Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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Colorectal cancer risk and dyslipidemia: a case-cohort study nested in an Italian multicentre cohort
Agnoli, C. ; Grioni, S. ; Sieri, S. ; Sacerdote, C. ; Vineis, P. ; Tumino, R. ; Giurdanella, M.C. ; Pala, V. ; Mattiello, A. ; Chiodini, P. ; Iacoviello, L. ; Curtis, A. de; Cattaneo, L. ; Duijnhoven, F.J.B. van - \ 2014
Cancer Epidemiology 38 (2014)2. - ISSN 1877-7821 - p. 144 - 151.
metabolic syndrome - serum-cholesterol - colon-cancer - lipoprotein levels - blood-cholesterol - glucose - triglyceride - association - nutrition - lipids
Background: Dyslipidemia is an established risk factor for many diseases, but its effect on colorectal cancer risk is less clear. We investigated the association of colorectal cancer risk with plasma triglycerides, total, HDL, and LDL cholesterol in four Italian EPIC centers. Methods: We conducted a case-cohort study on participants recruited to four Italian EPIC centers (Turin, Varese, Naples, and Ragusa; 34,148 subjects). A random subcohort of 850 subjects was obtained and 286 colorectal cancer cases were diagnosed. Triglycerides, total and HDL cholesterol were determined in plasma samples obtained at baseline and stored at -196 degrees C; LDL cholesterol was calculated. Hazard ratios (HR) with 95% confidence intervals (CI), adjusted for potential confounders, were estimated by Cox regression models using the Prentice method. Results: The highest tertiles of total (HR 1.66, 95% CI 1.12-2.45) and LDL cholesterol (HR 1.87, 95% CI 1.27-2.76) were associated with increased colorectal cancer risk compared to lowest tertiles. Risks were greater for men than women, and for postmenopausal than premenopausal women. Highest tertiles of total and LDL cholesterol were also significantly associated with increased risks of colon cancer, distal colon cancer, and rectal cancer, but not proximal colon cancer. Conclusions: Our findings suggest that high levels of total and LDL cholesterol increase colorectal cancer risk, particularly in men and postmenopausal women. However additional studies are needed to clarify the role of plasma lipids in these cancers, particularly in view of the conflicting findings of previous studies. (C) 2014 Elsevier Ltd. All rights reserved.
Active and passive cigarette smoking and breast cancer risk: results from the EPIC cohort
Dossus, L. ; Boutron-Ruault, M.C. ; Kaaks, R. ; Gram, I.T. ; Vilier, A. ; Fervers, B. ; Manjer, J. ; Tjonneland, A. ; Olsen, A. ; Overvad, K. ; Chang-Claude, J. ; Boeing, H. ; Steffen, A. ; Trichopoulou, A. ; Lagiou, P. ; Sarantopoulou, M. ; Palli, D. ; Berrino, F. ; Tumino, R. ; Vineis, P. ; Mattiello, A. ; Bueno-de-Mesquita, H.B. ; Duijnhoven, F.J.B. van - \ 2014
International Journal of Cancer 134 (2014)8. - ISSN 0020-7136 - p. 1871 - 1888.
environmental tobacco-smoke - postmenopausal women - california teachers - 1st childbirth - never smokers - exposure - metaanalysis - association - carcinogens - reanalysis
Recent cohort studies suggest that increased breast cancer risks were associated with longer smoking duration, higher pack-years and a dose-response relationship with increasing pack-years of smoking between menarche and first full-term pregnancy (FFTP). Studies with comprehensive quantitative life-time measures of passive smoking suggest an association between passive smoking dose and breast cancer risk. We conducted a study within the European Prospective Investigation into Cancer and Nutrition to examine the association between passive and active smoking and risk of invasive breast cancer and possible effect modification by known breast cancer risk factors. Among the 322,988 women eligible for the study, 9,822 developed breast cancer (183,608 women with passive smoking information including 6,264 cases). When compared to women who never smoked and were not being exposed to passive smoking at home or work at the time of study registration, current, former and currently exposed passive smokers were at increased risk of breast cancer (hazard ratios (HR) [95% confidence interval (CI)] 1.16 [1.05–1.28], 1.14 [1.04–1.25] and 1.10 [1.01–1.20], respectively). Analyses exploring associations in different periods of life showed the most important increase in risk with pack-years from menarche to FFTP (1.73 [1.29–2.32] for every increase of 20 pack-years) while pack-years smoked after menopause were associated with a significant decrease in breast cancer risk (HR = 0.53, 95% CI: 0.34–0.82 for every increase of 20 pack-years). Our results provide an important replication, in the largest cohort to date, that smoking (passively or actively) increases breast cancer risk and that smoking between menarche and FFTP is particularly deleterious.
Lifestyle factors and mortality risk in individuals with diabetes mellitus: are the associations different from those in individuals without diabetes?
Sluik, D. ; Boeing, H. ; Li, K. ; Fons Johnsen, N. ; Tjonneland, A. ; Arriola, L. ; Barricarte, A. ; Masala, G. ; Grioni, S. ; Tumino, R. ; Ricceri, F. ; Matiello, A. ; Spijkerman, A.M.W. ; A, D.L. van der; Sluijs, I. van der - \ 2014
Diabetologia 57 (2014)1. - ISSN 0012-186X - p. 63 - 72.
food frequency questionnaire - american-heart-association - cardiovascular-disease - multiple imputation - relative validity - physical-activity - clinical-research - missing data - dietary-fat - cancer
Aims/hypothesis Thus far, it is unclear whether lifestyle recommendations for people with diabetes should be different from those for the general public. We investigated whether the associations between lifestyle factors and mortality risk differ between individuals with and without diabetes. Methods Within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort was formed of 6,384 persons with diabetes and 258,911 EPIC participants without known diabetes. Joint Cox proportional hazard regression models of people with and without diabetes were built for the following lifestyle factors in relation to overall mortality risk: BMI, waist/height ratio, 26 food groups, alcohol consumption, leisure-time physical activity, smoking. Likelihood ratio tests for heterogeneity assessed statistical differences in regression coefficients. Results Multivariable adjusted mortality risk among individuals with diabetes compared with those without was increased, with an HR of 1.62 (95% CI 1.51, 1.75). Intake of fruit, legumes, nuts, seeds, pasta, poultry and vegetable oil was related to a lower mortality risk, and intake of butter and margarine was related to an increased mortality risk. These associations were significantly different in magnitude from those in diabetes-free individuals, but directions were similar. No differences between people with and without diabetes were detected for the other lifestyle factors. Conclusions/interpretation Diabetes status did not substantially influence the associations between lifestyle and mortality risk. People with diabetes may benefit more from a healthy diet, but the directions of association were similar. Thus, our study suggests that lifestyle advice with respect to mortality for patients with diabetes should not differ from recommendations for the general population.
Fruit and Vegetable Consumption and Mortality: European Prospective Investigation Into Cancer and Nutrition
Leenders, M. ; Sluijs, I. van der; Ros, M.M. ; Boshuizen, H.C. ; Siersema, P.D. ; Ferrari, P. ; Weikert, C. ; Tjonneland, A. ; Olsen, A. ; Boutron-Ruault, M.C. ; Clavel-Chapelon, F. ; Nailler, L. ; Teucher, B. ; Li, K.R. ; Boeing, H. ; Bergmann, M.M. ; Trichopoulou, A. ; Lagiou, P. ; Trichopoulos, D. ; Palli, D. ; Pala, V. ; Panico, S. ; Tumino, R. ; Sacerdote, C. ; Peeters, P.H.M. ; Gils, C.H. van; Lund, E. ; Engeset, D. ; Redondo, M.L. ; Agudo, A. ; Sanchez, M.J. ; Navarro, C. ; Ardanaz, E. ; Sonestedt, E. ; Ericson, U. ; Nilsson, L.M. ; Khaw, K.T. ; Warcham, N.J. ; Key, T.J. ; Crowe, F.L. ; Romieu, I. ; Gunter, M.J. ; Gallo, V. ; Overvad, K. ; Riboli, E. ; Bueno-de-Mesquita, H.B. - \ 2013
American Journal of Epidemiology 178 (2013)4. - ISSN 0002-9262 - p. 590 - 602.
cardiovascular-disease - oxidative stress - heart-disease - dietary assessment - risk - population - impact - men - calibration - health
In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death.
Nort-South gradients in plasma concentrations of B-vitamins and other components of one-carbon metabolism in Western Europe: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study
Eussen, S.J.P.M. ; Nilsen, R.M. ; Midttun, O. ; Hustad, S. ; IJssenagger, N. ; Meyer, K. ; Fredriksen, A. ; Ulvik, A. ; Ueland, P.M. ; Brennan, P. ; Johansson, M. ; Bueno-de-Mesquita, B. ; Vineis, P. ; Chuang, S.C. ; Boutron-Ruault, M.C. ; Dossus, L. ; Perquier, F. ; Overvad, K. ; Teucher, B. ; Grote, V.A. ; Trichopoulou, A. ; Adarakis, G. ; Plada, M. ; Sieri, S. ; Tumino, R. ; Santucci de Magistris, M. ; Ros, M.M. ; Peeters, P.H.M. ; Redondo, M.L. ; Zamora-Ros, R. ; Chirlaque, M.D. ; Ardanaz, E. ; Sonestedt, E. ; Ericson, U. ; Schneede, J. ; Guelpen, B. ; Wark, P.A. ; Gallo, V. ; Norat, T. ; Riboli, E. ; Vollset, S.E. - \ 2013
The British journal of nutrition 110 (2013)2. - ISSN 0007-1145 - p. 363 - 374.
tandem mass-spectrometry - 24-hour dietary recalls - colorectal-cancer - homocysteine metabolism - microbiological assay - alcohol-consumption - nutrient intake - dairy-products - folate intake - 10 countries
Different lifestyle patterns across Europe may influence plasma concentrations of B-vitamins and one-carbon metabolites and their relation to chronic disease. Comparison of published data on one-carbon metabolites in Western European regions is difficult due to differences in sampling procedures and analytical methods between studies. The present study aimed, to compare plasma concentrations of one-carbon metabolites in Western European regions with one laboratory performing all biochemical analyses. We performed the present study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort among 5446 presumptively healthy individuals. Quantile regression was used to compare sex-specific median concentrations between Northern (Denmark and Sweden), Central (France, Germany, The Netherlands and United Kingdom) and Southern (Greece, Spain and Italy) European regions. The lowest folate concentrations were observed in Northern Europe (men, 10·4 nmol/l; women, 10·7 nmol/l) and highest concentrations in Central Europe. Cobalamin concentrations were slightly higher in Northern Europe (men, 330 pmol/l; women, 352 pmol/l) compared with Central and Southern Europe, but did not show a clear north–south gradient. Vitamin B2 concentrations were highest in Northern Europe (men, 22·2 nmol/l; women, 26·0 nmol/l) and decreased towards Southern Europe (P trend <0·001). Vitamin B6 concentrations were highest in Central Europe in men (77·3 nmol/l) and highest in the North among women (70·4 nmol/l), with decreasing concentrations towards Southern Europe in women (P trend <0·001). In men, concentrations of serine, glycine and sarcosine increased from the north to south. In women, sarcosine increased from Northern to Southern Europe. These findings may provide relevant information for the study of regional differences of chronic disease incidence in association with lifestyle.
Dietary Fibre Intake and Risks of Cancers of the Colon and Rectum in the European Prospective Investigation into Cancer and Nutrition (EPIC)
Murphy, N. ; Norat, T. ; Ferrari, P. ; Jenab, M. ; Bueno-de-Mesquita, B. ; Skeie, G. ; Dahm, C.C. ; Overvad, K. ; Olsen, A. ; Tjonneland, A. ; Clavel-Chapelon, F. ; Boutron-Ruault, M.C. ; Racine, A. ; Kaaks, R. ; Teucher, B. ; Boeing, H. ; Bergmann, M.M. ; Trichopoulou, A. ; Trichopoulos, D. ; Lagiou, P. ; Palli, D. ; Pala, V. ; Panico, S. ; Tumino, R. ; Vineis, P. ; Siersema, P. ; Duijnhoven, F.J.B. van; Peeters, P.H.M. ; Hjartaker, A. ; Engeset, D. ; Gonzalez, C.A. ; Sanchez, M.J. ; Dorronsoro, M. ; Navarro, C. ; Ardanaz, E. ; Quiros, J.R. ; Sonestedt, E. ; Ericson, U. ; Nilsson, L. ; Palmqvist, R. ; Khaw, K.T. ; Wareham, N. ; Key, T.J. ; Crowe, F.L. ; Fedirko, V. ; Wark, P.A. ; Chuang, S.C. ; Riboli, E. - \ 2012
PLoS ONE 7 (2012)6. - ISSN 1932-6203
colorectal-cancer - nonstarch polysaccharides - epidemiologic evidence - measurement error - glycemic index - cohort - project - carbohydrate - calibration - protection
Background: Earlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location. Methodology/Principal Findings: After a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79-0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals. Conclusions/Significance: Our results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.
Fruit and vegetable consumption and risk of aggressive and non-aggressive urothelial cell carcinomas in the European prospective investigation into cancer and nutrition
Ros, M. ; Bueno-de-Mesquita, H.B. ; Kampman, E. ; Büchner, F.L. ; Aben, K.K. ; Egevad, L. ; Overvad, K. ; Tjonneland, A. ; Roswall, N. ; Clavel-Chapelon, F. ; Boutron-Ruault, M.C. ; Moiros, S. ; Kaaks, R. ; Teucher, B. ; Weikert, S. ; Ruesten, A.V. ; Trichopoulou, A. ; Naska, A. ; Benetou, V. ; Saieva, C. ; Pala, V. ; Ricceri, F. ; Tumino, R. ; Mattiello, A. ; Peeters, P.H.M. ; Gils, C.H. van; Gram, I.T. ; Engeset, D. ; Chirlaque, M.D. ; Ardanazx, E. ; Rodriguez, L. - \ 2012
European Journal of Cancer 48 (2012)17. - ISSN 0959-8049 - p. 3267 - 3277.
bladder-cancer - vitamin-c - prospective cohort - carotenoids - smoking - diet - carcinogenesis - prevention - nutrient - folate
Background - Many epidemiological studies have examined fruit and vegetable consumption in relation to the risk of urothelial cell carcinoma (UCC) of the bladder, but results are inconsistent. The association between fruit and vegetable consumption and UCC risk may vary by bladder tumour aggressiveness. Therefore, we examined the relation between fruit and vegetable consumption and the risk of aggressive and non-aggressive UCC in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods - After 8.9 years of follow-up, 947 UCC were diagnosed among 468,656 EPIC participants. Of these, 421 could be classified as aggressive UCC and 433 as non-aggressive UCC cases. At recruitment, fruit and vegetable consumption was assessed by validated dietary questionnaires. Multivariable hazard ratios were estimated using Cox regression stratified by age, sex and center and adjusted for smoking status, duration and intensity of smoking, and energy intake. Results - Total consumption of fruits and vegetables was not associated with aggressive UCC nor with non-aggressive UCC. A 25 g/day increase in leafy vegetables and grapes consumption was associated with a reduced risk of non-aggressive UCC (hazard ratio (HR) 0.88; 95% confidence interval (CI) 0.78–1.00 and HR 0.87; 95% CI 0.77–0.98, respectively), while the intake of root vegetables was inversely associated with risk of aggressive UCC (HR 0.87; 95% CI 0.77–0.98). Conclusion - Our study did not confirm a protective effect of total fruit and/or vegetable consumption on aggressive or non-aggressive UCC. High consumption of certain types of vegetables and of fruits may reduce the risk of aggressive or non-aggressive UCC; however chance findings cannot be excluded.
Educational level and risk of colorectal cancer in EPIC with specific reference to tumor location
Leufkens, A.M. ; Duijnhoven, F.J.B. van; Boshuizen, H.C. ; Sierseman, P.D. ; Kunst, A.E. ; Mouw, T. ; Tjonneland, A. ; Olsen, A. ; Overvad, K. ; Boutron-Ruault, M.C. ; Clavel-Chapelon, F. ; Morois, S. ; Krogh, V. ; Tumino, R. ; Panico, S. ; Polidoro, S. ; Palli, D. ; Kaaks, R. ; Teucher, B. ; Pischon, T. ; Trichopoulou, A. ; Orfanos, P. ; Goufa, I. ; Peeters, P.H. ; Skeie, G. ; Braaten, T. ; Rodriguez, L. ; Lujan-Barroso, L. ; Sanchez-Perez, M.J. ; Navarro, C. ; Barricarte, A. ; Zackrisson, S. ; Almquist, M. ; Hallmans, G. ; Palmqvist, R. ; Tsilidis, K.K. ; Khaw, K.T. ; Wareham, N. ; Gallo, V. ; Jenab, M. ; Riboli, E. ; Bueno-de-Mesquita, H.B. - \ 2012
International Journal of Cancer 130 (2012)3. - ISSN 0020-7136 - p. 622 - 630.
socioeconomic-status - united-states - nutrition - colon - survival - health - women - inequalities - deprivation - rectum
Existing evidence is inconclusive on whether socioeconomic status (SES) and educational inequalities influence colorectal cancer (CRC) risk, and whether low or high SES/educational level is associated with developing CRC. The aim of our study was to investigate the relationship between educational level and CRC. We studied data from 400,510 participants in the EPIC (European Prospective Investigation into Cancer and Nutrition) study, of whom 2,447 developed CRC (colon: 1,551, rectum: 896, mean follow-up 8.3 years). Cox proportional hazard regression analysis stratified by age, gender and center, and adjusted for potential confounders were used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI). Relative indices of inequality (RII) for education were estimated using Cox regression models. We conducted separate analyses for tumor location, gender and geographical region. Compared with participants with college/university education, participants with vocational secondary education or less had a nonsignificantly lower risk of developing CRC. When further stratified for tumor location, adjusted risk estimates for the proximal colon were statistically significant for primary education or less (HR 0.73, 95%CI 0.57–0.94) and for vocational secondary education (HR 0.76, 95%CI 0.58–0.98). The inverse association between low education and CRC risk was particularly found in women and Southern Europe. These associations were statistically significant for CRC, for colon cancer and for proximal colon cancer. In conclusion, CRC risk, especially in the proximal colon, is lower in subjects with a lower educational level compared to those with a higher educational level. This association is most pronounced in women and Southern Europe
Variety in vegetable and fruit consumption and the risk of gastric and esophageal cancer in the European prospective investigation into cancer and nutrition
Jeurnink, S.M. ; Büchner, F.L. ; Bueno-de Mesquita, H.B. ; Siersema, P.D. ; Boshuizen, H.C. ; Numans, M.E. ; Dahm, C.C. ; Overvad, K. ; Tjonneland, A. ; Roswall, N. ; Clavel-Chapelon, F. ; Boutron-Ruault, M.C. ; Morois, S. ; Kaaks, R. ; Teucher, B. ; Boeing, H. ; Buijsse, B. ; Trichopoulou, A. ; Benetou, V. ; Zylis, D. ; Palli, D. ; Sieri, S. ; Vineis, P. ; Tumino, R. ; Panico, S. ; Ocké, M.C. ; Peeters, P.H. ; Skeie, G. ; Brustad, M. ; Lund, E. ; Sanchez-Cantalejo, E. ; Navarro, C. ; Amiano, P. ; Ardanaz, E. ; Ramón Quirós, J. ; Hallmans, G. ; Johansson, I. ; Lindkvist, B. ; Regnér, S. ; Khaw, K.T. ; Wareham, N. ; Key, T.J. ; Slimani, N. ; Norat, T. ; Vergnaud, A.C. ; Romaguera, D. ; Gonzalez, C.A. - \ 2012
International Journal of Cancer 131 (2012)6. - ISSN 0020-7136 - p. E963 - E973.
epic-eurgast - epidemiologic evidence - helicobacter-pylori - physical-activity - diet diversity - cereal fiber - vitamin-c - stomach - adenocarcinomas - metaanalysis
Diets high in vegetables and fruits have been suggested to be inversely associated with risk of gastric cancer. However, the evidence of the effect of variety of consumption is limited. We therefore investigated whether consumption of a variety of vegetables and fruit is associated with gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition study. Data on food consumption and follow-up on cancer incidence were available for 452,269 participants from 10 European countries. After a mean follow-up of 8.4 years, 475 cases of gastric and esophageal adenocarcinomas (180 noncardia, 185 cardia, gastric esophageal junction and esophagus, 110 not specified) and 98 esophageal squamous cell carcinomas were observed. Diet Diversity Scores were used to quantify the variety in vegetable and fruit consumption. We used multivariable Cox proportional hazard models to calculate risk ratios. Independent from quantity of consumption, variety in the consumption of vegetables and fruit combined and of fruit consumption alone were statistically significantly inversely associated with the risk of esophageal squamous cell carcinoma (continuous hazard ratio per 2 products increment 0.88; 95% CI 0.79–0.97 and 0.76; 95% CI 0.62–0.94, respectively) with the latter particularly seen in ever smokers. Variety in vegetable and/or fruit consumption was not associated with risk of gastric and esophageal adenocarcinomas. Independent from quantity of consumption, more variety in vegetable and fruit consumption combined and in fruit consumption alone may decrease the risk of esophageal squamous cell carcinoma. However, residual confounding by lifestyle factors cannot be excluded
A risk model for lung cancer incidence
Hoggart, C. ; Brennan, P. ; Tjonneland, A. ; Vogel, U. ; Overvad, K. ; Ostergaard, J.N. ; Kaaks, R. ; Canzian, F. ; Boeing, H. ; Steffen, A. ; Trichopoulou, A. ; Bamia, C. ; Trichopoulos, D. ; Johansson, M. ; Palli, D. ; Krogh, V. ; Tumino, R. ; Sacerdote, C. ; Panico, S. ; Boshuizen, H.C. ; Bueno-de-Mesquita, H.B. ; Peeters, P.H. ; Lund, E. ; Gram, I.T. ; Braaten, T. ; Rodrígues, L. ; Agudo, A. ; Sánchez-Cantalejo, E. ; Arriola, L. ; Chirlaque, M.D. ; Barricarte, A. ; Rasmuson, T. ; Khaw, K.T. ; Wareham, N. ; Allen, N.E. ; Riboli, E. ; Vineis, P. - \ 2012
Cancer Prevention Research / American Association for Cancer Research 5 (2012)6. - ISSN 1940-6207 - p. 834 - 846.
body-mass index - susceptibility locus - smoking-cessation - cigarette-smoking - prediction model - smokers - mortality - women - association - 5p15.33
Risk models for lung cancer incidence would be useful for prioritizing individuals for screening and participation in clinical trials of chemoprevention. We present a risk model for lung cancer built using prospective cohort data from a general population which predicts individual incidence in a given time period. We build separate risk models for current and former smokers using 169,035 ever smokers from the multicenter European Prospective Investigation into Cancer and Nutrition (EPIC) and considered a model for never smokers. The data set was split into independent training and test sets. Lung cancer incidence was modeled using survival analysis, stratifying by age started smoking, and for former smokers, also smoking duration. Other risk factors considered were smoking intensity, 10 occupational/environmental exposures previously implicated with lung cancer, and single-nucleotide polymorphisms at two loci identified by genome-wide association studies of lung cancer. Individual risk in the test set was measured by the predicted probability of lung cancer incidence in the year preceding last follow-up time, predictive accuracy was measured by the area under the receiver operator characteristic curve (AUC). Using smoking information alone gave good predictive accuracy: the AUC and 95% confidence interval in ever smokers was 0.843 (0.810-0.875), the Bach model applied to the same data gave an AUC of 0.775 (0.737-0.813). Other risk factors had negligible effect on the AUC, including never smokers for whom prediction was poor. Our model is generalizable and straightforward to implement. Its accuracy can be attributed to its modeling of lifetime exposure to smoking.
Bias in protein and potassium intake collected with 24-h recalls (EPIC-Soft) is rather comparable across European populations
Crispim, S.P. ; Geelen, A. ; Freisling, H. ; Souverein, O.W. ; Hulshof, P.J.M. ; Ocke, M.C. ; Boshuizen, H.C. ; Andersen, L.F. ; Ruprich, J. ; Keizer, W. de; Huybrechts, I. ; Lafay, L. ; DeMagistris, M.S. ; Ricceri, F. ; Tumino, R. ; Krogh, V. ; Bueono-de-Mesquita, H.B. ; Beulens, J.W.J. ; Boutron-Ruault, M.C. ; Naska, A. ; Crowe, F.L. ; Boeing, H. ; McTaggart, A.R. ; Kaaks, R. ; Veer, P. van 't; Slimani, N. - \ 2012
European Journal of Nutrition 51 (2012)8. - ISSN 1436-6207 - p. 997 - 1010.
consumption validation efcoval - diet recall - urinary nitrogen - nutrition - cancer - calibration - telephone - countries - biomarker - centers
Purpose: We investigated whether group-level bias of a 24-h recall estimate of protein and potassium intake, as compared to biomarkers, varied across European centers and whether this was influenced by characteristics of individuals or centers. Methods: The combined data from EFCOVAL and EPIC studies included 14 centers from 9 countries (n = 1,841). Dietary data were collected using a computerized 24-h recall (EPIC-Soft). Nitrogen and potassium in 24-h urine collections were used as reference method. Multilevel linear regression analysis was performed, including individual-level (e.g., BMI) and center-level (e.g., food pattern index) variables. Results: For protein intake, no between-center variation in bias was observed in men while it was 5.7% in women. For potassium intake, the between-center variation in bias was 8.9% in men and null in women. BMI was an important factor influencing the biases across centers (p <0.01 in all analyses). In addition, mode of administration (p = 0.06 in women) and day of the week (p = 0.03 in men and p = 0.06 in women) may have influenced the bias in protein intake across centers. After inclusion of these individual variables, between-center variation in bias in protein intake disappeared for women, whereas for potassium, it increased slightly in men (to 9.5%). Center-level variables did not influence the results. Conclusion: The results suggest that group-level bias in protein and potassium (for women) collected with 24-h recalls does not vary across centers and to a certain extent varies for potassium in men. BMI and study design aspects, rather than center-level characteristics, affected the biases across centers
Cigarette smoking and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition study.
Leufkens, A.M. ; Duijnhoven, F.J.B. van; Siersema, P.D. ; Boshuizen, H.C. ; Vrieling, A. ; Agudo, A. ; Gram, I.T. ; Weiderpass, E. ; Dahm, C. ; Overvad, K. ; Tjonneland, A. ; Olsen, A. ; Boutron-Ruault, M.C. ; Clavel-Chapelon, F. ; Morois, S. ; Palli, D. ; Grioni, S. ; Tumino, R. ; Sacerdote, C. ; Mattiello, A. ; Herman, S. ; Kaaks, R. ; Steffen, A. ; Boeing, H. ; Trichopoulou, A. ; Lagiou, P. ; Trichopoulos, D. ; Peeters, P.H. ; Gils, C.H. van; Kranen, H. van; Lund, E. ; Dumeaux, V. ; Engeset, D. ; Rodriguez, L. ; Sanchez, M.J. ; Chirlaque, M.D. ; Barricarte, A. ; Manjer, J. ; Almquist, M. ; Guelpen, B. ; Hallmans, G. ; Khaw, K.T. ; Wareham, N. ; Tsilidis, K.K. ; Straif, K. ; Leon-Roux, M. ; Vineis, P. ; Norat, T. ; Riboli, E. ; Bueno-de-Mesquita, H.B. - \ 2011
Clinical Gastroenterology and Hepatology 9 (2011)2. - ISSN 1542-3565 - p. 137 - 144.
tumor microsatellite instability - life-style factors - alcohol-consumption - rectal-cancer - colon tumors - cohort - women - polymorphisms - associations - metaanalysis
BACKGROUND & AIMS: There has been consistent evidence for a relationship between smoking and colorectal cancer (CRC), although it is not clear whether the colon or rectum is more sensitive to the effects of smoking. We investigated the relationships between cigarette smoking and risk of CRC and tumor location. METHODS: We analyzed data from 465,879 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study; 2741 developed CRC during the follow-up period (mean, 8.7 years). Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: The risk of colon carcinoma was increased among ever smokers (HR, 1.18; 95% CI, 1.06-1.32) and former cigarette smokers (HR, 1.21; 95% CI, 1.08-1.36), compared with never smokers; the increased risk for current smokers was of borderline significance (HR, 1.13; 95% CI, 0.98-1.31). When stratified for tumor location, the risk of proximal colon cancer was increased for former (HR, 1.25; 95% CI, 1.04-1.50) and current smokers (HR, 1.31; 95% CI, 1.06-1.64), but the risks for cancers in the distal colon or rectum were not. Subsite analyses showed a nonsignificant difference between the proximal and distal colon (P = .45) for former smokers and a significant difference for current smokers (P = .02). For smokers who had stopped smoking for at least 20 years, the risk of developing colon cancer was similar to that of never smokers. CONCLUSIONS: Ever smokers have an increased risk of colon cancer, which appeared to be more pronounced in the proximal than the distal colon location.
Consumption of meat and fish and risk of lung cancer: results from the European Prospective Investigation into Cancer and Nutrition
Linseisen, J. ; Rohrmann, S. ; Bueno-de-Mesquita, B. ; Büchner, F.L. ; Boshuizen, H.C. ; Agudo, A. ; Gram, I.T. ; Dahm, C.C. ; Overvad, K. ; Egeberg, R. ; Tjonneland, A. ; Boeing, H. ; Steffen, A. ; Kaaks, R. ; Lukanova, A. ; Berrino, F. ; Palli, D. ; Panico, S. ; Tumino, R. ; Ardanaz, E. ; Dorronsoro, M. ; Huerta, J.M. ; Rodríguez, L. ; Sánchez, M.J. ; Rasmuson, T. ; Hallmans, G. ; Manjer, J. ; Wirfält, E. ; Engeset, D. ; Skeie, G. ; Katsoulis, M. ; Oikonomou, E. ; Trichopoulou, A. ; Peeters, P.H. ; Khaw, K.T. ; Wareham, N. ; Allen, N. ; Key, T. ; Brennan, P. ; Romieu, I. ; Slimani, N. ; Vergnaud, A.C. ; Xun, W.W. ; Vineis, P. ; Riboli, E. - \ 2011
Cancer Causes and Control 22 (2011)6. - ISSN 0957-5243 - p. 909 - 918.
heterocyclic amines - dietary habits - heme iron - women - calibration - cohort - recalls - mortality - mutagens - fat
Evidence from case–control studies, but less so from cohort studies, suggests a positive association between meat intake and risk of lung cancer. Therefore, this association was evaluated in the frame of the European Prospective Investigation into Cancer and Nutrition, EPIC. Data from 478,021 participants, recruited from 10 European countries, who completed a dietary questionnaire in 1992–2000 were evaluated; 1,822 incident primary lung cancer cases were included in the present evaluation. Relative risk estimates were calculated for categories of meat intake using multi-variably adjusted Cox proportional hazard models. In addition, the continuous intake variables were calibrated by means of 24-h diet recall data to account for part of the measurement error. There were no consistent associations between meat consumption and the risk of lung cancer. Neither red meat (RR = 1.06, 95% CI 0.89–1.27 per 50 g intake/day; calibrated model) nor processed meat (RR = 1.13, 95% CI 0.95–1.34 per 50 g/day; calibrated model) was significantly related to an increased risk of lung cancer. Also, consumption of white meat and fish was not associated with the risk of lung cancer. These findings do not support the hypothesis that a high intake of red and processed meat is a risk factor for lung cancer
EPIC-Heart: The cardiovascular component of a prospective study of nutritional, lifestyle and biological factors in 520,000 middle-aged participants from 10 European countries
Danesh, J. ; Saracci, R. ; Berglund, G. ; Feskens, E.J.M. ; Overvad, K. ; Panico, S. ; Thompson, S. ; Fournier, A. ; Clavel-Chapelon, F. ; Canonico, M. ; Kaaks, R. ; Linseisen, J. ; Boeing, H. ; Pischon, T. ; Weikert, C. ; Olsen, A. ; Tjonneland, A. ; Johnsen, S.P. ; Jensen, M.K. ; Quiros, J.R. ; Gonzalez-Svatetz, C.A. ; Sanchez-Perez, M.J. ; Larranaga, N. ; Navarro Sanchez, C. ; Moreno Iribas, C. ; Bingham, S. ; Khaw, K.T. ; Wareham, N. ; Key, T. ; Roddam, A. ; Trichopoulou, A. ; Benetou, V. ; Trichopoulous, D. ; Masala, G. ; Sieri, S. ; Tumino, R. ; Sacerdote, C. ; Mattiello, A. ; Verschuren, W.M.M. ; Bueno de Mesquita, H.B. ; Grobbee, D.E. ; Schouw, Y.T. van der; Melander, O. ; Hallmans, G. ; Wennberg, P. ; Lund, E. ; Kumle, M. ; Skeie, G. ; Ferrari, P. ; Slimani, N. ; Norat, T. ; Riboli, E. - \ 2007
European Journal of Epidemiology 22 (2007)2. - ISSN 0393-2990 - p. 129 - 141.
coronary-artery-disease - dietary assessment methods - high blood-pressure - fat distribution - norfolk cohort - plasma-levels - cancer - risk - women - population
EPIC-Heart is the cardiovascular component of the European Prospective Investigation into Cancer and Nutrition (EPIC), a multi-centre prospective cohort study investigating the relationship between nutrition and major chronic disease outcomes. Its objective is to advance understanding about the separate and combined influences of lifestyle (especially dietary), environmental, metabolic and genetic factors in the development of cardiovascular diseases by making best possible use of the unusually informative database and biological samples in EPIC. Between 1992 and 2000, 519,978 participants (366,521 women and 153,457 men, mostly aged 35¿70 years) in 23 centres in 10 European countries commenced follow-up for cause- specific mortality, cancer incidence and major cardiovascular morbidity. Dietary information was collected with quantitative questionnaires or semi-quantitative food frequency questionnaires, including a 24-h dietary recall sub-study to help calibrate the dietary measurements. Information was collected on physical activity, tobacco smoking, alcohol consumption, occupational history, socio-economic status, and history of previous illnesses. Anthropometric measurements and blood pressure recordings were made in the majority of participants. Blood samples were taken from 385,747 individuals, from which plasma, serum, red cells, and buffy coat fractions were separated and aliquoted for long-term storage. By 2004, an estimated 10,000 incident fatal and non-fatal coronary and stroke events had been recorded. The first cycle of EPIC-Heart analyses will assess associations of coronary mortality with several prominent dietary hypotheses and with established cardiovascular risk factors. Subsequent analyses will extend this approach to non-fatal cardiovascular outcomes¿and to further dietary, biochemical and genetic factors.
Group level validation of protein intakes estimated by 24-hour diet recall and dietary questionnaires against 24-hour urinary nitrogen in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study
Slimani, N. ; Bingham, S. ; Runswick, S. ; Ferrari, P. ; Day, N.E. ; Welch, A.A. ; Key, T.J. ; Miller, A.B. ; Boeing, H. ; Sieri, S. ; Veglia, F. ; Palli, D. ; Panico, S. ; Tumino, R. ; Bueno de Mesquita, B. ; Ocké, M.C. ; Clavel-Chapelon, F. ; Trichopoulou, A. ; Staveren, W.A. van; Riboli, E. - \ 2003
Cancer Epidemiology Biomarkers and Prevention 12 (2003). - ISSN 1055-9965 - p. 784 - 795.
doubly-labeled water - low-energy reporters - multicenter cohort - subject variation - national-health - weighed records - between-subject - nutrient intake - within-subject - food-intake
A calibration approach was developed to correct for systematic between-cohort dietary measurement errors in the European Prospective Investigation into Cancer and Nutrition (EPIC), a large multicenter cohort study. To validate the 24-h diet recalls (24-HDRs) as reference measurements for between-cohort calibration, we estimated the agreement between center mean nitrogen (N) and total energy intakes and mean 24-h urinary N. Similar analyses using N and energy intake data from different dietary questionnaires (DQs) used at study baseline were conducted to estimate the effect of the calibration approach. This study was conducted between 1995 and 1999, and involved 1103 volunteers of both genders from 12 centers participating in European Prospective Investigation into Cancer and Nutrition. Pearson's correlation coefficients were weighted for study center sample size. When both genders were considered together (n=22), the correlation coefficients between the center mean log-transformed urinary estimates and the center mean log-transformed dietary N estimates from the 24-HDRs were 0.86 and 0.94 after exclusion of outliers. The corresponding correlation with the DQs was 0.53. When center mean total energy intakes were regressed on center mean urinary N, the correlation remained slightly higher with 24-HDRs (0.91; 0.95 after exclusion of outliers) than DQs (0.86). When stratified by gender, these correlations were systematically higher in men than women with both dietary methods. The 13 regression coefficients were not significantly different from 1 when mean N (or total energy intakes) from 24-HDR or DQ were regressed on urinary estimates, except with N from 24-HDRs in men and, in most cases, after adjustment for age, body mass index, and sex with both genders together. This suggests that overall the systematic bias across centers is of uniform magnitude. Although relatively high correlations were observed between urinary N and both dietary methods in men, the errors in DQs tend to vary in both directions (under- and over-reporting) in contrast with 24-HDRs in women. This observation may have implications on the dietary measurement error characteristics and support the potential benefit of between-cohort calibration.
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