseases treated by surgery were self-reported. Thyroid cancers were validated by histological reports. Time-dependent covariates included smoking status, BMI and history of benign thyroid disease. Cox proportional hazard models with age as timescale were used to estimate Hazard Ratios (HR) and 95% confidence intervals (CI)., Results: A total of 412 cases of thyroid cancer were diagnosed during follow-up. A history of hysterectomy was associated with an increased risk of differentiated thyroid cancer (adjusted HR=2.05; 95%CI: 1.65-2.55). The association was not altered after further adjustment for reproductive factors. Endometriosis, uterine polyps, ovarian cysts and oophorectomy without hysterectomy were not associated with the risk of thyroid cancer. A history of fibroids was also significantly related to the risk of thyroid cancer over the follow-up period (adjusted HR=1.91; 95%CI: 1.50-2.44) and the increased risk persisted after adjustment for history of hysterectomy., Conclusions: Women who had either a history of fibroids or hysterectomy had an increased risk of differentiated thyroid cancer. These findings suggest shared biological mechanisms between fibroids and thyroid cancer, which deserve to be further dissected., (© 2018 John Wiley & Sons Ltd.)
Published: 2019
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40. Micronutrient dietary patterns associated with type 2 diabetes mellitus among women of the E3N-EPIC (Etude Epidémiologique auprès de femmes de l'Education Nationale) cohort study.

Author: Mancini FR, Dow C, Affret A, Rajaobelina K, Dartois L, Balkau B, Bonnet F, Boutron-Ruault MC, and Fagherazzi G
Subjects: Cohort Studies, Female, France epidemiology, Humans, Middle Aged, Principal Component Analysis, Risk Factors, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 metabolism, Diet, Micronutrients metabolism, Surveys and Questionnaires
Abstract: Background: Micronutrients play a key role in type 2 diabetes mellitus (T2DM), but methodological difficulties arise from their collinearity and interdependencies with foods. The aim of the present study was to identify micronutrient dietary patterns in the E3N-EPIC (Etude Epidémiologique auprès de femmes de l'Education Nationale) cohort and to investigate their association with risk of T2DM., Methods: Principal component analysis was used to identify micronutrient patterns among 71 270 women from the E3N-EPIC cohort. Associations between micronutrient patterns and risk of T2DM were quantified by hazard ratios (HRs) and 95% confidence intervals (CIs) from Cox proportional hazards regression models, adjusted for potential confounders., Results: Six micronutrient patterns were identified explaining 78% of the total variance in micronutrient intake. A positive association was found between T2DM and a pattern highly correlated with intake of vitamins B 2 and B 5 (HR 1.34; 95% CI 1.16-1.56). Similarly, a positive association was found with a pattern characterized by high intakes of vitamin B 12 and retinol, and a low intake of vitamin C (HR 1.30; 95% CI 1.15-1.48). An inverse association was observed between T2DM and another two patterns: one correlated with magnesium and vitamin B 3 (HR 0.75; 95% CI 0.66-0.86), and the other correlated with manganese intake (HR 0.82; 95% CI 0.72-0.94)., Conclusions: The findings of the present study identify micronutrients that have an effect on the risk of T2DM, and enable better understanding of the complexity of the diet when investigating the association between micronutrients and T2DM., (© 2018 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)
Published: 2018
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41. How do self and proxy dependency evaluations agree? Results from a large cohort of older women.

Author: Bouscaren N, Dartois L, Boutron-Ruault MC, and Vercambre MN
Subjects: Age Factors, Aged, Aged, 80 and over, Exercise, Female, France, Health Status, Humans, Prospective Studies, Reproducibility of Results, Sex Factors, Activities of Daily Living, Aging psychology, Dependency, Psychological, Proxy, Self Report, Spouses psychology
Abstract: Background: epidemiological studies based on questionnaires can face difficulties when collecting data on functional ability of older people, and may thus use a proxy to obtain or confirm data. It is therefore of importance to compare data from older people and from their proxies, to establish to what extent proxies' answers can be used as a substitute or a complement in epidemiological studies on dependency., Objective: we evaluated agreement in dependency assessment, and identified factors associated with discrepancy between older people and proxy reports, in a large postal epidemiological survey., Methodology: autonomy of 5,164 community-dwelling women from the French E3N cohort study aged 75-83 was self- and proxy-evaluated with the instrumental activities of daily living (IADL) scales. Agreement was assessed using Cohen's Kappa coefficients, and factors associated with discrepancy were determined using logistic regression models., Results: there was agreement between self and proxy dependency assessment in 90.8% of the women, with satisfactory Cohen's kappa. Discrepancy was associated with older age, poor self-reported health, prior low level of physical activity and the proxy being the partner., Discussion: we found that a proxy could be a reliable source of dependency assessment in large epidemiological surveys, and that some characteristics of the older person and of the proxy could modulate the agreement between proxy- and self-dependency assessments., (© The Author(s) 2018. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Published: 2018
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42. Patterns of Ultraviolet Radiation Exposure and Skin Cancer Risk: the E3N-SunExp Study.

Author: Savoye I, Olsen CM, Whiteman DC, Bijon A, Wald L, Dartois L, Clavel-Chapelon F, Boutron-Ruault MC, and Kvaskoff M
Subjects: Aged, Aged, 80 and over, Carcinoma, Basal Cell epidemiology, Carcinoma, Squamous Cell epidemiology, Case-Control Studies, Female, France epidemiology, Humans, Melanoma epidemiology, Middle Aged, Prospective Studies, Risk Factors, Sunburn epidemiology, Melanoma, Cutaneous Malignant, Environmental Exposure adverse effects, Environmental Exposure statistics & numerical data, Skin Neoplasms epidemiology, Ultraviolet Rays adverse effects
Abstract: Background: While ultraviolet (UV) radiation exposure is a recognized risk factor for skin cancer, associations are complex and few studies have allowed a direct comparison of exposure profiles associated with cutaneous melanoma, basal-cell carcinoma (BCC), and squamous-cell carcinoma (SCC) within a single population., Methods: We examined associations between UV exposures and skin cancer risk in a nested case-control study within E3N, a prospective cohort of 98,995 French women born in 1925-1950. In 2008, a lifetime UV exposure questionnaire was sent to all reported skin cancer cases and three controls per case, which were matched on age, county of birth, and education. Analyses were performed using conditional logistic regression and included 366 melanoma cases, 1,027 BCC cases, 165 SCC cases, and 3,647 controls., Results: A history of severe sunburns <25 years was associated with increased risks of all skin cancers (melanoma: OR 2.7; BCC: OR 1.7; SCC: OR 2.0 for ≥6 sunburns vs. none), while sunburns ≥25 years were associated with BCC and SCC only. While high-sun protection factor sunscreen use before age 25 was associated with lower BCC risk (P trend = 0.02), use since age 25 and reapplication of sunscreen were associated with higher risks of all three types of skin cancer. There were positive linear associations between total UV score and risks of BCC (P trend = 0.01) and SCC (P trend = 0.09), but not melanoma. While recreational UV score was strongly associated with BCC, total and residential UV scores were more strongly associated with SCC., Conclusions: Melanoma, BCC, and SCC are associated with different sun exposure profiles in women.
Published: 2018
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43. Endometriosis and the risk of skin cancer: a prospective cohort study.

Author: Farland LV, Lorrain S, Missmer SA, Dartois L, Cervenka I, Savoye I, Mesrine S, Boutron-Ruault MC, and Kvaskoff M
Subjects: Adult, Aged, Female, Humans, Middle Aged, Proportional Hazards Models, Prospective Studies, Risk, Carcinoma, Basal Cell epidemiology, Carcinoma, Squamous Cell epidemiology, Endometriosis epidemiology, Melanoma epidemiology, Skin Neoplasms epidemiology
Abstract: Purpose: Endometriosis has been associated with an increased risk of skin melanoma. However, associations with other skin cancer types and how they compare with melanoma are unclear. Our objective was to prospectively investigate the relationships between endometriosis and risk of non-melanoma and melanoma skin cancers., Methods: E3N is a prospective cohort of 98,995 French women aged 40-65 years in 1990. Data on surgically confirmed endometriosis and skin cancer diagnoses were collected every 2-3 years through self-report, with skin cancer cases confirmed through pathology reports. Hazard Ratios (HR) and 95% confidence intervals (CIs) were calculated using Cox regression models., Results: Between 1990 and 2008, 535 melanoma, 247 squamous-cell carcinoma (SCC), and 1,712 basal-cell carcinoma (BCC) cases were ascertained. Endometriosis was associated with an increased overall risk of skin cancer (HR 1.28, 95% CI 1.05-1.55). When considering skin cancer type, endometriosis was associated with melanoma risk (HR 1.64, 95% CI 1.15-2.35), but not with SCC (HR 1.21, 95% CI 0.62-2.36) or BCC (HR 1.16, 95% CI 0.91-1.48) (non-melanoma skin cancers combined: HR 1.17, 95% CI 0.93-1.46), although no heterogeneity was detected across skin cancer types (Phomogeneity = 0.13)., Conclusion: These data support an association between a personal history of endometriosis and the risk of skin cancer and suggest that the association is strongest for melanoma.
Published: 2017
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44. Coffee Drinking and Mortality in 10 European Countries: A Multinational Cohort Study.

Author: Gunter MJ, Murphy N, Cross AJ, Dossus L, Dartois L, Fagherazzi G, Kaaks R, Kühn T, Boeing H, Aleksandrova K, Tjønneland A, Olsen A, Overvad K, Larsen SC, Redondo Cornejo ML, Agudo A, Sánchez Pérez MJ, Altzibar JM, Navarro C, Ardanaz E, Khaw KT, Butterworth A, Bradbury KE, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Grioni S, Vineis P, Panico S, Tumino R, Bueno-de-Mesquita B, Siersema P, Leenders M, Beulens JWJ, Uiterwaal CU, Wallström P, Nilsson LM, Landberg R, Weiderpass E, Skeie G, Braaten T, Brennan P, Licaj I, Muller DC, Sinha R, Wareham N, and Riboli E
Subjects: Adult, Biomarkers blood, Cardiovascular Diseases mortality, Cause of Death, Cerebrovascular Disorders mortality, Digestive System Diseases mortality, Europe epidemiology, Female, Humans, Inflammation blood, Liver Function Tests, Male, Middle Aged, Ovarian Neoplasms mortality, Proportional Hazards Models, Prospective Studies, Risk Factors, Coffee, Drinking ethnology, Mortality
Abstract: Background: The relationship between coffee consumption and mortality in diverse European populations with variable coffee preparation methods is unclear., Objective: To examine whether coffee consumption is associated with all-cause and cause-specific mortality., Design: Prospective cohort study., Setting: 10 European countries., Participants: 521 330 persons enrolled in EPIC (European Prospective Investigation into Cancer and Nutrition)., Measurements: Hazard ratios (HRs) and 95% CIs estimated using multivariable Cox proportional hazards models. The association of coffee consumption with serum biomarkers of liver function, inflammation, and metabolic health was evaluated in the EPIC Biomarkers subcohort (n = 14 800)., Results: During a mean follow-up of 16.4 years, 41 693 deaths occurred. Compared with nonconsumers, participants in the highest quartile of coffee consumption had statistically significantly lower all-cause mortality (men: HR, 0.88 [95% CI, 0.82 to 0.95]; P for trend < 0.001; women: HR, 0.93 [CI, 0.87 to 0.98]; P for trend = 0.009). Inverse associations were also observed for digestive disease mortality for men (HR, 0.41 [CI, 0.32 to 0.54]; P for trend < 0.001) and women (HR, 0.60 [CI, 0.46 to 0.78]; P for trend < 0.001). Among women, there was a statistically significant inverse association of coffee drinking with circulatory disease mortality (HR, 0.78 [CI, 0.68 to 0.90]; P for trend < 0.001) and cerebrovascular disease mortality (HR, 0.70 [CI, 0.55 to 0.90]; P for trend = 0.002) and a positive association with ovarian cancer mortality (HR, 1.31 [CI, 1.07 to 1.61]; P for trend = 0.015). In the EPIC Biomarkers subcohort, higher coffee consumption was associated with lower serum alkaline phosphatase; alanine aminotransferase; aspartate aminotransferase; γ-glutamyltransferase; and, in women, C-reactive protein, lipoprotein(a), and glycated hemoglobin levels., Limitations: Reverse causality may have biased the findings; however, results did not differ after exclusion of participants who died within 8 years of baseline. Coffee-drinking habits were assessed only once., Conclusion: Coffee drinking was associated with reduced risk for death from various causes. This relationship did not vary by country., Primary Funding Source: European Commission Directorate-General for Health and Consumers and International Agency for Research on Cancer.
Published: 2017
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45. Tumor characteristics and family history in relation to mammographic density and breast cancer: The French E3N cohort.

Author: Maskarinec G, Dartois L, Delaloge S, Hopper J, Clavel-Chapelon F, and Baglietto L
Subjects: Aged, Breast diagnostic imaging, Breast pathology, Breast Neoplasms genetics, Breast Neoplasms pathology, Case-Control Studies, Cohort Studies, Family Health statistics & numerical data, Female, France epidemiology, Humans, Logistic Models, Mammography statistics & numerical data, Middle Aged, Odds Ratio, Risk Factors, Breast Density, Breast Neoplasms diagnostic imaging, Breast Neoplasms epidemiology
Abstract: Background: Mammographic density is a known heritable risk factor for breast cancer, but reports how tumor characteristics and family history may modify this association are inconsistent., Methods: Dense and total breast areas were assessed using Cumulus™ from pre-diagnostic mammograms for 820 invasive breast cancer cases and 820 matched controls nested within the French E3N cohort study. To allow comparisons across models, percent mammographic density (PMD) was standardized to the distribution of the controls. Odds ratios (OR) and 95% confidence intervals (CI) of breast cancer risk for mammographic density were estimated by conditional logistic regression while adjusting for age and body mass index. Heterogeneity according to tumor characteristic and family history was assessed using stratified analyses., Results: Overall, the OR per 1 SD for PMD was 1.50 (95% CI, 1.33-1.69). No evidence for significant heterogeneity by tumor size, lymph node status, grade, and hormone receptor status (estrogen, progesterone, and HER2) was detected. However, the association of PMD was stronger for women reporting a family history of breast cancer (OR 1SD =2.25; 95% CI, 1.67-3.04) than in women reporting none (OR 1SD =1.41; 95% CI, 1.24-1.60; p heterogeneity =0.002). Similarly, effect modification by FHBC was observed using categories of PMD (p heterogeneity =0.02) with respective ORs of 15.16 (95% CI, 4.23-54.28) vs. 3.14 (95% CI, 1.89-5.22) for ≥50% vs. <10% PMD., Conclusions: The stronger association between mammographic density and breast cancer risk with a family history supports the hypothesis of shared genetic factors responsible for familial aggregation of breast cancer and the heritable component of mammographic density., (Copyright © 2017 Elsevier Ltd. All rights reserved.)
Published: 2017
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46. Dietary antioxidant capacity and all-cause and cause-specific mortality in the E3N/EPIC cohort study.

Author: Bastide N, Dartois L, Dyevre V, Dossus L, Fagherazzi G, Serafini M, and Boutron-Ruault MC
Subjects: Cardiovascular Diseases prevention & control, Cohort Studies, Female, Follow-Up Studies, Humans, Middle Aged, Multivariate Analysis, Neoplasms prevention & control, Proportional Hazards Models, Prospective Studies, Reactive Oxygen Species metabolism, Reproducibility of Results, Risk Factors, Smoking, Surveys and Questionnaires, Antioxidants administration & dosage, Cardiovascular Diseases mortality, Diet, Neoplasms mortality
Abstract: Purpose: The cellular oxidative stress (balance between pro-oxidant and antioxidant) may be a major risk factor for chronic diseases. Antioxidant capacity of human diet can be globally assessed through the dietary non-enzymatic antioxidant capacity (NEAC). Our aim was to investigate the relationship between the NEAC and all-cause and cause-specific mortality, and to test potential interactions with smoking status, a well-known pro-oxidant factor., Methods: Among the French women of the E3N prospective cohort study initiated in 1990, including 4619 deaths among 1,199,011 persons-years of follow-up. A validated dietary history questionnaire assessed usual food intake; NEAC intake was estimated using a food composition table from two different methods: ferric ion reducing antioxidant power (FRAP) and total radical-trapping antioxidant parameter (TRAP). Hazard ratio (HR) estimates and 95 % confidence intervals (CI) were derived from Cox proportional hazards regression models., Results: In multivariate analyses, FRAP dietary equivalent intake was inversely associated with mortality from all-causes (HR for the fourth vs. the first quartile: HR 4 = 0.75, 95 % CI 0.67, 0.83, p trend < 0.0001), cancer, and cardiovascular diseases. Similar results were obtained with TRAP. There was an interaction between NEAC dietary equivalent intake and smoking status for all-cause and cardiovascular disease mortality, but not cancer mortality (respectively, for FRAP, p inter = 0.002; 0.013; 0.113, results were similar with TRAP), and the association was the strongest among current smokers., Conclusion: This prospective cohort study highlights the importance of antioxidant consumption for mortality prevention, especially among current smokers.
Published: 2017
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47. The association between adult attained height and sitting height with mortality in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Author: Sawada N, Wark PA, Merritt MA, Tsugane S, Ward HA, Rinaldi S, Weiderpass E, Dartois L, His M, Boutron-Ruault MC, Turzanski-Fortner R, Kaaks R, Overvad K, Redondo ML, Travier N, Molina-Portillo E, Dorronsoro M, Cirera L, Ardanaz E, Perez-Cornago A, Trichopoulou A, Lagiou P, Valanou E, Masala G, Pala V, Hm Peeters P, T van der Schouw Y, Melander O, Manjer J, da Silva M, Skeie G, Tjønneland A, Olsen A, J Gunter M, Riboli E, and J Cross A
Subjects: Adult, Aged, Cardiovascular Diseases epidemiology, Cardiovascular Diseases mortality, Cardiovascular Diseases pathology, Europe epidemiology, Female, Humans, Incidence, Male, Middle Aged, Neoplasms epidemiology, Neoplasms mortality, Neoplasms pathology, Prognosis, Prospective Studies, Respiratory Tract Diseases epidemiology, Respiratory Tract Diseases mortality, Respiratory Tract Diseases pathology, Survival Analysis, Body Height, Cardiovascular Diseases diagnosis, Neoplasms diagnosis, Respiratory Tract Diseases diagnosis
Abstract: Adult height and sitting height may reflect genetic and environmental factors, including early life nutrition, physical and social environments. Previous studies have reported divergent associations for height and chronic disease mortality, with positive associations observed for cancer mortality but inverse associations for circulatory disease mortality. Sitting height might be more strongly associated with insulin resistance; however, data on sitting height and mortality is sparse. Using the European Prospective Investigation into Cancer and Nutrition study, a prospective cohort of 409,748 individuals, we examined adult height and sitting height in relation to all-cause and cause-specific mortality. Height was measured in the majority of participants; sitting height was measured in ~253,000 participants. During an average of 12.5 years of follow-up, 29,810 deaths (11,931 from cancer and 7,346 from circulatory disease) were identified. Hazard ratios (HR) with 95% confidence intervals (CI) for death were calculated using multivariable Cox regression within quintiles of height. Height was positively associated with cancer mortality (men: HRQ5 vs. Q1 = 1.11, 95%CI = 1.00-1.24; women: HRQ5 vs. Q1 = 1.17, 95%CI = 1.07-1.28). In contrast, height was inversely associated with circulatory disease mortality (men: HRQ5 vs. Q1 = 0.63, 95%CI = 0.56-0.71; women: HRQ5 vs. Q1 = 0.81, 95%CI = 0.70-0.93). Although sitting height was not associated with cancer mortality, it was inversely associated with circulatory disease (men: HRQ5 vs. Q1 = 0.64, 95%CI = 0.55-0.75; women: HRQ5 vs. Q1 = 0.60, 95%CI = 0.49-0.74) and respiratory disease mortality (men: HRQ5 vs. Q1 = 0.45, 95%CI = 0.28-0.71; women: HRQ5 vs. Q1 = 0.60, 95%CI = 0.40-0.89). We observed opposing effects of height on cancer and circulatory disease mortality. Sitting height was inversely associated with circulatory disease and respiratory disease mortality.
Published: 2017
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48. Comparison of methods for estimating the attributable risk in the context of survival analysis.

Author: Gassama M, Bénichou J, Dartois L, and Thiébaut AC
Subjects: Breast Neoplasms chemically induced, Cohort Studies, Computer Simulation, Female, Follow-Up Studies, Hormone Replacement Therapy adverse effects, Humans, Kaplan-Meier Estimate, Postmenopause, Proportional Hazards Models, Reproducibility of Results, Risk Factors, Surveys and Questionnaires, Survival Analysis, Algorithms, Models, Theoretical, Risk Assessment methods, Risk Assessment statistics & numerical data
Abstract: Background: The attributable risk (AR) measures the proportion of disease cases that can be attributed to an exposure in the population. Several definitions and estimation methods have been proposed for survival data., Methods: Using simulations, we compared four methods for estimating AR defined in terms of survival functions: two nonparametric methods based on Kaplan-Meier's estimator, one semiparametric based on Cox's model, and one parametric based on the piecewise constant hazards model, as well as one simpler method based on estimated exposure prevalence at baseline and Cox's model hazard ratio. We considered a fixed binary exposure with varying exposure probabilities and strengths of association, and generated event times from a proportional hazards model with constant or monotonic (decreasing or increasing) Weibull baseline hazard, as well as from a nonproportional hazards model. We simulated 1,000 independent samples of size 1,000 or 10,000. The methods were compared in terms of mean bias, mean estimated standard error, empirical standard deviation and 95% confidence interval coverage probability at four equally spaced time points., Results: Under proportional hazards, all five methods yielded unbiased results regardless of sample size. Nonparametric methods displayed greater variability than other approaches. All methods showed satisfactory coverage except for nonparametric methods at the end of follow-up for a sample size of 1,000 especially. With nonproportional hazards, nonparametric methods yielded similar results to those under proportional hazards, whereas semiparametric and parametric approaches that both relied on the proportional hazards assumption performed poorly. These methods were applied to estimate the AR of breast cancer due to menopausal hormone therapy in 38,359 women of the E3N cohort., Conclusion: In practice, our study suggests to use the semiparametric or parametric approaches to estimate AR as a function of time in cohort studies if the proportional hazards assumption appears appropriate.
Published: 2017
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49. Associations between serum lipids and breast cancer incidence and survival in the E3N prospective cohort study.

Author: His M, Dartois L, Fagherazzi G, Boutten A, Dupré T, Mesrine S, Boutron-Ruault MC, Clavel-Chapelon F, and Dossus L
Subjects: Adult, Aged, Breast Neoplasms mortality, Female, Humans, Incidence, Life Style, Middle Aged, Neoplasm Recurrence, Local mortality, Prospective Studies, Risk Factors, Survival Rate, Waist Circumference, Breast Neoplasms blood, Breast Neoplasms epidemiology, Lipids blood, Neoplasm Recurrence, Local blood, Neoplasm Recurrence, Local epidemiology
Abstract: Purpose: Several mechanistic studies support a role of cholesterol or its metabolites in breast cancer etiology, but associations have been inconsistent in epidemiological studies. In observational studies, possible reverse causation must be accounted for using a prospective design. We investigated prospective associations between pre-diagnostic serum lipid concentrations [total cholesterol (TC), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides], and both breast cancer risk and survival in the E3N cohort study., Methods: Analyses were performed on 583 cases from the E3N prospective cohort diagnosed between 1994 and 2005, and 1,043 controls matched on date, age, recruitment center and menopausal status at blood collection. Odds ratios (OR) and 95% confidence intervals were estimated using conditional logistic regression. Risks of recurrence were estimated among cases using Cox proportional hazards model. Models were adjusted for lifestyle risk factors and mutually adjusted for lipid concentrations. Survival analyses were additionally adjusted for tumor characteristics., Results: Overall, there was no association between any serum lipid and breast cancer risk or survival. In stratified analyses, statistically significant interaction was observed between TC and menopausal status (P interaction = 0.05) and between TC and waist circumference (P interaction = 0.03), although the ORs did not reach statistical significance in any of the strata. There was no statistically significant effect modification by BMI, time between blood donation and diagnosis or ER status., Conclusions: Our results suggest that serum lipids are not associated with breast cancer risk overall, but that menopausal status and waist circumference should be considered in further studies.
Published: 2017
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50. Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study.

Author: Muller DC, Murphy N, Johansson M, Ferrari P, Tsilidis KK, Boutron-Ruault MC, Clavel F, Dartois L, Li K, Kaaks R, Weikert C, Bergmann M, Boeing H, Tjønneland A, Overvad K, Redondo ML, Agudo A, Molina-Portillo E, Altzibar JM, Cirera L, Ardanaz E, Khaw KT, Wareham NJ, Key TJ, Travis RC, Bamia C, Orfanos P, Trichopoulou A, Palli D, Pala V, Tumino R, Vineis P, Panico S, Bueno-de-Mesquita HB, Verschuren WM, Struijk EA, Peeters PH, Engström G, Melander O, Sund M, Weiderpass E, Skeie G, Lund E, Norat T, Gunter M, Riboli E, and Brennan P
Subjects: Adult, Aged, Alcohol Drinking adverse effects, Alcohol Drinking mortality, Cohort Studies, Europe epidemiology, Female, Humans, Hypertension complications, Hypertension mortality, Male, Middle Aged, Motor Activity, Obesity complications, Obesity mortality, Prospective Studies, Risk Factors, Smoking adverse effects, Smoking mortality, Life Expectancy, Mortality, Premature
Abstract: Background: Life expectancy is increasing in Europe, yet a substantial proportion of adults still die prematurely before the age of 70 years. We sought to estimate the joint and relative contributions of tobacco smoking, hypertension, obesity, physical inactivity, alcohol and poor diet towards risk of premature death., Methods: We analysed data from 264,906 European adults from the EPIC prospective cohort study, aged between 40 and 70 years at the time of recruitment. Flexible parametric survival models were used to model risk of death conditional on risk factors, and survival functions and attributable fractions (AF) for deaths prior to age 70 years were calculated based on the fitted models., Results: We identified 11,930 deaths which occurred before the age of 70. The AF for premature mortality for smoking was 31 % (95 % confidence interval (CI), 31-32 %) and 14 % (95 % CI, 12-16 %) for poor diet. Important contributions were also observed for overweight and obesity measured by waist-hip ratio (10 %; 95 % CI, 8-12 %) and high blood pressure (9 %; 95 % CI, 7-11 %). AFs for physical inactivity and excessive alcohol intake were 7 % and 4 %, respectively. Collectively, the AF for all six risk factors was 57 % (95 % CI, 55-59 %), being 35 % (95 % CI, 32-37 %) among never smokers and 74 % (95 % CI, 73-75 %) among current smokers., Conclusions: While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially. Any attempt to minimise premature deaths will ultimately require all six factors to be addressed.
Published: 2016
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